Therapists in Lake City, Seattle, WA

Photo of Rj Solomon, LMHCA, Pre-Licensed Professional
Rj Solomon
Pre-Licensed Professional, LMHCA
Verified Verified
1 Endorsed
Lake City, Seattle, WA 98125
The path to healing is not one-size-fits-all or linear. Regardless of who you are, we're all out here just trying to be human. The decision to seek help is not an easy one, but my calling is to make the process feel safe, approachable, and welcomed. My goal is to be your mirror and witness to your story. I hope to create a collaborative and safe space to address your needs, achieve your goals, and bring peace and contentment to your whole self.
The path to healing is not one-size-fits-all or linear. Regardless of who you are, we're all out here just trying to be human. The decision to seek help is not an easy one, but my calling is to make the process feel safe, approachable, and welcomed. My goal is to be your mirror and witness to your story. I hope to create a collaborative and safe space to address your needs, achieve your goals, and bring peace and contentment to your whole self.
(206) 207-3642 View (206) 207-3642
Photo of Tanya Ruckstuhl, LICSW, Clinical Social Work/Therapist
Tanya Ruckstuhl
Clinical Social Work/Therapist, LICSW
Verified Verified
Lake City, Seattle, WA 98125
Waitlist for new clients
Are you a growth-minded person who takes responsibility for your wellbeing? Do you have a good quality of life already, but want to use the tool of therapy to uncover old sources of pain and to release thinking and behavioral patterns that no longer serve you? Do you want to develop your relationship skills so that you can express yourself without domination or submission?
Are you a growth-minded person who takes responsibility for your wellbeing? Do you have a good quality of life already, but want to use the tool of therapy to uncover old sources of pain and to release thinking and behavioral patterns that no longer serve you? Do you want to develop your relationship skills so that you can express yourself without domination or submission?
(206) 759-8889 View (206) 759-8889
Photo of Carrie Lanza, PhD, MSW, LSWAIC, Clinical Social Work/Therapist
Carrie Lanza
Clinical Social Work/Therapist, PhD, MSW, LSWAIC
Verified Verified
1 Endorsed
Lake City, Seattle, WA 98125  (Online Only)
Appointments available evenings (Tues, Weds) and Saturday mornings! I specialize in therapy with a focus on sex and relationships as well as general challenges like anxiety and depression. One of the aspects of my work that I love most is helping clients uncover strengths that may not be readily apparent in moments of crisis. Life can present unexpected challenges, and through our therapeutic journey, I aim to assist you in recognizing and tapping into your strengths and the reservoirs of resilience that lead to growth and empowerment.
Appointments available evenings (Tues, Weds) and Saturday mornings! I specialize in therapy with a focus on sex and relationships as well as general challenges like anxiety and depression. One of the aspects of my work that I love most is helping clients uncover strengths that may not be readily apparent in moments of crisis. Life can present unexpected challenges, and through our therapeutic journey, I aim to assist you in recognizing and tapping into your strengths and the reservoirs of resilience that lead to growth and empowerment.
(206) 222-6585 View (206) 222-6585
Photo of Dr. Alina Soto, ND, LMHCA
Dr. Alina Soto
ND, LMHCA
Verified Verified
Lake City, Seattle, WA 98125
You've achieved incredible success, but beneath the surface, you feel unseen and unheard. The truth is, 75% of High Performers share a secret: moderate to severe trauma, including loss, poverty, or abuse. People see your wins, but not the struggle with the fear of failure, isolation, exhaustion, and the need to perform or else...who are you? Like you, I've had to work a lot on myself, alone. The unfortunate paradox is the more you know, the harder it is to find someone to truly help. I get that frustration. With my unique approach, you will feel empowered to cultivate healthy systems and make conscious choices towards healing.
You've achieved incredible success, but beneath the surface, you feel unseen and unheard. The truth is, 75% of High Performers share a secret: moderate to severe trauma, including loss, poverty, or abuse. People see your wins, but not the struggle with the fear of failure, isolation, exhaustion, and the need to perform or else...who are you? Like you, I've had to work a lot on myself, alone. The unfortunate paradox is the more you know, the harder it is to find someone to truly help. I get that frustration. With my unique approach, you will feel empowered to cultivate healthy systems and make conscious choices towards healing.
(206) 472-1771 View (206) 472-1771
Photo of Hilary Ison, Pre-Licensed Professional
Hilary Ison
Pre-Licensed Professional
Verified Verified
1 Endorsed
Lake City, Seattle, WA 98115  (Online Only)
You are likely seeking therapy feeling a strange mixture of despair and hope. You might be struggling with patterns of behavior, past traumas, or painful emotions; but you also believe that change is possible. Together we can establish safety, look underneath your presenting symptoms, and harness your inherent capacity to heal.
You are likely seeking therapy feeling a strange mixture of despair and hope. You might be struggling with patterns of behavior, past traumas, or painful emotions; but you also believe that change is possible. Together we can establish safety, look underneath your presenting symptoms, and harness your inherent capacity to heal.
(206) 278-7511 View (206) 278-7511
Photo of Madeline Rae Nadis Schwartz, LICSWA, Clinical Social Work/Therapist
Madeline Rae Nadis Schwartz
Clinical Social Work/Therapist, LICSWA
Verified Verified
3 Endorsed
Lake City, Seattle, WA 98125  (Online Only)
I love working with individuals, as well as couples. I have a lot of experience working with queer, non-heteronormative, BIPOC, LGBTQIA+ clients, but that is not to say that I don’t love working with people who do not identify within those marginalized identities as well! I enjoy working with those who want to learn more about how to manage anxiety and panic disorder, engage with attachment disorders/historical ruptures, and childhood trauma. Check out my website for more details: www.cognitivecongruence.com
I love working with individuals, as well as couples. I have a lot of experience working with queer, non-heteronormative, BIPOC, LGBTQIA+ clients, but that is not to say that I don’t love working with people who do not identify within those marginalized identities as well! I enjoy working with those who want to learn more about how to manage anxiety and panic disorder, engage with attachment disorders/historical ruptures, and childhood trauma. Check out my website for more details: www.cognitivecongruence.com
(206) 278-9974 View (206) 278-9974
Photo of William Cornwell, MA, LMHC, Counselor
William Cornwell
Counselor, MA, LMHC
Verified Verified
9 Endorsed
Lake City, Seattle, WA 98125  (Online Only)
My therapeutic practice focuses on helping people from all walks address a wide range of issues including adult ADHD, grief and loss, relationship struggles, depression, and recovery from past trauma and abuse. My work with individuals involves facilitating awareness and insight on how the influences of the past impacts present behavioral, emotional, and cognitive patterns. I focus on interpersonal dynamics, attachment issues, and the function of one's personality type/relational style as it relates to the issues presented.
My therapeutic practice focuses on helping people from all walks address a wide range of issues including adult ADHD, grief and loss, relationship struggles, depression, and recovery from past trauma and abuse. My work with individuals involves facilitating awareness and insight on how the influences of the past impacts present behavioral, emotional, and cognitive patterns. I focus on interpersonal dynamics, attachment issues, and the function of one's personality type/relational style as it relates to the issues presented.
(425) 786-9934 View (425) 786-9934
Photo of Samantha Powers - Healing Powers of Therapy, PhD, LICSW, Clinical Social Work/Therapist
Healing Powers of Therapy
Clinical Social Work/Therapist, PhD, LICSW
Verified Verified
Lake City, Seattle, WA 98125  (Online Only)
Waitlist for new clients
I have experience working with military service members (active duty, reserves, and guard) and veterans (and their families). I also have experience working with students in a variety of different settings (to include student veterans). Additionally, I specialize in working with women for women-focused issues, women leaders in particular. My ideal client wants to process their issue with me as their guide to obtain an ultimate goal of feeling better. Ultimately, my clients will be the deciders of their own goals in therapy with me.
I have experience working with military service members (active duty, reserves, and guard) and veterans (and their families). I also have experience working with students in a variety of different settings (to include student veterans). Additionally, I specialize in working with women for women-focused issues, women leaders in particular. My ideal client wants to process their issue with me as their guide to obtain an ultimate goal of feeling better. Ultimately, my clients will be the deciders of their own goals in therapy with me.
(206) 875-2465 View (206) 875-2465
Photo of Madeline Frank, PhD, BCBA-D, LBA
Madeline Frank
PhD, BCBA-D, LBA
Verified Verified
Lake City, Seattle, WA 98125
My experience as a behavior analyst spans educational, clinical, and home/community settings. I worked for several years as a special education classroom teacher and I feel strongly that parent involvement/training is critical for a child's success. I aim to provide children and families with tools to rapidly improve language comprehension and vocalization, replace problem behaviors, teach self-help skills, and enhance age-appropriate social skills. I primarily work with children between 2-10 years old, but have experience working with clients up to 21 years old.
My experience as a behavior analyst spans educational, clinical, and home/community settings. I worked for several years as a special education classroom teacher and I feel strongly that parent involvement/training is critical for a child's success. I aim to provide children and families with tools to rapidly improve language comprehension and vocalization, replace problem behaviors, teach self-help skills, and enhance age-appropriate social skills. I primarily work with children between 2-10 years old, but have experience working with clients up to 21 years old.
(206) 312-6845 View (206) 312-6845
Photo of Loni Itah, LCPC, Counselor
Loni Itah
Counselor, LCPC
Verified Verified
Lake City, Seattle, WA 98101  (Online Only)
Attention: Limited morning openings currently! - telehealth -When we live our lives in a state of constant fight-or-flight, we can go into survival mode. Worries, phobias, panic attacks, trauma, obsessive thoughts, avoidant behavior, and/or repetitive/compulsive behaviors can make us feel hopeless and helpless. We can find ourselves overthinking, overanalyzing, and feeling powerless. If you're feeling like life hasn't been moving in a positive direction, find yourself in a state of hypervigilence due to trauma and/or frozen by fears and uncertainty, you CAN find your way out - sometimes we just need some extra support to do so.
Attention: Limited morning openings currently! - telehealth -When we live our lives in a state of constant fight-or-flight, we can go into survival mode. Worries, phobias, panic attacks, trauma, obsessive thoughts, avoidant behavior, and/or repetitive/compulsive behaviors can make us feel hopeless and helpless. We can find ourselves overthinking, overanalyzing, and feeling powerless. If you're feeling like life hasn't been moving in a positive direction, find yourself in a state of hypervigilence due to trauma and/or frozen by fears and uncertainty, you CAN find your way out - sometimes we just need some extra support to do so.
(206) 672-5742 View (206) 672-5742
Photo of Theresa L Epstein - The Healing Connection Counseling LLC, MSW, LICSW, Clinical Social Work/Therapist
The Healing Connection Counseling LLC
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Lake City, Seattle, WA 98125
Not accepting new clients
I am not accepting new clients at this time. Compassion, Empathy & Empowerment are core values in my counseling practice. I am an experienced feminist therapist working with clients to make positive changes in relationships & daily life. Relationship disruptions, isolation, loneliness, anxiety and depression are issues many of us face. I believe that healthy connections and growth fostering relationships help us heal. I am available for education, consultation & clinical supervision.
I am not accepting new clients at this time. Compassion, Empathy & Empowerment are core values in my counseling practice. I am an experienced feminist therapist working with clients to make positive changes in relationships & daily life. Relationship disruptions, isolation, loneliness, anxiety and depression are issues many of us face. I believe that healthy connections and growth fostering relationships help us heal. I am available for education, consultation & clinical supervision.
(206) 922-8075 View (206) 922-8075
Photo of Matthew Vogler, PsyD, Psychologist
Matthew Vogler
Psychologist, PsyD
Verified Verified
Lake City, Seattle, WA 98125
Dr. Vogler is a licensed clinical psychologist offering assessments for children, adolescents, and young adults. He takes a comprehensive, neuropsychological approach to his evaluations which consists of cognitive, academic, and social-emotional functioning. Based on the referral and the needs of the client, his assessments may include attention, executive functioning, learning/memory, personality, sensory, motor, and visuospatial components.
Dr. Vogler is a licensed clinical psychologist offering assessments for children, adolescents, and young adults. He takes a comprehensive, neuropsychological approach to his evaluations which consists of cognitive, academic, and social-emotional functioning. Based on the referral and the needs of the client, his assessments may include attention, executive functioning, learning/memory, personality, sensory, motor, and visuospatial components.
(206) 203-8011 View (206) 203-8011
Photo of Mysti Coccia-Eddy, LMHC, Counselor
Mysti Coccia-Eddy
Counselor, LMHC
Verified Verified
3 Endorsed
Lake City, Seattle, WA 98125  (Online Only)
My approach to counseling is positive, strengths-based and client-centered. Every person is capable of healing and growth, and sometimes we need some extra support to get there.
My approach to counseling is positive, strengths-based and client-centered. Every person is capable of healing and growth, and sometimes we need some extra support to get there.
(206) 673-5279 View (206) 673-5279
Photo of Karyn Andriesen, MA, LMHCA, Counselor
Karyn Andriesen
Counselor, MA, LMHCA
Verified Verified
4 Endorsed
Lake City, Seattle, WA 98125  (Online Only)
Sometimes in life we all need a “companion on the journey,” someone to partner with us and help make sense of our experience, ease our pain, and support our goals. As a therapist, I am committed to providing a safe environment where individuals can identify their strengths, recognize unhelpful patterns, and live into their goals. Working from an integrative, client-centered approach, I seek to support individuals wherever they are on their journey and my approach is holistic, collaborative, and non-judgmental. I value cultural humility and look forward to working with people of all backgrounds, identities, and walks of life.
Sometimes in life we all need a “companion on the journey,” someone to partner with us and help make sense of our experience, ease our pain, and support our goals. As a therapist, I am committed to providing a safe environment where individuals can identify their strengths, recognize unhelpful patterns, and live into their goals. Working from an integrative, client-centered approach, I seek to support individuals wherever they are on their journey and my approach is holistic, collaborative, and non-judgmental. I value cultural humility and look forward to working with people of all backgrounds, identities, and walks of life.
(206) 752-3471 View (206) 752-3471
Photo of Bob Goettle - Bob Goettle, MA, LMHC, Counselor
Bob Goettle
Counselor, MA, LMHC
Verified Verified
Lake City, Seattle, WA 98125  (Online Only)
My office is a safe space for all individuals and couples. People look to counseling for a variety of reasons - anxiety, depression, dissatisfaction, misery. Those who find work with me helpful seek fuller understanding of themselves and their connections in the world. We take a compassionate and curious stance as we pay attention to you. Through the lens of attachment, we examine how your current experience of (in)security and safety influence your feelings and choices in adulthood. In couple work we look at repairing what interferes with meeting each partner's normal human need for safety and connection with one another.
My office is a safe space for all individuals and couples. People look to counseling for a variety of reasons - anxiety, depression, dissatisfaction, misery. Those who find work with me helpful seek fuller understanding of themselves and their connections in the world. We take a compassionate and curious stance as we pay attention to you. Through the lens of attachment, we examine how your current experience of (in)security and safety influence your feelings and choices in adulthood. In couple work we look at repairing what interferes with meeting each partner's normal human need for safety and connection with one another.
(206) 429-8261 View (206) 429-8261
Photo of Kelly Granite Enck, CHT, BA, RRT
Kelly Granite Enck
CHT, BA, RRT
Verified Verified
1 Endorsed
Lake City, Seattle, WA 98125
Rapid Resolution Therapy (RRT) is a cutting-edge hypnotherapy technique that helps individuals overcome anxiety, panic attacks, trauma, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), quit smoking, manage grief, insomnia, lose weight, enhance sports performance, and build confidence. Book your Online or In-Office RRT Therapy Session with Kelly on her website, clicking the "Book Now" button www.DoylestownHypnosis.com.
Rapid Resolution Therapy (RRT) is a cutting-edge hypnotherapy technique that helps individuals overcome anxiety, panic attacks, trauma, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), quit smoking, manage grief, insomnia, lose weight, enhance sports performance, and build confidence. Book your Online or In-Office RRT Therapy Session with Kelly on her website, clicking the "Book Now" button www.DoylestownHypnosis.com.
(206) 507-3203 View (206) 507-3203
Photo of Troy E Fenlason, PsyD, Psychologist
Troy E Fenlason
Psychologist, PsyD
Verified Verified
Lake City, Seattle, WA 98125
Not accepting new clients
My practice is about creating space... a relational space to be, to reflect, to see, to heal, and imagine anew. Life can often feel overwhelming or bring feelings of hopelessness, but our inner resources are often more than we are able to imagine in the moment of our distress. New strength and connection can be found in parts of yourself that have been cut off or neglected for various reasons. Often we need the presence of someone, like a therapist, who has the potential to reflect back who we are being and what we might be neglecting, in order to see ourselves more clearly and engage life and relationships more fully.
My practice is about creating space... a relational space to be, to reflect, to see, to heal, and imagine anew. Life can often feel overwhelming or bring feelings of hopelessness, but our inner resources are often more than we are able to imagine in the moment of our distress. New strength and connection can be found in parts of yourself that have been cut off or neglected for various reasons. Often we need the presence of someone, like a therapist, who has the potential to reflect back who we are being and what we might be neglecting, in order to see ourselves more clearly and engage life and relationships more fully.
(425) 256-3943 View (425) 256-3943
Photo of Lark Huang-Storms, PhD, Psychologist
Lark Huang-Storms
Psychologist, PhD
Verified Verified
Lake City, Seattle, WA 98125
Waitlist for new clients
I am a clinical psychologist who specializes in diagnostic assessment of autism across the lifespan (including presentation in adult women). I provide evaluations for clients who wonder about possible autism for themselves or their children. I also have a small therapy practice where I focus on mental health and wellness with clients who are autistic or whose lives are shaped by autism (including Asperger’s Syndrome). Over the past decades, I directed Autism Centers at UT Southwestern Medical Center and Oregon Health & Science University where I engaged in research, training and clinical care.
I am a clinical psychologist who specializes in diagnostic assessment of autism across the lifespan (including presentation in adult women). I provide evaluations for clients who wonder about possible autism for themselves or their children. I also have a small therapy practice where I focus on mental health and wellness with clients who are autistic or whose lives are shaped by autism (including Asperger’s Syndrome). Over the past decades, I directed Autism Centers at UT Southwestern Medical Center and Oregon Health & Science University where I engaged in research, training and clinical care.
(206) 279-6922 View (206) 279-6922
Photo of Kaitlyn S McGurn, MA, LMHC, RPT, Counselor
Kaitlyn S McGurn
Counselor, MA, LMHC, RPT
Verified Verified
Lake City, Seattle, WA 98125
It takes courage to reach out for support during times of struggle and hardship. I provide a safe and nonjudgmental environment where clients can build self-awareness, a feeling of wellbeing and confidence, and coping skills to face life transitions and obstacles. I draw from a variety of therapeutic modalities from experiential therapies (play, art, and sand tray) with young clients, to cognitive behavioral, solution focused, and narrative therapy for older clients. I believe in tailoring a therapeutic approach that is specific to the individual needs of each client.
It takes courage to reach out for support during times of struggle and hardship. I provide a safe and nonjudgmental environment where clients can build self-awareness, a feeling of wellbeing and confidence, and coping skills to face life transitions and obstacles. I draw from a variety of therapeutic modalities from experiential therapies (play, art, and sand tray) with young clients, to cognitive behavioral, solution focused, and narrative therapy for older clients. I believe in tailoring a therapeutic approach that is specific to the individual needs of each client.
(206) 672-9985 View (206) 672-9985
Photo of Bex Worsham, LCSWA, Clinical Social Work/Therapist
Bex Worsham
Clinical Social Work/Therapist, LCSWA
Verified Verified
1 Endorsed
Lake City, Seattle, WA 98125  (Online Only)
Therapy is a space for you to feel heard, validated and supported. It's an approach to feel less anxious, work toward goals, heal from trauma, and improve relationships. It can sometimes feel impossible to find ways to thrive in the capitalistic, oppressive system we're in, especially for marginalized folks. It is my goal for us to find ways for you to feel safe, fulfilled and content.
Therapy is a space for you to feel heard, validated and supported. It's an approach to feel less anxious, work toward goals, heal from trauma, and improve relationships. It can sometimes feel impossible to find ways to thrive in the capitalistic, oppressive system we're in, especially for marginalized folks. It is my goal for us to find ways for you to feel safe, fulfilled and content.
(206) 483-0623 View (206) 483-0623

See more therapy options for Lake City, Seattle

How does your Therapist compare?

Number of Therapists in Lake City, Seattle, WA

100+

Average cost per session

$150

Therapists in Lake City, Seattle, WA who prioritize treating:

89% Anxiety
76% Depression
73% Self Esteem
72% Relationship Issues
65% Coping Skills
64% Life Transitions
61% Stress

Average years in practice

11 Years

Top 3 insurances accepted

69% Premera
52% Aetna
51% Regence

How Therapists in Lake City, Seattle, WA see their clients

53% In Person and Online
47% Online Only

Gender breakdown

79% Female
18% Male
3% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Lake City, Seattle?

Search for nearby therapists or counselors by inputting your city, town, or suburb; or zip code; or a provider’s name into the search bar. From there, you can filter providers by the issues they treat, cost, insurance, gender, and other factors to find providers who are well-suited to your needs. To navigate between locations within the same country, enter a new city or zip code into the search bar.

Learn more about how to find a therapist

Is everyone in the Psychology Today Therapy Directory a licensed therapist?

The Psychology Today directory lists providers who offer legitimate mental health services to the public, including psychologists, psychiatrists, social workers, and counselors.

Many have been licensed by the country or state where they practice; providers whose license or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Some clinicians or organizations provide services for which their state or country does not offer licenses, such as pastoral counseling. They may be selectively included without the “Verified” seal.

What’s the difference between a psychologist, a therapist, and a counselor?

Therapists, psychologists, and counselors are all licensed mental health professionals. In the US, psychologists have earned a doctoral degree. The terms “therapist” and “counselor” are used somewhat interchangeably, but generally therapists offer longer-term, mental health care, while counselors offer shorter-term care that may focus on one domain, such as marriage, career, or academic challenges.

Clients should consider factors such as insurance coverage and their primary reason(s) for seeking therapy to determine the type of professional best suited to their needs. Someone struggling with mental health challenges such as depression or anxiety, for example, may wish to seek out a clinical psychologist or therapist, while someone navigating career obstacles or marital upheaval may benefit from seeing a counselor who can offer short-term, targeted support.

What type of therapy is right for me?

The type of therapy best suited to a particular individual depends on several factors, including their primary reason for seeking therapy, their preferred timeline (some therapy types last for a set number of sessions, while others are open-ended), and their personality and preferences—some may prefer a more structured approach. For many individuals, multiple types of therapy could provide a good fit.

How much does therapy cost?

The cost of therapy depends on a number of variables, including location and the therapist’s experience and training. On average, a therapy session in the United States could cost between $100 and $200 or more. If you have insurance, the expense of mental health care is typically lower, but it varies based on your insurance plan details and whether you choose an in-network or out-of-network mental healthcare provider.

What are more affordable or low cost therapy solutions?

Many therapists offer sliding scale payments, usually on a limited number of slots, which consists in an agreement between the therapist and a client to pay a reduced rate. Therapists who provide such arrangements often consider the client's income or ability to pay, but the extent of the discount is ultimately at the therapist's discretion. Furthermore, while group therapy may have different goals and benefits compared to individual therapy, it can be a more affordable solution to address certain types of issues.

Is online therapy cheaper than in-person therapy?

Many therapists charge the same amount for online therapy as they do for in-person therapy—though clients may still find this cost-effective if it cuts down on their transportation costs. Health insurance plans often offer equivalent coverage for online and in-person therapy; indeed, in many places, they are legally required to do so. Text-based or on-demand therapy apps may be cheaper than traditional one-on-one psychotherapy; however, the practice may be less effective and is not likely to be covered by insurance.

Is online therapy a good option?

Therapy conducted online can be just as effective as in-person therapy, as long as there is a strong alliance between the client and the therapist. To find a therapist who provides telehealth services to clients in your area, click “Online Therapy” on the directory homepage and search by your city or town or your zip code.

Are therapy sessions confidential?

Confidentiality is a crucial part of the therapeutic relationship. Therapists in the United States are bound by the regulations set out by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which aims to protect sensitive health information. With very few exceptions, a therapist will only discuss their client with others when the client has given their written permission. The instances in which a therapist would be required to disclose personal information are: if a client poses a danger to themselves or others, if the therapist suspects the abuse of a child or an elderly or otherwise dependent adult, or if they are legally forced to by court order. These exceptions to the confidentiality agreement are usually discussed with a client before their first session.