Therapists in Cheyenne, WY
![Photo of Jeremy Bay, MS, USN, Ret, Pre-Licensed Professional](https://photos.psychologytoday.com/ea1de97b-b70f-4158-9bfe-be368b95110a/1/320x400.jpeg)
Jeremy is a provisional professional counselor with a graduate degree in Military and Emergency Responder Psychology from the Colorado State University System. He is a native of Cheyenne, WY, returning home after completing more than two decades of service in the United States Navy. He has experience working with individuals, couples, and families and has additional cultural competency surrounding military and veteran communities, emergency responders and geek culture.
Jeremy is a provisional professional counselor with a graduate degree in Military and Emergency Responder Psychology from the Colorado State University System. He is a native of Cheyenne, WY, returning home after completing more than two decades of service in the United States Navy. He has experience working with individuals, couples, and families and has additional cultural competency surrounding military and veteran communities, emergency responders and geek culture.
![Photo of Chriss Frost, MSW, PCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/5ad3d506-0618-4956-b39b-34508509d1e6/2/320x400.jpeg)
Chriss Frost
Clinical Social Work/Therapist, MSW, PCSW
Verified Verified
Cheyenne, WY 82001
Waitlist for new clients
My passion is working with individuals that want to make positive changes in their life. Changes can be difficult and life's road can feel overwhelming at times. Through therapy, you can learn tools and skills to make the ride a little smoother. It is my job to provide support as you navigate through your mental health journey. I have a direct, honest, and forward personality that is solution-focused. Start your mental health journey today by contacting me through Specialty Counseling & Consulting or directly through email at the link above.
My passion is working with individuals that want to make positive changes in their life. Changes can be difficult and life's road can feel overwhelming at times. Through therapy, you can learn tools and skills to make the ride a little smoother. It is my job to provide support as you navigate through your mental health journey. I have a direct, honest, and forward personality that is solution-focused. Start your mental health journey today by contacting me through Specialty Counseling & Consulting or directly through email at the link above.
![Photo of Amanda Bullock, MS, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/e0213ef5-7939-4a3a-acf1-4c2488d8fe5b/1/320x400.jpeg)
Amanda Bullock
Licensed Professional Counselor, MS, LPC
Verified Verified
Cheyenne, WY 82009 (Online Only)
Welcome! I am so grateful you are here, and I am honored to be a part of your healing journey. I strongly believe you are the expert on yourself. You know yourself best, and I am here to walk beside you as we gently and curiously explore your goals. I recognize the strength and bravery it takes to go to therapy and I applaud you for taking the steps you are taking to heal.
Welcome! I am so grateful you are here, and I am honored to be a part of your healing journey. I strongly believe you are the expert on yourself. You know yourself best, and I am here to walk beside you as we gently and curiously explore your goals. I recognize the strength and bravery it takes to go to therapy and I applaud you for taking the steps you are taking to heal.
![Photo of Mindy Falkner-Wann, MA, LMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/491f4f1b-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
We are all human, therefore we all have problems from time to time. It’s in those times of trouble that we sometimes need help. I hold a Bachelor’s degree in Psychology and a Masters degree in Marriage and Family Counseling and am a Licensed Marriage and Family Therapist in Cheyenne, WY. Getting to apply my skills with a variety of people and problems is really where I find purpose. Whether it's depression, anxiety, relationship issues, or another problem, I would be honored to help in your time of need.
We are all human, therefore we all have problems from time to time. It’s in those times of trouble that we sometimes need help. I hold a Bachelor’s degree in Psychology and a Masters degree in Marriage and Family Counseling and am a Licensed Marriage and Family Therapist in Cheyenne, WY. Getting to apply my skills with a variety of people and problems is really where I find purpose. Whether it's depression, anxiety, relationship issues, or another problem, I would be honored to help in your time of need.
![Photo of Caitilin M Barrett, PhD, Psychologist](https://photos.psychologytoday.com/5c2a4ed2-594c-4b54-b784-7e22bd61979e/1/320x400.jpeg)
Balance is the key to well-being. Distress and discomfort come from imbalance. When problems like stress, sadness, and worry start overshadowing the most valuable parts of life, we need a little help. As a licensed clinical psychologist, I aim to help enhance what’s already working and provide tools to address things that aren’t. Exploring how past experiences shape the mind’s unique way of experiencing and interacting enables new ways of behaving and relating to thoughts and feelings to restore balance in life. For therapy to be successful, clients need to be seen and valued while learning concrete strategies for change. Through my
Balance is the key to well-being. Distress and discomfort come from imbalance. When problems like stress, sadness, and worry start overshadowing the most valuable parts of life, we need a little help. As a licensed clinical psychologist, I aim to help enhance what’s already working and provide tools to address things that aren’t. Exploring how past experiences shape the mind’s unique way of experiencing and interacting enables new ways of behaving and relating to thoughts and feelings to restore balance in life. For therapy to be successful, clients need to be seen and valued while learning concrete strategies for change. Through my
![Photo of Frank Shablo, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/283c92ba-2074-4d97-8b8c-6fdb22fac020/2/320x400.jpeg)
My name is Frank Shablo and I am a Licensed Professional Counselor based in Green River, Wyoming and offering services statewide via telehealth. My primary modalities are Cognitive Behavioral Therapy and Reality Therapy, and specialize in helping those struggling with depression, anxiety, serious and persistent mental illness, and substance dependence. I find the best approach to client communication is positive regard. Establishing a therapeutic relationship requires a warm and consistent temperament, active listening, and clearly expressing my understanding of my client's needs.
My name is Frank Shablo and I am a Licensed Professional Counselor based in Green River, Wyoming and offering services statewide via telehealth. My primary modalities are Cognitive Behavioral Therapy and Reality Therapy, and specialize in helping those struggling with depression, anxiety, serious and persistent mental illness, and substance dependence. I find the best approach to client communication is positive regard. Establishing a therapeutic relationship requires a warm and consistent temperament, active listening, and clearly expressing my understanding of my client's needs.
![Photo of Jeanette Nelson, MSW, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/65f4741b-2d84-4d58-b314-58c13347152b/2/320x400.jpeg)
Jeanette Nelson
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Cheyenne, WY 82001 (Online Only)
Hello fellow traveler! This life is a journey and everyone’s path is uniquely their own. But one thing we all have in common is that as soon as we think we have our path perfectly planned, we find ourselves off balanced, nudged, even pushed in a different direction. With empathy and respect, I strive to help you discover your inner strengths, increase your resiliency, and understand and live in harmony with your values so you can navigate the difficulties and challenges in life with grace and self assurance. Searching for someone to assist you was the first brave step toward transforming your life and blazing new trails.
Hello fellow traveler! This life is a journey and everyone’s path is uniquely their own. But one thing we all have in common is that as soon as we think we have our path perfectly planned, we find ourselves off balanced, nudged, even pushed in a different direction. With empathy and respect, I strive to help you discover your inner strengths, increase your resiliency, and understand and live in harmony with your values so you can navigate the difficulties and challenges in life with grace and self assurance. Searching for someone to assist you was the first brave step toward transforming your life and blazing new trails.
![Photo of Laura Kietell, MSW, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/439f363f-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
I enjoy working with adolescents, adults and couples. A sample of issues I am experienced in working with include but are not limited to: anxiety, relationships, self esteem, depression, eating disorders, trauma, grief and loss. I am certified in Accelerated Resolution Therapy for trauma. I also work with pet loss. I am here to help others see their value, fulfill their authentic selves and live life as they see fit. I am also a DQCS for those in need of clinical supervision.
I enjoy working with adolescents, adults and couples. A sample of issues I am experienced in working with include but are not limited to: anxiety, relationships, self esteem, depression, eating disorders, trauma, grief and loss. I am certified in Accelerated Resolution Therapy for trauma. I also work with pet loss. I am here to help others see their value, fulfill their authentic selves and live life as they see fit. I am also a DQCS for those in need of clinical supervision.
![Photo of Alyse Pfankuch, MA, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/38f3bdc2-3131-4667-9c76-f4d0a1db3548/1/320x400.jpeg)
Confronting the unyielding grasp of anxiety, depression, or OCD is a relentless struggle, but there is hope. They distort reality, making everyday tasks seem insurmountable and thoughts unshakeable. Each moment becomes a battle against unseen forces, where progress is hard-won and every step forward is a triumph.
Confronting the unyielding grasp of anxiety, depression, or OCD is a relentless struggle, but there is hope. They distort reality, making everyday tasks seem insurmountable and thoughts unshakeable. Each moment becomes a battle against unseen forces, where progress is hard-won and every step forward is a triumph.
![Photo of Ronda Lee, LPC, 1871, Counselor](https://photos.psychologytoday.com/4ee055e5-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
I am a Change Agent believing we as people possess limitless possibilities to have the lives and relationships we dream of if only we have the skills. Many times we possess the answers to our own questions and it just takes a new perspective to see them. I love to help others find the way to happiness. I believe the therapeutic relationship should be a team approach lead by the client. I would love the opportunity to explore your lives and relationships with you.
I am a Change Agent believing we as people possess limitless possibilities to have the lives and relationships we dream of if only we have the skills. Many times we possess the answers to our own questions and it just takes a new perspective to see them. I love to help others find the way to happiness. I believe the therapeutic relationship should be a team approach lead by the client. I would love the opportunity to explore your lives and relationships with you.
![Photo of Preston Hobbs, MS, PPC, Pre-Licensed Professional](https://photos.psychologytoday.com/a2a00b4f-7e27-4334-93b7-2ddc52599a17/2/320x400.jpeg)
Preston brings a calming presence into each of his sessions that helps to dissolve anxiety when seeking change. He is passionate about providing a healing space for each individual where they are allowed to express their unique story and feel understood without experiencing judgment or shame. Preston maintains a collaborative relationship with his clients to assist them in discovery and reclamation of their own authentic lived experience. He strives to view each individual in a holistic manner in order to help individuals, couples, and families become empowered to feel at their best.
Preston brings a calming presence into each of his sessions that helps to dissolve anxiety when seeking change. He is passionate about providing a healing space for each individual where they are allowed to express their unique story and feel understood without experiencing judgment or shame. Preston maintains a collaborative relationship with his clients to assist them in discovery and reclamation of their own authentic lived experience. He strives to view each individual in a holistic manner in order to help individuals, couples, and families become empowered to feel at their best.
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![Photo of Mary Beth Thompson, MS, LMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/026cb299-09a3-4d5a-bb64-a83416da1750/2/320x400.jpeg)
Mary Beth Thompson
Marriage & Family Therapist, MS, LMFT
Verified Verified
Cheyenne, WY 82001
Waitlist for new clients
I am a licensed psychotherapist, providing person-centered and trauma-informed care for individuals, couples and families. I endeavor to help clients heal and develop more effective and adaptive behavior for a more fulfilling life. Clients are helped to learn and use positive, effective coping skills and to develop the motivation to reach their greatest potential. I take into account dealing with life challenges, as well at being at different stages of readiness and change. Clients are helped to move forward at their ideal pace.
I am a licensed psychotherapist, providing person-centered and trauma-informed care for individuals, couples and families. I endeavor to help clients heal and develop more effective and adaptive behavior for a more fulfilling life. Clients are helped to learn and use positive, effective coping skills and to develop the motivation to reach their greatest potential. I take into account dealing with life challenges, as well at being at different stages of readiness and change. Clients are helped to move forward at their ideal pace.
![Photo of Mary Ellen Sternitzke, PhD, Psychologist](https://photos.psychologytoday.com/cd8bd11c-1ee2-4c32-af4e-0082cec42e03/2/320x400.jpeg)
Mary Ellen Sternitzke is a licensed psychologist in Wyoming and Colorado; she earned her doctorate from the University of Nebraska in Lincoln. She served as Associate and Clinical Director at Catholic Charities of Wyoming for their outpatient mental health program. Her current work with adults emphasizes solution-focused interventions, targeted EMDR for trauma and anxiety, managing ADD/ADHD, post partum anxiety and depression and negotiating transitions like bereavement and divorce.
Mary Ellen Sternitzke is a licensed psychologist in Wyoming and Colorado; she earned her doctorate from the University of Nebraska in Lincoln. She served as Associate and Clinical Director at Catholic Charities of Wyoming for their outpatient mental health program. Her current work with adults emphasizes solution-focused interventions, targeted EMDR for trauma and anxiety, managing ADD/ADHD, post partum anxiety and depression and negotiating transitions like bereavement and divorce.
![Photo of Brandon Sego, Intern, Pre-Licensed Professional](https://photos.psychologytoday.com/d1d88181-e497-467f-bca5-6ad95ae06fab/1/320x400.jpeg)
Are you struggling with functioning in daily tasks? Do you feel overwhelmed, anxious, lost, alone, depressed, or constantly struggling with racing thoughts? Life can be difficult to navigate when you're constantly being bombarded with these negative thoughts. I understand the difficulty of dealing with these thoughts and feelings as well as addressing them. I am here for your needs and to support you in your path to a better overall mental well-being.
Are you struggling with functioning in daily tasks? Do you feel overwhelmed, anxious, lost, alone, depressed, or constantly struggling with racing thoughts? Life can be difficult to navigate when you're constantly being bombarded with these negative thoughts. I understand the difficulty of dealing with these thoughts and feelings as well as addressing them. I am here for your needs and to support you in your path to a better overall mental well-being.
![Photo of Mitsi Corwin Jones - Better Life Counseling llc, MS, LPC, NCC, Licensed Professional Counselor](https://photos.psychologytoday.com/470555a7-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Better Life Counseling llc
Licensed Professional Counselor, MS, LPC, NCC
Verified Verified
Cheyenne, WY 82001
Have you ever felt hopeless, anxious, or worried? Have you tried to get help and found it did not work? Then I am the therapist for you! I have years of experience. I especially enjoy helping families resolve conflict by figuring out what leads to it and working together. I am capable to do so, sometimes in as few as a couple sessions. I love working with young children. I have successfully used EMDR for stress and anxiety about health procedures.
Have you ever felt hopeless, anxious, or worried? Have you tried to get help and found it did not work? Then I am the therapist for you! I have years of experience. I especially enjoy helping families resolve conflict by figuring out what leads to it and working together. I am capable to do so, sometimes in as few as a couple sessions. I love working with young children. I have successfully used EMDR for stress and anxiety about health procedures.
![Photo of Valerie Mitchell, MA, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/429901cd-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
Hi. Welcome! I have been a counselor in Cheyenne for over 15 years. My practice is specialized in working with trauma, children, adolescents, women's issues, divorce, depression, and anxiety. I truly believe that you have the ability and capability to heal, and I will assist you in obtaining your goal.
Hi. Welcome! I have been a counselor in Cheyenne for over 15 years. My practice is specialized in working with trauma, children, adolescents, women's issues, divorce, depression, and anxiety. I truly believe that you have the ability and capability to heal, and I will assist you in obtaining your goal.
![Photo of Elizabeth Stithem, MSW, PCSW, Pre-Licensed Professional](https://photos.psychologytoday.com/f11e556e-a737-47a6-95cd-3be44a9fa660/1/320x400.jpeg)
Lizzy is a Provisional Clinical Social Worker (PCSW) who recently received her MSW from the University of Kansas. She has several years of experience working intensively with children and families in public mental health and child protection services. Lizzy is passionate about accessibility to therapy and believes every person has the right to a safe place to be vulnerable, feel heard, and partner with an authentic and collaborative therapist to help work through life's challenges. Lizzy is warm and compassionate yet direct and is eager to help clients achieve the best version of themselves.
Lizzy is a Provisional Clinical Social Worker (PCSW) who recently received her MSW from the University of Kansas. She has several years of experience working intensively with children and families in public mental health and child protection services. Lizzy is passionate about accessibility to therapy and believes every person has the right to a safe place to be vulnerable, feel heard, and partner with an authentic and collaborative therapist to help work through life's challenges. Lizzy is warm and compassionate yet direct and is eager to help clients achieve the best version of themselves.
![Photo of James Preston Nelson - Foundations Counseling & Consulting WY, LLC, MA, LPC, NCC, Licensed Professional Counselor](https://photos.psychologytoday.com/4c784ef0-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Foundations Counseling & Consulting WY, LLC
Licensed Professional Counselor, MA, LPC, NCC
Verified Verified
Cheyenne, WY 82009
I truly enjoy working with those that want and need to make a change for the better in their lives. Problems can be hard to isolate. Often, the solutions are elusive. Changes can be challenging sometimes. I'm here to help!
I truly enjoy working with those that want and need to make a change for the better in their lives. Problems can be hard to isolate. Often, the solutions are elusive. Changes can be challenging sometimes. I'm here to help!
![Photo of Stephanie Kettl, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/404720c7-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
Stephanie Kettl was born and raised in Casper, WY. She attended the University of Wyoming and graduated in 2003 with a Bachelor of Arts Degree in Secondary Education/Social Studies and a Minor in Sociology and then in 2005 she earned a Master of Science Degree in Counselor Education. She moved to Aurora, where she was a Treatment Coordinator at Excelsior Youth Center, treating severely at risk adolescent females from around the country. While at Excelsior, she facilitated individual, group, family therapy, along with canine and equine therapy groups. She has also completed Level I and Level II EMDR training.
Stephanie Kettl was born and raised in Casper, WY. She attended the University of Wyoming and graduated in 2003 with a Bachelor of Arts Degree in Secondary Education/Social Studies and a Minor in Sociology and then in 2005 she earned a Master of Science Degree in Counselor Education. She moved to Aurora, where she was a Treatment Coordinator at Excelsior Youth Center, treating severely at risk adolescent females from around the country. While at Excelsior, she facilitated individual, group, family therapy, along with canine and equine therapy groups. She has also completed Level I and Level II EMDR training.
![Photo of Kara Willcox, PPC, Pre-Licensed Professional](https://photos.psychologytoday.com/bce28184-974d-4a72-829f-a25d01ae9155/1/320x400.jpeg)
Kara is a Provisionally Licensed Clinical Social Worker (PCSW- 1114) and enjoys working clients in various stages of life. With her internship at the Wyoming Children's Trust Fund, Kara was actively involved in direct family advocacy work at the state level, including public health studies, outreach and education, and community-specific programming recommendations. Kara was born and raised in Cheyenne, Wyoming, and she is the mother of three beautiful children who are growing up in this community as well.
Kara is a Provisionally Licensed Clinical Social Worker (PCSW- 1114) and enjoys working clients in various stages of life. With her internship at the Wyoming Children's Trust Fund, Kara was actively involved in direct family advocacy work at the state level, including public health studies, outreach and education, and community-specific programming recommendations. Kara was born and raised in Cheyenne, Wyoming, and she is the mother of three beautiful children who are growing up in this community as well.
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How does your Therapist compare?
Number of Therapists in Cheyenne, WY
100+
Average cost per session
$150
Therapists in Cheyenne, WY who prioritize treating:
89% | Anxiety |
85% | Depression |
77% | Trauma and PTSD |
77% | Self Esteem |
75% | Relationship Issues |
71% | Stress |
69% | Coping Skills |
Average years in practice
11 Years
Top 3 insurances accepted
81% | BlueCross and BlueShield |
76% | Cigna and Evernorth |
68% | Aetna |
How Therapists in Cheyenne, WY see their clients
77% | In Person and Online | |
23% | Online Only |
Gender breakdown
82% | Female | |
17% | Male | |
1% | Non-Binary |
FAQs - About Therapy and Counseling
How can I find a therapist in Cheyenne?
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
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.
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.
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.