Therapists in La Mesa, CA

Photo of Kelsey Barillas, LMFT, #133292, Marriage & Family Therapist in La Mesa, CA
Kelsey Barillas, LMFT, #133292
Marriage & Family Therapist, LMFT
Verified Verified
La Mesa, CA 91942  (Online Only)
How’s life? Want to talk about it? It can be hard to take the first step in finding a psychotherapist who is a good fit for you but, you’ve already gotten closer by exploring the web. Depression, Anxiety, Stress, and other Mental Health matters can be hard to manage and get in the way of having a peaceful and fulfilling life. If you or your teen/young adult are struggling with your emotional wellbeing, thoughts, feelings, or adjustments to life experiences, we can work together to look at how to make progress and the changes that you need to process some of the current matters you are facing.
How’s life? Want to talk about it? It can be hard to take the first step in finding a psychotherapist who is a good fit for you but, you’ve already gotten closer by exploring the web. Depression, Anxiety, Stress, and other Mental Health matters can be hard to manage and get in the way of having a peaceful and fulfilling life. If you or your teen/young adult are struggling with your emotional wellbeing, thoughts, feelings, or adjustments to life experiences, we can work together to look at how to make progress and the changes that you need to process some of the current matters you are facing.
(619) 375-5117 View (619) 375-5117
Photo of Julie M Hayden, Psychologist in La Mesa, CA
Julie M Hayden
Psychologist, MRS, MACP, PsyD
Verified Verified
La Mesa, CA 91942
Addiction is not a problem to be fixed, but rather a person. I have worked with many people with various addictions and realize that addressing one problem from one perspective is not enough. I specialize in getting to know a person first and then helping that person heal from past hurts, learn skills for problem-solving, improve communication, build strong relationships, practice ways to manage strong emotions, learn to slow down and change their harmful or intrusive thoughts, draw from their faith for strength, develop strong support systems, and with all this, hope of long-term recovery can become reality.
Addiction is not a problem to be fixed, but rather a person. I have worked with many people with various addictions and realize that addressing one problem from one perspective is not enough. I specialize in getting to know a person first and then helping that person heal from past hurts, learn skills for problem-solving, improve communication, build strong relationships, practice ways to manage strong emotions, learn to slow down and change their harmful or intrusive thoughts, draw from their faith for strength, develop strong support systems, and with all this, hope of long-term recovery can become reality.
(844) 262-8310 View (844) 262-8310
Photo of Danielle McGuire, Marriage & Family Therapist in La Mesa, CA
Danielle McGuire
Marriage & Family Therapist, LMFT
Verified Verified
La Mesa, CA 91941
I am a devoted therapist who specializes in working with children, teens, families and individuals. I am driven by a profound commitment to empower each client I work with. My approach emphasizes not only addressing immediate concerns, but also equipping individuals and families with lasting tools for ongoing support. When working with families, I partner with the parents and I will work along side you to build a solid foundation, ensuring that your children, teens and family as a whole feels confident in being able to navigate life's complexities with strength, understanding and lasting connections.
I am a devoted therapist who specializes in working with children, teens, families and individuals. I am driven by a profound commitment to empower each client I work with. My approach emphasizes not only addressing immediate concerns, but also equipping individuals and families with lasting tools for ongoing support. When working with families, I partner with the parents and I will work along side you to build a solid foundation, ensuring that your children, teens and family as a whole feels confident in being able to navigate life's complexities with strength, understanding and lasting connections.
(619) 514-1871 View (619) 514-1871
Photo of Connie Padera, Clinical Social Work/Therapist in La Mesa, CA
Connie Padera
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
La Mesa, CA 91942  (Online Only)
Are you struggling with substance use or disordered eating habits? Or maybe you need some guidance on self-esteem or relationship issues? It's okay to not be okay, and I'm here to help you through whatever life has brought your way. I believe in treating each these issues from a whole person perspective, and will work with you to enrich all areas of your well-being. Through openhearted and compassionate communication, we will create a safe space for you to mindfully explore your thoughts, feelings, and behaviors, and identify which among them no longer serve you.
Are you struggling with substance use or disordered eating habits? Or maybe you need some guidance on self-esteem or relationship issues? It's okay to not be okay, and I'm here to help you through whatever life has brought your way. I believe in treating each these issues from a whole person perspective, and will work with you to enrich all areas of your well-being. Through openhearted and compassionate communication, we will create a safe space for you to mindfully explore your thoughts, feelings, and behaviors, and identify which among them no longer serve you.
(760) 456-2524 View (760) 456-2524
Photo of Ryan Berwold, Marriage & Family Therapist in La Mesa, CA
Ryan Berwold
Marriage & Family Therapist, LMFT
Verified Verified
2 Endorsed
La Mesa, CA 91942
Hello, my name is Ryan. I’m a Licensed Marriage & Family Therapist practicing in San Diego, California. I am glad that you are reaching out by just reading this, thank you. You already have great strengths and talents which can be amplified in therapy. I guide people towards health with deep care while exploring your strengths and your wounds of the mind and heart.
Hello, my name is Ryan. I’m a Licensed Marriage & Family Therapist practicing in San Diego, California. I am glad that you are reaching out by just reading this, thank you. You already have great strengths and talents which can be amplified in therapy. I guide people towards health with deep care while exploring your strengths and your wounds of the mind and heart.
(858) 281-2943 View (858) 281-2943
Photo of Kaely Ferrara, Clinical Social Work/Therapist in La Mesa, CA
Kaely Ferrara
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
La Mesa, CA 91942
I specialize in treating teens and adults who are struggling with symptoms of trauma, depression, anxiety, grief, and attachment based issues rooted in child abuse and neglect. I use a variety of modalities including neuropsychology, Cognitive Behavior Therapy, Dialectical Behavior Therapy, Attachment Based Therapy, Internal Family Systems, and Somatic Therapy. I have experience working with first responders, veterans, survivors of domestic violence, and childhood abuse survivors. I also have experience working with individuals diagnosed with special needs and their family members as a Board Certified Behavior Analyst.
I specialize in treating teens and adults who are struggling with symptoms of trauma, depression, anxiety, grief, and attachment based issues rooted in child abuse and neglect. I use a variety of modalities including neuropsychology, Cognitive Behavior Therapy, Dialectical Behavior Therapy, Attachment Based Therapy, Internal Family Systems, and Somatic Therapy. I have experience working with first responders, veterans, survivors of domestic violence, and childhood abuse survivors. I also have experience working with individuals diagnosed with special needs and their family members as a Board Certified Behavior Analyst.
(619) 789-1566 View (619) 789-1566
Photo of Kristin Steele, Psychologist in La Mesa, CA
Kristin Steele
Psychologist, PsyD
Verified Verified
La Mesa, CA 91941
Thank you for taking the time to consider me in choosing a support person for yourself or family member. I am a Licensed Clinical Psychologist dedicated to providing effective, specialized psychological services for Adolescents and Adults. I facilitate Psychological Evaluations/Testing, Psychotherapy, and Mental Health/Performance Coaching. I take an Individualized, Empowerment and Wellness-based approach whereby I incorporate brief, solutions focused interventions to address the overall psychological needs of a person or family to help reduce suffering and bring about optimal Well-being and long-term Recovery.
Thank you for taking the time to consider me in choosing a support person for yourself or family member. I am a Licensed Clinical Psychologist dedicated to providing effective, specialized psychological services for Adolescents and Adults. I facilitate Psychological Evaluations/Testing, Psychotherapy, and Mental Health/Performance Coaching. I take an Individualized, Empowerment and Wellness-based approach whereby I incorporate brief, solutions focused interventions to address the overall psychological needs of a person or family to help reduce suffering and bring about optimal Well-being and long-term Recovery.
(619) 762-4623 View (619) 762-4623
Photo of Dr. Tamara Marks, Psychological Associate in La Mesa, CA
Dr. Tamara Marks
Psychological Associate, PsyD
Verified Verified
1 Endorsed
La Mesa, CA 91942
I am a compassionate and empathetic therapist who specializes in supporting your mental health and personal growth. My passion revolves around enhancing relationships and communication skills. I utilize my expertise to tailor therapy sessions to meet the unique needs of each client, providing them with effective tools and strategies to navigate their specific challenges.
I am a compassionate and empathetic therapist who specializes in supporting your mental health and personal growth. My passion revolves around enhancing relationships and communication skills. I utilize my expertise to tailor therapy sessions to meet the unique needs of each client, providing them with effective tools and strategies to navigate their specific challenges.
(619) 848-0118 View (619) 848-0118
Photo of Cody Gustaveson, Psychologist in La Mesa, CA
Cody Gustaveson
Psychologist, PhD
Verified Verified
La Mesa, CA 91942
Dr. Cody Gustaveson is a Psychologist in California who has been working in mental health since 2016. He has a PhD in Clinical Psychology from Alliant International University, completed his Internship at Norton Sound Health Corporation, and his Post-Doc at Kaiser Permanente. Dr. Gustaveson is uniquely trained in health psychology and community mental health. This means that he has specialized training in treating individuals who experience depression, anxiety, or a whole host of other psychiatric disorders that occur with chronic illness as well as the entire spectrum of diagnoses.
Dr. Cody Gustaveson is a Psychologist in California who has been working in mental health since 2016. He has a PhD in Clinical Psychology from Alliant International University, completed his Internship at Norton Sound Health Corporation, and his Post-Doc at Kaiser Permanente. Dr. Gustaveson is uniquely trained in health psychology and community mental health. This means that he has specialized training in treating individuals who experience depression, anxiety, or a whole host of other psychiatric disorders that occur with chronic illness as well as the entire spectrum of diagnoses.
(619) 824-9761 View (619) 824-9761
Photo of Julie Ellen Williams, Marriage & Family Therapist in La Mesa, CA
Julie Ellen Williams
Marriage & Family Therapist, MA, LMFT
Verified Verified
La Mesa, CA 91942  (Online Only)
Julie Williams (They/She) is a compassionate, authentic, and experienced Mental Health Clinician that guides clients in gaining greater self-awareness and self-acceptance using Holistic, Transpersonal, and Somatic approaches for individual adults, teens, children, &/or families. Holistic Psychotherapy with Julie is for you if you are looking to learn ways to reduce symptoms of anxiety, depression, and/or post traumatic stress through the use of mindfulness-based coping skills. Centered on each individual’s unique needs and preferences, Julie weaves together several different therapeutic approaches and psychological theories.
Julie Williams (They/She) is a compassionate, authentic, and experienced Mental Health Clinician that guides clients in gaining greater self-awareness and self-acceptance using Holistic, Transpersonal, and Somatic approaches for individual adults, teens, children, &/or families. Holistic Psychotherapy with Julie is for you if you are looking to learn ways to reduce symptoms of anxiety, depression, and/or post traumatic stress through the use of mindfulness-based coping skills. Centered on each individual’s unique needs and preferences, Julie weaves together several different therapeutic approaches and psychological theories.
(619) 598-0637 View (619) 598-0637
Photo of Melissa Stevenson, Marriage & Family Therapist in La Mesa, CA
Melissa Stevenson
Marriage & Family Therapist, MA, LMFT
Verified Verified
3 Endorsed
La Mesa, CA 91942
Your sense of inner peace and healing are the focus of my practice. I am best at helping people discover and embody the best versions of themselves in the midst of challenging circumstances. I do depth work with individuals that have experienced trauma, are struggling with a major life transition or are trying to get over a major heartbreak.
Your sense of inner peace and healing are the focus of my practice. I am best at helping people discover and embody the best versions of themselves in the midst of challenging circumstances. I do depth work with individuals that have experienced trauma, are struggling with a major life transition or are trying to get over a major heartbreak.
(619) 776-3761 View (619) 776-3761
Photo of Amy White, Marriage & Family Therapist Associate in La Mesa, CA
Amy White
Marriage & Family Therapist Associate, AMFT
Verified Verified
3 Endorsed
La Mesa, CA 91942
Sometimes, we feel stuck and find connecting with ourselves and others challenging. You are not alone if you have difficulty in relationships, trouble detangling from old habits, or wish for more control over your internal world. I am passionate about honoring your story and human experience while offering the structure necessary to build greater internal peace.
Sometimes, we feel stuck and find connecting with ourselves and others challenging. You are not alone if you have difficulty in relationships, trouble detangling from old habits, or wish for more control over your internal world. I am passionate about honoring your story and human experience while offering the structure necessary to build greater internal peace.
(619) 304-5517 View (619) 304-5517
Photo of Gary D Hittle, Marriage & Family Therapist in La Mesa, CA
Gary D Hittle
Marriage & Family Therapist, PhD
Verified Verified
La Mesa, CA 91942
I have been in private psychological practice for over 30 years specializing in Marital and Relational therapy, Family problem interventions, Adolescents, and in the treatment of Sexual and Substance Abuse, and family therapy related to these issues. I have a broad range of training and utilize multiple modalities in the course of assisting my clients toward growth and personal change. I also assist clients with value related questions and am helpful for those looking for a "Christian Therapist". Further, I have extensive experience in dealing with the issues of aging, serious health issue, terminal illness, and chronic pain.
I have been in private psychological practice for over 30 years specializing in Marital and Relational therapy, Family problem interventions, Adolescents, and in the treatment of Sexual and Substance Abuse, and family therapy related to these issues. I have a broad range of training and utilize multiple modalities in the course of assisting my clients toward growth and personal change. I also assist clients with value related questions and am helpful for those looking for a "Christian Therapist". Further, I have extensive experience in dealing with the issues of aging, serious health issue, terminal illness, and chronic pain.
(619) 377-3720 View (619) 377-3720
Photo of Ethan John Messer, Marriage & Family Therapist in La Mesa, CA
Ethan John Messer
Marriage & Family Therapist, MA
Verified Verified
2 Endorsed
La Mesa, CA 91942
I am currently accepting new clients for in-person counseling. I am able to provide counseling services for couples, families, individuals, children & adolescents. I have experience in helping individuals with depression, anxiety, self-esteem issues, suicidal thoughts and in counseling children who are experiencing negative effects from divorce and have extensive experience in working with children/adolescents in a wide variety of settings.
I am currently accepting new clients for in-person counseling. I am able to provide counseling services for couples, families, individuals, children & adolescents. I have experience in helping individuals with depression, anxiety, self-esteem issues, suicidal thoughts and in counseling children who are experiencing negative effects from divorce and have extensive experience in working with children/adolescents in a wide variety of settings.
(619) 536-0812 View (619) 536-0812
Photo of Raul Gutierrez, Clinical Social Work/Therapist in La Mesa, CA
Raul Gutierrez
Clinical Social Work/Therapist, LCSW
Verified Verified
La Mesa, CA 91942
I have been a practicing therapist for over 5 years now. I have worked with a diverse group of populations dealing with depression/anxiety all the way to psychosis diagnoses. I implement a lot of Trauma Focused CBT and Motivational Interviewing into my practice. My clients have often told me that I bring a genuine and compassionate atmosphere to sessions which helps them feel more at ease. I take a very nonjudgmental "at your own pace" type of approach. I want to ensure you feel comfortable every step of the way through your journey with mental health.
I have been a practicing therapist for over 5 years now. I have worked with a diverse group of populations dealing with depression/anxiety all the way to psychosis diagnoses. I implement a lot of Trauma Focused CBT and Motivational Interviewing into my practice. My clients have often told me that I bring a genuine and compassionate atmosphere to sessions which helps them feel more at ease. I take a very nonjudgmental "at your own pace" type of approach. I want to ensure you feel comfortable every step of the way through your journey with mental health.
(619) 393-9614 View (619) 393-9614
Photo of Niamh ( Neeve) Martin, Marriage & Family Therapist in La Mesa, CA
Niamh ( Neeve) Martin
Marriage & Family Therapist, LMFT
Verified Verified
La Mesa, CA 91941  (Online Only)
Are you feeling stuck in life? Do you wake up with a knot in your stomach ? Or get on a train of thought to the worst case scenario ? Are you worried about what others think and does this drive your life instead of you?
Are you feeling stuck in life? Do you wake up with a knot in your stomach ? Or get on a train of thought to the worst case scenario ? Are you worried about what others think and does this drive your life instead of you?
(619) 273-0344 View (619) 273-0344
Photo of Michelle Van Aken, Counselor in La Mesa, CA
Michelle Van Aken
Counselor, LMHC, LPCC
Verified Verified
La Mesa, CA 91942
As a compassionate and attuned therapist, my mission is to provide a safe and supportive space for you to explore and transform the challenges you face. Together, we will unlock the power of your brain's natural healing abilities, leading you towards a more fulfilling and authentic life. I am a dedicated and empathic therapist with a passion for helping navigate emotional landscapes. With specialized training in Brainspotting, a cutting-edge approach in trauma and stress resolution, as well as other modalities, I offer you a unique therapeutic experience tailored to your specific needs.
As a compassionate and attuned therapist, my mission is to provide a safe and supportive space for you to explore and transform the challenges you face. Together, we will unlock the power of your brain's natural healing abilities, leading you towards a more fulfilling and authentic life. I am a dedicated and empathic therapist with a passion for helping navigate emotional landscapes. With specialized training in Brainspotting, a cutting-edge approach in trauma and stress resolution, as well as other modalities, I offer you a unique therapeutic experience tailored to your specific needs.
(619) 536-1534 View (619) 536-1534
Photo of Betty Lemos-Arellano, Marriage & Family Therapist in La Mesa, CA
Betty Lemos-Arellano
Marriage & Family Therapist, MA, MFT, LPCC
Verified Verified
La Mesa, CA 91941
Through my work for non profit, public and private sectors, I have developed an unrelenting passion for helping children, adolescents, and adults overcome life's many challenges. I consider it a privilege to have treated these populations from a variety of backgrounds with an equally varied mental health conditions. I have worked with juvenile sex offenders, juvenile delinquents, foster children, chronically mentally ill, and criminally insane, couples, to name a few. Although, their problems were different, their goals were the same, to live a life filled with happiness self sufficiency and success.I have been working in an underserved community.
Through my work for non profit, public and private sectors, I have developed an unrelenting passion for helping children, adolescents, and adults overcome life's many challenges. I consider it a privilege to have treated these populations from a variety of backgrounds with an equally varied mental health conditions. I have worked with juvenile sex offenders, juvenile delinquents, foster children, chronically mentally ill, and criminally insane, couples, to name a few. Although, their problems were different, their goals were the same, to live a life filled with happiness self sufficiency and success.I have been working in an underserved community.
(858) 260-3253 View (858) 260-3253
Photo of Shirla de Magalhães, Marriage & Family Therapist in La Mesa, CA
Shirla de Magalhães
Marriage & Family Therapist, LMFT, RPT-S, RSP
Verified Verified
9 Endorsed
La Mesa, CA 91942
Are you seeking therapeutic support to work on personal growth, life transitions, inner child work, aging, divorce, menopause, grief & loss? I offer a holistic approach to therapy where we look at underlying issues instead of just treating the surface symptoms. Together we'll explore internal stressors, attachment styles and trauma to help alleviate emotional pain, expand consciousness, access inner wisdom and awaken your creativity.
Are you seeking therapeutic support to work on personal growth, life transitions, inner child work, aging, divorce, menopause, grief & loss? I offer a holistic approach to therapy where we look at underlying issues instead of just treating the surface symptoms. Together we'll explore internal stressors, attachment styles and trauma to help alleviate emotional pain, expand consciousness, access inner wisdom and awaken your creativity.
(619) 870-1834 View (619) 870-1834
Photo of Irenda Rios Immigration Evaluation Evaluaciones Inmigracion, Marriage & Family Therapist Associate in La Mesa, CA
Irenda Rios Immigration Evaluation Evaluaciones Inmigracion
Marriage & Family Therapist Associate, AMFT
Verified Verified
La Mesa, CA 91942
Mental health, addiction and traumas can be treated with the appropriate psychotherapy. With thirteen years of experience in the field, I have had the opportunity to work with clients who have different problems, needs and objectives. People of all ages, ethnicities and cultures; therefore, giving me the opportunity to develop a deeper understanding on how to detect and treat various conditions. Psychotherapy helps people to go through a recovery process without problems.
Mental health, addiction and traumas can be treated with the appropriate psychotherapy. With thirteen years of experience in the field, I have had the opportunity to work with clients who have different problems, needs and objectives. People of all ages, ethnicities and cultures; therefore, giving me the opportunity to develop a deeper understanding on how to detect and treat various conditions. Psychotherapy helps people to go through a recovery process without problems.
(619) 304-3617 View (619) 304-3617

How does your Therapist compare?

Number of Therapists in La Mesa, CA

200+

Average cost per session

$150

Therapists in La Mesa, CA who prioritize treating:

93% Anxiety
88% Depression
75% Relationship Issues
70% Self Esteem
68% Trauma and PTSD
66% Coping Skills
63% Stress

Average years in practice

12 Years

Top 3 insurances accepted

78% Aetna
74% Cigna and Evernorth
66% UnitedHealthcare UHC | UBH

How Therapists in La Mesa, CA see their clients

75% In Person and Online
25% Online Only

Gender breakdown

78% Female
21% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in La Mesa?

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.