Therapists in Cary, NC
Mallori Thompson
Licensed Clinical Mental Health Counselor, MA, LCMHC, FT
Verified Verified
1 Endorsed
Cary, NC 27518
Are you feeling overwhelmed, stuck or struggling in your relationships? Have you lost a sense of meaning while juggling work, relationships, or caring for loved ones? Wherever you are, my goal is to help you find greater coping, clarity and ultimately thrive in any situation you find yourself in. My approach to working with any client(s) is to offer a space to share their story in a way that is authentic, honest and individualized. Through this sharing, we collaborate to find reliable pathways to change that mirror the clients values and beliefs.
Are you feeling overwhelmed, stuck or struggling in your relationships? Have you lost a sense of meaning while juggling work, relationships, or caring for loved ones? Wherever you are, my goal is to help you find greater coping, clarity and ultimately thrive in any situation you find yourself in. My approach to working with any client(s) is to offer a space to share their story in a way that is authentic, honest and individualized. Through this sharing, we collaborate to find reliable pathways to change that mirror the clients values and beliefs.
Whitney Draper
Psychologist, PsyD
Verified Verified
Cary, NC 27518
*I am not currently accepting new therapy clients at this time*. I specialize in both short and long-term therapies for children, adolescents, and adults. Over the past 12 years I have worked in various settings including: community clinics, schools, inpatient hospitals, correctional facilities, and day treatment centers. I currently work in private practice treating individuals who struggle with various emotional and behavioral issues. In addition to therapy, I also provide psychological testing and evaluations. For more information about me please visit my website www.whitneydraper.com
*I am not currently accepting new therapy clients at this time*. I specialize in both short and long-term therapies for children, adolescents, and adults. Over the past 12 years I have worked in various settings including: community clinics, schools, inpatient hospitals, correctional facilities, and day treatment centers. I currently work in private practice treating individuals who struggle with various emotional and behavioral issues. In addition to therapy, I also provide psychological testing and evaluations. For more information about me please visit my website www.whitneydraper.com
Tony Harris
LCSW Associate , LCSW-A
Verified Verified
Cary, NC 27511
Tony is a Licensed Clinical Social Worker- Associate in North Carolina with some years of experience working with individuals and couples. Tony received his Master of Social Work (MSW) in 2012 from East Carolina University. Tony has experience working with children, adolescents, and adults. Drawing from a diverse array of educational, career and life experiences, Tony is trained in the use of Cognitive-Behavior Therapy, Family Systems Theory, and Dialectical Behavior Therapy to support the individual from a holistic approach.
Tony is a Licensed Clinical Social Worker- Associate in North Carolina with some years of experience working with individuals and couples. Tony received his Master of Social Work (MSW) in 2012 from East Carolina University. Tony has experience working with children, adolescents, and adults. Drawing from a diverse array of educational, career and life experiences, Tony is trained in the use of Cognitive-Behavior Therapy, Family Systems Theory, and Dialectical Behavior Therapy to support the individual from a holistic approach.
Lisa Caprioli
Clinical Social Work/Therapist, LISW, LCSW
Verified Verified
4 Endorsed
Cary, NC 27511
Excepting new clients! In-network with United Healthcare, Cigna, and Aetna. Got relationship problems? Relationships are my specialty! Whether you are having challenges in your romantic relationship, with friends, co-workers, or your children, I can help. Caprioli Counseling provides individual therapy to adults needing help setting boundaries, learning to say no, and getting rid of guilt and anxiety. If you are looking for couples counseling, please visit my couples practice at www.relationship.repair
Excepting new clients! In-network with United Healthcare, Cigna, and Aetna. Got relationship problems? Relationships are my specialty! Whether you are having challenges in your romantic relationship, with friends, co-workers, or your children, I can help. Caprioli Counseling provides individual therapy to adults needing help setting boundaries, learning to say no, and getting rid of guilt and anxiety. If you are looking for couples counseling, please visit my couples practice at www.relationship.repair
Joy Wall
Clinical Social Work/Therapist, LCSW-A
Verified Verified
Cary, NC 27519
We all seek to achieve a balanced life, but little do we often pour into ourselves. The few times we do cater to ourselves, the biggest piece of us goes untouched. Mental health is a big part of our identity and self-care that deserves a little more TLC. My name is Joy Wall, a Licensed Clinical Social Worker Associate and an alum of Winston-Salem and North Carolina State University.
We all seek to achieve a balanced life, but little do we often pour into ourselves. The few times we do cater to ourselves, the biggest piece of us goes untouched. Mental health is a big part of our identity and self-care that deserves a little more TLC. My name is Joy Wall, a Licensed Clinical Social Worker Associate and an alum of Winston-Salem and North Carolina State University.
Amanda Bloom
Counselor, MEd, NCC, LCMHC
Verified Verified
Cary, NC 27511
I believe that we have all experienced challenging situations or have felt lost at some point in our lives. Taking the leap to seek additional guidance and support takes courage and vulnerability and I believe it cultivates our growth and well-being. Together we collaborate to examine thoughts, emotions and behaviors and identify new tools and solutions that will move you toward a place of worthiness, purpose and authenticity to meet your personalized goals. With over 14 years of experience, I specialize in treating adults who have concerns regarding anxiety, depression, relationships, life transitions, trauma, and women's issues.
I believe that we have all experienced challenging situations or have felt lost at some point in our lives. Taking the leap to seek additional guidance and support takes courage and vulnerability and I believe it cultivates our growth and well-being. Together we collaborate to examine thoughts, emotions and behaviors and identify new tools and solutions that will move you toward a place of worthiness, purpose and authenticity to meet your personalized goals. With over 14 years of experience, I specialize in treating adults who have concerns regarding anxiety, depression, relationships, life transitions, trauma, and women's issues.
Bradley Hack
Psychologist, PhD
Verified Verified
Cary, NC 27518
I am a Licensed Psychologist with 23 years of experience helping adolescents and adults who are struggling with anxiety, depression, self-doubt, overthinking, and dissatisfaction in their relationships. My style is down to earth and practical. I want you to have better management over your mind as quickly as possible. Our meetings can vary from developing deep emotional understanding and self-awareness, to practical coaching on how to feel your feelings without wallowing or how to manage your thoughts without fighting them. I will work collaboratively with you and I consider us co-captains on your self-improvement project.
I am a Licensed Psychologist with 23 years of experience helping adolescents and adults who are struggling with anxiety, depression, self-doubt, overthinking, and dissatisfaction in their relationships. My style is down to earth and practical. I want you to have better management over your mind as quickly as possible. Our meetings can vary from developing deep emotional understanding and self-awareness, to practical coaching on how to feel your feelings without wallowing or how to manage your thoughts without fighting them. I will work collaboratively with you and I consider us co-captains on your self-improvement project.
Tammie Ducre Moore
Psychologist, PhD, HSP-P
Verified Verified
Cary, NC 27518
Dr. Tammie Ducre' Moore is a licensed clinical psychologist & North Carolina Board Certified Health Services Provider. She is the Founder and CEO of Western Wake Counseling & Psychological Services, PLLC in Cary, NC. In her private practice, she treats individuals, couples, and families, helping them to clarify their feelings, develop goals, and to create a plan of action to achieve those goals.
Dr. Tammie Ducre' Moore is a licensed clinical psychologist & North Carolina Board Certified Health Services Provider. She is the Founder and CEO of Western Wake Counseling & Psychological Services, PLLC in Cary, NC. In her private practice, she treats individuals, couples, and families, helping them to clarify their feelings, develop goals, and to create a plan of action to achieve those goals.
Sara Monazah
Clinical Social Work/Therapist, Owner, LCSW
Verified Verified
1 Endorsed
Cary, NC 27511
Hi, I am Sara and I am so excited to meet you! The decision to seek help is a brave step and I am so proud that you are here. I know that finding a therapist that feels right can be difficult, but I am here to let you know this process does not have to feel this way. I believe everyone deserves a safe place to be seen; encouraging individuals to take a step outside of their comfort zone to grow in any direction they desire. My hope is that together we can create your safe place and through a holistic approach, help you evolve!
Hi, I am Sara and I am so excited to meet you! The decision to seek help is a brave step and I am so proud that you are here. I know that finding a therapist that feels right can be difficult, but I am here to let you know this process does not have to feel this way. I believe everyone deserves a safe place to be seen; encouraging individuals to take a step outside of their comfort zone to grow in any direction they desire. My hope is that together we can create your safe place and through a holistic approach, help you evolve!
Edla Prevette
Licensed Clinical Mental Health Counselor, LCMHC, RPT
Verified Verified
Cary, NC 27518
My primary focus is to help children, parents and adults reframe, rethink, then refresh their views, opinions, and actions. I enjoy taking research based theories and sharing the information in a pragmatic way. I believe my authentic and genuine interest in helping others is what enables my clients to "flip" their thinking and actions for positive change. With children I use various play and cognitive behavior therapies to help in navigating the academic, emotional and social stress they are faced with in today's digital world. Additionally, I work with parents to offer effective ways to parent their children for optimal success.
My primary focus is to help children, parents and adults reframe, rethink, then refresh their views, opinions, and actions. I enjoy taking research based theories and sharing the information in a pragmatic way. I believe my authentic and genuine interest in helping others is what enables my clients to "flip" their thinking and actions for positive change. With children I use various play and cognitive behavior therapies to help in navigating the academic, emotional and social stress they are faced with in today's digital world. Additionally, I work with parents to offer effective ways to parent their children for optimal success.
Rebecca King-Marks
Clinical Social Work/Therapist, LCSWA
Verified Verified
1 Endorsed
Cary, NC 27511
Greetings and a warm welcome! I am thrilled to embark on the potential journey of self-discovery, growth, and healing with you. My name is Rebecca and I am a dedicated therapist deeply committed to guiding individuals like you towards a place of inner harmony and well-being. I am dedicated to helping people navigate life's intricate tapestries of challenges and triumphs. My educational journey has been complemented by a wealth of hands-on experience working with diverse individuals, each bringing their unique stories and aspiration.My therapeutic approach is rooted in compassion, empathy, and respect.
Greetings and a warm welcome! I am thrilled to embark on the potential journey of self-discovery, growth, and healing with you. My name is Rebecca and I am a dedicated therapist deeply committed to guiding individuals like you towards a place of inner harmony and well-being. I am dedicated to helping people navigate life's intricate tapestries of challenges and triumphs. My educational journey has been complemented by a wealth of hands-on experience working with diverse individuals, each bringing their unique stories and aspiration.My therapeutic approach is rooted in compassion, empathy, and respect.
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Ariel Dale
Marriage & Family Therapist Associate, LMFTA
Verified Verified
2 Endorsed
Cary, NC 27511
I am currently accepting new clients. My approach to therapy is non judgemental, trauma-informed, and LGBTQIA+/gender affirming. I specialize in working with clients who are exploring gender or sexual identities, childhood trauma, PTSD, individuals late diagnosed with ADHD or seeking ADHD diagnosis, depression, borderline personality disorder, and anxiety. I work with children, adults and couples to support you through difficult moments, explore how the past impacts you today, strengthen your relationships, and build awareness and understanding of your emotions.
I am currently accepting new clients. My approach to therapy is non judgemental, trauma-informed, and LGBTQIA+/gender affirming. I specialize in working with clients who are exploring gender or sexual identities, childhood trauma, PTSD, individuals late diagnosed with ADHD or seeking ADHD diagnosis, depression, borderline personality disorder, and anxiety. I work with children, adults and couples to support you through difficult moments, explore how the past impacts you today, strengthen your relationships, and build awareness and understanding of your emotions.
Audrey Ahlvers
Clinical Social Work/Therapist, MSW, LCSW, M-IOP
Verified Verified
2 Endorsed
Cary, NC 27518
I am an Executive Coach specializing in Corporate Psychology. I help C-Suite Level Executives, Senior Managers, high ranking military personnel, senior government officials, elite and professional athletes, and professional artists remove their performance blocks, improve professional performance and reach their maximum potentials. I use a variety of Evidence Based methods to accomplish goals, to include Executive Coaching and EMDR for performance enhancement, and ADHD coaching. I offer services in the Triangle, and virtually. I serve individual Clients and Companies. Emotional Support Animal (hairless cat) available upon request.
I am an Executive Coach specializing in Corporate Psychology. I help C-Suite Level Executives, Senior Managers, high ranking military personnel, senior government officials, elite and professional athletes, and professional artists remove their performance blocks, improve professional performance and reach their maximum potentials. I use a variety of Evidence Based methods to accomplish goals, to include Executive Coaching and EMDR for performance enhancement, and ADHD coaching. I offer services in the Triangle, and virtually. I serve individual Clients and Companies. Emotional Support Animal (hairless cat) available upon request.
Lorna T Vanden Heuvel
Clinical Social Work/Therapist, LCSW, LCAS, CCTP
Verified Verified
1 Endorsed
Cary, NC 27511
Accepting New Clients for In-Person & Virtual sessions in Cary (off Kildaire Farm Road)! I am in-network with Aetna & BCBS. My commitment to you is that I will walk alongside you to help you determine how you can make change happen and provide you with a supportive and safe environment that allows you to explore your concerns. My approach to working with clients is multi-faceted as I pull from various theories, modalities, and tools that will best suit your circumstances. I work with individuals who are 18+ and I have a God-filled heart for working with couples who are seeking to repair their relationships.
Accepting New Clients for In-Person & Virtual sessions in Cary (off Kildaire Farm Road)! I am in-network with Aetna & BCBS. My commitment to you is that I will walk alongside you to help you determine how you can make change happen and provide you with a supportive and safe environment that allows you to explore your concerns. My approach to working with clients is multi-faceted as I pull from various theories, modalities, and tools that will best suit your circumstances. I work with individuals who are 18+ and I have a God-filled heart for working with couples who are seeking to repair their relationships.
Kevin Boyd
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Cary, NC 27513 (Online Only)
I work with creatives, professionals, and men. On New York State of Mind, Nas sings, "I never sleep, cause sleep is the cousin of death.” Maybe you too aim for excellence, work hard, and crush goals. But you haven’t found a work-life balance, or your current role is smaller than your aspirations. Or you relate to Propaganda's line “I’m not the artist I’m the canvas” and you create and inspire others through art, music, design, etc. But you are not inspired in daily life. It’s hard to translate that creative process to your personal habits, relationships, coping skills and day to day living.
I work with creatives, professionals, and men. On New York State of Mind, Nas sings, "I never sleep, cause sleep is the cousin of death.” Maybe you too aim for excellence, work hard, and crush goals. But you haven’t found a work-life balance, or your current role is smaller than your aspirations. Or you relate to Propaganda's line “I’m not the artist I’m the canvas” and you create and inspire others through art, music, design, etc. But you are not inspired in daily life. It’s hard to translate that creative process to your personal habits, relationships, coping skills and day to day living.
M. Kathleen Holmes
Psychologist, PhD
Verified Verified
Cary, NC 27511
Therapy is a powerful tool that can help you recognize perceptions and behavior patterns that may have served you at some point but that currently hold you back. It can help you harness your strengths, heal from trauma, become more fully present, develop more authentic connections, and relate to your emotions as allies instead of enemies. I offer a flexible approach to therapy, drawing from evidence-based treatments while taking into account your unique needs and preferences. I highly value the working relationship and will check in with you regularly about how therapy is going and whether you are on track with your goals.
Therapy is a powerful tool that can help you recognize perceptions and behavior patterns that may have served you at some point but that currently hold you back. It can help you harness your strengths, heal from trauma, become more fully present, develop more authentic connections, and relate to your emotions as allies instead of enemies. I offer a flexible approach to therapy, drawing from evidence-based treatments while taking into account your unique needs and preferences. I highly value the working relationship and will check in with you regularly about how therapy is going and whether you are on track with your goals.
Judith Reyes
Marriage & Family Therapist, MS, LMFT
Verified Verified
1 Endorsed
Cary, NC 27511 (Online Only)
Welcome! I understand how difficult it can be to ask for help, thus I strive to make therapy a place where my clients can feel comfortable to be themself and reach their therapy goals. I enjoy working with children 5+ who are struggling with anxiety, family issues, and self-esteem. I also enjoy working with Latinx, first generation, and queer-identified individuals who are exploring their identity and relationships. As a marriage and family therapist, I have the ideal training to help you work on your relationships and get you to a place where you and your loved ones feel heard and understood.
Welcome! I understand how difficult it can be to ask for help, thus I strive to make therapy a place where my clients can feel comfortable to be themself and reach their therapy goals. I enjoy working with children 5+ who are struggling with anxiety, family issues, and self-esteem. I also enjoy working with Latinx, first generation, and queer-identified individuals who are exploring their identity and relationships. As a marriage and family therapist, I have the ideal training to help you work on your relationships and get you to a place where you and your loved ones feel heard and understood.
Elizabeth Pugliese
Licensed Clinical Mental Health Counselor, LCMHC, LCAS, NCC
Verified Verified
3 Endorsed
Cary, NC 27511 (Online Only)
It can be exhausting to navigate life when isolated, facing one stressor after another, feeling depressed or anxious, or trying to recover from a traumatic experience. For many, these experiences interfere with day-to-day life such as our relationships, work, school, and more. For many, therapy can provide needed support. The most significant part of therapy is your relationship with your therapist, this is why I approach therapy by getting to know you as a whole person and use a collaborative approach to help empower your innate strengths.
It can be exhausting to navigate life when isolated, facing one stressor after another, feeling depressed or anxious, or trying to recover from a traumatic experience. For many, these experiences interfere with day-to-day life such as our relationships, work, school, and more. For many, therapy can provide needed support. The most significant part of therapy is your relationship with your therapist, this is why I approach therapy by getting to know you as a whole person and use a collaborative approach to help empower your innate strengths.
Alan Nahle
Clinical Social Work/Therapist, MSW, LCSWA
Verified Verified
1 Endorsed
Cary, NC 27511 (Online Only)
Not accepting new clients
Do you feel like your life is not where you want it to be and find it difficult to enjoy to the fullest? Have you been having difficulties managing symptoms of Depression or Anxiety in the form of difficulty sleeping, lack of socialization, negative/low moods, feelings of hopelessness, suicidal ideation, poor appetite, quickness to frustration, and difficulty concentrating? If you would like support and resources to help you take more control over your life, I encourage you to reach out to me so we can start the process to getting you to where you want to be.
Do you feel like your life is not where you want it to be and find it difficult to enjoy to the fullest? Have you been having difficulties managing symptoms of Depression or Anxiety in the form of difficulty sleeping, lack of socialization, negative/low moods, feelings of hopelessness, suicidal ideation, poor appetite, quickness to frustration, and difficulty concentrating? If you would like support and resources to help you take more control over your life, I encourage you to reach out to me so we can start the process to getting you to where you want to be.
J Michael Goulding
Clinical Social Work/Therapist, LCSW, CHWC
Verified Verified
Cary, NC 27511 (Online Only)
If you are feeling resistant, frustrated, or uncertain about what next steps to take to feel better, then I can help you get started in an experienced, judge-free, comfortable setting. If anger, anxiety, depression, OCD, ADHD, traumatic events, oppositional children, interpersonal conflicts, workplace issues, or bullying is getting in your way of happiness, I can guide you to overcome these challenges. I also help people who are satisfied with their current situation but would like to enhance skills and live at their fullest potential. I look forward to you contacting me at www.meaningfultransformation.com/mike
If you are feeling resistant, frustrated, or uncertain about what next steps to take to feel better, then I can help you get started in an experienced, judge-free, comfortable setting. If anger, anxiety, depression, OCD, ADHD, traumatic events, oppositional children, interpersonal conflicts, workplace issues, or bullying is getting in your way of happiness, I can guide you to overcome these challenges. I also help people who are satisfied with their current situation but would like to enhance skills and live at their fullest potential. I look forward to you contacting me at www.meaningfultransformation.com/mike
See more therapy options for Cary
How does your Therapist compare?
Number of Therapists in Cary, NC
900+
Average cost per session
$140
Therapists in Cary, NC who prioritize treating:
92% | Anxiety |
87% | Depression |
78% | Self Esteem |
77% | Relationship Issues |
72% | Coping Skills |
69% | Stress |
63% | Life Transitions |
Average years in practice
11 Years
Top 3 insurances accepted
83% | BlueCross and BlueShield |
73% | Aetna |
54% | Cigna and Evernorth |
How Therapists in Cary, NC see their clients
70% | In Person and Online | |
30% | Online Only |
Gender breakdown
83% | Female | |
16% | Male | |
1% | Non-Binary |
FAQs - About Therapy and Counseling
How can I find a therapist in Cary?
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.