Therapists in Steamboat Springs, CO

Photo of Rebecca Nowosielski, Marriage & Family Therapist in Steamboat Springs, CO
Rebecca Nowosielski
Marriage & Family Therapist, MA, LMFT, EMDR
Verified Verified
4 Endorsed
Steamboat Springs, CO 80487
I am proud to offer Couples & Individual therapy that helps each client generate insight into what is working, what is not working, and how to collaboratively work towards your goals for change. I use an integrated and collaborative therapy approach that highlights exploration, introspection, insight, healing, and growth.
I am proud to offer Couples & Individual therapy that helps each client generate insight into what is working, what is not working, and how to collaboratively work towards your goals for change. I use an integrated and collaborative therapy approach that highlights exploration, introspection, insight, healing, and growth.
(720) 571-7303 View (720) 571-7303
Photo of Heidi Berend, Licensed Professional Counselor in Steamboat Springs, CO
Heidi Berend
Licensed Professional Counselor, MA
Verified Verified
1 Endorsed
Steamboat Springs, CO 80477
I specialize in building healthy relationships with your partner, children and family members. In life we develop negative coping skills in our family of origin that protect us in our youth but do not support us in forming healthy relationships in our present and future. I believe we can break these negative cycles through a combination of healing our past, increased awareness of our negative patterns and gaining tools to change these behaviors. I specifically work with adult children of alcoholics & addicts and family members currently faced with these challenges. I offer support, hope and empowerment during an extremely unmanageable time.
I specialize in building healthy relationships with your partner, children and family members. In life we develop negative coping skills in our family of origin that protect us in our youth but do not support us in forming healthy relationships in our present and future. I believe we can break these negative cycles through a combination of healing our past, increased awareness of our negative patterns and gaining tools to change these behaviors. I specifically work with adult children of alcoholics & addicts and family members currently faced with these challenges. I offer support, hope and empowerment during an extremely unmanageable time.
(970) 296-8208 View (970) 296-8208
Photo of Dr. Laurie Crider, Psychologist in Steamboat Springs, CO
Dr. Laurie Crider
Psychologist, PsyD
Verified Verified
Steamboat Springs, CO 80487
Do you want to feel better? Are you interested in gaining insight into why you feel the way you do and open to trying new behaviors that lead to a greater sense of well being and inner peace? My treatment approach involves providing a safe, nonjudgemental environment while taking an in-depth life history in order to arrive at a greater understanding of what is currently causing your problems and relational patterns. How we move forward is individualized based on your treatment goals and history. Having over 25 years of clinical experience helps me get to the root of your problems quickly.
Do you want to feel better? Are you interested in gaining insight into why you feel the way you do and open to trying new behaviors that lead to a greater sense of well being and inner peace? My treatment approach involves providing a safe, nonjudgemental environment while taking an in-depth life history in order to arrive at a greater understanding of what is currently causing your problems and relational patterns. How we move forward is individualized based on your treatment goals and history. Having over 25 years of clinical experience helps me get to the root of your problems quickly.
(970) 875-4755 View (970) 875-4755
Photo of Brooke Lightner, Clinical Social Work/Therapist in Steamboat Springs, CO
Brooke Lightner
Clinical Social Work/Therapist, CSW
Verified Verified
Steamboat Springs, CO 80487
I am a licensed clinical social worker and a certified Synergetic Play Therapist. I serve youth and families, providing individual play therapy and family therapy in my private practice in Steamboat Springs. I see clients ages 5 to mid twenties primarily. I have been working in a youth serving capacity for 25 years and as a therapist since 2015. I welcome the opportunity to support your child and your family.
I am a licensed clinical social worker and a certified Synergetic Play Therapist. I serve youth and families, providing individual play therapy and family therapy in my private practice in Steamboat Springs. I see clients ages 5 to mid twenties primarily. I have been working in a youth serving capacity for 25 years and as a therapist since 2015. I welcome the opportunity to support your child and your family.
(970) 341-2163 View (970) 341-2163
Photo of Olivia Rose, Counselor in Steamboat Springs, CO
Olivia Rose
Counselor, MA, LPCC
Verified Verified
Steamboat Springs, CO 80487
I understand that every individual’s journey is unique, and I tailor my therapeutic approach to meet your specific needs. Whether you're navigating anxiety, depression, chronic pain or seeking to improve your mental health, I provide a supportive and empowering space for you to explore, heal, and thrive.
I understand that every individual’s journey is unique, and I tailor my therapeutic approach to meet your specific needs. Whether you're navigating anxiety, depression, chronic pain or seeking to improve your mental health, I provide a supportive and empowering space for you to explore, heal, and thrive.
(970) 761-2249 View (970) 761-2249
Photo of Dr. Nicole McGuffin Psyd, Licensed Professional Counselor in Steamboat Springs, CO
Dr. Nicole McGuffin Psyd
Licensed Professional Counselor, PsyD, LPC, BCN
Verified Verified
Steamboat Springs, CO 80487
Hey there, I absolutely love partnering with couples and helping them nurture a relationship that's full of love and security. Thanks to my training in PACT and years of experience, I have a keen understanding of the unique dynamics & needs of each relationship. Whether you're dealing with communication hurdles, bouts of anger, intimacy, considering divorce, or anything else, I'm here for you. My goal? To deepen your bond and teach positive conflict resolution. Tying the knot? I offer premarital counseling for a solid relationship foundation. Remember, navigating love's beautiful, yet complex journey doesn't have to be solo.
Hey there, I absolutely love partnering with couples and helping them nurture a relationship that's full of love and security. Thanks to my training in PACT and years of experience, I have a keen understanding of the unique dynamics & needs of each relationship. Whether you're dealing with communication hurdles, bouts of anger, intimacy, considering divorce, or anything else, I'm here for you. My goal? To deepen your bond and teach positive conflict resolution. Tying the knot? I offer premarital counseling for a solid relationship foundation. Remember, navigating love's beautiful, yet complex journey doesn't have to be solo.
(720) 735-0013 View (720) 735-0013
Photo of Alex Osias, Clinical Social Work/Therapist in Steamboat Springs, CO
Alex Osias
Clinical Social Work/Therapist, MSW, LCSW, MFTC
Verified Verified
1 Endorsed
Steamboat Springs, CO 80487  (Online Only)
I believe in the power of a therapeutic relationship built on trust, empathy, and respect. My integrative approach combines EMDR, EFT, and IFS to create a customized treatment plan that addresses your unique needs and goals. Together, we will navigate your journey towards healing, self-discovery, and personal growth.
I believe in the power of a therapeutic relationship built on trust, empathy, and respect. My integrative approach combines EMDR, EFT, and IFS to create a customized treatment plan that addresses your unique needs and goals. Together, we will navigate your journey towards healing, self-discovery, and personal growth.
(970) 323-2567 View (970) 323-2567
Photo of Spiritual/Intuitive Counseling - Dr. Nancy Harris in Steamboat Springs, CO
Spiritual/Intuitive Counseling - Dr. Nancy Harris
MSS, DSS, NLP-Cer
Verified Verified
Steamboat Springs, CO 80487
Looking for a spiritual/intuitive approach to resolving your everyday issues? Wondering what is wrong with you that your Soul Mate has never showed up or your relationship(s) is not working? Feel as though you don't fit in anywhere? Want the answers to "Why do I feel so sensitive, weird, and different?" Want to Discover your Spiritual Life Purpose, plus Release and Re-program your past issues, traumas, and experiences (even past lives) that block you from connecting to your "True Self", God/Source and others? Quickly and easily transform your issues using Energy Psychology and Intuitve Counseling. For Adults/Couples - especially Highly Sensitive and Intuitive People.
Looking for a spiritual/intuitive approach to resolving your everyday issues? Wondering what is wrong with you that your Soul Mate has never showed up or your relationship(s) is not working? Feel as though you don't fit in anywhere? Want the answers to "Why do I feel so sensitive, weird, and different?" Want to Discover your Spiritual Life Purpose, plus Release and Re-program your past issues, traumas, and experiences (even past lives) that block you from connecting to your "True Self", God/Source and others? Quickly and easily transform your issues using Energy Psychology and Intuitve Counseling. For Adults/Couples - especially Highly Sensitive and Intuitive People.
(720) 316-7058 View (720) 316-7058
Photo of Jill N Rubinstein, Registered Psychotherapist in Steamboat Springs, CO
Jill N Rubinstein
Registered Psychotherapist, EdD, CAT
Verified Verified
Steamboat Springs, CO 80487
Many of us have experienced talk therapy where we discuss our problems and past. Unfortunately, sometimes this therapy hasn't included concrete ways to help us change how we manage these problems and create a life of joy. The good news is that there ARE skills and tools that every one of us can learn and integrate into our lives so that we are able to better navigate what the world throws at us! Anxiety, depression, overwhelm, perfectionism, addiction, relationship difficulties, and more can be addressed by learning how to regulate emotion, better tolerate distress, and live mindfully. Join Dr. Jill in learning these skills.
Many of us have experienced talk therapy where we discuss our problems and past. Unfortunately, sometimes this therapy hasn't included concrete ways to help us change how we manage these problems and create a life of joy. The good news is that there ARE skills and tools that every one of us can learn and integrate into our lives so that we are able to better navigate what the world throws at us! Anxiety, depression, overwhelm, perfectionism, addiction, relationship difficulties, and more can be addressed by learning how to regulate emotion, better tolerate distress, and live mindfully. Join Dr. Jill in learning these skills.
(970) 440-2736 View (970) 440-2736
Barbara Philip
Clinical Social Work/Therapist, LCSW
Verified Verified
Steamboat Springs, CO 80477
Not accepting new clients
I love my work as a psychotherapist. I feel humbled and honored to have had the opportunity to help many individuals and couples make the life changes they have desired in my career of 34 years. My clients have sought help from me for issues such as depression, anxiety, relationship problems, past trauma which is still affecting them, divorce, illness, death, etc. I use a variety of therapy techniques to help my clients achieve their goals and learn tools that they can continue to use after therapy is completed.
I love my work as a psychotherapist. I feel humbled and honored to have had the opportunity to help many individuals and couples make the life changes they have desired in my career of 34 years. My clients have sought help from me for issues such as depression, anxiety, relationship problems, past trauma which is still affecting them, divorce, illness, death, etc. I use a variety of therapy techniques to help my clients achieve their goals and learn tools that they can continue to use after therapy is completed.
(970) 368-4555 x5 View (970) 368-4555 x5
Photo of Meggan McBride Garwood, Clinical Social Work/Therapist in Steamboat Springs, CO
Meggan McBride Garwood
Clinical Social Work/Therapist, BSW, MSW, LCSW
Verified Verified
1 Endorsed
Steamboat Springs, CO 80487
I have treated a wide variety of presenting concerns. Areas of clinical interest: pregnant/ new moms, healing generational trauma ,nervous system regulation, career wellness, quarter life crisis, recovery coaching, family estrangement, positive psychology, pre-marital counseling, anxiety, lessening the impact of divorce on children, recovering professionals and families, menopause, intuitive wellness, developmental trauma, & intersection of spirituality and psychology. I believe we were all put on this beautiful planet to do things only we were meant to do. Working on “clinical soul care” helps us connect to purposeful living.
I have treated a wide variety of presenting concerns. Areas of clinical interest: pregnant/ new moms, healing generational trauma ,nervous system regulation, career wellness, quarter life crisis, recovery coaching, family estrangement, positive psychology, pre-marital counseling, anxiety, lessening the impact of divorce on children, recovering professionals and families, menopause, intuitive wellness, developmental trauma, & intersection of spirituality and psychology. I believe we were all put on this beautiful planet to do things only we were meant to do. Working on “clinical soul care” helps us connect to purposeful living.
(970) 538-9891 View (970) 538-9891
Photo of Foundry Outpatient Colorado in Steamboat Springs, CO
Foundry Outpatient Colorado
MA, LPC, NCC
Not Verified Not Verified
Steamboat Springs, CO 80487
Foundry Treatment Center Steamboat provides comprehensive, trauma-integrated residential and intensive outpatient treatment for adults and families experiencing substance use and mental health disorders. Foundry Steamboat provides men’s residential treatment in Steamboat Springs, Colorado, and virtual intensive outpatient treatment for women and men throughout the state.
Foundry Treatment Center Steamboat provides comprehensive, trauma-integrated residential and intensive outpatient treatment for adults and families experiencing substance use and mental health disorders. Foundry Steamboat provides men’s residential treatment in Steamboat Springs, Colorado, and virtual intensive outpatient treatment for women and men throughout the state.
(970) 251-1764 View (970) 251-1764
Photo of Tina Harlow, Clinical Social Work/Therapist in Steamboat Springs, CO
Tina Harlow
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Steamboat Springs, CO 80487
Not accepting new clients
There are children in this world who experience life with great intensity, complexity and depth. They are highly intuitive, anxious, sensitive and have a strong sense of justice. Some of them are identified as gifted through the education system. When the inner world of these children collides with the realities of our external world, it often creates a firestorm of thoughts, emotions and behaviors that can be very difficult to manage. They are in need of guidance to gain a better understanding of their experiences and learn how to harness them for growth.
There are children in this world who experience life with great intensity, complexity and depth. They are highly intuitive, anxious, sensitive and have a strong sense of justice. Some of them are identified as gifted through the education system. When the inner world of these children collides with the realities of our external world, it often creates a firestorm of thoughts, emotions and behaviors that can be very difficult to manage. They are in need of guidance to gain a better understanding of their experiences and learn how to harness them for growth.
(970) 406-7770 View (970) 406-7770
Photo of Natalie Gavic, Marriage & Family Therapist in Steamboat Springs, CO
Natalie Gavic
Marriage & Family Therapist, MS, LMFT
Verified Verified
2 Endorsed
Steamboat Springs, CO 80487
Are there common themes or patterns coming up in your life that aren’t shifting? Are you hoping to find more meaning or connection in life? In my 12 years of experience I offer knowledge, strategies, and ways to gain awareness and change. The environment I provide to my clients is one with honesty, openness, safety, and compassion. Therapy with me is a place to become curious and more aware about yourself and your relationships in order to shift the patterns that exist.
Are there common themes or patterns coming up in your life that aren’t shifting? Are you hoping to find more meaning or connection in life? In my 12 years of experience I offer knowledge, strategies, and ways to gain awareness and change. The environment I provide to my clients is one with honesty, openness, safety, and compassion. Therapy with me is a place to become curious and more aware about yourself and your relationships in order to shift the patterns that exist.
(970) 436-9840 View (970) 436-9840
Photo of Amanda Bushek, Licensed Professional Counselor in Steamboat Springs, CO
Amanda Bushek
Licensed Professional Counselor, LAC
Verified Verified
Steamboat Springs, CO 80487  (Online Only)
Amanda Bushek (she, her), LPC, LAC, MAC resides in Steamboat Springs, Colorado. She works in direct service, supervision, team building, training, consulting, strategy, management, and leadership development. Amanda is an excellent therapist and will partner with you every step of the way. Amanda is known for her experience, effectiveness, and genuine approach.
Amanda Bushek (she, her), LPC, LAC, MAC resides in Steamboat Springs, Colorado. She works in direct service, supervision, team building, training, consulting, strategy, management, and leadership development. Amanda is an excellent therapist and will partner with you every step of the way. Amanda is known for her experience, effectiveness, and genuine approach.
(970) 414-4149 View (970) 414-4149
Photo of Craig Thornhill, Licensed Professional Counselor in Steamboat Springs, CO
Craig Thornhill
Licensed Professional Counselor, LPC, LAC
Verified Verified
Steamboat Springs, CO 80487
Clients who experience dual diagnoses with mental health and addiction concerns are who I specialize in. Adults and adolescents (16 years or older) who struggle with mood disorder, anxiety, prior adverse trauma and/or addiction can find treatment here. Treatment goals are individualized according to a client's needs and are formed collaboratively. You can find more detailed information at https://www.thornhillcounseling.com/.
Clients who experience dual diagnoses with mental health and addiction concerns are who I specialize in. Adults and adolescents (16 years or older) who struggle with mood disorder, anxiety, prior adverse trauma and/or addiction can find treatment here. Treatment goals are individualized according to a client's needs and are formed collaboratively. You can find more detailed information at https://www.thornhillcounseling.com/.
(970) 875-6449 x7 View (970) 875-6449 x7
Photo of Zak Conway, Licensed Professional Counselor in Steamboat Springs, CO
Zak Conway
Licensed Professional Counselor, LPC, LAC
Verified Verified
Steamboat Springs, CO 80487
I have been licensed as a therapist since 2013. Originally from Wisconsin I have lived in Steamboat Springs, Colorado since 2017. I focus primarily in treating addictions, anxiety, depression, OCD, sleep issues, sports performance improvement and trauma (PTSD). When people seek out a therapist they often fall into two categories. The first being those who are seeking therapy for the first time. The second are people who have been in therapy before who are seeking a therapist who can help them heal permanently from whatever issue they are dealing with. That is my goal, to help people heal permanently and move forward in their lives.
I have been licensed as a therapist since 2013. Originally from Wisconsin I have lived in Steamboat Springs, Colorado since 2017. I focus primarily in treating addictions, anxiety, depression, OCD, sleep issues, sports performance improvement and trauma (PTSD). When people seek out a therapist they often fall into two categories. The first being those who are seeking therapy for the first time. The second are people who have been in therapy before who are seeking a therapist who can help them heal permanently from whatever issue they are dealing with. That is my goal, to help people heal permanently and move forward in their lives.
(970) 514-6312 View (970) 514-6312
Photo of Colleen Clark Lay, Clinical Social Work/Therapist in Steamboat Springs, CO
Colleen Clark Lay
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Steamboat Springs, CO 80487
The decision to seek counseling is a life altering one. It is a commitment of time, energy and money. Therefore, finding a counselor that you can make a connection with is very important. With 19+ years of experience, my unique approach to individual counseling is to treat the whole person. A healthy self is made up of physical, emotional and spiritual components. All of which need nurturing to feel happy and fulfilled. My approach to couples counseling is to treat each of the components of the relationship. The you, the partner, the relationship. In that process, my role is to be on the side of the relationship.
The decision to seek counseling is a life altering one. It is a commitment of time, energy and money. Therefore, finding a counselor that you can make a connection with is very important. With 19+ years of experience, my unique approach to individual counseling is to treat the whole person. A healthy self is made up of physical, emotional and spiritual components. All of which need nurturing to feel happy and fulfilled. My approach to couples counseling is to treat each of the components of the relationship. The you, the partner, the relationship. In that process, my role is to be on the side of the relationship.
(970) 875-6605 View (970) 875-6605
Photo of William Hambleton Bishop, Counselor in Steamboat Springs, CO
William Hambleton Bishop
Counselor, MA, LPC, LMFT
Verified Verified
3 Endorsed
Steamboat Springs, CO 80487  (Online Only)
I work primarily with high-functioning motivated clients who benefit from a more intellectual/philosophical intervention style. We will strengthen your ability to stay conscious and intentional while we observe your fears and habits, develop your relational skills, build on your emotional intelligence and resilience, increase your ability to feel regulated and present, and identify your core self so that you can feel congruent with a sense of purpose and a set of values. My process is attuned, artistic, playful, spiritual, and kind while also being intentional, philosophical, direct, strategic, and insightful.
I work primarily with high-functioning motivated clients who benefit from a more intellectual/philosophical intervention style. We will strengthen your ability to stay conscious and intentional while we observe your fears and habits, develop your relational skills, build on your emotional intelligence and resilience, increase your ability to feel regulated and present, and identify your core self so that you can feel congruent with a sense of purpose and a set of values. My process is attuned, artistic, playful, spiritual, and kind while also being intentional, philosophical, direct, strategic, and insightful.
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Photo of Brian Yoder, Licensed Professional Counselor in Steamboat Springs, CO
Brian Yoder
Licensed Professional Counselor, LPC
Verified Verified
Steamboat Springs, CO 80487  (Online Only)
I specialize in working with adults as well as mid-late teens (15+) who are experiencing anxiety, depression, stress, relationship distress, working through life transitions and trauma (PTSD). I believe that as human beings, we ALL will have times in our lives where we can use someone to help us do "the work" that can help us live more fulfilling lives.
I specialize in working with adults as well as mid-late teens (15+) who are experiencing anxiety, depression, stress, relationship distress, working through life transitions and trauma (PTSD). I believe that as human beings, we ALL will have times in our lives where we can use someone to help us do "the work" that can help us live more fulfilling lives.
(970) 514-5961 View (970) 514-5961

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Number of Therapists in Steamboat Springs, CO

50+

Average cost per session

$140

Therapists in Steamboat Springs, CO who prioritize treating:

88% Anxiety
79% Depression
77% Trauma and PTSD
70% Stress
68% Life Transitions
61% Relationship Issues
60% Self Esteem

Average years in practice

13 Years

Top 3 insurances accepted

68% Aetna
68% UnitedHealthcare UHC | UBH
65% Cigna and Evernorth

How Therapists in Steamboat Springs, CO see their clients

60% In Person and Online
40% Online Only

Gender breakdown

79% Female
21% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Steamboat Springs?

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.