Therapists in Richmond, VA

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Photo of Dr. Abigail Conley, Resident in Counseling in Richmond, VA
Dr. Abigail Conley
Resident in Counseling, PhD, NCC
Verified Verified
Richmond, VA 23221  (Online Only)
Do you feel stressed out and overwhelmed balancing parenthood with your career and relationships? Do you wake up exhausted and dreading the day? If you’re struggling to balance life’s demands and be at your best, now is a good time to connect with an experienced therapist who can help. Now more than ever parents are feeling overwhelmed and uncertain on how to juggle their kids, spouses, careers, and their own well-being. Prioritizing others first while putting your own needs last can work a little, but leads to longer-term issues like burnout, depression, and chronic stress. You don't want to burden your friends and family either.
Do you feel stressed out and overwhelmed balancing parenthood with your career and relationships? Do you wake up exhausted and dreading the day? If you’re struggling to balance life’s demands and be at your best, now is a good time to connect with an experienced therapist who can help. Now more than ever parents are feeling overwhelmed and uncertain on how to juggle their kids, spouses, careers, and their own well-being. Prioritizing others first while putting your own needs last can work a little, but leads to longer-term issues like burnout, depression, and chronic stress. You don't want to burden your friends and family either.
(804) 578-7569 View (804) 578-7569
Photo of Kat Grace, Licensed Professional Counselor in Richmond, VA
Kat Grace
Licensed Professional Counselor, LPC, MA, EdS
Verified Verified
1 Endorsed
Richmond, VA 23220
Waitlist for new clients
We all have our own struggles. Maybe you’re not feeling like yourself lately or can’t seem to keep up with your days. Perhaps your emotions often get the best of you or you're having a hard time connecting with others. You’re stressed, tired, and just want to feel better. I’m here for you. In therapy, you will learn how to manage your mood, develop greater awareness, lean into self-acceptance, overcome trauma, and build more fulfilling relationships. You’ll find a safe, nurturing space where you can be authentically you and heal on your own terms, as we collaborate to create a therapeutic experience that best fits your unique needs.
We all have our own struggles. Maybe you’re not feeling like yourself lately or can’t seem to keep up with your days. Perhaps your emotions often get the best of you or you're having a hard time connecting with others. You’re stressed, tired, and just want to feel better. I’m here for you. In therapy, you will learn how to manage your mood, develop greater awareness, lean into self-acceptance, overcome trauma, and build more fulfilling relationships. You’ll find a safe, nurturing space where you can be authentically you and heal on your own terms, as we collaborate to create a therapeutic experience that best fits your unique needs.
(804) 979-2941 View (804) 979-2941
Photo of Andrew Larsen, Pre-Licensed Professional in Richmond, VA
Andrew Larsen
Pre-Licensed Professional, MS, LPSC, LPC-R
Verified Verified
1 Endorsed
Richmond, VA 23219
Andrew is a dedicated counseling resident specializing in supporting individuals grappling with depression, anxiety, and a spectrum of mental health challenges. While currently serving as a full-time middle school counselor, Andrew is actively transitioning into a professional counseling role, with a focused commitment to providing tailored, evidence-based therapy. In his practice, Andrew adeptly combines Cognitive Behavioral Therapy (CBT) and solution-focused techniques to fa cilitate transformative therapeutic experiences. By leveraging these approaches, Andrew creates a nurturing space for clients to explore their inner workings.
Andrew is a dedicated counseling resident specializing in supporting individuals grappling with depression, anxiety, and a spectrum of mental health challenges. While currently serving as a full-time middle school counselor, Andrew is actively transitioning into a professional counseling role, with a focused commitment to providing tailored, evidence-based therapy. In his practice, Andrew adeptly combines Cognitive Behavioral Therapy (CBT) and solution-focused techniques to fa cilitate transformative therapeutic experiences. By leveraging these approaches, Andrew creates a nurturing space for clients to explore their inner workings.
(804) 372-7523 View (804) 372-7523
Photo of Jessica Hodges, Licensed Professional Counselor in Richmond, VA
Jessica Hodges
Licensed Professional Counselor, LPC
Verified Verified
Richmond, VA 23234
My name is Jessica Hodges. I am a Licensed Professional Counselor as well as a Certified Substance Abuse counselor in the state of Virginia. I practice from a person-centered modality while working with my clients to develop treatment goals. I specialize in addiction, anxiety, and emotional regulation. I am most comfortable in treating clients aged 18 and older. I believe that as long as my clients aim for improved mental health, we can work together to achieve that! I believe in open and honest communication with my clients. Full transparency with professional boundaries is essential in encouraging change.
My name is Jessica Hodges. I am a Licensed Professional Counselor as well as a Certified Substance Abuse counselor in the state of Virginia. I practice from a person-centered modality while working with my clients to develop treatment goals. I specialize in addiction, anxiety, and emotional regulation. I am most comfortable in treating clients aged 18 and older. I believe that as long as my clients aim for improved mental health, we can work together to achieve that! I believe in open and honest communication with my clients. Full transparency with professional boundaries is essential in encouraging change.
(804) 589-4095 View (804) 589-4095
Photo of Nazarell Williams, Licensed Professional Counselor in Richmond, VA
Nazarell Williams
Licensed Professional Counselor, LPC, CCTP
Verified Verified
Richmond, VA 23223
I am passionate about helping people. I enjoy seeing growth, change, and seeing my patients identify hidden potentials. I enjoy seeing my patients being comfortable to express themselves during sessions.
I am passionate about helping people. I enjoy seeing growth, change, and seeing my patients identify hidden potentials. I enjoy seeing my patients being comfortable to express themselves during sessions.
(804) 409-2462 View (804) 409-2462
Photo of Milo S Wilson, Psychologist in Richmond, VA
Milo S Wilson
Psychologist, PhD
Verified Verified
Richmond, VA 23219
As a psychologist there is nothing I love more than helping people who are ready to learn new ways of coping to make meaningful changes in their lives! I have three areas of expertise. I provide private, specialized, and personalized Cognitive-Behavioral and Mindfulness-Based therapies for anxiety and depression. I am passionate about working with LGBTQ+ adults in therapy to create an affirming, therapeutic space for working on LGBTQ+ specific or general mental health concerns, such as anxiety or depression. I love helping transgender adults develop a healthy, positive identity as a trans person and navigate transition.
As a psychologist there is nothing I love more than helping people who are ready to learn new ways of coping to make meaningful changes in their lives! I have three areas of expertise. I provide private, specialized, and personalized Cognitive-Behavioral and Mindfulness-Based therapies for anxiety and depression. I am passionate about working with LGBTQ+ adults in therapy to create an affirming, therapeutic space for working on LGBTQ+ specific or general mental health concerns, such as anxiety or depression. I love helping transgender adults develop a healthy, positive identity as a trans person and navigate transition.
(804) 207-5477 View (804) 207-5477
Photo of Alyssa Shank, Licensed Professional Counselor in Richmond, VA
Alyssa Shank
Licensed Professional Counselor, LPCS, CCTPII
Verified Verified
Richmond, VA 23225  (Online Only)
Does life seem confusing or even impossible? Does it ever feel like even when you are with others you feel alone? It is brave to ask for help. With every fiber of my being, I believe you have the answers you need and you can be the expert on you. Let me help you better understand your story and help guide you out of the dark places you are stuck in and into your truth. So much of the time we are living a narrative that others have crafted, by pain rather than strength. These narratives can feel like prisons but you have the ability to heal and take back your story.
Does life seem confusing or even impossible? Does it ever feel like even when you are with others you feel alone? It is brave to ask for help. With every fiber of my being, I believe you have the answers you need and you can be the expert on you. Let me help you better understand your story and help guide you out of the dark places you are stuck in and into your truth. So much of the time we are living a narrative that others have crafted, by pain rather than strength. These narratives can feel like prisons but you have the ability to heal and take back your story.
(361) 304-3908 View (361) 304-3908
Photo of Naharia Holt-Elliot, Licensed Professional Counselor in Richmond, VA
Naharia Holt-Elliot
Licensed Professional Counselor, PhD, LPC, ACS, NCC
Verified Verified
Richmond, VA 23223  (Online Only)
Dr. Naharia Holt-Elliott is a Licensed Professional Counselor, Certified Substance Abuse Counselor, Nationally Certified Counselor, and Approved Clinical Supervisor (LPC, CSAC, NCC, ACS) in the state of Virginia with more than 10 years of experience. She is also a mother and Army veteran who specializes in helping adult clients and families that are having difficulties managing stress and anxiety, struggling with coping skills, anxiety, depression, sexual abuse, combat, substance abuse, family and relational issues.
Dr. Naharia Holt-Elliott is a Licensed Professional Counselor, Certified Substance Abuse Counselor, Nationally Certified Counselor, and Approved Clinical Supervisor (LPC, CSAC, NCC, ACS) in the state of Virginia with more than 10 years of experience. She is also a mother and Army veteran who specializes in helping adult clients and families that are having difficulties managing stress and anxiety, struggling with coping skills, anxiety, depression, sexual abuse, combat, substance abuse, family and relational issues.
(804) 331-1168 View (804) 331-1168
Photo of Megan Chenoweth, Pre-Licensed Professional in Richmond, VA
Megan Chenoweth
Pre-Licensed Professional, MSW
Verified Verified
1 Endorsed
Richmond, VA 23226
Anxiety, depression, trauma, addiction, and other mental health struggles can at times prevent us from living the life we deserve. I believe by working in collaboration with clients, we can create a plan of care catered to your specific needs. I aim to teach clients how to become more self-aware and explore their thoughts, feelings, goals, and dreams to find what’s important to them—allowing for growth, healing, and a higher quality of life.
Anxiety, depression, trauma, addiction, and other mental health struggles can at times prevent us from living the life we deserve. I believe by working in collaboration with clients, we can create a plan of care catered to your specific needs. I aim to teach clients how to become more self-aware and explore their thoughts, feelings, goals, and dreams to find what’s important to them—allowing for growth, healing, and a higher quality of life.
(804) 494-5774 View (804) 494-5774
Photo of Michelle Gorden, Licensed Professional Counselor in Richmond, VA
Michelle Gorden
Licensed Professional Counselor, LPC
Verified Verified
Richmond, VA 23234
Hi, I'm Michelle Gorden, a Licensed Professional Counselor (LPC) in Virginia and a Nationally Certified Counselor (NCC). I specialize in treating mood disorders, trauma, and PTSD. My background is diverse and supports my ability to help my clients reach their highest potential. I strive to work collaboratively with each client in a non-judgmental space to improve overall happiness and well-being. Counseling can help you with many stressors in life such as anxiety, depression, grief, eating disorders, family conflict, and self-exploration.
Hi, I'm Michelle Gorden, a Licensed Professional Counselor (LPC) in Virginia and a Nationally Certified Counselor (NCC). I specialize in treating mood disorders, trauma, and PTSD. My background is diverse and supports my ability to help my clients reach their highest potential. I strive to work collaboratively with each client in a non-judgmental space to improve overall happiness and well-being. Counseling can help you with many stressors in life such as anxiety, depression, grief, eating disorders, family conflict, and self-exploration.
(804) 429-1007 View (804) 429-1007
Latoya Renea Smith
Licensed Professional Counselor
Verified Verified
Richmond, VA 23220
Renea Smith is a Resident in Counseling (RIC) with over a year of supervised clinical counseling experience, working with seniors, adults, adolescents, families, and couples in private practice settings. Renea also has over 14 years of experience in school counseling. Having grown up in a multi-generational home during her adolescent years and having served both the comprehensive and exceptional education school settings, she has a deep-rooted admiration and respect for the older population, parents, educators, caregivers of children with unique needs and abilities.
Renea Smith is a Resident in Counseling (RIC) with over a year of supervised clinical counseling experience, working with seniors, adults, adolescents, families, and couples in private practice settings. Renea also has over 14 years of experience in school counseling. Having grown up in a multi-generational home during her adolescent years and having served both the comprehensive and exceptional education school settings, she has a deep-rooted admiration and respect for the older population, parents, educators, caregivers of children with unique needs and abilities.
(804) 575-5607 View (804) 575-5607
Photo of Dr. Bryan R Boyles in Richmond, VA
Dr. Bryan R Boyles
MSW, PhD
Verified Verified
Richmond, VA 23220
Doesn't it make sense to talk with someone who has actually experienced what you are going through? Someone who understands drinking and/or substance use can both cause problems AND provide much needed relief. I have been where you are, or somewhere close, and together we can find a way out. My ability to help is grounded in 10 years of active addiction, followed by 27 years of continuous recovery and 14 years of academic training (MSW, PhD). I understand the science, and I know the suffering. I work with others who have suffered, their families and loved ones.
Doesn't it make sense to talk with someone who has actually experienced what you are going through? Someone who understands drinking and/or substance use can both cause problems AND provide much needed relief. I have been where you are, or somewhere close, and together we can find a way out. My ability to help is grounded in 10 years of active addiction, followed by 27 years of continuous recovery and 14 years of academic training (MSW, PhD). I understand the science, and I know the suffering. I work with others who have suffered, their families and loved ones.
(804) 432-1474 View (804) 432-1474
Photo of Jennifer Ann Huffman, Clinical Social Work/Therapist in Richmond, VA
Jennifer Ann Huffman
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Richmond, VA 23220  (Online Only)
Not accepting new clients
Congratulations on taking the first step to heal, grow and make a difference in your life. I truly believe there is hope for every client who is willing to learn and make changes. Every individual, couple and family are different, so I will customize a therapeutic plan specifically to your needs and concerns.
Congratulations on taking the first step to heal, grow and make a difference in your life. I truly believe there is hope for every client who is willing to learn and make changes. Every individual, couple and family are different, so I will customize a therapeutic plan specifically to your needs and concerns.
(804) 480-4833 View (804) 480-4833
Photo of Vanity Lane, Counselor in Richmond, VA
Vanity Lane
Counselor, LPC
Verified Verified
Richmond, VA 23225  (Online Only)
Greetings. Whatever led you to this site, this profile, in this moment. Welcome! Life can be complicated, overwhelming, and flat out hard. However, it CAN also be purposeful, rewarding, and fulfilling. Whatever you may have encountered on your journey this far and whatever your needs may be in this moment that led you here, I'm honored to provide a safe space for you to explore and work through it.
Greetings. Whatever led you to this site, this profile, in this moment. Welcome! Life can be complicated, overwhelming, and flat out hard. However, it CAN also be purposeful, rewarding, and fulfilling. Whatever you may have encountered on your journey this far and whatever your needs may be in this moment that led you here, I'm honored to provide a safe space for you to explore and work through it.
(804) 567-7214 View (804) 567-7214
Photo of Heather Lambert, Clinical Social Work/Therapist in Richmond, VA
Heather Lambert
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Richmond, VA 23219  (Online Only)
Heather is a licensed clinical social worker who has been working in the mental health field since 2013. Throughout her work she has had the privilege of serving individuals throughout the lifespan (toddlers to older adults) with diverse backgrounds. Heather enjoys working with folks who are coping with chronic illness, challenging life transitions, grief, mood disorders, and trauma survivors. Throughout her work Heather incorporates interventions from evidence-based modalities of Dialectical Behavior Therapy and Cognitive Behavioral Therapy. Heather is also trained to use Eye Movement Desensitization and Reprocessing (EMDR).
Heather is a licensed clinical social worker who has been working in the mental health field since 2013. Throughout her work she has had the privilege of serving individuals throughout the lifespan (toddlers to older adults) with diverse backgrounds. Heather enjoys working with folks who are coping with chronic illness, challenging life transitions, grief, mood disorders, and trauma survivors. Throughout her work Heather incorporates interventions from evidence-based modalities of Dialectical Behavior Therapy and Cognitive Behavioral Therapy. Heather is also trained to use Eye Movement Desensitization and Reprocessing (EMDR).
(804) 494-5975 View (804) 494-5975
Photo of Rashika N Wallace Lcsw, Clinical Social Work/Therapist in Richmond, VA
Rashika N Wallace Lcsw
Clinical Social Work/Therapist, LCSW
Verified Verified
Richmond, VA 23231
Owner and clinician of Renewal Counseling & Consulting, LLC. I am a Licensed therapist who enjoys working with individuals, families, groups and couples. I have over 16 years counseling experience specializing in depression, anxiety, grief, and stress. I have a passion for working with young adult females. I treat the whole person, not their symptoms or circumstances in a safe and comfortable space. I specialize in depression, anxiety, grief and stress. I have a passion for working young adult females.
Owner and clinician of Renewal Counseling & Consulting, LLC. I am a Licensed therapist who enjoys working with individuals, families, groups and couples. I have over 16 years counseling experience specializing in depression, anxiety, grief, and stress. I have a passion for working with young adult females. I treat the whole person, not their symptoms or circumstances in a safe and comfortable space. I specialize in depression, anxiety, grief and stress. I have a passion for working young adult females.
(804) 681-7305 View (804) 681-7305
Photo of Norma M Murdoch-Kitt, Psychologist in Richmond, VA
Norma M Murdoch-Kitt
Psychologist, PhD
Verified Verified
Richmond, VA 23227
I like to work with clients who genuinely want to improve their lives and are willing to devote time and effort in order to achieve permanent change.
I like to work with clients who genuinely want to improve their lives and are willing to devote time and effort in order to achieve permanent change.
(804) 684-1958 View (804) 684-1958
Photo of Grace J Hadeed, Clinical Social Work/Therapist in Richmond, VA
Grace J Hadeed
Clinical Social Work/Therapist, EdD, LCSW, LPC
Verified Verified
Richmond, VA 23221
Dr. Grace Hadeed primarily offers Family Therapy, Marital Therapy, Education,Clinical Supervision and Individual/Professional Consultation. We also assist clients who have difficulty "launching" into adulthood. She offers therapy specializing in family and intergenerational systems, providing therapy to couples and families to address issues at the source.
Dr. Grace Hadeed primarily offers Family Therapy, Marital Therapy, Education,Clinical Supervision and Individual/Professional Consultation. We also assist clients who have difficulty "launching" into adulthood. She offers therapy specializing in family and intergenerational systems, providing therapy to couples and families to address issues at the source.
(804) 409-2482 View (804) 409-2482
Photo of Alex Hilert, Licensed Professional Counselor in Richmond, VA
Alex Hilert
Licensed Professional Counselor, PhD, LPC, LSATP, CCTP
Verified Verified
1 Endorsed
Richmond, VA 23230  (Online Only)
If you are struggling with anxiety, depression, substance use, or the lingering effects of trauma, you are not alone. We all face stress and uncertainty and sometimes our usual coping mechanisms just aren't enough. In counseling, you will have the space to freely process your thoughts and feelings while working on new skills that can help you improve your mental health and relationships. As a therapist, I take a collaborative and person-centered approach designed to empower you to reach your goals. I also work from a multicultural, anti-racist, neurodiverse and LGBTQIA+ affirmative framework with my clients.
If you are struggling with anxiety, depression, substance use, or the lingering effects of trauma, you are not alone. We all face stress and uncertainty and sometimes our usual coping mechanisms just aren't enough. In counseling, you will have the space to freely process your thoughts and feelings while working on new skills that can help you improve your mental health and relationships. As a therapist, I take a collaborative and person-centered approach designed to empower you to reach your goals. I also work from a multicultural, anti-racist, neurodiverse and LGBTQIA+ affirmative framework with my clients.
(804) 298-2906 View (804) 298-2906
Photo of Alan Kleinkopf, Psychologist in Richmond, VA
Alan Kleinkopf
Psychologist, PsyD
Verified Verified
Richmond, VA 23226
Welcome! As a licensed clinical psychologist, I have been helping individuals and couples overcome obstacles to achieving happiness and contentment for over 30 years. Sometimes the issues can seem insurmountable when it's really the way one is trying to cope with them that is the problem. That way of thinking can often be adjusted and can make all the difference! Whether you're experiencing a situational adjustment related issue or a more longstanding one as an individual or couple with depression, excessive stress, anxiety or anger, help yourself by making an appointment and get started.
Welcome! As a licensed clinical psychologist, I have been helping individuals and couples overcome obstacles to achieving happiness and contentment for over 30 years. Sometimes the issues can seem insurmountable when it's really the way one is trying to cope with them that is the problem. That way of thinking can often be adjusted and can make all the difference! Whether you're experiencing a situational adjustment related issue or a more longstanding one as an individual or couple with depression, excessive stress, anxiety or anger, help yourself by making an appointment and get started.
(804) 424-5526 View (804) 424-5526

How does your Therapist compare?

Number of Therapists in Richmond, VA

1,000+

Average cost per session

$135

Therapists in Richmond, VA who prioritize treating:

93% Anxiety
89% Depression
75% Self Esteem
74% Coping Skills
70% Trauma and PTSD
68% Relationship Issues
67% Stress

Average years in practice

11 Years

Top 3 insurances accepted

78% Aetna
77% UnitedHealthcare UHC | UBH
76% Cigna and Evernorth

How Therapists in Richmond, VA see their clients

56% In Person and Online
44% Online Only

Gender breakdown

83% Female
16% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Richmond?

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.