Therapists in Orting, WA

Photo of Anthony M Kagochi, Counselor in Orting, WA
Anthony M Kagochi
Counselor, MA, LMHC
Verified Verified
2 Endorsed
Orting, WA 98360
Waitlist for new clients
I welcome all people young and older; I have extensive experience working with individuals and families who are struggling with addiction issues, relationship/marital issues, depression, anxiety, trauma and troubles in their career.
I welcome all people young and older; I have extensive experience working with individuals and families who are struggling with addiction issues, relationship/marital issues, depression, anxiety, trauma and troubles in their career.
(253) 259-2505 View (253) 259-2505
Photo of Sydney Leigh Doherty, Clinical Social Work/Therapist in Orting, WA
Sydney Leigh Doherty
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
1 Endorsed
Orting, WA 98360  (Online Only)
Life presents us with many challenges, but I strongly believe we all can navigate those challenges and overcome some of the depression, anxiety and other symptoms that life can cause. We will work together on understanding why you are feeling some of the emotions that you are experiencing. It can be helpful to understand how you fit into your interpersonal relationships including those with children, significant others, parents, work, etc. Understanding our roles and how we function in those roles can help to navigate change.
Life presents us with many challenges, but I strongly believe we all can navigate those challenges and overcome some of the depression, anxiety and other symptoms that life can cause. We will work together on understanding why you are feeling some of the emotions that you are experiencing. It can be helpful to understand how you fit into your interpersonal relationships including those with children, significant others, parents, work, etc. Understanding our roles and how we function in those roles can help to navigate change.
(425) 470-5681 View (425) 470-5681
Photo of LuAnne Rivera, Lighthouse Counseling LLC, Counselor in Orting, WA
LuAnne Rivera, Lighthouse Counseling LLC
Counselor, MA, LMHCA
Verified Verified
4 Endorsed
Orting, WA 98360
Are you tired of going around that same mountain over and over? Let me help you find the way out. While therapy can feel like a scary place, I strive to make your therapy encounter a safe, collaborative, encouraging, and even a thriving experience. I am certified in trauma focused cognitive/behavioral therapy, and trained in grief assessment, EMDR therapy, as a SYMBIS facilitator and a chemical dependency specialist, Currently I am accepting adolescents and older. I enjoy the interaction and growth that occurs through empowering you, the client, to make your own choices and become your most authentic self.
Are you tired of going around that same mountain over and over? Let me help you find the way out. While therapy can feel like a scary place, I strive to make your therapy encounter a safe, collaborative, encouraging, and even a thriving experience. I am certified in trauma focused cognitive/behavioral therapy, and trained in grief assessment, EMDR therapy, as a SYMBIS facilitator and a chemical dependency specialist, Currently I am accepting adolescents and older. I enjoy the interaction and growth that occurs through empowering you, the client, to make your own choices and become your most authentic self.
(253) 499-7632 View (253) 499-7632
Photo of Meg Goodfellow, Marriage & Family Therapist in Orting, WA
Meg Goodfellow
Marriage & Family Therapist, RN, LMFT
Verified Verified
1 Endorsed
Orting, WA 98360  (Online Only)
I believe therapists should listen, not just “nod”. I believe therapists should be just as authentic as they ask of their clients. I ascribe to the philosophy of the humanistic therapist, Carl Rogers, in providing each client with genuine warmth, empathy, and unconditional positive regard. I bring my whole heart, my whole self into the hour with you. It is your hour where you can curse and cry. Nothing is off limits, nothing will be judged and every emotion is valid.
I believe therapists should listen, not just “nod”. I believe therapists should be just as authentic as they ask of their clients. I ascribe to the philosophy of the humanistic therapist, Carl Rogers, in providing each client with genuine warmth, empathy, and unconditional positive regard. I bring my whole heart, my whole self into the hour with you. It is your hour where you can curse and cry. Nothing is off limits, nothing will be judged and every emotion is valid.
View

More Therapists Nearby

Photo of Mark Duris, Psychologist in Orting, WA
Mark Duris
Psychologist, PhD
Verified Verified
Puyallup, WA 98372
Not accepting new clients
As a psychologist, I seek to provide guidance in identifying strategies and solutions for tapping into your inner strengths and capacity for positive change. I have found that a positive therapeutic relationship serves an important role in accessing the resilience, insight, and courage needed to make important lifestyle changes that allow individuals and families to live happier, healthier, and more balanced lives. I approach the therapeutic relationship as a collaborative process where positive change occurs when we work together to identify strategies that will allow you to adaptively manage and overcome difficult life challenges. I strive to create a safe place by providing unconditional support.
As a psychologist, I seek to provide guidance in identifying strategies and solutions for tapping into your inner strengths and capacity for positive change. I have found that a positive therapeutic relationship serves an important role in accessing the resilience, insight, and courage needed to make important lifestyle changes that allow individuals and families to live happier, healthier, and more balanced lives. I approach the therapeutic relationship as a collaborative process where positive change occurs when we work together to identify strategies that will allow you to adaptively manage and overcome difficult life challenges. I strive to create a safe place by providing unconditional support.
(253) 227-9718 View (253) 227-9718
Photo of Kate Travis, Clinical Social Work/Therapist in Orting, WA
Kate Travis
Clinical Social Work/Therapist, LMSW
Verified Verified
Puyallup, WA 98372
Life can be challenging, confusing, and down right overwhelming. Sometimes we bury our trauma, hurt, and confusion attempting to cope, or our ability to cope is inadequate to the challenges we face. You have been making it through life, even accomplishing wonderful things, but often wearing a mask and feeling like you are barely keeping it together. Your resilience is obvious, but maybe you are still troubled by your past and how it has affected who you are. Maybe today’s challenges are beginning to weigh too heavy for you to work through them alone. You have survived, but now it is time to thrive and live your life to the fullest.
Life can be challenging, confusing, and down right overwhelming. Sometimes we bury our trauma, hurt, and confusion attempting to cope, or our ability to cope is inadequate to the challenges we face. You have been making it through life, even accomplishing wonderful things, but often wearing a mask and feeling like you are barely keeping it together. Your resilience is obvious, but maybe you are still troubled by your past and how it has affected who you are. Maybe today’s challenges are beginning to weigh too heavy for you to work through them alone. You have survived, but now it is time to thrive and live your life to the fullest.
(253) 342-4331 View (253) 342-4331
Photo of Rachel Soule, Clinical Social Work/Therapist in Orting, WA
Rachel Soule
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Puyallup, WA 98375  (Online Only)
My passion lies in empowering clients to reclaim control over their lives. We all encounter moments of feeling stuck, anxious, and overwhelmed, and I am here to provide the support needed to navigate through these challenges. In therapy, I start by attentively listening to my clients' reasons for seeking therapy, understanding their stressors, and identifying what does or doesn't serve them. I firmly believe in the transformative power of therapy, offering a pathway to shape the life we aspire to lead.
My passion lies in empowering clients to reclaim control over their lives. We all encounter moments of feeling stuck, anxious, and overwhelmed, and I am here to provide the support needed to navigate through these challenges. In therapy, I start by attentively listening to my clients' reasons for seeking therapy, understanding their stressors, and identifying what does or doesn't serve them. I firmly believe in the transformative power of therapy, offering a pathway to shape the life we aspire to lead.
View
Photo of Claire Kilbourne, Marriage & Family Therapist Associate in Orting, WA
Claire Kilbourne
Marriage & Family Therapist Associate, MA, LMFTA
Verified Verified
3 Endorsed
Puyallup, WA 98372
As a systemic therapist, I believe that people are shaped by their experiences and the people they’ve encountered along the way. I work from a place of non-judgement and celebrate body positivity, 2SLGBTQ+, and neurodiversity. I tend to use interventions from various theories, and will do my best to shape sessions so that they best fit my clients and their needs.
As a systemic therapist, I believe that people are shaped by their experiences and the people they’ve encountered along the way. I work from a place of non-judgement and celebrate body positivity, 2SLGBTQ+, and neurodiversity. I tend to use interventions from various theories, and will do my best to shape sessions so that they best fit my clients and their needs.
(253) 364-1126 View (253) 364-1126
Photo of Leana West, Marriage & Family Therapist Associate in Orting, WA
Leana West
Marriage & Family Therapist Associate, MA
Verified Verified
1 Endorsed
Puyallup, WA 98373
Not accepting new clients
As a Marriage and Family Therapist, I am passionate about getting to the heart of the challenge(s) my clients face. I desire to work with my clients in discovering who they are by working through the issue(s) they face and achieve their desired goal(s). I believe wholeheartedly in finding the beauty within that makes one uniquely who they are. There is no absolute way to achieve that, however; my role is to offer a judgment free safe space for my clients that allows for transparency in all aspects of their life to allow for hope to eliminate the feelings of being stuck and overwhelmed. I work with individuals, couples, and families
As a Marriage and Family Therapist, I am passionate about getting to the heart of the challenge(s) my clients face. I desire to work with my clients in discovering who they are by working through the issue(s) they face and achieve their desired goal(s). I believe wholeheartedly in finding the beauty within that makes one uniquely who they are. There is no absolute way to achieve that, however; my role is to offer a judgment free safe space for my clients that allows for transparency in all aspects of their life to allow for hope to eliminate the feelings of being stuck and overwhelmed. I work with individuals, couples, and families
(253) 544-4418 View (253) 544-4418
Photo of Suzra Martha Antoine, Clinical Social Work/Therapist in Orting, WA
Suzra Martha Antoine
Clinical Social Work/Therapist, MSW, LICSWA, CCTP
Verified Verified
2 Endorsed
Spanaway, WA 98387  (Online Only)
Not accepting new clients
Are you struggling with anxiety, depression, PTSD, ADHD, trauma, and multiple mental health diagnoses? I assist clients in healing from trauma, helping youth, adolescents, and adults cope with life stressors, and low self-esteem. I also assist individuals in identifying their emotions, thoughts, and behaviors, establishing goals, empowering individuals to believe in themselves by offering compassion and support to clients in learning different coping skills to overcome life's stressors.
Are you struggling with anxiety, depression, PTSD, ADHD, trauma, and multiple mental health diagnoses? I assist clients in healing from trauma, helping youth, adolescents, and adults cope with life stressors, and low self-esteem. I also assist individuals in identifying their emotions, thoughts, and behaviors, establishing goals, empowering individuals to believe in themselves by offering compassion and support to clients in learning different coping skills to overcome life's stressors.
(206) 204-5185 View (206) 204-5185
Photo of Shelleigh-Mairi W Ferguson, Marriage & Family Therapist in Orting, WA
Shelleigh-Mairi W Ferguson
Marriage & Family Therapist, LMFT, MHP
Verified Verified
1 Endorsed
Puyallup, WA 98372
ACCEPTING NEW CLIENTS Do you have a sense that you have no control over your life, thoughts, or feelings, causing you NOT to be an active participant in your own life? Do these feelings cause you to feel that you are drifting through life, becoming depressed and anxious? My goal is to offer a safe, supportive space, to walk with you on your journey, explore aspects of the 'self' that you would like to build, and discover strengths that can be used in your present and future, in order to construct the life you desire. Remember, the steps you take don’t have to be big, they just have to be heading you in the right direction.
ACCEPTING NEW CLIENTS Do you have a sense that you have no control over your life, thoughts, or feelings, causing you NOT to be an active participant in your own life? Do these feelings cause you to feel that you are drifting through life, becoming depressed and anxious? My goal is to offer a safe, supportive space, to walk with you on your journey, explore aspects of the 'self' that you would like to build, and discover strengths that can be used in your present and future, in order to construct the life you desire. Remember, the steps you take don’t have to be big, they just have to be heading you in the right direction.
(253) 240-4994 View (253) 240-4994
Photo of Wendy Tate dba Excel Counseling, Counselor in Orting, WA
Wendy Tate dba Excel Counseling
Counselor, NCC, MS, LMHC
Verified Verified
1 Endorsed
Sumner, WA 98390
Waitlist for new clients
Hi, I'm Wendy and I provide counseling to children, adolescents, adults, and Seniors. I use a strength based integrative approach that sees each person as unique. I pull from a variety of models including but not limited to Cognitive Behavioral Therapy, Solution Focused Brief Therapy, Mindfulness, Humanistic, Sports, and Positive Psychology. I work with many challenges individuals face addressing emotional, behavioral, and social needs; such as anxiety, depression, domestic violence, attachment disorders, ADHD, and more. I want to help you become empowered by further discovering your inner strength, beauty, purpose, and passion.
Hi, I'm Wendy and I provide counseling to children, adolescents, adults, and Seniors. I use a strength based integrative approach that sees each person as unique. I pull from a variety of models including but not limited to Cognitive Behavioral Therapy, Solution Focused Brief Therapy, Mindfulness, Humanistic, Sports, and Positive Psychology. I work with many challenges individuals face addressing emotional, behavioral, and social needs; such as anxiety, depression, domestic violence, attachment disorders, ADHD, and more. I want to help you become empowered by further discovering your inner strength, beauty, purpose, and passion.
(253) 237-7861 View (253) 237-7861
Photo of Joshua Gates, MA, LMFT, Marriage & Family Therapist in Orting, WA
Joshua Gates, MA, LMFT
Marriage & Family Therapist, MA, LMFT
Verified Verified
1 Endorsed
Puyallup, WA 98374
Not accepting new clients
Are you having difficulty coping with stress or life transition? Are your relationships with your significant other, family, or coworkers less than desirable? Maybe you feel depressed or anxious. Life can be difficult at times without help from someone else. I have 15 years of experience in providing counseling and psychotherapy to individuals, couples, and families from all walks of life. Let me help you discover your strengths and get things back on track.
Are you having difficulty coping with stress or life transition? Are your relationships with your significant other, family, or coworkers less than desirable? Maybe you feel depressed or anxious. Life can be difficult at times without help from someone else. I have 15 years of experience in providing counseling and psychotherapy to individuals, couples, and families from all walks of life. Let me help you discover your strengths and get things back on track.
(253) 215-4139 View (253) 215-4139
Photo of Maloy Morgan Moore, Marriage & Family Therapist Associate in Orting, WA
Maloy Morgan Moore
Marriage & Family Therapist Associate, LMFTA
Verified Verified
Puyallup, WA 98372
I acknowledge the larger systems of oppression that disproportionately affect minoritized folks such as people of color, LGBTQ+ people, polyamorous relationships, non-traditional family structures, and anyone else whose existence threatens the capitalist patriarchy in which we exist. My dream is to create a space in therapy where people can bring their whole, authentic selves. Together, we can explore narratives of self, family, and the world that impact your health. My philosophy is that healing cannot happen in isolation, and so I work systemically with families to promote wellness.
I acknowledge the larger systems of oppression that disproportionately affect minoritized folks such as people of color, LGBTQ+ people, polyamorous relationships, non-traditional family structures, and anyone else whose existence threatens the capitalist patriarchy in which we exist. My dream is to create a space in therapy where people can bring their whole, authentic selves. Together, we can explore narratives of self, family, and the world that impact your health. My philosophy is that healing cannot happen in isolation, and so I work systemically with families to promote wellness.
(253) 487-0438 View (253) 487-0438
Photo of Always In Bloom, Marriage & Family Therapist Associate in Orting, WA
Always In Bloom
Marriage & Family Therapist Associate, LMFTA, LMHCA, SUDPT
Verified Verified
3 Endorsed
Puyallup, WA 98373
Life is challenging! Family stress, work difficulties, personal concerns...I get it. I have lived experience with overcoming desperate circumstances. If you're feeling stuck, frustrated, confused and need some empathy and encouragement, please consider me for your therapy needs. I can hold space for all the things that are preventing you from living your best life. As your therapist I'll walk with you on your journey to healing & living the life you've always dreamed but didn't quite know how to achieve. I'm here to help you reach your goals & live the life of your dreams.
Life is challenging! Family stress, work difficulties, personal concerns...I get it. I have lived experience with overcoming desperate circumstances. If you're feeling stuck, frustrated, confused and need some empathy and encouragement, please consider me for your therapy needs. I can hold space for all the things that are preventing you from living your best life. As your therapist I'll walk with you on your journey to healing & living the life you've always dreamed but didn't quite know how to achieve. I'm here to help you reach your goals & live the life of your dreams.
(253) 465-2175 View (253) 465-2175
Photo of Jennifer Rogers, Psychologist in Orting, WA
Jennifer Rogers
Psychologist, PsyD
Verified Verified
Puyallup, WA 98371
Not accepting new clients
Not accepting new clients... Many of us experience challenging, unpleasant, or harmful experiences at some point in our lives, and for some of us, these experiences begin in childhood. Although these threats or conflicts may no longer exist, the experiences sometimes have a lasting impact on the way we view ourself, others, and the world around us. We may find ourselves thinking, feeling, and behaving in ways that are not useful and are preventing us from living the life we desire. I provide a safe space for people to tell their stories while supporting them to ​find their own purpose and path in life.
Not accepting new clients... Many of us experience challenging, unpleasant, or harmful experiences at some point in our lives, and for some of us, these experiences begin in childhood. Although these threats or conflicts may no longer exist, the experiences sometimes have a lasting impact on the way we view ourself, others, and the world around us. We may find ourselves thinking, feeling, and behaving in ways that are not useful and are preventing us from living the life we desire. I provide a safe space for people to tell their stories while supporting them to ​find their own purpose and path in life.
(253) 733-1414 View (253) 733-1414
Photo of Bethany Sutton, Marriage & Family Therapist in Orting, WA
Bethany Sutton
Marriage & Family Therapist, MA, LMFT
Verified Verified
Puyallup, WA 98371
Waitlist for new clients
Everyone is worthy of love and belonging. I am committed to creating a safe space for my clients no matter their background, story, or identity. I believe that each client is unique and deserves to be heard. Therapy is a collaborative process. My role is to meet you where you are and guide you toward healing. I will respect and honor your story and help you move through the pain to find new beginnings.
Everyone is worthy of love and belonging. I am committed to creating a safe space for my clients no matter their background, story, or identity. I believe that each client is unique and deserves to be heard. Therapy is a collaborative process. My role is to meet you where you are and guide you toward healing. I will respect and honor your story and help you move through the pain to find new beginnings.
(253) 499-8871 View (253) 499-8871
Photo of Erika St Peter, Counselor in Orting, WA
Erika St Peter
Counselor, MA, LMHC
Verified Verified
Puyallup, WA 98374  (Online Only)
No longer taking new clients at this time.
No longer taking new clients at this time.
(206) 430-1810 View (206) 430-1810
Photo of Daniel Foss, Licensed Professional Counselor in Orting, WA
Daniel Foss
Licensed Professional Counselor, MA, LMHCA
Verified Verified
1 Endorsed
Puyallup, WA 98372
Now Accepting New Patients. Dan is trained in EMDR. Trauma comes out in many different ways for the individuals I treat. Let's put together the goals that best suit your goals and life to best help you get better and feel better. Dan has been trained in EMDR and worked in the hospital setting with trauma, injurious behaviors, PTSD, Depression, Anxiety, Bipolar, Grief and loss, and OCD patients.
Now Accepting New Patients. Dan is trained in EMDR. Trauma comes out in many different ways for the individuals I treat. Let's put together the goals that best suit your goals and life to best help you get better and feel better. Dan has been trained in EMDR and worked in the hospital setting with trauma, injurious behaviors, PTSD, Depression, Anxiety, Bipolar, Grief and loss, and OCD patients.
(253) 252-5226 View (253) 252-5226
Photo of Amberlyn Casperson in Orting, WA
Amberlyn Casperson
MA, LMHCA
Verified Verified
2 Endorsed
Puyallup, WA 98373
Seeking help from others can be very challenging, and in my experience, it is those that seek help that express the utmost courage. As a therapist, most of my experience has been centered around helping children and their families, many of whom have viewed therapy as a last resort. As a therapist, my mission is to help my clients heal and recover from things like depression, anxiety, or trauma in a way that is central to who they are. I utilize both art and play therapy to help understand my clients in expressive ways. I also utilize psychodynamic therapy to gain a bigger perspective of my clients’ past, present and futures.
Seeking help from others can be very challenging, and in my experience, it is those that seek help that express the utmost courage. As a therapist, most of my experience has been centered around helping children and their families, many of whom have viewed therapy as a last resort. As a therapist, my mission is to help my clients heal and recover from things like depression, anxiety, or trauma in a way that is central to who they are. I utilize both art and play therapy to help understand my clients in expressive ways. I also utilize psychodynamic therapy to gain a bigger perspective of my clients’ past, present and futures.
(253) 544-3548 View (253) 544-3548

How does your Therapist compare?

Number of Therapists in Orting, WA

< 10

Therapists in Orting, WA who prioritize treating:

100% Depression
100% Anxiety
75% Trauma and PTSD
75% Behavioral Issues
75% Coping Skills
50% Relationship Issues
50% Addiction

Average years in practice

7 Years

Top 3 insurances accepted

100% BlueCross and BlueShield
100% Premera
100% Regence

How Therapists in Orting, WA see their clients

50% In Person and Online
50% Online Only

Gender breakdown

50% Female
25% Male
25% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Orting?

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.