Therapists in Saint Louis, MO
Kimberly E Keegan
Licensed Professional Counselor, MS, LPC, NCC
Verified Verified
Saint Louis, MO 63131
I find that often a person is suffering with one or more unresolved issues and continues to hope things will change. When things don't change or get better, they may be ready to seek counseling and become open to talking with a stranger. That's often a big step to take. The goal is to improve the situation, handle a crisis and/or just stop the pain. There are many issues that result in reaching out to a counselor including a relationship crisis, loss of some sort, surviving trauma, addictions, difficulty with family or significant others, and changes that may occur within the person such as depression or anxiety.
I find that often a person is suffering with one or more unresolved issues and continues to hope things will change. When things don't change or get better, they may be ready to seek counseling and become open to talking with a stranger. That's often a big step to take. The goal is to improve the situation, handle a crisis and/or just stop the pain. There are many issues that result in reaching out to a counselor including a relationship crisis, loss of some sort, surviving trauma, addictions, difficulty with family or significant others, and changes that may occur within the person such as depression or anxiety.
Eric Gregory
Licensed Professional Counselor, MDiv, MAC, LPC
Verified Verified
1 Endorsed
Saint Louis, MO 63116
I come to the counseling room as a fellow traveller with a strong desire to create emotional and spiritual safety, regardless of what must be faced. Much of my experience has been focused on helping men find hope and a voice amid brokenness, loneliness, and relational trouble. I meet with individuals wrestling with anxiety, depression, past or present abuse, sexual confusion, sexual addiction, and spiritual and emotional health in general. Real relief and real growth are really possible!
I come to the counseling room as a fellow traveller with a strong desire to create emotional and spiritual safety, regardless of what must be faced. Much of my experience has been focused on helping men find hope and a voice amid brokenness, loneliness, and relational trouble. I meet with individuals wrestling with anxiety, depression, past or present abuse, sexual confusion, sexual addiction, and spiritual and emotional health in general. Real relief and real growth are really possible!
Pete Sandoval
Licensed Professional Counselor, LPC, NCC, CCTP
Verified Verified
1 Endorsed
Saint Louis, MO 63114 (Online Only)
Today is a new day! Having someone to listen without judgment is a tremendous gift. It can remove the loneliness and despair that can happen when life gets to be too much to bear. Perhaps you've had therapy before but something's still missing. You've done everything you can think of or that your previous therapist told you. You are dedicated to your personal growth. You engage in regular practices and are committed to do whatever it takes to be your best self. Despite some real progress, the deeper relief you've been looking for hasn't occurred just yet.
Today is a new day! Having someone to listen without judgment is a tremendous gift. It can remove the loneliness and despair that can happen when life gets to be too much to bear. Perhaps you've had therapy before but something's still missing. You've done everything you can think of or that your previous therapist told you. You are dedicated to your personal growth. You engage in regular practices and are committed to do whatever it takes to be your best self. Despite some real progress, the deeper relief you've been looking for hasn't occurred just yet.
Caitlin McNeece
Clinical Social Work/Therapist, MSW, LCSW, RYT 200
Verified Verified
Saint Louis, MO 63116 (Online Only)
Not accepting new clients
Anxiety and past trauma have kept you playing small, but in your heart you know that life can be so much bigger! You’re ready to wrestle with anxiety, shine a light on hurts and hardships of the past, and begin living life on your own terms. It feels like you’ve been waiting forever, unsure if the timing is right, but now you realize that “ready” might never happen, and you’re willing to try anyway. You're dreaming of a life where you stop second guessing yourself, where you feel connected and have a deep sense of belonging, and where you're no longer paralyzed by worries. You're ready to get back in the driver's seat of life!
Anxiety and past trauma have kept you playing small, but in your heart you know that life can be so much bigger! You’re ready to wrestle with anxiety, shine a light on hurts and hardships of the past, and begin living life on your own terms. It feels like you’ve been waiting forever, unsure if the timing is right, but now you realize that “ready” might never happen, and you’re willing to try anyway. You're dreaming of a life where you stop second guessing yourself, where you feel connected and have a deep sense of belonging, and where you're no longer paralyzed by worries. You're ready to get back in the driver's seat of life!
Sarah Howell
Pre-Licensed Professional
Verified Verified
1 Endorsed
Saint Louis, MO 63131
Are you feeling trapped in a dizzying maze of emotional distress and longing for deeper connections but struggling due to grief, unresolved trauma, or a loved one’s illness? Whether you're wrestling with the shadows of a difficult past, feeling the sting of relationship trauma, or navigating grief, I'm here to help. I understand the pain of feeling alone, stuck and craving a deeper connection. Picture yourself escaping the labyrinth of emotional distress and imagine the warmth and safety of a secure connection with yourself and others. Envision a future where you feel safe, secure, loved, and soothed.
Are you feeling trapped in a dizzying maze of emotional distress and longing for deeper connections but struggling due to grief, unresolved trauma, or a loved one’s illness? Whether you're wrestling with the shadows of a difficult past, feeling the sting of relationship trauma, or navigating grief, I'm here to help. I understand the pain of feeling alone, stuck and craving a deeper connection. Picture yourself escaping the labyrinth of emotional distress and imagine the warmth and safety of a secure connection with yourself and others. Envision a future where you feel safe, secure, loved, and soothed.
Ja'nai Barnes
Clinical Social Work/Therapist, LCSW, CEAP
Verified Verified
Saint Louis, MO 63146 (Online Only)
Are you struggling with anxiety, stress, or changes in relationships or friendships? Are you feeling overwhelmed with the pressures of every day life and struggling to figure out next steps? Life transitions such as starting a new path, making a career change and figuring out who you are and what you want to be and do can all feel overwhelming. I can provide a supportive and empathetic space to explore the present and obstacles and challenges that are being faced.
Are you struggling with anxiety, stress, or changes in relationships or friendships? Are you feeling overwhelmed with the pressures of every day life and struggling to figure out next steps? Life transitions such as starting a new path, making a career change and figuring out who you are and what you want to be and do can all feel overwhelming. I can provide a supportive and empathetic space to explore the present and obstacles and challenges that are being faced.
Jill Storm - Sandhill Counseling
Pre-Licensed Professional, MEd, PLPC
Verified Verified
Saint Louis, MO 63128
We spend a lot of our lives trying to be who others want us to be or who we imagine ourselves to be. But if we put aside those expectations, who are we? Who can we become? I consider it a great privilege to sit with clients and help them peel back the layers of themselves. This can be a painful process. It can also lead to a more enriching present and future.
We spend a lot of our lives trying to be who others want us to be or who we imagine ourselves to be. But if we put aside those expectations, who are we? Who can we become? I consider it a great privilege to sit with clients and help them peel back the layers of themselves. This can be a painful process. It can also lead to a more enriching present and future.
Michelle Smart
Clinical Social Work/Therapist, LCSW, MSW
Verified Verified
1 Endorsed
Saint Louis, MO 63108 (Online Only)
Just imagine a time in your life when your difficulties were so surmountable that the quality of your life diminished—struggling with weighty feelings from the loss of a loved one to thoughts of suicide. There is a solution: therapy! When individuals seek help and fully engage in the therapeutic process, the results lead to individuals living healthier lives. Together, we will create change in the areas of your life that no longer have meaning and purpose. I work to make everyone's therapy the best fit for them. I will use evidence-based therapy concepts, but I do not limit our work to any single model. My treatment style is rooted
Just imagine a time in your life when your difficulties were so surmountable that the quality of your life diminished—struggling with weighty feelings from the loss of a loved one to thoughts of suicide. There is a solution: therapy! When individuals seek help and fully engage in the therapeutic process, the results lead to individuals living healthier lives. Together, we will create change in the areas of your life that no longer have meaning and purpose. I work to make everyone's therapy the best fit for them. I will use evidence-based therapy concepts, but I do not limit our work to any single model. My treatment style is rooted
Clayton A. Clark
Licensed Professional Counselor, MEd, LPC, NCC
Verified Verified
Saint Louis, MO 63108
Something’s not right, and maybe it hasn’t been for a while, but you know it’s time to make some changes. If you (or you & your partner) need help making that change, I’d be honored to work with you. I take a flexible approach, bringing thoughtfulness and creativity to the process to meet you where you are. Here are areas I help people with most often: anxiety & stress, depression, couples counseling (Gottman Method), trauma (Brainspotting), career counseling & life design, substance use & addiction, men's issues, life transitions, anger, mindfulness, and grief.
Something’s not right, and maybe it hasn’t been for a while, but you know it’s time to make some changes. If you (or you & your partner) need help making that change, I’d be honored to work with you. I take a flexible approach, bringing thoughtfulness and creativity to the process to meet you where you are. Here are areas I help people with most often: anxiety & stress, depression, couples counseling (Gottman Method), trauma (Brainspotting), career counseling & life design, substance use & addiction, men's issues, life transitions, anger, mindfulness, and grief.
Steven Mark Weiner
Psychologist, PhD
Verified Verified
Saint Louis, MO 63141
When people decide to come to therapy, they are struggling. They are stressed, suffering, and feeling stuck or lost. In most cases, they are feeling a loss of control over some important aspect of their lives. This loss of control results in symptoms such as depression, anxiety, stress, feelings of guilt or shame, family problems, relationship problems, or problems at work or school. It is my goal to help you regain control of your life!
When people decide to come to therapy, they are struggling. They are stressed, suffering, and feeling stuck or lost. In most cases, they are feeling a loss of control over some important aspect of their lives. This loss of control results in symptoms such as depression, anxiety, stress, feelings of guilt or shame, family problems, relationship problems, or problems at work or school. It is my goal to help you regain control of your life!
Ann Ramatowski Netzer
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Saint Louis, MO 63108
Hi! I'm Ann. I enjoy working with people who are open-minded, inquisitive and who like to challenge norms. Part of the therapeutic process is about confronting the parts of ourselves that we tend to hide and feel a bit less comfortable with. I'd like to help you get to know your whole self and walk beside you as you question some of the beliefs you've held, which may be in conflict with who you are now. Like you, I've been there and asked myself. "What do I want?" "Who am I?" and "What feels motivating and pleasurable in my life?" It's tough to feel ‘stuck’ and also, it's the start of something brand new.
Hi! I'm Ann. I enjoy working with people who are open-minded, inquisitive and who like to challenge norms. Part of the therapeutic process is about confronting the parts of ourselves that we tend to hide and feel a bit less comfortable with. I'd like to help you get to know your whole self and walk beside you as you question some of the beliefs you've held, which may be in conflict with who you are now. Like you, I've been there and asked myself. "What do I want?" "Who am I?" and "What feels motivating and pleasurable in my life?" It's tough to feel ‘stuck’ and also, it's the start of something brand new.
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Pre-Licensed Professional, MA, PLPC, RYT
Verified Verified
4 Endorsed
Saint Louis, MO 63139
Mama, you deserve to thrive. You live in a world of "should": You SHOULD look like you have it all together. You SHOULD always be understanding. You SHOULD put others first. You feel trapped. You learned these rules a long time ago, and motherhood simply reinforces them. As a mama myself, I know parenthood is HARD and selfless work. It's time to define who you are again. Bust out of those boxes. Carve out the space to enjoy life again. Behave in an intentional, meaningful way that aligns with YOUR values, not the ones you learned as a kid. The power is in your hands, and I will help you find it. Let's do some dazzling work together.
Mama, you deserve to thrive. You live in a world of "should": You SHOULD look like you have it all together. You SHOULD always be understanding. You SHOULD put others first. You feel trapped. You learned these rules a long time ago, and motherhood simply reinforces them. As a mama myself, I know parenthood is HARD and selfless work. It's time to define who you are again. Bust out of those boxes. Carve out the space to enjoy life again. Behave in an intentional, meaningful way that aligns with YOUR values, not the ones you learned as a kid. The power is in your hands, and I will help you find it. Let's do some dazzling work together.
Emily Mitchell-Harris
Clinical Social Work/Therapist, MSW, LCSW, RPT
Verified Verified
Saint Louis, MO 63127 (Online Only)
Growing up is HARD. You get home after a tiring day at school where you felt invisible. You sat with friends at lunch, but left feeling like they don’t really get you. You open your backpack to loads of homework, when your mom reminds you to work on your college applications. The overwhelm takes over. You grab your phone and start to scroll, which leaves you feeling numb, empty and alone. After a tense family dinner, you go back to your room, feeling unheard and misunderstood. Figuring out who you are and what you want is hard while navigating school, work, friends, family, and relationships. You just wish things were easier.
Growing up is HARD. You get home after a tiring day at school where you felt invisible. You sat with friends at lunch, but left feeling like they don’t really get you. You open your backpack to loads of homework, when your mom reminds you to work on your college applications. The overwhelm takes over. You grab your phone and start to scroll, which leaves you feeling numb, empty and alone. After a tense family dinner, you go back to your room, feeling unheard and misunderstood. Figuring out who you are and what you want is hard while navigating school, work, friends, family, and relationships. You just wish things were easier.
Dr. Ryan Liberati
Licensed Professional Counselor, PhD, LPC, RPT-S, M-RAS, LCPC
Verified Verified
1 Endorsed
Saint Louis, MO 63118
Thank you for your interest. My ideal client is motivated for change and open to exploring more about themselves. I use a more direct style of counseling that heavily incorporates aspects of choice theory, reality therapy, and cognitive behavioral therapy to help my adult clients make real changes in their lives. For children, I utilize evidence-based directive and non-directive play therapy approaches, depending upon the child's unique psychosocial needs.
Thank you for your interest. My ideal client is motivated for change and open to exploring more about themselves. I use a more direct style of counseling that heavily incorporates aspects of choice theory, reality therapy, and cognitive behavioral therapy to help my adult clients make real changes in their lives. For children, I utilize evidence-based directive and non-directive play therapy approaches, depending upon the child's unique psychosocial needs.
Tosha T Pearson
Licensed Professional Counselor, MEd, LPC
Verified Verified
1 Endorsed
Saint Louis, MO 63111
Hello, everyone! My name is Tosha Pearson, and I'm a Licensed Professional Counselor in Saint Louis. I'm here to support individuals of all ages with their social-emotional needs, and well-being. Whether you're a child, a teenager, or an adult, I firmly believe that taking care of our emotional health is crucial for our overall development and success. In a safe and welcoming environment we can explore your feelings, address challenges, and develop effective strategies to navigate life's ups and downs.
Hello, everyone! My name is Tosha Pearson, and I'm a Licensed Professional Counselor in Saint Louis. I'm here to support individuals of all ages with their social-emotional needs, and well-being. Whether you're a child, a teenager, or an adult, I firmly believe that taking care of our emotional health is crucial for our overall development and success. In a safe and welcoming environment we can explore your feelings, address challenges, and develop effective strategies to navigate life's ups and downs.
Renew With Wren Counseling, LLC
Licensed Professional Counselor, MA, LPC
Verified Verified
2 Endorsed
Saint Louis, MO 63144
Hi there, Deb Wren here with Renew With Wren Counseling. If you are reading my profile, that means that you are in the market for someone who can provide a different perspective on your situation. Are you tired of fighting with your significant other over and over on the same old things, feeling unheard and undervalued, or maybe communication is non-existent and you want to be able to get on the same page? Or maybe you are having blended family issues and you didn't realize how complicated things would be and need a new perspective on making the family work. I can help with this process so please don't hesitate to give me a call,
Hi there, Deb Wren here with Renew With Wren Counseling. If you are reading my profile, that means that you are in the market for someone who can provide a different perspective on your situation. Are you tired of fighting with your significant other over and over on the same old things, feeling unheard and undervalued, or maybe communication is non-existent and you want to be able to get on the same page? Or maybe you are having blended family issues and you didn't realize how complicated things would be and need a new perspective on making the family work. I can help with this process so please don't hesitate to give me a call,
Colleen Gosser
Pre-Licensed Professional, PLPC
Verified Verified
1 Endorsed
Saint Louis, MO 63132
No matter what you're struggling with, you shouldn’t have to navigate it alone. In our sessions, we will work to uncover themes and patterns across your life, to gain better understanding of yourself. I hope to help you foster growth and healing. My aim is always to equip you with new insights, perspectives, and skills to help you progress.
No matter what you're struggling with, you shouldn’t have to navigate it alone. In our sessions, we will work to uncover themes and patterns across your life, to gain better understanding of yourself. I hope to help you foster growth and healing. My aim is always to equip you with new insights, perspectives, and skills to help you progress.
Master Mind Hypnosis
CCH
Verified Verified
Saint Louis, MO 63132
"...hypnosis is not mind control. It's a naturally occurring state of concentration; It's actually a means of enhancing your control over both your mind and your body."
Dr. David Spiegel, Assoc. Chair of Psychiatry (Stanford University School of Medicine). Hypnosis is a powerful tool that helps people change behavior, improve emotional response and physical wellbeing. Through hypnosis, you can improve study habits, reduce stress and bost self-esteem...Wehn it is difficult to control appetite, sleep or stress, hypnosis will help you change in a positive way faster with more comfort.
"...hypnosis is not mind control. It's a naturally occurring state of concentration; It's actually a means of enhancing your control over both your mind and your body."
Dr. David Spiegel, Assoc. Chair of Psychiatry (Stanford University School of Medicine). Hypnosis is a powerful tool that helps people change behavior, improve emotional response and physical wellbeing. Through hypnosis, you can improve study habits, reduce stress and bost self-esteem...Wehn it is difficult to control appetite, sleep or stress, hypnosis will help you change in a positive way faster with more comfort.
Helen R Friedman
Psychologist, PhD
Verified Verified
Saint Louis, MO 63130 (Online Only)
Dr. Helen Friedman is a compassionate and interactive clinical psychologist with 10 years of additional formal training after her Ph.D. and 41 years in practice. She works with anxiety, stress, depression, grief, divorce, sexual and relationship issues. Specialty areas are child sexual abuse (children, adults, victims and perpetrators), compulsive sexual behavior (including porn addiction and partners), dissociative identity disorder, and gender identity. Trained in a variety of therapeutic modalities (family systems, psychodynamic, cognitive-behavioral, gestalt, etc.), she tailors her approach to the individual, couple, or family.
Dr. Helen Friedman is a compassionate and interactive clinical psychologist with 10 years of additional formal training after her Ph.D. and 41 years in practice. She works with anxiety, stress, depression, grief, divorce, sexual and relationship issues. Specialty areas are child sexual abuse (children, adults, victims and perpetrators), compulsive sexual behavior (including porn addiction and partners), dissociative identity disorder, and gender identity. Trained in a variety of therapeutic modalities (family systems, psychodynamic, cognitive-behavioral, gestalt, etc.), she tailors her approach to the individual, couple, or family.
Vivian Marie Sierra
Marriage & Family Therapist, PhD, LMFT
Verified Verified
Saint Louis, MO 63132
Hello, I'm Dr. Vivian! I focus my practice on relationship counseling and coaching to help improve the quality of relationships whether romantic, family or work-related. I will teach you vital relationship skills, and facilitate your own self-awareness in order to empower change. My approach gives relief from the suffering that accompanies the painful experience of family estrangement and relationship issues. No matter what you bring to therapy, I offer empathy, support, a safe, nonjudgmental space. I use evidence-based therapy and empathic approach to discover ways for you to heal, learn, grow and find peace of mind.
Hello, I'm Dr. Vivian! I focus my practice on relationship counseling and coaching to help improve the quality of relationships whether romantic, family or work-related. I will teach you vital relationship skills, and facilitate your own self-awareness in order to empower change. My approach gives relief from the suffering that accompanies the painful experience of family estrangement and relationship issues. No matter what you bring to therapy, I offer empathy, support, a safe, nonjudgmental space. I use evidence-based therapy and empathic approach to discover ways for you to heal, learn, grow and find peace of mind.
See more therapy options for Saint Louis
Nearby Searches for Saint Louis
- Affton
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How does your Therapist compare?
Number of Therapists in Saint Louis, MO
1,000+
Average cost per session
$126
Therapists in Saint Louis, MO who prioritize treating:
92% | Anxiety |
87% | Depression |
77% | Relationship Issues |
74% | Self Esteem |
70% | Trauma and PTSD |
67% | Coping Skills |
67% | Stress |
Average years in practice
11 Years
Top 3 insurances accepted
74% | UnitedHealthcare UHC | UBH |
72% | Aetna |
71% | Cigna and Evernorth |
How Therapists in Saint Louis, MO see their clients
75% | In Person and Online | |
25% | Online Only |
Gender breakdown
78% | Female | |
20% | Male | |
2% | Non-Binary |
FAQs - About Therapy and Counseling
How can I find a therapist in Saint Louis?
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.