Therapists in Gresham, OR

Ryan Altstadt
Counselor, LPC, QMHP-C
Verified Verified
Gresham, OR 97080  (Online Only)
Not accepting new clients
While counseling is a collaborative process, I have found it to be most successful and more sustaining when it is client-centered and driven. I have the honor to offer you my slice of proficiency. But, you are the expert in your life and it is thus your vision, your goals, and your strengths that will guide our work together. Wellness is a dynamic endeavor and our efforts will extend beyond the therapy room as we collaborate to exchange formal intervention and active treatment with informal support and on-going self-care. Counseling is an incredible guardrail. Yet, you are the pilot of your life's path and I but your humble guide.
While counseling is a collaborative process, I have found it to be most successful and more sustaining when it is client-centered and driven. I have the honor to offer you my slice of proficiency. But, you are the expert in your life and it is thus your vision, your goals, and your strengths that will guide our work together. Wellness is a dynamic endeavor and our efforts will extend beyond the therapy room as we collaborate to exchange formal intervention and active treatment with informal support and on-going self-care. Counseling is an incredible guardrail. Yet, you are the pilot of your life's path and I but your humble guide.
(503) 836-8655 View (503) 836-8655
Photo of Tiffany Barr, Pre-Licensed Professional in Gresham, OR
Tiffany Barr
Pre-Licensed Professional, MA
Verified Verified
Gresham, OR 97030
I work with adults on issues ranging from mood disorders, self image issues, self-destructive behaviors, severe persistent mental illness, and trauma recovery. I am currently able to take OHP, CareOregon and private pay clients for in-person and telehealth sessions. My availability is Monday-Wednesday 9am-2pm.
I work with adults on issues ranging from mood disorders, self image issues, self-destructive behaviors, severe persistent mental illness, and trauma recovery. I am currently able to take OHP, CareOregon and private pay clients for in-person and telehealth sessions. My availability is Monday-Wednesday 9am-2pm.
(503) 647-6707 View (503) 647-6707
Photo of Bethaney Clark, Licensed Professional Counselor in Gresham, OR
Bethaney Clark
Licensed Professional Counselor, MA, LPC
Verified Verified
2 Endorsed
Gresham, OR 97030
Limited openings available - Do you find yourself struggling with self-acceptance, self-worth and value in this world? Have feelings of stress, anxiety and worry been taking over your life? Are you in search of growth, healing and restoration? If so, you are in a good place. Life comes with the burden of pain, suffering, loss and difficulty. These are the seasons in which seeking help can be a brave first step. I would love to assist you in identifying your strengths, finding your voice, and building confidence as you move forward knowing yourself deeper, improving your relationships, and managing the challenges of life before you.
Limited openings available - Do you find yourself struggling with self-acceptance, self-worth and value in this world? Have feelings of stress, anxiety and worry been taking over your life? Are you in search of growth, healing and restoration? If so, you are in a good place. Life comes with the burden of pain, suffering, loss and difficulty. These are the seasons in which seeking help can be a brave first step. I would love to assist you in identifying your strengths, finding your voice, and building confidence as you move forward knowing yourself deeper, improving your relationships, and managing the challenges of life before you.
(503) 512-6992 View (503) 512-6992
Photo of Catherine E Archibald, Clinical Social Work/Therapist in Gresham, OR
Catherine E Archibald
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
2 Endorsed
Gresham, OR 97030
I work with a wide array of clients experiencing challenges in their lives ranging from eating disorders to substance abuse to serious trauma. In my years of work specializing in children and parents contending with anger, anxiety, depression, foster-care, parenting struggles and divorce issues I have helped families find healing and recover fun in their relationships. Whether a person is seeking services because they realize their problems can improve and they want professional support or at the insistence of a concerned family member, therapy should be a place where you experience confidence that the situation will improve.
I work with a wide array of clients experiencing challenges in their lives ranging from eating disorders to substance abuse to serious trauma. In my years of work specializing in children and parents contending with anger, anxiety, depression, foster-care, parenting struggles and divorce issues I have helped families find healing and recover fun in their relationships. Whether a person is seeking services because they realize their problems can improve and they want professional support or at the insistence of a concerned family member, therapy should be a place where you experience confidence that the situation will improve.
(971) 270-1551 View (971) 270-1551
Photo of Donita L. Jordan, Marriage & Family Therapist Associate in Gresham, OR
Donita L. Jordan
Marriage & Family Therapist Associate, MA
Verified Verified
Gresham, OR 97030  (Online Only)
My focus is to serve couples, families and individuals working through life, struggle and hopelessness. I have a passion to see couples thrive, overcome and stay on the path of commitment. I have a genuine heart to see people healed and fully functioning in life. I trust in the human tendency to realize his or her full potential. I believe humans have the capacity and desire for personal growth and change. I desire to hold a safe space for client's growth while addressing their presenting problem.
My focus is to serve couples, families and individuals working through life, struggle and hopelessness. I have a passion to see couples thrive, overcome and stay on the path of commitment. I have a genuine heart to see people healed and fully functioning in life. I trust in the human tendency to realize his or her full potential. I believe humans have the capacity and desire for personal growth and change. I desire to hold a safe space for client's growth while addressing their presenting problem.
(971) 260-9367 View (971) 260-9367
Photo of Jill M Visscher, Pre-Licensed Professional in Gresham, OR
Jill M Visscher
Pre-Licensed Professional, MA
Verified Verified
Gresham, OR 97030
It is a privilege to come alongside clients in their most challenging time to help them to heal, resolve conflict and recover from the hard that life can bring. I believe clients are the experts of their experience and I am a resource to help the attain their goals. I work collaboratively with my clients to create a safe and trusting environment that supports their discovery of internal strengths, hope, and resiliency.
It is a privilege to come alongside clients in their most challenging time to help them to heal, resolve conflict and recover from the hard that life can bring. I believe clients are the experts of their experience and I am a resource to help the attain their goals. I work collaboratively with my clients to create a safe and trusting environment that supports their discovery of internal strengths, hope, and resiliency.
(503) 809-4475 View (503) 809-4475
Photo of Courtney Baczko, Clinical Social Work/Therapist in Gresham, OR
Courtney Baczko
Clinical Social Work/Therapist, LICSW, CADCIII, LCSW
Verified Verified
Gresham, OR 97080  (Online Only)
If this is your first time looking for a therapist, or continuing your journey into self discovery finding someone to connect with may feel like a difficult task. I believe that the most important step in finding success in therapy is connecting with someone who understands you and can hear your perspective and respectfully challenge your thought process. Whether you are someone who comes to this setting thinking, “I don’t even know where to start,” or are coming with a list of tasks to begin working on, I would enjoy getting to know you.
If this is your first time looking for a therapist, or continuing your journey into self discovery finding someone to connect with may feel like a difficult task. I believe that the most important step in finding success in therapy is connecting with someone who understands you and can hear your perspective and respectfully challenge your thought process. Whether you are someone who comes to this setting thinking, “I don’t even know where to start,” or are coming with a list of tasks to begin working on, I would enjoy getting to know you.
(503) 852-5193 View (503) 852-5193
Photo of Dawn Forrester, Professional Counselor Associate in Gresham, OR
Dawn Forrester
Professional Counselor Associate, MS, NCC
Verified Verified
Gresham, OR 97030  (Online Only)
Are you at a turning point in your life? Do you believe there is something more ‘out there’ for you? Are you experiencing a major life transition? Times of change can be disorienting, scary, and challenging. During these times, you may question whether or not you can successfully navigate the changes you are facing. Depending on your situation, you may feel helpless, hopeless, sad, and/or angry. But there is hope, you are resilient, you can do this! I whole-heartedly believe that we all have the power within us to create positive change and transformation.
Are you at a turning point in your life? Do you believe there is something more ‘out there’ for you? Are you experiencing a major life transition? Times of change can be disorienting, scary, and challenging. During these times, you may question whether or not you can successfully navigate the changes you are facing. Depending on your situation, you may feel helpless, hopeless, sad, and/or angry. But there is hope, you are resilient, you can do this! I whole-heartedly believe that we all have the power within us to create positive change and transformation.
(971) 265-6375 View (971) 265-6375
Photo of Melissa Hartley, Licensed Professional Counselor in Gresham, OR
Melissa Hartley
Licensed Professional Counselor, LPC, NCC
Verified Verified
Gresham, OR 97030
I believe that at the core of every person, there is a wise Self that drives us towards health and healing. But that can get interrupted, and we can feel separated from ourselves by trauma, depression, anxiety, injustice etc. I help my clients connect with themselves so they can live in their authentic Self comfortably, and approach life successfully.
I believe that at the core of every person, there is a wise Self that drives us towards health and healing. But that can get interrupted, and we can feel separated from ourselves by trauma, depression, anxiety, injustice etc. I help my clients connect with themselves so they can live in their authentic Self comfortably, and approach life successfully.
(503) 822-6107 View (503) 822-6107
Photo of Sandra Caroompas Psychotherapist, Marriage & Family Therapist in Gresham, OR
Sandra Caroompas Psychotherapist
Marriage & Family Therapist, MA, LMFT, LLC
Verified Verified
Gresham, OR 97080  (Online Only)
Life is a journey! Do you feel overwhelmed, distressed, disconnected or lost, is your life hard to navigate. I believe that compassionate, reflective therapy can help restore vitality and renew hope. Individuals, couples, children/families, experience emotional struggles and challenging behaviors because of the impact of a variety of past and present variables, not because of weakness. Symptoms/Behaviors are simply indicators of need, and actually illuminate innate strength that guides healing. I'mabout collaborating with you to build strengths, explore barriers to enjoyment of life, and create a joyful resilience.
Life is a journey! Do you feel overwhelmed, distressed, disconnected or lost, is your life hard to navigate. I believe that compassionate, reflective therapy can help restore vitality and renew hope. Individuals, couples, children/families, experience emotional struggles and challenging behaviors because of the impact of a variety of past and present variables, not because of weakness. Symptoms/Behaviors are simply indicators of need, and actually illuminate innate strength that guides healing. I'mabout collaborating with you to build strengths, explore barriers to enjoyment of life, and create a joyful resilience.
(541) 216-6743 View (541) 216-6743
Photo of Taunya M Gesner, Licensed Professional Counselor in Gresham, OR
Taunya M Gesner
Licensed Professional Counselor, MEd
Verified Verified
Gresham, OR 97080  (Online Only)
Sometimes when the world feels overwhelming, we don't connect how past abuse has led us to emotions that feel out of control. It's like when stress builds up over lots of little things and you finally snap at someone you care about in a way you didn't mean. Or feeling overly tired of trying to live in this world because every choice you make seems hard and a large amount of effort. These are things I can help with. Additionally - if you are struggling with your significant other, like feeling not heard, or having problems in the bedroom, or feeling like you are carrying more than your share; we can work on this together.
Sometimes when the world feels overwhelming, we don't connect how past abuse has led us to emotions that feel out of control. It's like when stress builds up over lots of little things and you finally snap at someone you care about in a way you didn't mean. Or feeling overly tired of trying to live in this world because every choice you make seems hard and a large amount of effort. These are things I can help with. Additionally - if you are struggling with your significant other, like feeling not heard, or having problems in the bedroom, or feeling like you are carrying more than your share; we can work on this together.
(971) 274-5497 View (971) 274-5497
Photo of Kristan Chow, Licensed Professional Counselor in Gresham, OR
Kristan Chow
Licensed Professional Counselor, MA, LPC, NCC
Verified Verified
Gresham, OR 97030
Limited Availability at this time - NO after school openings. I believe every client has a story to be told and deserves to be heard. I seek to create a place of refuge for clients and their stories where they feel safe and judgement-free. I believe that everyone has immense resilience within themselves that can be used to help themselves overcome life obstacles and transitions. Issues may include mood disorders, grief, trauma, relationship issues, chronic stress and anxiety, and/or general life transitions.
Limited Availability at this time - NO after school openings. I believe every client has a story to be told and deserves to be heard. I seek to create a place of refuge for clients and their stories where they feel safe and judgement-free. I believe that everyone has immense resilience within themselves that can be used to help themselves overcome life obstacles and transitions. Issues may include mood disorders, grief, trauma, relationship issues, chronic stress and anxiety, and/or general life transitions.
(971) 248-9791 View (971) 248-9791
Photo of Meeta Heuss, Clinical Social Work/Therapist in Gresham, OR
Meeta Heuss
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Gresham, OR 97030  (Online Only)
Life is a beautiful journey, but it comes with its share of challenges, transitions, and moments of profound loss. If you find yourself navigating the complexities of aging, facing the unique struggles of parenthood, or dealing with the intricate dynamics of grief and life transitions, you're not alone. I am here to accompany you on your path to healing, growth, and empowerment.
Life is a beautiful journey, but it comes with its share of challenges, transitions, and moments of profound loss. If you find yourself navigating the complexities of aging, facing the unique struggles of parenthood, or dealing with the intricate dynamics of grief and life transitions, you're not alone. I am here to accompany you on your path to healing, growth, and empowerment.
(971) 307-9433 View (971) 307-9433
Photo of Sarah M Manlupig, Licensed Professional Counselor in Gresham, OR
Sarah M Manlupig
Licensed Professional Counselor, MA, LPC
Verified Verified
4 Endorsed
Gresham, OR 97030
Eastside Child and Family Therapy is a counseling group practice serving parents, early childhood, children, teens & young adults. We believe in removing some of the barriers to therapy by offering face to face, at our Gresham location & in schools, with our school based program and all over Oregon, with our Telehealth program. We serve families utilizing family systems and parenting support, individuals utilizing PLAY therapy and talk therapy. We believe that parents, children, teens & young adults should be equipped with tools for success! Our Hybrid model of support might be what you've been searching for.
Eastside Child and Family Therapy is a counseling group practice serving parents, early childhood, children, teens & young adults. We believe in removing some of the barriers to therapy by offering face to face, at our Gresham location & in schools, with our school based program and all over Oregon, with our Telehealth program. We serve families utilizing family systems and parenting support, individuals utilizing PLAY therapy and talk therapy. We believe that parents, children, teens & young adults should be equipped with tools for success! Our Hybrid model of support might be what you've been searching for.
(503) 676-5022 View (503) 676-5022
Photo of Natasha Kutzke, Marriage & Family Therapist in Gresham, OR
Natasha Kutzke
Marriage & Family Therapist, MA, MFT
Verified Verified
2 Endorsed
Gresham, OR 97030  (Online Only)
I have a dedication to collaborating with driven individuals eager to embark on a sincere journey of self-discovery. My goal is to empower them to lead more authentic lives free from shame. I specialize in assisting clients dealing with issues such as childhood trauma, I support clients in cultivating self-awareness and overcoming obstacles that hinder them from authentically embracing their lives without shame, acknowledging and honoring all dimensions of their identity and aspirations. My therapeutic approach is trauma-informed, sex-positive, body-neutral, anti-racist, and affirming of LGBTQIA+ and polyamorous experiences.
I have a dedication to collaborating with driven individuals eager to embark on a sincere journey of self-discovery. My goal is to empower them to lead more authentic lives free from shame. I specialize in assisting clients dealing with issues such as childhood trauma, I support clients in cultivating self-awareness and overcoming obstacles that hinder them from authentically embracing their lives without shame, acknowledging and honoring all dimensions of their identity and aspirations. My therapeutic approach is trauma-informed, sex-positive, body-neutral, anti-racist, and affirming of LGBTQIA+ and polyamorous experiences.
(503) 974-1165 View (503) 974-1165
Photo of New Pattern Counseling, Licensed Professional Counselor in Gresham, OR
New Pattern Counseling
Licensed Professional Counselor, LPC, CADC, II, MA
Verified Verified
1 Endorsed
Gresham, OR 97030
We are an inter-disciplinary team supporting long term sobriety and trauma healing for individuals, couples, youth, and families. Every role and relationship in the family needs support to heal from addiction and trauma. We specialize in the intersection between substance use, sex addiction, betrayal trauma, other trauma, attachment distress, and faith crisis. We promote healing and recovery through cultivating a sober way of life that heals and transforms a person's relationships to their body, to primary partners, children, peers, community, and seeks resilience through meaningful spiritual practices.
We are an inter-disciplinary team supporting long term sobriety and trauma healing for individuals, couples, youth, and families. Every role and relationship in the family needs support to heal from addiction and trauma. We specialize in the intersection between substance use, sex addiction, betrayal trauma, other trauma, attachment distress, and faith crisis. We promote healing and recovery through cultivating a sober way of life that heals and transforms a person's relationships to their body, to primary partners, children, peers, community, and seeks resilience through meaningful spiritual practices.
(971) 803-3609 View (971) 803-3609
Photo of Nancy Maloy, Licensed Professional Counselor in Gresham, OR
Nancy Maloy
Licensed Professional Counselor, LPC
Verified Verified
Gresham, OR 97030
I am an experienced Therapist. I offer counseling to couples, families and individuals. Most couples that I work with have strengths and struggles. I assist them in tuning-up their communication and problem solving skills. Individuals are often seeking therapy to better understand and treat their symptoms; such as depression, anxiety, PTSD, past unresolved issues. Causes are many; including relationship conflict, parenting, aging, illness, jobs and other life stressors. I have experience working with gay/lesbian individuals.
I am an experienced Therapist. I offer counseling to couples, families and individuals. Most couples that I work with have strengths and struggles. I assist them in tuning-up their communication and problem solving skills. Individuals are often seeking therapy to better understand and treat their symptoms; such as depression, anxiety, PTSD, past unresolved issues. Causes are many; including relationship conflict, parenting, aging, illness, jobs and other life stressors. I have experience working with gay/lesbian individuals.
(503) 907-9458 View (503) 907-9458
Photo of Take The Reins Counseling & Consulting, LPC Intern in Gresham, OR
Take The Reins Counseling & Consulting
LPC Intern, MS, CRC
Verified Verified
1 Endorsed
Gresham, OR 97030
The days are getting longer, and brighter times are ahead. Spring is a season of renewal – a great time to refresh your mental well-being too. If you need a listening ear, guidance, or a boost of support, our doors are open. Let's work together to help you blossom. Overcoming anxiety and depression? Let's break free from negative thoughts and feelings and build a brighter future.
The days are getting longer, and brighter times are ahead. Spring is a season of renewal – a great time to refresh your mental well-being too. If you need a listening ear, guidance, or a boost of support, our doors are open. Let's work together to help you blossom. Overcoming anxiety and depression? Let's break free from negative thoughts and feelings and build a brighter future.
(503) 461-5776 View (503) 461-5776
Photo of Secret Room Therapy Center LLC, Clinical Social Work/Therapist in Gresham, OR
Secret Room Therapy Center LLC
Clinical Social Work/Therapist, MSW, LCSW, CADC
Verified Verified
Gresham, OR 97030
The Secret Room is the ancient word for chrysalis.Its within the walls of the chrysalis "the safe and protected space" that total transformation takes place. It is the secrets that are within our family systems the secrets that we keep from ourselves and the secrets that others keep that we need to be freed from. Within the safety of The Secret Room you will be able to transform to your highest potential and unveil the secrets that hold you back from the life you truly want and deserve!
The Secret Room is the ancient word for chrysalis.Its within the walls of the chrysalis "the safe and protected space" that total transformation takes place. It is the secrets that are within our family systems the secrets that we keep from ourselves and the secrets that others keep that we need to be freed from. Within the safety of The Secret Room you will be able to transform to your highest potential and unveil the secrets that hold you back from the life you truly want and deserve!
(503) 212-9518 View (503) 212-9518
Photo of Emily A LaMarca, Professional Counselor Associate in Gresham, OR
Emily A LaMarca
Professional Counselor Associate, MA
Verified Verified
Gresham, OR 97030
I believe that everyone has the strength and potential to heal and lead a rich and fulfilling life but the way we think often informs how we feel and behave. Together we can work on confronting harmful and distorted thought patterns in order to develop healthier and more hopeful views of life and the future. This can involve acknowledging past hurts, working through trauma, learning new ways to cope with anxiety or depression, practicing self-acceptance, developing and maintaining self-care habits, learning mindfulness exercises, and so much more.
I believe that everyone has the strength and potential to heal and lead a rich and fulfilling life but the way we think often informs how we feel and behave. Together we can work on confronting harmful and distorted thought patterns in order to develop healthier and more hopeful views of life and the future. This can involve acknowledging past hurts, working through trauma, learning new ways to cope with anxiety or depression, practicing self-acceptance, developing and maintaining self-care habits, learning mindfulness exercises, and so much more.
(503) 496-7857 View (503) 496-7857

How does your Therapist compare?

Number of Therapists in Gresham, OR

100+

Average cost per session

$160

Therapists in Gresham, OR who prioritize treating:

94% Anxiety
90% Depression
80% Self Esteem
78% Trauma and PTSD
76% Relationship Issues
71% Stress
65% Grief

Average years in practice

10 Years

Top 3 insurances accepted

47% PacificSource
46% Aetna
46% BlueCross and BlueShield

How Therapists in Gresham, OR see their clients

57% In Person and Online
43% Online Only

Gender breakdown

77% Female
22% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Gresham?

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.