Therapists in Middletown, CT

Photo of Strong Minds, LLC, Licensed Professional Counselor in Middletown, CT
Strong Minds, LLC
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Middletown, CT 06457
My name is Katelynn Bento, I am a licensed professional counselor and I am the owner of Strong Minds, LLC. My hours are flexible, but they will be Monday-Friday. During your initial visit we will spend some time getting to know one another and what your goals are for treatment. I have 6 years’ experience working in mental health predominantly in the hospital setting. I have a lot of experience working with trauma, anxiety, depression, binge eating disorders, gender identity issues, addiction, and mood disorders.
My name is Katelynn Bento, I am a licensed professional counselor and I am the owner of Strong Minds, LLC. My hours are flexible, but they will be Monday-Friday. During your initial visit we will spend some time getting to know one another and what your goals are for treatment. I have 6 years’ experience working in mental health predominantly in the hospital setting. I have a lot of experience working with trauma, anxiety, depression, binge eating disorders, gender identity issues, addiction, and mood disorders.
(860) 385-6434 View (860) 385-6434
Photo of Katie Conforti, Licensed Professional Counselor in Middletown, CT
Katie Conforti
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Middletown, CT 06457
Not accepting new clients
***Not currently accepting new clients*** Self-care and finding balance are so important. I would like to help you feel more at ease, and better able to handle some of life's difficulties. I have worked with a diverse range of individuals seeking support in areas such as depression, anxiety, stress management, grief and loss, relationship issues, infertility, trauma, and addiction.
***Not currently accepting new clients*** Self-care and finding balance are so important. I would like to help you feel more at ease, and better able to handle some of life's difficulties. I have worked with a diverse range of individuals seeking support in areas such as depression, anxiety, stress management, grief and loss, relationship issues, infertility, trauma, and addiction.
(959) 500-6106 View (959) 500-6106
Photo of Donna S. Grisham, Drug & Alcohol Counselor in Middletown, CT
Donna S. Grisham
Drug & Alcohol Counselor, LADC, LCSW
Verified Verified
1 Endorsed
Middletown, CT 06457
My work as a Licensed Alcohol and Drug Counselor and a Licensed Clinical Social Worker with a Master of Social Work in Mental Health and Addiction is to assist individuals and family members in reaching their goals and potential as they overcome their challenges and make use of their opportunities. I have had the pleasure of working with people in this field for over 20 years.
My work as a Licensed Alcohol and Drug Counselor and a Licensed Clinical Social Worker with a Master of Social Work in Mental Health and Addiction is to assist individuals and family members in reaching their goals and potential as they overcome their challenges and make use of their opportunities. I have had the pleasure of working with people in this field for over 20 years.
(860) 598-4672 View (860) 598-4672
Photo of Heather Ram, Marriage & Family Therapist in Middletown, CT
Heather Ram
Marriage & Family Therapist, LMFT
Verified Verified
11 Endorsed
Middletown, CT 06457
Daytime availability only: I have been privileged to work with a wide variety of clients and know that everyone feels "stuck" at some point in time. Men, women, and kids are all managing the stress of work, school, family, and intimate relationships. I have demonstrated success helping people manage stress, and I know that everyone in your personal and professional life benefits when you feel more capable of dealing with life's emotional challenges. I help you get "unstuck" and move past your sadness, your fears, your anger, and your frustrations.
Daytime availability only: I have been privileged to work with a wide variety of clients and know that everyone feels "stuck" at some point in time. Men, women, and kids are all managing the stress of work, school, family, and intimate relationships. I have demonstrated success helping people manage stress, and I know that everyone in your personal and professional life benefits when you feel more capable of dealing with life's emotional challenges. I help you get "unstuck" and move past your sadness, your fears, your anger, and your frustrations.
(860) 305-4500 View (860) 305-4500
Photo of Winifred M Neville, Licensed Professional Counselor in Middletown, CT
Winifred M Neville
Licensed Professional Counselor, LPC
Verified Verified
Middletown, CT 06457
Waitlist for new clients
I have been working in the field of Mental Health and Addiction for 20 years. I graduated with a Master's degree in Mental Health Counseling from CCSU. My main focus is trauma, centering on Addictions, including substance abuse, eating disorders and excessive spending, however, I am also experienced working with clients who have, depression, anxiety or trauma related symptoms. I have extensive experience working with adolescents and adults I believe strongly in recovery, use various therapeutic approaches to assist clients to live a productive and self directed life. And pets are always welcome so bring yours in.
I have been working in the field of Mental Health and Addiction for 20 years. I graduated with a Master's degree in Mental Health Counseling from CCSU. My main focus is trauma, centering on Addictions, including substance abuse, eating disorders and excessive spending, however, I am also experienced working with clients who have, depression, anxiety or trauma related symptoms. I have extensive experience working with adolescents and adults I believe strongly in recovery, use various therapeutic approaches to assist clients to live a productive and self directed life. And pets are always welcome so bring yours in.
(860) 406-5906 x1 View (860) 406-5906 x1
Photo of Full and Fit Family LLC Erika Moses, Clinical Social Work/Therapist in Middletown, CT
Full and Fit Family LLC Erika Moses
Clinical Social Work/Therapist, LCSW
Verified Verified
Middletown, CT 06457
“Currently Holding Video Sessions.” Are you like many others, whom on a daily basis, face a variety of stressors and struggle to keep things organized? Do you, or a close family member juggle many roles, such as work, family, children and relationships? As a Licensed Clinical Social Worker, I understand that some days are overwhelming, and stress can take an emotional toll. In my practice, I work to help people identify the best ways to incorporate balance in their ever changing lives. Through a supportive environment people learn how to take time for themselves, and/or develop ways to manage more chronic emotional conditions.
“Currently Holding Video Sessions.” Are you like many others, whom on a daily basis, face a variety of stressors and struggle to keep things organized? Do you, or a close family member juggle many roles, such as work, family, children and relationships? As a Licensed Clinical Social Worker, I understand that some days are overwhelming, and stress can take an emotional toll. In my practice, I work to help people identify the best ways to incorporate balance in their ever changing lives. Through a supportive environment people learn how to take time for themselves, and/or develop ways to manage more chronic emotional conditions.
(203) 779-6374 View (203) 779-6374
Photo of Shanyah Wright, Marriage & Family Therapist in Middletown, CT
Shanyah Wright
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Middletown, CT 06457  (Online Only)
Life is a journey with ebbs and flows. Whether you're enjoying the highs of life, facing a low point, or somewhere in between, therapy always adds value and helps to ground us no matter where we are on that journey. As it is often said, healing isn't linear and it's an ever evolving process. The more we seek to heal ourselves, the more it shifts and impacts our relationships with others. And I hope to walk alongside you on your journey to a healthier you and healthier relationships.
Life is a journey with ebbs and flows. Whether you're enjoying the highs of life, facing a low point, or somewhere in between, therapy always adds value and helps to ground us no matter where we are on that journey. As it is often said, healing isn't linear and it's an ever evolving process. The more we seek to heal ourselves, the more it shifts and impacts our relationships with others. And I hope to walk alongside you on your journey to a healthier you and healthier relationships.
(860) 530-4678 View (860) 530-4678
Photo of Katie Chesanek, Clinical Social Work/Therapist in Middletown, CT
Katie Chesanek
Clinical Social Work/Therapist, MA, LCSW
Verified Verified
Middletown, CT 06457
Are you feeling anxious or depressed? Struggling with a life transition such as beginning college or a divorce? Grieving the loss of a loved one? The decision you have made to start therapy is an incredibly important first step in improving your quality of life and achieving your wellness goals. I am happy you are here!
Are you feeling anxious or depressed? Struggling with a life transition such as beginning college or a divorce? Grieving the loss of a loved one? The decision you have made to start therapy is an incredibly important first step in improving your quality of life and achieving your wellness goals. I am happy you are here!
View
Photo of Chelsea Poloski, Clinical Social Work/Therapist in Middletown, CT
Chelsea Poloski
Clinical Social Work/Therapist, LCSW
Verified Verified
Middletown, CT 06457
Waitlist for new clients
I believe in being real. I believe in being vulnerable. I believe the foundation for a successful therapy experience is engaging in an authentic & genuine relationship. I specialize in working with female adolescents and young adults as well as clients of the LGBTQIA+ community. I have extensive experience working with individuals struggling with anxiety, depression, low self-esteem, self-harm, body image challenges, sexuality and gender identity, as well as other behavioral health concerns.
I believe in being real. I believe in being vulnerable. I believe the foundation for a successful therapy experience is engaging in an authentic & genuine relationship. I specialize in working with female adolescents and young adults as well as clients of the LGBTQIA+ community. I have extensive experience working with individuals struggling with anxiety, depression, low self-esteem, self-harm, body image challenges, sexuality and gender identity, as well as other behavioral health concerns.
(860) 578-8550 View (860) 578-8550
Photo of Katie McDermott, Clinical Social Work/Therapist in Middletown, CT
Katie McDermott
Clinical Social Work/Therapist, LCSW
Verified Verified
3 Endorsed
Middletown, CT 06457
Welcome! Life is hard, support is needed. I am passionate about providing a space for individuals to explore and facilitate ways to help them reach their own self-identified goals in life. I learn so much from the individuals I see everyday and consider that a very exciting honor. It can be so interesting to learn “why we do/feel what we do”. As a therapist trained in EMDR, I'm a big believer in the need to "go back" before we can move forward in a different way. Therapy is an opportunity to begin to heal past wounds so that we can navigate life free from the negative thoughts and painful memories that can make it so difficult.
Welcome! Life is hard, support is needed. I am passionate about providing a space for individuals to explore and facilitate ways to help them reach their own self-identified goals in life. I learn so much from the individuals I see everyday and consider that a very exciting honor. It can be so interesting to learn “why we do/feel what we do”. As a therapist trained in EMDR, I'm a big believer in the need to "go back" before we can move forward in a different way. Therapy is an opportunity to begin to heal past wounds so that we can navigate life free from the negative thoughts and painful memories that can make it so difficult.
(860) 200-3445 View (860) 200-3445
Photo of Carrissa Phipps, Psychologist in Middletown, CT
Carrissa Phipps
Psychologist, PhD
Verified Verified
6 Endorsed
Middletown, CT 06457
Not accepting new clients
NOT CURRENTLY ACCEPTING NEW CLIENTS. SEE WEBSITE TO LEARN ABOUT OTHER THERAPISTS ON THE SMALL VICTORIES TEAM. In this moment, you're taking a courageous step by exploring your options for psychotherapy. It's a small victory, and you deserve to own it! Whether it's your first time trying therapy or you're looking to start again, seeking change can feel really overwhelming. You might be hoping to heal from your past, adjusting to major positive or negative changes in your life, managing anxiety that is limiting you in some way, or feeling so down and lost that it's hard to enjoy life like you used to.
NOT CURRENTLY ACCEPTING NEW CLIENTS. SEE WEBSITE TO LEARN ABOUT OTHER THERAPISTS ON THE SMALL VICTORIES TEAM. In this moment, you're taking a courageous step by exploring your options for psychotherapy. It's a small victory, and you deserve to own it! Whether it's your first time trying therapy or you're looking to start again, seeking change can feel really overwhelming. You might be hoping to heal from your past, adjusting to major positive or negative changes in your life, managing anxiety that is limiting you in some way, or feeling so down and lost that it's hard to enjoy life like you used to.
(860) 947-4758 View (860) 947-4758
Photo of Keona Leary, Licensed Professional Counselor in Middletown, CT
Keona Leary
Licensed Professional Counselor, MA, NCC, LPC
Verified Verified
1 Endorsed
Middletown, CT 06457
l believe growth starts with a number of stages and experiences. The process of counseling is an ongoing experience that includes the elements of a flourishing plant.
l believe growth starts with a number of stages and experiences. The process of counseling is an ongoing experience that includes the elements of a flourishing plant.
(860) 615-3631 View (860) 615-3631
Photo of Viv Torres-Calcagno, Licensed Professional Counselor in Middletown, CT
Viv Torres-Calcagno
Licensed Professional Counselor, LPC, ATR-BC
Verified Verified
1 Endorsed
Middletown, CT 06457  (Online Only)
I’m Viviana Torres-Calcagno, a licensed Art Therapist, Professional Counselor and artist. Whether you are looking to process, heal and move through trauma, regulate your nervous system, work through grief, life transitions, or relationship problems, or slow down, connect to nature, and find your soul’s sacred purpose, I feel passionate about working with you from a wholistic, humanistic, and strength-based approach to help you build the tools and skills to live a more nourishing life that is more in alignment with your true self.
I’m Viviana Torres-Calcagno, a licensed Art Therapist, Professional Counselor and artist. Whether you are looking to process, heal and move through trauma, regulate your nervous system, work through grief, life transitions, or relationship problems, or slow down, connect to nature, and find your soul’s sacred purpose, I feel passionate about working with you from a wholistic, humanistic, and strength-based approach to help you build the tools and skills to live a more nourishing life that is more in alignment with your true self.
(860) 580-5349 View (860) 580-5349
Photo of Laura Liistro, Clinical Social Work/Therapist in Middletown, CT
Laura Liistro
Clinical Social Work/Therapist, LCSW
Verified Verified
Middletown, CT 06457
Waitlist for new clients
Currently Waitlist for New Clients If you are suffering and looking for an environment to share your thoughts, feelings, and anxieties; I would love to provide the safe and judgement free space for you to do so. As a team, we will create a plan to tackle the things you are struggling with and help you become the best version of yourself.
Currently Waitlist for New Clients If you are suffering and looking for an environment to share your thoughts, feelings, and anxieties; I would love to provide the safe and judgement free space for you to do so. As a team, we will create a plan to tackle the things you are struggling with and help you become the best version of yourself.
(860) 935-6727 View (860) 935-6727
Photo of Michael Probert, Clinical Social Work/Therapist in Middletown, CT
Michael Probert
Clinical Social Work/Therapist, LCSW
Verified Verified
Middletown, CT 06457
Now Accepting New Patients! I specialize in treating people who are feeling overwhelmed, anxious, depressed, or desiring something better out of life. I have over 15 years of experience treating people with depression, anxiety, and trauma as well as those struggling to have satisfying relationships with other people. I use a person-centered, psychodynamic approach during treatment. I have been trained in cognitive behavioral therapy, motivational interviewing, dialectical behavior therapy, and mindfulness.
Now Accepting New Patients! I specialize in treating people who are feeling overwhelmed, anxious, depressed, or desiring something better out of life. I have over 15 years of experience treating people with depression, anxiety, and trauma as well as those struggling to have satisfying relationships with other people. I use a person-centered, psychodynamic approach during treatment. I have been trained in cognitive behavioral therapy, motivational interviewing, dialectical behavior therapy, and mindfulness.
(860) 854-4425 View (860) 854-4425
Photo of Samantha Jean Pelkey-Flock, Licensed Professional Counselor in Middletown, CT
Samantha Jean Pelkey-Flock
Licensed Professional Counselor, MS, LPC, NCC
Verified Verified
1 Endorsed
Middletown, CT 06457
Life has a way of proving just how much is out of our control, but that doesn’t have to stop us from pursuing and achieving our goals. While navigating roadblocks, therapy can help you process feelings of uncertainty, loneliness and anxiety. I understand how difficult the journey to mental wellness can be and am honored to walk beside you. Ultimately, I believe in your ability to discern the right path and solutions. I believe it is my role to assist in uncovering those answers and support healing while offering a space to be vulnerable. I specialize in the treatment of anxiety, depression, infertility, and life transitions.
Life has a way of proving just how much is out of our control, but that doesn’t have to stop us from pursuing and achieving our goals. While navigating roadblocks, therapy can help you process feelings of uncertainty, loneliness and anxiety. I understand how difficult the journey to mental wellness can be and am honored to walk beside you. Ultimately, I believe in your ability to discern the right path and solutions. I believe it is my role to assist in uncovering those answers and support healing while offering a space to be vulnerable. I specialize in the treatment of anxiety, depression, infertility, and life transitions.
(860) 485-7420 View (860) 485-7420
Photo of Amy LaMarre, Marriage & Family Therapist in Middletown, CT
Amy LaMarre
Marriage & Family Therapist, LMFT
Verified Verified
Middletown, CT 06457
Daytime openings! We are all constantly changing. We may have already accomplished goals in our lives, yet are at a crossroads again. This time, we may wish to seek help, whether it’s to develop a goal, figure out what may be a little “off” in our life or maybe some direction with some heavier challenges. I specifically have experience working with substance use disorders, infant mental health and parent-child attachment. I've been trained in Infant Mental Health, Risking Connection, Seeking Safety as well as Circle of Security, but have worked with many individuals and families with varying reasons that brought them to therapy.
Daytime openings! We are all constantly changing. We may have already accomplished goals in our lives, yet are at a crossroads again. This time, we may wish to seek help, whether it’s to develop a goal, figure out what may be a little “off” in our life or maybe some direction with some heavier challenges. I specifically have experience working with substance use disorders, infant mental health and parent-child attachment. I've been trained in Infant Mental Health, Risking Connection, Seeking Safety as well as Circle of Security, but have worked with many individuals and families with varying reasons that brought them to therapy.
(860) 485-7917 View (860) 485-7917
Photo of Karen Walsh, Licensed Professional Counselor in Middletown, CT
Karen Walsh
Licensed Professional Counselor, LPC
Verified Verified
Middletown, CT 06457
Not accepting new clients
Unfortunately, I am not accepting new clients. Is anger or anxiety preventing you from living your best life? Let me help you manage your emotions and embrace the joys surrounding you. We'll explore the thoughts that are getting in the way of your happiness and the patterns of behavior that are keeping you from living your dreams. Let's work together to make your dream life a reality!
Unfortunately, I am not accepting new clients. Is anger or anxiety preventing you from living your best life? Let me help you manage your emotions and embrace the joys surrounding you. We'll explore the thoughts that are getting in the way of your happiness and the patterns of behavior that are keeping you from living your dreams. Let's work together to make your dream life a reality!
(860) 390-5036 View (860) 390-5036
Photo of Michelle M Pellin, Licensed Professional Counselor in Middletown, CT
Michelle M Pellin
Licensed Professional Counselor, MS, MA, LPC, CBIS, LLC
Verified Verified
1 Endorsed
Middletown, CT 06457  (Online Only)
Do you feel lost? Is everyday a chore to get through? Do you want to feel heard and validated? Let me help you facilitate your healing journey and find the joy in life again by using many different conventional techniques (and spiritual, only for those who are open to it), in an open and affirming space to all walks of life. My services include both clinical counseling and/or life coaching services, in order to help you be the best version of you and find happiness again. One of my favorite techniques is called Accelerated Resolution Therapy (ART), which assists in removing the intense emotions related to traumatic flashbacks.
Do you feel lost? Is everyday a chore to get through? Do you want to feel heard and validated? Let me help you facilitate your healing journey and find the joy in life again by using many different conventional techniques (and spiritual, only for those who are open to it), in an open and affirming space to all walks of life. My services include both clinical counseling and/or life coaching services, in order to help you be the best version of you and find happiness again. One of my favorite techniques is called Accelerated Resolution Therapy (ART), which assists in removing the intense emotions related to traumatic flashbacks.
(203) 496-4923 View (203) 496-4923
Photo of Richard V. Daly, Clinical Social Work/Therapist in Middletown, CT
Richard V. Daly
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Middletown, CT 06457
Warm greetings, I am happy that you have found your way here and I am looking forward to helping. It is important for you to know that my approach to therapy is solution focused and strength based. I am a highly experienced therapist with over 40 years of clinical treatment experience. My main interests and expertise as a therapist center around Individual therapy, Couples Therapy, Parenting and Substance Abuse. During my long and rewarding career I have worked as a primary therapist with individual adults, families, children, couples and groups and as a parenting coach. I thoroughly enjoy my work and look forward to helping you.
Warm greetings, I am happy that you have found your way here and I am looking forward to helping. It is important for you to know that my approach to therapy is solution focused and strength based. I am a highly experienced therapist with over 40 years of clinical treatment experience. My main interests and expertise as a therapist center around Individual therapy, Couples Therapy, Parenting and Substance Abuse. During my long and rewarding career I have worked as a primary therapist with individual adults, families, children, couples and groups and as a parenting coach. I thoroughly enjoy my work and look forward to helping you.
(959) 210-0115 View (959) 210-0115

How does your Therapist compare?

Number of Therapists in Middletown, CT

200+

Average cost per session

$150

Therapists in Middletown, CT who prioritize treating:

93% Anxiety
90% Depression
83% Relationship Issues
79% Self Esteem
74% Trauma and PTSD
71% Coping Skills
67% Stress

Average years in practice

12 Years

Top 3 insurances accepted

76% Cigna and Evernorth
72% Husky | CT BHP
70% Aetna

How Therapists in Middletown, CT see their clients

71% In Person and Online
29% Online Only

Gender breakdown

89% Female
11% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Middletown?

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.