Therapists in Burlington, VT

Photo of Lisa K Lax, Clinical Social Work/Therapist in Burlington, VT
Lisa K Lax
Clinical Social Work/Therapist, MSW, LICSW, EdD
Verified Verified
1 Endorsed
Burlington, VT 05401
Not accepting new clients
I have extensive experience as a psychotherapist and clinical social worker. I enjoy working with adults of all ages and backgrounds, and have the experience, training, and skills to help with a wide array of issues and problems. My specialties include general mental health issues, family and relationship problems, work related stress, life transitions, care-giving, grief and loss. I also provide clinical supervision and consultation on clinical and organizational issues.
I have extensive experience as a psychotherapist and clinical social worker. I enjoy working with adults of all ages and backgrounds, and have the experience, training, and skills to help with a wide array of issues and problems. My specialties include general mental health issues, family and relationship problems, work related stress, life transitions, care-giving, grief and loss. I also provide clinical supervision and consultation on clinical and organizational issues.
(802) 992-8248 View (802) 992-8248
Photo of Diana Buchanan, Registered Psychotherapist in Burlington, VT
Diana Buchanan
Registered Psychotherapist, MSW
Verified Verified
Burlington, VT 05401
Waitlist for new clients
Note: I am not able to take new clients at the moment but I can still provide support letters for gender affirming surgery. I am a transgender woman who specializes in working collaboratively with transgender and gender diverse adults. I understand from personal experience that many of us feel like others have written our life stories and that these stories don’t reflect who we really are. Using the strengths-based framework of narrative therapy, I will help you take control of your life story and find your happily ever after.
Note: I am not able to take new clients at the moment but I can still provide support letters for gender affirming surgery. I am a transgender woman who specializes in working collaboratively with transgender and gender diverse adults. I understand from personal experience that many of us feel like others have written our life stories and that these stories don’t reflect who we really are. Using the strengths-based framework of narrative therapy, I will help you take control of your life story and find your happily ever after.
(802) 210-3446 x462 View (802) 210-3446 x462
Photo of Aida R Luce, Counselor in Burlington, VT
Aida R Luce
Counselor, LCMHC, MAFT
Verified Verified
1 Endorsed
Burlington, VT 05401
Aida Luce has been practicing for over 30 years, she is committed and passionate about her work. She comes from the perspective that therapy is a very private and personal relationship that is enhanced by mutual respect. Aida cares deeply about social justice, holistic health and the mind/body connection. Aida works with couples , and families as one of her specialities. I am working with couples and individuals virtually. I am accepting new clients at this time. Be in touch, and stay safe!!
Aida Luce has been practicing for over 30 years, she is committed and passionate about her work. She comes from the perspective that therapy is a very private and personal relationship that is enhanced by mutual respect. Aida cares deeply about social justice, holistic health and the mind/body connection. Aida works with couples , and families as one of her specialities. I am working with couples and individuals virtually. I am accepting new clients at this time. Be in touch, and stay safe!!
(802) 238-5974 View (802) 238-5974
Photo of Song Lee, Registered Psychotherapist in Burlington, VT
Song Lee
Registered Psychotherapist, MS, JD
Verified Verified
Burlington, VT 05401
Waitlist for new clients
As a therapist, my approach is grounded in blending Internal Family Systems (IFS) understandings (includes psychodynamic and mindfulness practices) and somatic psychotherapy to increase aliveness, build meta-cognitive self-understanding, and promote self-regulation. This approach works with the whole person by addressing conflicts cognitively, emotionally and physically. Clients can gain greater awareness of old patterns of action and reaction, increased capacity to tolerate and resolve conflict or trauma and enhanced ability to experience pleasure.
As a therapist, my approach is grounded in blending Internal Family Systems (IFS) understandings (includes psychodynamic and mindfulness practices) and somatic psychotherapy to increase aliveness, build meta-cognitive self-understanding, and promote self-regulation. This approach works with the whole person by addressing conflicts cognitively, emotionally and physically. Clients can gain greater awareness of old patterns of action and reaction, increased capacity to tolerate and resolve conflict or trauma and enhanced ability to experience pleasure.
(802) 526-6897 View (802) 526-6897
Photo of Heloise Thorne Williams, Counselor in Burlington, VT
Heloise Thorne Williams
Counselor, MA, LCMHC
Verified Verified
3 Endorsed
Burlington, VT 05401
Not accepting new clients
Life can often feel difficult, confusing or overwhelming. Seeking help and finding the right counseling relationship can be challenging as well. My goal is to help you connect to your own inner guidance system. As an existentialist and a feminist counselor, it is my belief that people need to find a sense of purpose and meaning within themselves because the world outside doesn't always make sense. The stories we have told ourselves or been told about ourselves can have a significant impact on how we feel. The result can be depression, anxiety, anger, hopelessness, or confusion.
Life can often feel difficult, confusing or overwhelming. Seeking help and finding the right counseling relationship can be challenging as well. My goal is to help you connect to your own inner guidance system. As an existentialist and a feminist counselor, it is my belief that people need to find a sense of purpose and meaning within themselves because the world outside doesn't always make sense. The stories we have told ourselves or been told about ourselves can have a significant impact on how we feel. The result can be depression, anxiety, anger, hopelessness, or confusion.
(802) 613-0982 View (802) 613-0982
Photo of Victoria Diederich, Pre-Licensed Professional in Burlington, VT
Victoria Diederich
Pre-Licensed Professional, MA, LLC
Verified Verified
1 Endorsed
Burlington, VT 05401
Not accepting new clients
Are you looking to find a greater sense of self-compassion, ease, and presence in your daily life? Maybe you are feeling stuck with anxiety, low self-esteem, or relationship issues and can't seem to move forward in a new way. As a therapist, I aim to help you uncover the healing energy and wisdom that already exists within you. You will receive guidance and support in becoming more present and connecting with yourself, while processing past experiences and exploring current patterns that may be holding you back. Come as you are; I will meet you there.
Are you looking to find a greater sense of self-compassion, ease, and presence in your daily life? Maybe you are feeling stuck with anxiety, low self-esteem, or relationship issues and can't seem to move forward in a new way. As a therapist, I aim to help you uncover the healing energy and wisdom that already exists within you. You will receive guidance and support in becoming more present and connecting with yourself, while processing past experiences and exploring current patterns that may be holding you back. Come as you are; I will meet you there.
(802) 347-6663 View (802) 347-6663
Photo of John Roberts, Counselor in Burlington, VT
John Roberts
Counselor, MA, LCMHC
Verified Verified
1 Endorsed
Burlington, VT 05401
I believe that our mental health 'symptoms' are often our psyche's way of calling us to a different way of living. Each struggle in our lives is an opportunity for self-awareness and personal growth. Through many years of experience, I have developed an integrated approach utilizing the best practices in the field of psychotherapy. My approach adapts to the uniqueness of each individual and their own personal story, beliefs and interests. The foundation of my work is the development of a meaningful, trusting relationship with my clients.
I believe that our mental health 'symptoms' are often our psyche's way of calling us to a different way of living. Each struggle in our lives is an opportunity for self-awareness and personal growth. Through many years of experience, I have developed an integrated approach utilizing the best practices in the field of psychotherapy. My approach adapts to the uniqueness of each individual and their own personal story, beliefs and interests. The foundation of my work is the development of a meaningful, trusting relationship with my clients.
(802) 328-0327 View (802) 328-0327
Photo of Lauren Grant, Pre-Licensed Professional in Burlington, VT
Lauren Grant
Pre-Licensed Professional, MSW
Verified Verified
Burlington, VT 05401  (Online Only)
Waitlist for new clients
As humans, we experience both internal and external challenges as we navigate life, and how we understand and approach these challenges is what informs our mental and emotional wellbeing. As a therapist, I work with individuals who are experiencing such challenges and are seeking support in better understanding them as well as navigating them. Grounded in a strengths-based understanding of counseling, I approach my work with compassion, genuine curiosity and authenticity to best support individuals’ feelings of connection, insight and healing.
As humans, we experience both internal and external challenges as we navigate life, and how we understand and approach these challenges is what informs our mental and emotional wellbeing. As a therapist, I work with individuals who are experiencing such challenges and are seeking support in better understanding them as well as navigating them. Grounded in a strengths-based understanding of counseling, I approach my work with compassion, genuine curiosity and authenticity to best support individuals’ feelings of connection, insight and healing.
(802) 577-2772 View (802) 577-2772
Photo of Nyarkoa Mensah-Jordan, Clinical Social Work/Therapist in Burlington, VT
Nyarkoa Mensah-Jordan
Clinical Social Work/Therapist, LICSW
Verified Verified
Burlington, VT 05401
What if finding your way back to your own peace of mind, mental health, confidence and joy wasn't as hard as you thought? What if you didn’t have to relive past pain and trauma in order to heal? What if everything you need to live a beautiful life is already within you? You are not broken. You are not damaged goods. You are a whole, complete and beautiful human being. As a creative, collaborative, deeply compassionate therapist, I believe that the power for transformation lies in pointing you in the direction of your own innate intelligence and wisdom.
What if finding your way back to your own peace of mind, mental health, confidence and joy wasn't as hard as you thought? What if you didn’t have to relive past pain and trauma in order to heal? What if everything you need to live a beautiful life is already within you? You are not broken. You are not damaged goods. You are a whole, complete and beautiful human being. As a creative, collaborative, deeply compassionate therapist, I believe that the power for transformation lies in pointing you in the direction of your own innate intelligence and wisdom.
(802) 768-7712 View (802) 768-7712
Photo of Kerry K Skiffington, Licensed Clinical Mental Health Counselor in Burlington, VT
Kerry K Skiffington
Licensed Clinical Mental Health Counselor, MA, LCHMC, DHyp
Verified Verified
Burlington, VT 05408  (Online Only)
Life is a daring adventure... with a lot of pitfalls and crash landings. Sometimes you need help to get out, over and/or through. I provide psychotherapy with respect, compassion, and a sense of humor to guide and walk alongside you. I focus on skill-building and helping you become the hero of your own life, sometimes combining counseling with hypnotherapy. I follow the Intentional Peer Support philosophy: there is nothing wrong with you; and you are the expert on your own life.
Life is a daring adventure... with a lot of pitfalls and crash landings. Sometimes you need help to get out, over and/or through. I provide psychotherapy with respect, compassion, and a sense of humor to guide and walk alongside you. I focus on skill-building and helping you become the hero of your own life, sometimes combining counseling with hypnotherapy. I follow the Intentional Peer Support philosophy: there is nothing wrong with you; and you are the expert on your own life.
(802) 266-4538 View (802) 266-4538
Photo of Michael P Schaal, Clinical Social Work/Therapist in Burlington, VT
Michael P Schaal
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Burlington, VT 05401
Waitlist for new clients
I assist and support individuals and couples to live from the deepest places, to make meaning in their lives, and to improve functioning within self, and between self and others. I offer possibility. I have been in the private practice of psychotherapy since 1977. Clients sometimes come to me when therapy with other therapists has not worked. I am willing to go as deeply as you are within the safety of clear ethical boundaries. I value difference and work to hold and accept and work with differences, whether they be personal, sexual, racial or cultural.
I assist and support individuals and couples to live from the deepest places, to make meaning in their lives, and to improve functioning within self, and between self and others. I offer possibility. I have been in the private practice of psychotherapy since 1977. Clients sometimes come to me when therapy with other therapists has not worked. I am willing to go as deeply as you are within the safety of clear ethical boundaries. I value difference and work to hold and accept and work with differences, whether they be personal, sexual, racial or cultural.
(802) 868-1148 x2 View (802) 868-1148 x2
Photo of Georgina Achilles, Counselor in Burlington, VT
Georgina Achilles
Counselor, MS, LCMHC
Verified Verified
Burlington, VT 05401
I provide a safe, confidential space for our work together. Each person seeks a therapist for their own personal reasons. Whether you feel stuck at an impasse, want more satisfying relationships, or seek freedom from difficult patterns- no matter your struggle, having a place to think and talk about what is bothering you may help. The outcome of therapy is unpredictable, though it often results in a greater sense of well-being and eases internal conflict. Together we can seek to understand what is going on and explore possibilities not previously considered.
I provide a safe, confidential space for our work together. Each person seeks a therapist for their own personal reasons. Whether you feel stuck at an impasse, want more satisfying relationships, or seek freedom from difficult patterns- no matter your struggle, having a place to think and talk about what is bothering you may help. The outcome of therapy is unpredictable, though it often results in a greater sense of well-being and eases internal conflict. Together we can seek to understand what is going on and explore possibilities not previously considered.
(802) 376-1897 View (802) 376-1897
Photo of Kathleen Moore, Registered Psychotherapist in Burlington, VT
Kathleen Moore
Registered Psychotherapist, MS
Verified Verified
3 Endorsed
Burlington, VT 05401  (Online Only)
A compassionate and nonjudgmental space where you can reflect, discuss and learn about your reactions, choices, unconscious beliefs, and challenges can lead to increased well-being. I bring an attitude of kind presence, safety, and respect to the journey of discovery, supporting you to transform disharmony and stagnation into clarity. You’ll gain skills, support, and strength to recognize triggers to anxiety, worry, stress, sadness, relationship and work issues, or other life challenges. You’ll also gain insight into your strengths and gifts, clarify priorities, and open paths that allow for wise action.
A compassionate and nonjudgmental space where you can reflect, discuss and learn about your reactions, choices, unconscious beliefs, and challenges can lead to increased well-being. I bring an attitude of kind presence, safety, and respect to the journey of discovery, supporting you to transform disharmony and stagnation into clarity. You’ll gain skills, support, and strength to recognize triggers to anxiety, worry, stress, sadness, relationship and work issues, or other life challenges. You’ll also gain insight into your strengths and gifts, clarify priorities, and open paths that allow for wise action.
(802) 881-0824 View (802) 881-0824
Photo of Morella Devost, Licensed Clinical Mental Health Counselor in Burlington, VT
Morella Devost
Licensed Clinical Mental Health Counselor, EdM, MA, LCMHC
Verified Verified
1 Endorsed
Burlington, VT 05408  (Online Only)
Not accepting new clients
Hi there! It is my personal belief that we are all meant to thrive physically, mentally, and emotionally (that includes you). But we've all found ourselves at one point or another, feeling like life isn't exactly peachy... and trying to sort life out can feel really daunting. That's where I can help. My particular specialties are working with folks who have experienced childhood trauma and/or sexual trauma, people dealing with anxiety, or challenges in their interpersonal relationships.
Hi there! It is my personal belief that we are all meant to thrive physically, mentally, and emotionally (that includes you). But we've all found ourselves at one point or another, feeling like life isn't exactly peachy... and trying to sort life out can feel really daunting. That's where I can help. My particular specialties are working with folks who have experienced childhood trauma and/or sexual trauma, people dealing with anxiety, or challenges in their interpersonal relationships.
(802) 210-1732 View (802) 210-1732
Photo of Milton J Marasch, Psychologist in Burlington, VT
Milton J Marasch
Psychologist, PhD
Verified Verified
Burlington, VT 05401
Waitlist for new clients
For more information, you can access my professional website by clicking on the "website" button below my photo on the left. In summary, I am a licensed psychologist-doctorate who has been providing psychological services to adults and older adults since 1992. Conditions treated include anxiety, depression, anger management, grief/bereavement, life transition difficulties, relationship, and physical health problems. Psychological testing services (personality or cognitive/capacity testing) are offered as well. Providing services for all genders, faiths, and orientations.
For more information, you can access my professional website by clicking on the "website" button below my photo on the left. In summary, I am a licensed psychologist-doctorate who has been providing psychological services to adults and older adults since 1992. Conditions treated include anxiety, depression, anger management, grief/bereavement, life transition difficulties, relationship, and physical health problems. Psychological testing services (personality or cognitive/capacity testing) are offered as well. Providing services for all genders, faiths, and orientations.
(802) 560-4845 View (802) 560-4845
Photo of Julie Dauth, Counselor in Burlington, VT
Julie Dauth
Counselor, MA, LCMHC
Verified Verified
Burlington, VT 05401  (Online Only)
My goal is to create a safe, positive environment where you can explore the sources of stress and distress in your life. More than this, my goal is to work collaboratively with you to identify solutions and bring about positive change, whether in unwanted behaviors, challenging relationships, or new anxieties brought on by our ever-changing world.
My goal is to create a safe, positive environment where you can explore the sources of stress and distress in your life. More than this, my goal is to work collaboratively with you to identify solutions and bring about positive change, whether in unwanted behaviors, challenging relationships, or new anxieties brought on by our ever-changing world.
(802) 613-0689 View (802) 613-0689
Photo of Hollie Hurewitz, MACP, Psychologist in Burlington, VT
Hollie Hurewitz, MACP
Psychologist, MA
Verified Verified
Burlington, VT 05401
I have enjoyed helping people with stress, anxiety, depression, abuse (emotional, physical, sexual), addiction/alcoholism in the family, couples, self-esteem, dissociation, and attachment issues. I offer EVIDENCE BASED PSYCHOTHERAPY to individuals, couples and groups as a licensed psychologist since 1991. Expertise: INTERNAL FAMILY SYSTEMS THERAPY (IFS), PHASE ORIENTED TRAUMA TREATMENT, EMDR, 12 STEP work. My Aussie, Smudge works with me. She can be a source of comfort and kindness. I would be happy to speak with you. Outside of work, I am a mom and wife; artist and gardener; meditator, and do my own psychotherapy.
I have enjoyed helping people with stress, anxiety, depression, abuse (emotional, physical, sexual), addiction/alcoholism in the family, couples, self-esteem, dissociation, and attachment issues. I offer EVIDENCE BASED PSYCHOTHERAPY to individuals, couples and groups as a licensed psychologist since 1991. Expertise: INTERNAL FAMILY SYSTEMS THERAPY (IFS), PHASE ORIENTED TRAUMA TREATMENT, EMDR, 12 STEP work. My Aussie, Smudge works with me. She can be a source of comfort and kindness. I would be happy to speak with you. Outside of work, I am a mom and wife; artist and gardener; meditator, and do my own psychotherapy.
(802) 992-8268 View (802) 992-8268
Photo of Mina Levinsky-Wohl, Licensed Psychoanalyst in Burlington, VT
Mina Levinsky-Wohl
Licensed Psychoanalyst, LCMHC, MD
Verified Verified
Burlington, VT 05401
My approach is to help you explore your inner world. This treatment allows you to understand yourself better, accept yourself, build better relationships and be more productive. I have a background as an MD and I have a good understanding of mind-body problems and multicultural issues since I lived and worked in several countries. Treatment options range from once a week to more intense multiple times a week.
My approach is to help you explore your inner world. This treatment allows you to understand yourself better, accept yourself, build better relationships and be more productive. I have a background as an MD and I have a good understanding of mind-body problems and multicultural issues since I lived and worked in several countries. Treatment options range from once a week to more intense multiple times a week.
(802) 282-4592 View (802) 282-4592
Photo of Amy L. Adams MS, LMHC, LADC, Counselor in Burlington, VT
Amy L. Adams MS, LMHC, LADC
Counselor, MS, LCMHC, LADC
Verified Verified
Burlington, VT 05408  (Online Only)
To schedule a consultation, please copy and paste the following URL into your search bar: secure.helloalma.com/providers/amy-adams.
To schedule a consultation, please copy and paste the following URL into your search bar: secure.helloalma.com/providers/amy-adams.
(802) 999-3872 View (802) 999-3872
Photo of Caroline O'Connor Supervision & Counseling , Counselor in Burlington, VT
Caroline O'Connor Supervision & Counseling
Counselor, LCMHC
Verified Verified
1 Endorsed
Burlington, VT 05401
Not accepting new clients
Welcome! I currently have openings for supervisees who are acquiring the necessary hours for state licensure. I also have limited openings for couples' workshops or intensives, or those interested in holistic healing retreats. I help clients with deepening their understanding of themselves and their patterns. I offer guidance and support with relational issues, anxiety, personal transitions, and suppressed creativity & vitality. While working together, we may focus on thought processes, feelings and mindfulness, in order to support positive relationships, emotional health, and increased awareness & empowerment.
Welcome! I currently have openings for supervisees who are acquiring the necessary hours for state licensure. I also have limited openings for couples' workshops or intensives, or those interested in holistic healing retreats. I help clients with deepening their understanding of themselves and their patterns. I offer guidance and support with relational issues, anxiety, personal transitions, and suppressed creativity & vitality. While working together, we may focus on thought processes, feelings and mindfulness, in order to support positive relationships, emotional health, and increased awareness & empowerment.
(802) 373-4422 View (802) 373-4422

How does your Therapist compare?

Number of Therapists in Burlington, VT

700+

Average cost per session

$135

Therapists in Burlington, VT who prioritize treating:

95% Anxiety
87% Depression
83% Relationship Issues
79% Self Esteem
72% Trauma and PTSD
72% Stress
67% Coping Skills

Average years in practice

10 Years

Top 3 insurances accepted

83% BlueCross and BlueShield
64% Medicaid
53% MVP Health Care

How Therapists in Burlington, VT see their clients

57% In Person and Online
43% Online Only

Gender breakdown

75% Female
22% Male
3% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Burlington?

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.