Therapists in Nyack, NY
Nancy Bachman
Clinical Social Work/Therapist, MA, LCSW-R
Verified Verified
Nyack, NY 10960
I am a therapist, focused on women's issues, who can help you bring joy, strength and tranquility into your life. I believe that all women have an enormous amount of inner strength which often gets lost as we take on the roles of mother, wife, caregiver, partner, and provider. As women, we often give so much of ourselves that our spirit and energy can get squashed leaving us feeling depressed and anxious.
I am a therapist, focused on women's issues, who can help you bring joy, strength and tranquility into your life. I believe that all women have an enormous amount of inner strength which often gets lost as we take on the roles of mother, wife, caregiver, partner, and provider. As women, we often give so much of ourselves that our spirit and energy can get squashed leaving us feeling depressed and anxious.
Robyn Smith - Smith Psychotherapy Services, PLLC
Clinical Social Work/Therapist, LCSW
Verified Verified
Nyack, NY 10960
Welcome! My name is Robyn Smith and I’m a Licensed Clinical Social Worker and the founder of Smith Psychotherapy Services, a small private practice located in Nyack NY. We currently have three clinicians on staff, myself, Ebony Harris, LMHC, and Shareen Loubeau, LMSW. All are board certified clinicians with over 12 years of experience working in the mental health field. We are dedicated to helping individuals enhance their strengths to overcome challenges and attain personal growth. We recognize the importance of providing a safe, judgement free and supportive environment to do so. Our goal is to assist you in achieving your goals.
Welcome! My name is Robyn Smith and I’m a Licensed Clinical Social Worker and the founder of Smith Psychotherapy Services, a small private practice located in Nyack NY. We currently have three clinicians on staff, myself, Ebony Harris, LMHC, and Shareen Loubeau, LMSW. All are board certified clinicians with over 12 years of experience working in the mental health field. We are dedicated to helping individuals enhance their strengths to overcome challenges and attain personal growth. We recognize the importance of providing a safe, judgement free and supportive environment to do so. Our goal is to assist you in achieving your goals.
Naaz Hosseini
Licensed Psychoanalyst, MA, LP
Verified Verified
Nyack, NY 10960 (Online Only)
Waitlist for new clients
"I will support your journey into self-awareness, self-acceptance, and self-empowerment. The destination is ease, wholeness, and choice."Finding balance, peace, and fulfillment can be a challenge. Our work together will strengthen and support you from the inside by helping you identify and overcome the fears and beliefs that stand in the way of your personal satisfaction and healthy relationships. I bring more than twenty-five years experience to our partnership as we work together to create an effective pathway for you to develop inner harmony and achieve your goals.
"I will support your journey into self-awareness, self-acceptance, and self-empowerment. The destination is ease, wholeness, and choice."Finding balance, peace, and fulfillment can be a challenge. Our work together will strengthen and support you from the inside by helping you identify and overcome the fears and beliefs that stand in the way of your personal satisfaction and healthy relationships. I bring more than twenty-five years experience to our partnership as we work together to create an effective pathway for you to develop inner harmony and achieve your goals.
Kristen Nocerino
Counselor, MA, LMHC
Verified Verified
Nyack, NY 10960 (Online Only)
If you've been grappling with anxious thoughts that leave you feeling isolated & detached, & if you've landed on my page seeking support, please continue reading. With genuine compassion & unwavering kindness, I'm here to offer a supportive space, guiding you toward reconnecting with yourself & others. My approach is integrative & holistic, centered on the intricate relationship btwn the mind & body, recognizing how our mental & physical well-being are intertwined. As a LMHC I've assisted numerous individuals facing the challenges of negative thought patterns, anxiety, & depression, experiences that often create a sense of isolation
If you've been grappling with anxious thoughts that leave you feeling isolated & detached, & if you've landed on my page seeking support, please continue reading. With genuine compassion & unwavering kindness, I'm here to offer a supportive space, guiding you toward reconnecting with yourself & others. My approach is integrative & holistic, centered on the intricate relationship btwn the mind & body, recognizing how our mental & physical well-being are intertwined. As a LMHC I've assisted numerous individuals facing the challenges of negative thought patterns, anxiety, & depression, experiences that often create a sense of isolation
Perseverance Now Counseling Center
Clinical Social Work/Therapist, LCSW, CCATP, SIFI
Verified Verified
1 Endorsed
Nyack, NY 10960
Great to meet you! My name is Briana! I am a Licensed Clinical Social Worker, with over 13 years' experience working with adult individuals, couples, and groups. I seek to not only challenge Clients, but to support, empower, and foster growth towards accomplishing their goals. I look to working with people who need support for Trauma, Addiction, Mental Health, Infertility, Conflict Resolution and Communication.
Great to meet you! My name is Briana! I am a Licensed Clinical Social Worker, with over 13 years' experience working with adult individuals, couples, and groups. I seek to not only challenge Clients, but to support, empower, and foster growth towards accomplishing their goals. I look to working with people who need support for Trauma, Addiction, Mental Health, Infertility, Conflict Resolution and Communication.
Erika Brown-Campbell
Psychologist, PhD
Verified Verified
Nyack, NY 10960
I am a licensed clinical psychologist with a practice in adult individual and couples therapy. Issues commonly faced by those with whom I work often include themes of anxiety, depression, relationship strain or conflict, work related stress, difficulty adjusting to significant life transitions, and parenting concerns. While the struggles people bring are varied, requiring a thoughtful and personalized approach to each, I offer a consistently supportive and collaborative style in which to undertake the work together.
I am a licensed clinical psychologist with a practice in adult individual and couples therapy. Issues commonly faced by those with whom I work often include themes of anxiety, depression, relationship strain or conflict, work related stress, difficulty adjusting to significant life transitions, and parenting concerns. While the struggles people bring are varied, requiring a thoughtful and personalized approach to each, I offer a consistently supportive and collaborative style in which to undertake the work together.
Julie Buffington
Clinical Social Work/Therapist, LCSW
Verified Verified
Nyack, NY 10960
You will find me to be warm, engaging, compassionate , comfortable to connect with, and a very solid and experienced professional. As a clinical social worker with over 35 years experience, I am able to hear not only what your challenges are now, but what themes and patterns you carry with you as part of your life story. My approach is active and collaborative: together we will identify what you need help with and develop an approach accordingly. I am flexible and creative and I will listen and learn to help you explore the challenges you are facing.
You will find me to be warm, engaging, compassionate , comfortable to connect with, and a very solid and experienced professional. As a clinical social worker with over 35 years experience, I am able to hear not only what your challenges are now, but what themes and patterns you carry with you as part of your life story. My approach is active and collaborative: together we will identify what you need help with and develop an approach accordingly. I am flexible and creative and I will listen and learn to help you explore the challenges you are facing.
Gerson Lovera
Clinical Social Work/Therapist, LCSW
Verified Verified
Nyack, NY 10960 (Online Only)
Hi there! I'm Gerson Lovera. I'm a Latino therapist fluent in English and Spanish with eight years of therapeutic experience. Incorporating a psychodynamic approach, I use trauma informed therapy, narrative, and cognitive behavioral therapy (DBT) to serve those looking to manage symptoms of anxiety, depression, attachment disorders, and post traumatic stress disorder (PTSD). I primarily work with adults undergoing life transitions, including but not limited to moving to a new place, getting married, going through a divorce, and navigating medical issues.
Hi there! I'm Gerson Lovera. I'm a Latino therapist fluent in English and Spanish with eight years of therapeutic experience. Incorporating a psychodynamic approach, I use trauma informed therapy, narrative, and cognitive behavioral therapy (DBT) to serve those looking to manage symptoms of anxiety, depression, attachment disorders, and post traumatic stress disorder (PTSD). I primarily work with adults undergoing life transitions, including but not limited to moving to a new place, getting married, going through a divorce, and navigating medical issues.
Kate Nowicki
Clinical Social Work/Therapist, LCSW
Verified Verified
Nyack, NY 10960
In a caring and supportive environment you are invited to begin a journey of healing and change. I will teach you new and effective ways to deal with the challenges in your life. You can change destructive and unsatisfying relationships into positive, fulfilling relationships. You can learn to take control of your emotions, your anger, and your self-destructive thinking. Anxiety and depression will be relieved.
In a caring and supportive environment you are invited to begin a journey of healing and change. I will teach you new and effective ways to deal with the challenges in your life. You can change destructive and unsatisfying relationships into positive, fulfilling relationships. You can learn to take control of your emotions, your anger, and your self-destructive thinking. Anxiety and depression will be relieved.
Gregory A Birchett
Clinical Social Work/Therapist, LCSW
Verified Verified
Nyack, NY 10960 (Online Only)
Not accepting new clients
Please use the link below to schedule a FREE 30 MINUTE CONSULTATION. https://gregorybirchett.mytheranest.com/appointments/new I love what I do. I LOVE it. I get excited about helping people make progress with whatever they need to work with. I’ve lived in and around NYC my whole life-through 9/11 and now through this pandemic. If there’s one thing all of it has taught me, it’s how important is to cherish each moment and spend time with family & friends and to appreciate the people we have around us. My experiences along life’s journey have led me to this motto that guides my practice: Supporting Your Courage To Live Your Truth.
Please use the link below to schedule a FREE 30 MINUTE CONSULTATION. https://gregorybirchett.mytheranest.com/appointments/new I love what I do. I LOVE it. I get excited about helping people make progress with whatever they need to work with. I’ve lived in and around NYC my whole life-through 9/11 and now through this pandemic. If there’s one thing all of it has taught me, it’s how important is to cherish each moment and spend time with family & friends and to appreciate the people we have around us. My experiences along life’s journey have led me to this motto that guides my practice: Supporting Your Courage To Live Your Truth.
Rachel Astarte • Self Specialist
Marriage & Family Therapist, LMFT, MFA, CLC
Verified Verified
2 Endorsed
Nyack, NY 10960 (Online Only)
Whatever feels “off” in your life—depression, unhealthy boundaries, a dead-end career, anxiety, loneliness, low self-esteem—is a symptom of a larger problem: an unbalanced and under-appreciated Self. Just like a fever lets us know we have an infection, life problems let us know something deep within us isn’t right. We don’t blame the fever, we thank it for alerting us to the bigger problem. Using life’s challenges as a guide, we work together to build the foundation of self you need in order to live an enriching and fully human life. This deep work benefits not only yourself but also your loved ones and the rest of our human family.
Whatever feels “off” in your life—depression, unhealthy boundaries, a dead-end career, anxiety, loneliness, low self-esteem—is a symptom of a larger problem: an unbalanced and under-appreciated Self. Just like a fever lets us know we have an infection, life problems let us know something deep within us isn’t right. We don’t blame the fever, we thank it for alerting us to the bigger problem. Using life’s challenges as a guide, we work together to build the foundation of self you need in order to live an enriching and fully human life. This deep work benefits not only yourself but also your loved ones and the rest of our human family.
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Hanna Brinnier Perrault
Clinical Social Work/Therapist, LMSW
Verified Verified
4 Endorsed
Nyack, NY 10960 (Online Only)
Whether you're transitioning to a new job, anxious about a relationship, navigating a recent loss, these adjustments can feel stressful and overwhelming. I have experience working with trauma, grief, life transitions, depression, anxiety, relational difficulties, and academic/occupational issues. I enjoy working with college/graduate students and young professionals. am trained in a range of modalities including CBT and DBT, but overall, I am person-centered, attachment based and psychodynamically oriented. Thus, I approach therapy from a trauma-focused lens, providing a safe space for clients to process all thoughts and feelings.
Whether you're transitioning to a new job, anxious about a relationship, navigating a recent loss, these adjustments can feel stressful and overwhelming. I have experience working with trauma, grief, life transitions, depression, anxiety, relational difficulties, and academic/occupational issues. I enjoy working with college/graduate students and young professionals. am trained in a range of modalities including CBT and DBT, but overall, I am person-centered, attachment based and psychodynamically oriented. Thus, I approach therapy from a trauma-focused lens, providing a safe space for clients to process all thoughts and feelings.
Anthony A Thomas
Counselor, MA, LMHC
Verified Verified
Nyack, NY 10960
I'm a skilled, compassionate, empathetic and solutions-oriented mental health practitioner dedicated to providing exceptional care and implementing effective treatment for adolescents and adults experiencing emotional problems or exposed to drug and alcohol abuse. I have demonstrated a track record of success working with diverse client populations in one-on-one, couples and group settings. I'm an effective motivator, communicator, and advocate with an inherent ability to manage all types of personalities, diffuse stressful situations, resolve issues and help you achieve challenging objectives. Lastly, I have an innate ability to establish a rapport, build trust, and relate too individuals on all levels.
I'm a skilled, compassionate, empathetic and solutions-oriented mental health practitioner dedicated to providing exceptional care and implementing effective treatment for adolescents and adults experiencing emotional problems or exposed to drug and alcohol abuse. I have demonstrated a track record of success working with diverse client populations in one-on-one, couples and group settings. I'm an effective motivator, communicator, and advocate with an inherent ability to manage all types of personalities, diffuse stressful situations, resolve issues and help you achieve challenging objectives. Lastly, I have an innate ability to establish a rapport, build trust, and relate too individuals on all levels.
Stephen M Cheairs
Mental Health Counselor, MS, MHC-LP
Verified Verified
Nyack, NY 10960
I'm a therapist and if you are suffering from anxiety, depression, or intrusive negative thoughts that are interfering with your life, there is help available to you. The stress from living can become overwhelming at times. This is not necessarily negative, in fact it is an opportunity for growth. Troubling thoughts and emotions are signs that something in your life is out of balance and needs to be addressed. By seeking help and exploring the patterns in your life, you have the ability to not only lessen your suffering, but to become stronger and more resilient in the process. I hope you seize this opportunity for self improvement.
I'm a therapist and if you are suffering from anxiety, depression, or intrusive negative thoughts that are interfering with your life, there is help available to you. The stress from living can become overwhelming at times. This is not necessarily negative, in fact it is an opportunity for growth. Troubling thoughts and emotions are signs that something in your life is out of balance and needs to be addressed. By seeking help and exploring the patterns in your life, you have the ability to not only lessen your suffering, but to become stronger and more resilient in the process. I hope you seize this opportunity for self improvement.
Andrew McIntosh Lmhc
Mental Health Counselor, MS
Verified Verified
Nyack, NY 10960
I welcome and applaud you for being here and taking the first step towards addressing what blocks you from a life worth cherishing. My name is Andrew McIntosh and I love the work I do. I have completed my comprehensive training in Dialectical Behavior Therapy, as well as advanced training in DBT skills implementation. I utilize an integrated approach of DBT, CBT, and Internal Family systems to assist and support clients through the challenges they are currently facing in their lives. I believe that together we can address and change the issues holding you back from achieving your peace, and move towards celebrating life.
I welcome and applaud you for being here and taking the first step towards addressing what blocks you from a life worth cherishing. My name is Andrew McIntosh and I love the work I do. I have completed my comprehensive training in Dialectical Behavior Therapy, as well as advanced training in DBT skills implementation. I utilize an integrated approach of DBT, CBT, and Internal Family systems to assist and support clients through the challenges they are currently facing in their lives. I believe that together we can address and change the issues holding you back from achieving your peace, and move towards celebrating life.
Rikki Herbst
Clinical Social Work/Therapist, LCSW, MSEd
Verified Verified
Nyack, NY 10960
The healing process is vulnerable and courageous. Whether you seek healing for yourself or your child, a safe holding space that provides supportive containment and compassion is so vital. I embrace each individual with the knowledge that one is the expert of their own lives. My role is to provide a space to access deeper wisdom and personal expression. I began my career in early childhood education and have brought my knowledge of early childhood development into my work as a therapist, with a focus on attachment, sensory processing and the nervous system constantly informing my work.
The healing process is vulnerable and courageous. Whether you seek healing for yourself or your child, a safe holding space that provides supportive containment and compassion is so vital. I embrace each individual with the knowledge that one is the expert of their own lives. My role is to provide a space to access deeper wisdom and personal expression. I began my career in early childhood education and have brought my knowledge of early childhood development into my work as a therapist, with a focus on attachment, sensory processing and the nervous system constantly informing my work.
Nisa Rauschenberg
Art Therapist, MS, ATR-BC, LCAT, CCTP
Verified Verified
1 Endorsed
Nyack, NY 10960 (Online Only)
Art therapy uses the creative process to identify and resolve thoughts, attitudes, and feelings that present obstacles to emotional and cognitive growth. Art is a language of symbols-the same language of symbols that our subconscious uses in dreams. At Creative Arts Therapy Studio, PLLC, artwork is created to give *voice* to the subconscious allowing patients to deepen insight, increase well-being and build the lives they want to live.
Art therapy uses the creative process to identify and resolve thoughts, attitudes, and feelings that present obstacles to emotional and cognitive growth. Art is a language of symbols-the same language of symbols that our subconscious uses in dreams. At Creative Arts Therapy Studio, PLLC, artwork is created to give *voice* to the subconscious allowing patients to deepen insight, increase well-being and build the lives they want to live.
Rebecca Bowe
Clinical Social Work/Therapist, DSW, LCSW
Verified Verified
Nyack, NY 10960
Hello and welcome! My name is Dr. Rebecca Bowe, and I am a clinical social worker practicing in the state of New York. I have extensive experience working with adolescents, young adults, couples and family systems (specifically during times of difficult transitions). I believe therapy is a collaborative process and tailor sessions to meet my client's specific needs. Sessions may incorporate mindfulness practices, art integration, CBT techniques, and talk therapy.
Hello and welcome! My name is Dr. Rebecca Bowe, and I am a clinical social worker practicing in the state of New York. I have extensive experience working with adolescents, young adults, couples and family systems (specifically during times of difficult transitions). I believe therapy is a collaborative process and tailor sessions to meet my client's specific needs. Sessions may incorporate mindfulness practices, art integration, CBT techniques, and talk therapy.
Julie Taft
Mental Health Counselor, LMHC
Verified Verified
1 Endorsed
Nyack, NY 10960
My goal as a therapist is to partner with my clients to help them improve their quality of life. I am a licensed mental health counselor, a certified school counselor, and have been trained in EMDR (Eye Movement Desensitization and Reprocessing). With over twenty years of experience working in school, agency, and private practice settings, I have extensive familiarity with diverse populations of children, adolescents, and adults. Using a client-centered approach to counseling and therapy, I want my clients to feel supported, empowered, and encouraged to take an active role in their treatment.
My goal as a therapist is to partner with my clients to help them improve their quality of life. I am a licensed mental health counselor, a certified school counselor, and have been trained in EMDR (Eye Movement Desensitization and Reprocessing). With over twenty years of experience working in school, agency, and private practice settings, I have extensive familiarity with diverse populations of children, adolescents, and adults. Using a client-centered approach to counseling and therapy, I want my clients to feel supported, empowered, and encouraged to take an active role in their treatment.
Stephen Levy
Psychologist, PhD
Verified Verified
Nyack, NY 10960 (Online Only)
I have spent 50 years in the treatment fields of alcoholism, drug addiction and mental illness. I have been in private practice since 1977 providing individual and couples therapy for adults. I have taught in six colleges and two medical schools and am the author of three books and the editor of another. I am a founding member of the non-profit Emergency Assist Team of Rockland County. NY since 1990 providing support for first responders and military personnel. I am the Clinical Supervisor of the Therapy staff at Rockland Jewish Family Service. For further information consult my personal website at: rocklandpsych.net.
I have spent 50 years in the treatment fields of alcoholism, drug addiction and mental illness. I have been in private practice since 1977 providing individual and couples therapy for adults. I have taught in six colleges and two medical schools and am the author of three books and the editor of another. I am a founding member of the non-profit Emergency Assist Team of Rockland County. NY since 1990 providing support for first responders and military personnel. I am the Clinical Supervisor of the Therapy staff at Rockland Jewish Family Service. For further information consult my personal website at: rocklandpsych.net.
See more therapy options for Nyack
How does your Therapist compare?
Number of Therapists in Nyack, NY
100+
Average cost per session
$155
Therapists in Nyack, NY who prioritize treating:
95% | Anxiety |
90% | Depression |
81% | Relationship Issues |
76% | Self Esteem |
68% | Grief |
67% | Trauma and PTSD |
65% | Coping Skills |
Average years in practice
17 Years
Top 3 insurances accepted
65% | Aetna |
53% | Cigna and Evernorth |
53% | UnitedHealthcare UHC | UBH |
How Therapists in Nyack, NY see their clients
71% | In Person and Online | |
29% | Online Only |
Gender breakdown
76% | Female | |
23% | Male | |
1% | Non-Binary |
FAQs - About Therapy and Counseling
How can I find a therapist in Nyack?
Search for nearby therapists or counselors by inputting your city, town, or suburb; or zip code; or a provider’s name into the search bar. From there, you can filter providers by the issues they treat, cost, insurance, gender, and other factors to find providers who are well-suited to your needs. To navigate between locations within the same country, enter a new city or zip code into the search bar.
Learn more about how to find a therapist
Learn more about how to find a therapist
Is everyone in the Psychology Today Therapy Directory a licensed therapist?
The Psychology Today directory lists providers who offer legitimate mental health services to the public, including psychologists, psychiatrists, social workers, and counselors.
Many have been licensed by the country or state where they practice; providers whose license or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Some clinicians or organizations provide services for which their state or country does not offer licenses, such as pastoral counseling. They may be selectively included without the “Verified” seal.
Many have been licensed by the country or state where they practice; providers whose license or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Some clinicians or organizations provide services for which their state or country does not offer licenses, such as pastoral counseling. They may be selectively included without the “Verified” seal.
What’s the difference between a psychologist, a therapist, and a counselor?
Therapists, psychologists, and counselors are all licensed mental health professionals. In the US, psychologists have earned a doctoral degree. The terms “therapist” and “counselor” are used somewhat interchangeably, but generally therapists offer longer-term, mental health care, while counselors offer shorter-term care that may focus on one domain, such as marriage, career, or academic challenges.
Clients should consider factors such as insurance coverage and their primary reason(s) for seeking therapy to determine the type of professional best suited to their needs. Someone struggling with mental health challenges such as depression or anxiety, for example, may wish to seek out a clinical psychologist or therapist, while someone navigating career obstacles or marital upheaval may benefit from seeing a counselor who can offer short-term, targeted support.
Clients should consider factors such as insurance coverage and their primary reason(s) for seeking therapy to determine the type of professional best suited to their needs. Someone struggling with mental health challenges such as depression or anxiety, for example, may wish to seek out a clinical psychologist or therapist, while someone navigating career obstacles or marital upheaval may benefit from seeing a counselor who can offer short-term, targeted support.
What type of therapy is right for me?
The type of therapy best suited to a particular individual depends on several factors, including their primary reason for seeking therapy, their preferred timeline (some therapy types last for a set number of sessions, while others are open-ended), and their personality and preferences—some may prefer a more structured approach. For many individuals, multiple types of therapy could provide a good fit.
How much does therapy cost?
The cost of therapy depends on a number of variables, including location and the therapist’s experience and training. On average, a therapy session in the United States could cost between $100 and $200 or more. If you have insurance, the expense of mental health care is typically lower, but it varies based on your insurance plan details and whether you choose an in-network or out-of-network mental healthcare provider.
What are more affordable or low cost therapy solutions?
Many therapists offer sliding scale payments, usually on a limited number of slots, which consists in an agreement between the therapist and a client to pay a reduced rate. Therapists who provide such arrangements often consider the client's income or ability to pay, but the extent of the discount is ultimately at the therapist's discretion. Furthermore, while group therapy may have different goals and benefits compared to individual therapy, it can be a more affordable solution to address certain types of issues.
Is online therapy cheaper than in-person therapy?
Many therapists charge the same amount for online therapy as they do for in-person therapy—though clients may still find this cost-effective if it cuts down on their transportation costs. Health insurance plans often offer equivalent coverage for online and in-person therapy; indeed, in many places, they are legally required to do so. Text-based or on-demand therapy apps may be cheaper than traditional one-on-one psychotherapy; however, the practice may be less effective and is not likely to be covered by insurance.
Is online therapy a good option?
Therapy conducted online can be just as effective as in-person therapy, as long as there is a strong alliance between the client and the therapist. To find a therapist who provides telehealth services to clients in your area, click “Online Therapy” on the directory homepage and search by your city or town or your zip code.
Are therapy sessions confidential?
Confidentiality is a crucial part of the therapeutic relationship. Therapists in the United States are bound by the regulations set out by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which aims to protect sensitive health information. With very few exceptions, a therapist will only discuss their client with others when the client has given their written permission. The instances in which a therapist would be required to disclose personal information are: if a client poses a danger to themselves or others, if the therapist suspects the abuse of a child or an elderly or otherwise dependent adult, or if they are legally forced to by court order. These exceptions to the confidentiality agreement are usually discussed with a client before their first session.