Therapists in Urbandale, IA

Photo of Ellie Van Dam, Clinical Social Work/Therapist in Urbandale, IA
Ellie Van Dam
Clinical Social Work/Therapist, LISW
Verified Verified
2 Endorsed
Urbandale, IA 50322
Waitlist for new clients
I consider myself to be an existential therapist and believe that through suffering sometimes we find purpose and meaning in life. None of us are above suffering. Everyone will experience trauma or loss at some point in life and deserve a safe place to work through those experiences. I know what it is to suffer and have personal and professional experience with trauma, domestic violence, and substance use issues. I believe the therapeutic relationship is the most important component of effective therapy and place value on providing a non-judgmental, peaceful, safe space to heal.
I consider myself to be an existential therapist and believe that through suffering sometimes we find purpose and meaning in life. None of us are above suffering. Everyone will experience trauma or loss at some point in life and deserve a safe place to work through those experiences. I know what it is to suffer and have personal and professional experience with trauma, domestic violence, and substance use issues. I believe the therapeutic relationship is the most important component of effective therapy and place value on providing a non-judgmental, peaceful, safe space to heal.
(515) 446-7284 View (515) 446-7284
Photo of Kristen Peerbaccus, Clinical Social Work/Therapist in Urbandale, IA
Kristen Peerbaccus
Clinical Social Work/Therapist, LISW
Verified Verified
Urbandale, IA 50322
I am a licensed independent social worker and I currently provide therapy to kids ranging from ages 4-17. Children may display concerning behaviors and emotions such as a refusal to comply with expectations, inattention, impulsivity, a withdrawal from things they previously liked, excessive worrying, or being overly sensitive to different stimuli in the environment. These behaviors can negatively impact their relationships with parents and/or caregivers, siblings, teachers, and friends both at home and in school.
I am a licensed independent social worker and I currently provide therapy to kids ranging from ages 4-17. Children may display concerning behaviors and emotions such as a refusal to comply with expectations, inattention, impulsivity, a withdrawal from things they previously liked, excessive worrying, or being overly sensitive to different stimuli in the environment. These behaviors can negatively impact their relationships with parents and/or caregivers, siblings, teachers, and friends both at home and in school.
(515) 516-3753 View (515) 516-3753
Photo of Brian L Bentley, Marriage & Family Therapist in Urbandale, IA
Brian L Bentley
Marriage & Family Therapist, MA, LMFT, CADC, EMDR
Verified Verified
1 Endorsed
Urbandale, IA 50322
I am an emotion focused and cognitive behavioral therapist that incorporates a systemic, relational perspective to my work. I am passionate about helping individuals and couples create the relationship they desire, providing families with the tools necessary to create meaningful relationships, and assisting those in need of support and counsel with a variety of mental health issues. I use 28 years of marital and family counseling experience to provide therapy in the areas of marital therapy, affair reconciliation, divorce adjustment, sexual & drug addictions, depression, and anxiety.
I am an emotion focused and cognitive behavioral therapist that incorporates a systemic, relational perspective to my work. I am passionate about helping individuals and couples create the relationship they desire, providing families with the tools necessary to create meaningful relationships, and assisting those in need of support and counsel with a variety of mental health issues. I use 28 years of marital and family counseling experience to provide therapy in the areas of marital therapy, affair reconciliation, divorce adjustment, sexual & drug addictions, depression, and anxiety.
(515) 393-2774 View (515) 393-2774
Photo of Isaiah Fogle, Counselor in Urbandale, IA
Isaiah Fogle
Counselor, MS, LMHC
Verified Verified
1 Endorsed
Urbandale, IA 50322
Struggling with one of life's many challenges? I know how difficult life's hardships can be. We often experience long lasting effects related to these events. You don't have to go it alone. I look forward to hearing from you and having the opportunity to walk alongside you on this journey.
Struggling with one of life's many challenges? I know how difficult life's hardships can be. We often experience long lasting effects related to these events. You don't have to go it alone. I look forward to hearing from you and having the opportunity to walk alongside you on this journey.
(515) 446-7284 View (515) 446-7284
Photo of Rebecca O'Connell, Marriage & Family Therapist in Urbandale, IA
Rebecca O'Connell
Marriage & Family Therapist, MA, LMFT, CCTP
Verified Verified
Urbandale, IA 50322
Immediate and Early Evening Appointments Available. I view therapy as a journey. The path on this journey of life is twisting and winding with many detours, and it can be difficult to navigate on our own. The therapy hour is time carved out just for the client; a safe place with no shame, where people can give voice to their stories. It is my privilege to come alongside people on this journey to wholeness.
Immediate and Early Evening Appointments Available. I view therapy as a journey. The path on this journey of life is twisting and winding with many detours, and it can be difficult to navigate on our own. The therapy hour is time carved out just for the client; a safe place with no shame, where people can give voice to their stories. It is my privilege to come alongside people on this journey to wholeness.
(515) 212-7667 View (515) 212-7667
Photo of Real Connections Counseling, A Cotherapy company!, Marriage & Family Therapist in Urbandale, IA
Real Connections Counseling, A Cotherapy company!
Marriage & Family Therapist, LMFT, M Litt
Verified Verified
1 Endorsed
Urbandale, IA 50322
Instead of staring at a therapist staring back at you, you join up with a TEAM in a place where you belong, in a way where we all show up for practice together. Together we create your dream relationship. You work hard ... blood, sweat, and tears kind of hard sometimes. At the end of it you'll have the kind of love you may never have dreamed you could have. This isn't just therapy, it's co-therapy. A philosophy that empowers couples like you to discover the magic of "us." We're your team, and your needs come first. Sessions START at 85 mins. The RCC-System means you succeed, all outside the constraints and limitations of insurance.
Instead of staring at a therapist staring back at you, you join up with a TEAM in a place where you belong, in a way where we all show up for practice together. Together we create your dream relationship. You work hard ... blood, sweat, and tears kind of hard sometimes. At the end of it you'll have the kind of love you may never have dreamed you could have. This isn't just therapy, it's co-therapy. A philosophy that empowers couples like you to discover the magic of "us." We're your team, and your needs come first. Sessions START at 85 mins. The RCC-System means you succeed, all outside the constraints and limitations of insurance.
(515) 346-6075 View (515) 346-6075
Photo of Meagan Froehlich, Marriage & Family Therapist in Urbandale, IA
Meagan Froehlich
Marriage & Family Therapist, tLMFT, CCLS
Verified Verified
Urbandale, IA 50322
I look forward to helping clients meet their desired goals and achieve personal growth. I graduated from the University of Northern Iowa in 2001 with a Bachelor of Arts degree in Psychology and Family Services. I then attended Iowa State University and received a Master of Science degree in Marriage and Family Therapy. For fourteen years, I worked as a Certified Child Life Specialist, supporting patients and families who were experiencing acute or chronic illness. I also worked in the Neonatal Intensive Care (NICU) and maternity units.
I look forward to helping clients meet their desired goals and achieve personal growth. I graduated from the University of Northern Iowa in 2001 with a Bachelor of Arts degree in Psychology and Family Services. I then attended Iowa State University and received a Master of Science degree in Marriage and Family Therapy. For fourteen years, I worked as a Certified Child Life Specialist, supporting patients and families who were experiencing acute or chronic illness. I also worked in the Neonatal Intensive Care (NICU) and maternity units.
(515) 518-8393 View (515) 518-8393
Photo of Sarah Rowat, Counselor in Urbandale, IA
Sarah Rowat
Counselor, MS, LMHC
Verified Verified
1 Endorsed
Urbandale, IA 50322
Waitlist for new clients
Sarah believes we each author our own story in the context of our cultures and relationships. As a professional counselor, Sarah considers therapy to be the hope that change is possible, the past does not determine the future, and tomorrow can be different than today. Sarah remains humbled by the invitation to walk alongside individuals in their journeys toward wellness as they discover the richness within themselves to be whole, balanced, strong, and interwoven with healthy relationships.
Sarah believes we each author our own story in the context of our cultures and relationships. As a professional counselor, Sarah considers therapy to be the hope that change is possible, the past does not determine the future, and tomorrow can be different than today. Sarah remains humbled by the invitation to walk alongside individuals in their journeys toward wellness as they discover the richness within themselves to be whole, balanced, strong, and interwoven with healthy relationships.
(515) 717-3198 View (515) 717-3198
Photo of Mosaic Family Counseling Center Inc., Counselor in Urbandale, IA
Mosaic Family Counseling Center Inc.
Counselor, MS, LMHC
Verified Verified
1 Endorsed
Urbandale, IA 50322
Our group has been in business for over 16 years in the Des Moines area. We are trauma focused healing providers working with adults, children, couples, and families. We are committed and responsive to the cultural and spiritual needs as therapeutic issues are resolved. We enjoy the opportunity to witness and be a part of your journey as your partner in healing. We work with you to heal life's adverse experiences and traumatic life events. We believe that everyone deserves to be happy and feel capable in life. We are the Center of Excellence in supporting the healing of life's challenges.
Our group has been in business for over 16 years in the Des Moines area. We are trauma focused healing providers working with adults, children, couples, and families. We are committed and responsive to the cultural and spiritual needs as therapeutic issues are resolved. We enjoy the opportunity to witness and be a part of your journey as your partner in healing. We work with you to heal life's adverse experiences and traumatic life events. We believe that everyone deserves to be happy and feel capable in life. We are the Center of Excellence in supporting the healing of life's challenges.
(515) 523-0319 View (515) 523-0319
Photo of Erika Hansen, Counselor in Urbandale, IA
Erika Hansen
Counselor, LMHC
Verified Verified
Urbandale, IA 50322
Hello! I am scheduling new clients. I work with adults 18 and older. I don't have a waitlist currently as I am taking new clients. I specialize in Neurodivergent disorders, ADHD, Autism, and CPTSD. I also am comfortable in working with client who experiencing suicidal thinking and/or self-harm thinking. I am comfortable talking about suicide and figuring out a safety plan for you. I have been told by previous clients that I am very open, kink-friendly, sexually positive, LGBTQ+ affirming, and a nonjudgmental counselor. I really make sure that you are able to take up space and be heard.
Hello! I am scheduling new clients. I work with adults 18 and older. I don't have a waitlist currently as I am taking new clients. I specialize in Neurodivergent disorders, ADHD, Autism, and CPTSD. I also am comfortable in working with client who experiencing suicidal thinking and/or self-harm thinking. I am comfortable talking about suicide and figuring out a safety plan for you. I have been told by previous clients that I am very open, kink-friendly, sexually positive, LGBTQ+ affirming, and a nonjudgmental counselor. I really make sure that you are able to take up space and be heard.
(515) 523-6919 View (515) 523-6919
Photo of Leslie Henter, Clinical Social Work/Therapist in Urbandale, IA
Leslie Henter
Clinical Social Work/Therapist, MSW, LMSW
Verified Verified
Urbandale, IA 50322
Difficult situations in our lives can leave us confused, scared, and speechless. We’ve all been there, and I want to commend you for taking the first step in the therapeutic process! I know my clients are looking for a safe space to feel all the feels and figure out how to navigate them. My priority is creating a nonjudgmental environment where trust is developed and you feel safe with me—every single session and interaction. Therapy is a collaborative process between the two of us. I’m here to listen, support you, and give you opportunities to explore and design a plan that helps you move your life forward.
Difficult situations in our lives can leave us confused, scared, and speechless. We’ve all been there, and I want to commend you for taking the first step in the therapeutic process! I know my clients are looking for a safe space to feel all the feels and figure out how to navigate them. My priority is creating a nonjudgmental environment where trust is developed and you feel safe with me—every single session and interaction. Therapy is a collaborative process between the two of us. I’m here to listen, support you, and give you opportunities to explore and design a plan that helps you move your life forward.
(515) 854-4848 x7003 View (515) 854-4848 x7003
Photo of Amanda Smith, Counselor in Urbandale, IA
Amanda Smith
Counselor, LMHC
Verified Verified
1 Endorsed
Urbandale, IA 50322
The mind naturally wants to go towards wellness, sometimes we just need a little help in the right direction. Let me help you on your journey toward healing, growth, and wellness. Therapy is your unique journey towards wellness. Working in a partnership helps you know that you are in charge of your life, your healing, and your growth. Knowing you can depend on yourself with some guidance helps you blossom into the person you were meant to be. Together we will work through your journey of healing with you in the lead with me right beside you.
The mind naturally wants to go towards wellness, sometimes we just need a little help in the right direction. Let me help you on your journey toward healing, growth, and wellness. Therapy is your unique journey towards wellness. Working in a partnership helps you know that you are in charge of your life, your healing, and your growth. Knowing you can depend on yourself with some guidance helps you blossom into the person you were meant to be. Together we will work through your journey of healing with you in the lead with me right beside you.
(515) 854-3966 View (515) 854-3966
Photo of Tiffany Bandow, Clinical Social Work/Therapist in Urbandale, IA
Tiffany Bandow
Clinical Social Work/Therapist, LISW
Verified Verified
2 Endorsed
Urbandale, IA 50322
Not accepting new clients
I am grateful for the opportunity to be present with others as they journey towards a greater place of peace and wellness. I truly believe that YOU are the expert on your life and I am simply available to offer insight, connection and genuine support. It is my honor to be a part of your journey!
I am grateful for the opportunity to be present with others as they journey towards a greater place of peace and wellness. I truly believe that YOU are the expert on your life and I am simply available to offer insight, connection and genuine support. It is my honor to be a part of your journey!
(515) 604-8334 View (515) 604-8334
Photo of Quinn Bullis, Counselor in Urbandale, IA
Quinn Bullis
Counselor, MA, LMHC, NCC
Verified Verified
4 Endorsed
Urbandale, IA 50322
Everyone experiences difficulties at some point in their lives. In those moments, reaching out for help can be one of the hardest things to do. It's my goal to make the counseling process as safe and welcoming as possible to help you reach your goals. I place emphasis on creating an environment that incorporates empathy, genuineness, understanding, and patience to develop an individualized form of therapy for each client.
Everyone experiences difficulties at some point in their lives. In those moments, reaching out for help can be one of the hardest things to do. It's my goal to make the counseling process as safe and welcoming as possible to help you reach your goals. I place emphasis on creating an environment that incorporates empathy, genuineness, understanding, and patience to develop an individualized form of therapy for each client.
(515) 373-4693 View (515) 373-4693
Photo of Jake Bergman, Counselor in Urbandale, IA
Jake Bergman
Counselor, MS, LMHC, NCC
Verified Verified
Urbandale, IA 50322
My approach to therapy is based on my belief that no two individuals are exactly the same, and what works for one person might not work for the other. With that in mind, I utilize an individualized therapeutic approach to identify and select the most effective method, to address the specific needs of each client. My work with clients has a firm foundation in person-centered and cognitive-behavioral therapies and frequently incorporates; dialectical behavior therapy, acceptance and commitment therapy, and positive psychology.
My approach to therapy is based on my belief that no two individuals are exactly the same, and what works for one person might not work for the other. With that in mind, I utilize an individualized therapeutic approach to identify and select the most effective method, to address the specific needs of each client. My work with clients has a firm foundation in person-centered and cognitive-behavioral therapies and frequently incorporates; dialectical behavior therapy, acceptance and commitment therapy, and positive psychology.
(515) 203-8316 View (515) 203-8316
Photo of Sarah Cammoun-Myers, Counselor in Urbandale, IA
Sarah Cammoun-Myers
Counselor, LMHC
Verified Verified
1 Endorsed
Urbandale, IA 50322
Waitlist for new clients
At Sage Counseling and Wellness, I believe that healing can occur to develop a fulfilling and harmonious life filled with meaningful connections. I strive to help clients discover and feel comfortable with their authentic self and empower them to have the courage to bring that authenticity into their relationships. I believe in the importance of maintaining a supportive and affirming environment throughout the therapeutic process. I welcome people from all walks of life, including but not limited to: LGBTQIA+, BIPOC, and individuals with disabilities by providing a safe and affirming environment to all.
At Sage Counseling and Wellness, I believe that healing can occur to develop a fulfilling and harmonious life filled with meaningful connections. I strive to help clients discover and feel comfortable with their authentic self and empower them to have the courage to bring that authenticity into their relationships. I believe in the importance of maintaining a supportive and affirming environment throughout the therapeutic process. I welcome people from all walks of life, including but not limited to: LGBTQIA+, BIPOC, and individuals with disabilities by providing a safe and affirming environment to all.
View
Photo of Kelsey Finch, Counselor in Urbandale, IA
Kelsey Finch
Counselor, LMHC
Verified Verified
Urbandale, IA 50322
Making the decision to begin therapy can be difficult. Regardless of the circumstances that have brought you to consider therapy, you can be sure to find a safe, judgement-free space in my office. My role is to work with you to help you achieve your goals, whether that's overcoming obstacles, processing factors impacting you, or improving your overall satisfaction with life.
Making the decision to begin therapy can be difficult. Regardless of the circumstances that have brought you to consider therapy, you can be sure to find a safe, judgement-free space in my office. My role is to work with you to help you achieve your goals, whether that's overcoming obstacles, processing factors impacting you, or improving your overall satisfaction with life.
(515) 379-8685 View (515) 379-8685
Photo of Anna Schappaugh, Clinical Social Work/Therapist in Urbandale, IA
Anna Schappaugh
Clinical Social Work/Therapist, LISW
Verified Verified
1 Endorsed
Urbandale, IA 50322  (Online Only)
Coming to therapy requires some bravery, and I am excited to join you in learning more about yourself and exploring your story. I have experience in working with many ages, and am currently taking clients ages 11 and up. My greatest joy as a therapist is giving people new ideas and ways of understanding themselves and their life stories, which can broaden the way they are living. I love to work with finding meaning in your life, exploring personal symbolism, images, and stories, and working with your strengths and resources to move you towards greater life satisfaction. I'll look forward to meeting you!
Coming to therapy requires some bravery, and I am excited to join you in learning more about yourself and exploring your story. I have experience in working with many ages, and am currently taking clients ages 11 and up. My greatest joy as a therapist is giving people new ideas and ways of understanding themselves and their life stories, which can broaden the way they are living. I love to work with finding meaning in your life, exploring personal symbolism, images, and stories, and working with your strengths and resources to move you towards greater life satisfaction. I'll look forward to meeting you!
(515) 800-4456 View (515) 800-4456
Photo of Penny Nichols-Peterson, Clinical Social Work/Therapist in Urbandale, IA
Penny Nichols-Peterson
Clinical Social Work/Therapist, LISW
Verified Verified
1 Endorsed
Urbandale, IA 50322
I believe in the process of therapy and I am dedicated to helping you reach your goals. If you are seeking assistance and would like to begin therapy with a down-to-earth and compassionate therapist, I may be the right match for you. I believe you have the answers within you and any changes you make are the result of your hard work. If you choose to share your story with me, I will feel honored to help guide conversations, offer a different point of view, challenge thoughts, and listen with a non-judgmental mind and open heart.
I believe in the process of therapy and I am dedicated to helping you reach your goals. If you are seeking assistance and would like to begin therapy with a down-to-earth and compassionate therapist, I may be the right match for you. I believe you have the answers within you and any changes you make are the result of your hard work. If you choose to share your story with me, I will feel honored to help guide conversations, offer a different point of view, challenge thoughts, and listen with a non-judgmental mind and open heart.
(515) 619-5257 View (515) 619-5257
Photo of Sharaine Webster, Clinical Social Work/Therapist in Urbandale, IA
Sharaine Webster
Clinical Social Work/Therapist, LISW, IADC
Verified Verified
1 Endorsed
Urbandale, IA 50322
Waitlist for new clients
Are you feeling lost? Alone? Misunderstood? Do you ever wish that you could just talk to someone and they not only understand how you feel, but also allow you to be yourself? If you are looking for someone to listen, to understand, to support and push you necessary, then my hope is that I can help you. My clinical areas of interest and expertise include: addictions (gambling, gaming, drugs and alcohol, sex), anxiety, depression, sexual health and human sexuality, attachment issues, LGBTQIA+ and relationship and premarital/marital issues. If any of this sounds familiar, I may be speaking directly to you.
Are you feeling lost? Alone? Misunderstood? Do you ever wish that you could just talk to someone and they not only understand how you feel, but also allow you to be yourself? If you are looking for someone to listen, to understand, to support and push you necessary, then my hope is that I can help you. My clinical areas of interest and expertise include: addictions (gambling, gaming, drugs and alcohol, sex), anxiety, depression, sexual health and human sexuality, attachment issues, LGBTQIA+ and relationship and premarital/marital issues. If any of this sounds familiar, I may be speaking directly to you.
(515) 375-1488 View (515) 375-1488

How does your Therapist compare?

Number of Therapists in Urbandale, IA

100+

Average cost per session

$165

Therapists in Urbandale, IA who prioritize treating:

93% Anxiety
86% Relationship Issues
86% Depression
82% Trauma and PTSD
78% Stress
77% Self Esteem
75% Coping Skills

Average years in practice

9 Years

Top 3 insurances accepted

80% BlueCross and BlueShield
78% Wellmark BCBS
55% UnitedHealthcare UHC | UBH

How Therapists in Urbandale, IA see their clients

89% In Person and Online
11% Online Only

Gender breakdown

83% Female
17% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Urbandale?

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.