Therapists in Salem, MA

Photo of Kate Roberts, Psychologist in Salem, MA
Kate Roberts
Psychologist, PhD
Verified Verified
Salem, MA 01970
Most people are struggling with something in their lives today. Asking for help is not a sign of weakness. I offer Telehealth and in person counseling. I've been a practicing child, family and adult psychologist for more than 30 years. I combine supportive counseling and cognitive-behavioral therapy strategies, in a non-judgmental environment to help you manage your challenges and improve your life. At this time I am accepting insurance. I would love to hear from you and work with you. Please contact me at katemoraroberts at gmail.com.
Most people are struggling with something in their lives today. Asking for help is not a sign of weakness. I offer Telehealth and in person counseling. I've been a practicing child, family and adult psychologist for more than 30 years. I combine supportive counseling and cognitive-behavioral therapy strategies, in a non-judgmental environment to help you manage your challenges and improve your life. At this time I am accepting insurance. I would love to hear from you and work with you. Please contact me at katemoraroberts at gmail.com.
(978) 801-0964 View (978) 801-0964
Photo of Andrea S Zeren, Psychologist in Salem, MA
Andrea S Zeren
Psychologist, PhD
Verified Verified
Salem, MA 01970
Waitlist for new clients
I have been a clinician and educator for over twenty-five years and blend these methods in my clinical practice. My training encompasses a number of diverse content areas, such as clinical, developmental, family and substance-related issues, all of which helps enrich my understanding of the challenges that life can present. I believe that people have greater capabilities than they are aware of. My role is to collaborate with you, not tell offer advice, tell you what to do or how to live. I treat all of my clients with dignity and respect and seek active collaboration.
I have been a clinician and educator for over twenty-five years and blend these methods in my clinical practice. My training encompasses a number of diverse content areas, such as clinical, developmental, family and substance-related issues, all of which helps enrich my understanding of the challenges that life can present. I believe that people have greater capabilities than they are aware of. My role is to collaborate with you, not tell offer advice, tell you what to do or how to live. I treat all of my clients with dignity and respect and seek active collaboration.
(978) 432-9917 View (978) 432-9917
Photo of Josiah Colbert - Northbound Counseling, Marriage & Family Therapist in Salem, MA
Josiah Colbert - Northbound Counseling
Marriage & Family Therapist, LMFT
Verified Verified
4 Endorsed
Salem, MA 01970
UPDATE: Currently Accepting new Clients for Individual therapy. Let’s be honest, life can often be difficult and unpredictable. Whether you’re attempting to navigate a complex relationship, quell generational family conflicts, or manage the daily stresses of life, sometimes knowing where to begin can be the hardest part. If you’re struggling with where to start in your personal journey, seeking help from a professional can be a great first step towards making positive changes. As a Licensed Marriage and Family Therapist, I work with individuals, couples, and families to improve their relationships and their lives.
UPDATE: Currently Accepting new Clients for Individual therapy. Let’s be honest, life can often be difficult and unpredictable. Whether you’re attempting to navigate a complex relationship, quell generational family conflicts, or manage the daily stresses of life, sometimes knowing where to begin can be the hardest part. If you’re struggling with where to start in your personal journey, seeking help from a professional can be a great first step towards making positive changes. As a Licensed Marriage and Family Therapist, I work with individuals, couples, and families to improve their relationships and their lives.
(508) 715-3583 View (508) 715-3583
Photo of Erin Uzarski, Counselor in Salem, MA
Erin Uzarski
Counselor, LMHC
Verified Verified
Salem, MA 01970  (Online Only)
I provide a supportive therapeutic environment that is comfortable and non-judgmental. My clinical approach to therapy is a partnership that allows my clients to be interactive in their sessions. Together, we will discuss what your presenting concerns are and work on building skills that will help you cope with those issues. If you are unsure what your specific therapeutic goals are at this time and are looking for broader supports, we can also work together to gain a better understanding of yourself while building a toolbox of skills that will help you move forward on your journey.
I provide a supportive therapeutic environment that is comfortable and non-judgmental. My clinical approach to therapy is a partnership that allows my clients to be interactive in their sessions. Together, we will discuss what your presenting concerns are and work on building skills that will help you cope with those issues. If you are unsure what your specific therapeutic goals are at this time and are looking for broader supports, we can also work together to gain a better understanding of yourself while building a toolbox of skills that will help you move forward on your journey.
(978) 678-4036 View (978) 678-4036
Photo of Rachel Gedansky, Clinical Social Work/Therapist in Salem, MA
Rachel Gedansky
Clinical Social Work/Therapist, LICSW
Verified Verified
1 Endorsed
Salem, MA 01970
I believe one of the bravest things you can do is to understand your own story. Trauma, anxiety, depression, or just life stress in general can leave us feeling uncertain about our lives and apprehensive about what the future might hold. I'm here to help you make sense of the puzzle pieces in your life and to help you create a clearer view of your future and what brings you happiness. I'm deeply committed to making sure you feel seen, heard and understood. I've worked in a variety of settings in the mental health field over the years including roles providing family therapy, crisis work in hospital settings, and group therapy.
I believe one of the bravest things you can do is to understand your own story. Trauma, anxiety, depression, or just life stress in general can leave us feeling uncertain about our lives and apprehensive about what the future might hold. I'm here to help you make sense of the puzzle pieces in your life and to help you create a clearer view of your future and what brings you happiness. I'm deeply committed to making sure you feel seen, heard and understood. I've worked in a variety of settings in the mental health field over the years including roles providing family therapy, crisis work in hospital settings, and group therapy.
(781) 720-4975 View (781) 720-4975
Photo of Susan Gordon-Schiowitz, Clinical Social Work/Therapist in Salem, MA
Susan Gordon-Schiowitz
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Salem, MA 01970
Welcome, and thank you for taking the time to consider entering therapy. In my 20 years of experience, clients whom I have met have impressed me with their ability to establish achievable goals as they work toward improving their overall happiness and well being. Whether you are struggling with issues such as anxiety or depression, looking to improve relationships or consider major changes, coping with chronic medical conditions, feeling "stuck" at times, or caring for others who have multiple needs, I am here to help you navigate through these chapters in your life and establish a balance.
Welcome, and thank you for taking the time to consider entering therapy. In my 20 years of experience, clients whom I have met have impressed me with their ability to establish achievable goals as they work toward improving their overall happiness and well being. Whether you are struggling with issues such as anxiety or depression, looking to improve relationships or consider major changes, coping with chronic medical conditions, feeling "stuck" at times, or caring for others who have multiple needs, I am here to help you navigate through these chapters in your life and establish a balance.
(978) 248-0183 View (978) 248-0183
Photo of Emilie Mellal, Pre-Licensed Professional in Salem, MA
Emilie Mellal
Pre-Licensed Professional, MS, MFT
Verified Verified
Salem, MA 01970
My practice is: Queer/ Trans-affirming, Neurodiversity-affirming, Body positive, Fat positive, Sex positive, Kink-affirming, and Poly/Non-Monogamy-affirming. I work with individuals and relationships. I like to establish up front that I am a safe person to correct, call-out, interrupt, disagree and argue with. It will not impact our therapeutic relationship. You are the expert of your own life.
My practice is: Queer/ Trans-affirming, Neurodiversity-affirming, Body positive, Fat positive, Sex positive, Kink-affirming, and Poly/Non-Monogamy-affirming. I work with individuals and relationships. I like to establish up front that I am a safe person to correct, call-out, interrupt, disagree and argue with. It will not impact our therapeutic relationship. You are the expert of your own life.
(978) 440-6350 View (978) 440-6350
Photo of Summer Baidak, Counselor in Salem, MA
Summer Baidak
Counselor, LMHC
Verified Verified
Salem, MA 01970  (Online Only)
An interactive therapist who enjoys the collaboration of the process with the client as the expert ...and the therapist as a guide.... My approach integrates cognitive behavioral strategies ....interpersonal psychodynamic and solution-based strategies.... An extensive knowledge of human behavior in the daily life struggles that individuals, families and couples face daily.. Experience working with individuals and the families around special-needs/ cognitive/educational/life planning/educational advocacy/obtaining outside services psychotherapy/social skills training /behavior modification...
An interactive therapist who enjoys the collaboration of the process with the client as the expert ...and the therapist as a guide.... My approach integrates cognitive behavioral strategies ....interpersonal psychodynamic and solution-based strategies.... An extensive knowledge of human behavior in the daily life struggles that individuals, families and couples face daily.. Experience working with individuals and the families around special-needs/ cognitive/educational/life planning/educational advocacy/obtaining outside services psychotherapy/social skills training /behavior modification...
(978) 633-7765 View (978) 633-7765
Photo of David Rupert, Psychologist in Salem, MA
David Rupert
Psychologist, PsyD
Verified Verified
Salem, MA 01970
Not accepting new clients
**** Alert: I am currently full and not accepting new clients. **** I work primarily with adults who are struggling with emotional or relational issues. Intellectual understanding of a problem may not be enough to produce change. I try to listen deeply and help people integrate their strengths, values, and emotions in new ways. Many of my clients feel stuck or defeated in certain areas despite doing well in other domains of life.
**** Alert: I am currently full and not accepting new clients. **** I work primarily with adults who are struggling with emotional or relational issues. Intellectual understanding of a problem may not be enough to produce change. I try to listen deeply and help people integrate their strengths, values, and emotions in new ways. Many of my clients feel stuck or defeated in certain areas despite doing well in other domains of life.
(978) 767-9433 View (978) 767-9433
Photo of Full Cup LLC, Clinical Social Work/Therapist in Salem, MA
Full Cup LLC
Clinical Social Work/Therapist, LICSW
Verified Verified
Salem, MA 01970
Welcome! and thank you for visiting our profile! A little bit about our practice...Full Cup values authenticity! We believe that good therapy happens only once you have established a great rapport with your therapist. We strive to hire therapists with different expertise and ideas on how to best help clients. Some of the approaches our clinicians draw from include the following: Cognitive Behavioral Therapy, Dialectical Behavioral therapy , Mindfulness based approaches, spiritual practice/ psychotherapy combo and more! We are always looking for new ways to help our clients get the most they can out of our time together!
Welcome! and thank you for visiting our profile! A little bit about our practice...Full Cup values authenticity! We believe that good therapy happens only once you have established a great rapport with your therapist. We strive to hire therapists with different expertise and ideas on how to best help clients. Some of the approaches our clinicians draw from include the following: Cognitive Behavioral Therapy, Dialectical Behavioral therapy , Mindfulness based approaches, spiritual practice/ psychotherapy combo and more! We are always looking for new ways to help our clients get the most they can out of our time together!
(978) 800-3721 View (978) 800-3721
Photo of Erin Rioux, Clinical Social Work/Therapist in Salem, MA
Erin Rioux
Clinical Social Work/Therapist, LICSW
Verified Verified
1 Endorsed
Salem, MA 01970
I have no availability at this time. I have been a clinical mental health therapist for over 15 years. I have experience working with children, adolescents and adults with trauma, anxiety, depression, and major mental illness. I utilize evidenced-based practices specific to the presenting problem, ages, and stages of the client. These include but are not limited to EMDR, CBT/DBT, play therapy, family therapy, narrative therapy, progressive counting, client-focused, and strength based therapy. I am passionate about helping clients overcome challenges and difficulties so that they can reach their full potential.
I have no availability at this time. I have been a clinical mental health therapist for over 15 years. I have experience working with children, adolescents and adults with trauma, anxiety, depression, and major mental illness. I utilize evidenced-based practices specific to the presenting problem, ages, and stages of the client. These include but are not limited to EMDR, CBT/DBT, play therapy, family therapy, narrative therapy, progressive counting, client-focused, and strength based therapy. I am passionate about helping clients overcome challenges and difficulties so that they can reach their full potential.
(781) 622-9424 View (781) 622-9424
Photo of Patrick M. Szafran, Psychologist in Salem, MA
Patrick M. Szafran
Psychologist, PsyD
Verified Verified
7 Endorsed
Salem, MA 01970
Everyone deserves to experience joy & fulfillment in life & relationships, including you! At the foundation of my approach is a strong connection between two people that is based on mutual safety, trust, & genuine care. Within this relationship, I am my authentic self by bringing my warmth, dedication, & quirky personality that often puts folks at ease & enables them to more compassionately understand their true selves, strengths & imperfections in all. Through this process of self-exploration, people I work with learn to more honestly attend to & express their emotions, which leads to greater self-acceptance & consequently freedom from self-doubt & low self-esteem.
Everyone deserves to experience joy & fulfillment in life & relationships, including you! At the foundation of my approach is a strong connection between two people that is based on mutual safety, trust, & genuine care. Within this relationship, I am my authentic self by bringing my warmth, dedication, & quirky personality that often puts folks at ease & enables them to more compassionately understand their true selves, strengths & imperfections in all. Through this process of self-exploration, people I work with learn to more honestly attend to & express their emotions, which leads to greater self-acceptance & consequently freedom from self-doubt & low self-esteem.
(339) 210-1041 View (339) 210-1041
Photo of Jeff Driskell, Clinical Social Work/Therapist in Salem, MA
Jeff Driskell
Clinical Social Work/Therapist, PhD, MSW, LICSW
Verified Verified
Salem, MA 01970
Not accepting new clients
Life’s challenges can be thought of as opportunities and gifts as they help us to evolve, grow, and develop insight about how we navigate our world. Overtime, we learn what works, what no longer works, what keeps us stuck, all while developing insights to what changes need to occur. Whether you are facing life transitions, mental health or relationship challenges, issues surrounding sexual orientation, or general life issues, we will work together to explore solutions. My prior work includes working with adolescents and adults in a variety of settings.
Life’s challenges can be thought of as opportunities and gifts as they help us to evolve, grow, and develop insight about how we navigate our world. Overtime, we learn what works, what no longer works, what keeps us stuck, all while developing insights to what changes need to occur. Whether you are facing life transitions, mental health or relationship challenges, issues surrounding sexual orientation, or general life issues, we will work together to explore solutions. My prior work includes working with adolescents and adults in a variety of settings.
(978) 961-6665 View (978) 961-6665
Photo of Will Simmons, Clinical Social Work/Therapist in Salem, MA
Will Simmons
Clinical Social Work/Therapist, LICSW
Verified Verified
1 Endorsed
Salem, MA 01970  (Online Only)
Starting therapy can often be daunting, so please don't hesitate to contact me to discuss your needs and goals for treatment in a safe environment. I continue to offer a client-focused, personalized approach to therapy utilizing various cognitive and psychodynamic modalities. This may mean addressing early life influence on your current daily function, or specific goals for your profession, relationships with yourself, loved ones, and the world around you. Whether it is short-term solution-focused for a specific need, or long-term healing, personal growth, and exploration- positive change is possible, concrete, and within reach.
Starting therapy can often be daunting, so please don't hesitate to contact me to discuss your needs and goals for treatment in a safe environment. I continue to offer a client-focused, personalized approach to therapy utilizing various cognitive and psychodynamic modalities. This may mean addressing early life influence on your current daily function, or specific goals for your profession, relationships with yourself, loved ones, and the world around you. Whether it is short-term solution-focused for a specific need, or long-term healing, personal growth, and exploration- positive change is possible, concrete, and within reach.
(978) 648-2197 View (978) 648-2197
Photo of Wendy P. O'Hara, Clinical Social Work/Therapist in Salem, MA
Wendy P. O'Hara
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Salem, MA 01970
When we seek therapy- we are often "on the edge" of something...usually mystifying, hugely disappointing or nerve wracking. For a while it can be confusing and sometimes debilitating. It may be a relationship breakdown, a divorce, an addiction, a loss, or even "a cliff"- in which case psychotherapy can be life saving! Some of us clearly benefit with guidance. Perhaps our collaboration will achieve this.
When we seek therapy- we are often "on the edge" of something...usually mystifying, hugely disappointing or nerve wracking. For a while it can be confusing and sometimes debilitating. It may be a relationship breakdown, a divorce, an addiction, a loss, or even "a cliff"- in which case psychotherapy can be life saving! Some of us clearly benefit with guidance. Perhaps our collaboration will achieve this.
(978) 705-6850 View (978) 705-6850
Photo of Dave Dorvilier, Clinical Social Work/Therapist in Salem, MA
Dave Dorvilier
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
4 Endorsed
Salem, MA 01970
I believe therapy is based off a cooperative relationship between the therapist and client working together towards what you find important. Many events throughout the course of our lives shape and mold us; These life experiences and lessons can have a huge impact on our relationships with others and ourselves that leaves us feeling stuck or dissatisfied. I have over 8 years of experience working in clinics and community based service settings; I currently work primarily with adults with significant experience in relationship issues, career, self-esteem, trauma and abuse, stress, anxiety and depression.
I believe therapy is based off a cooperative relationship between the therapist and client working together towards what you find important. Many events throughout the course of our lives shape and mold us; These life experiences and lessons can have a huge impact on our relationships with others and ourselves that leaves us feeling stuck or dissatisfied. I have over 8 years of experience working in clinics and community based service settings; I currently work primarily with adults with significant experience in relationship issues, career, self-esteem, trauma and abuse, stress, anxiety and depression.
(857) 763-2737 View (857) 763-2737
Photo of Alex Maranto, Counselor in Salem, MA
Alex Maranto
Counselor, LMHC
Verified Verified
Salem, MA 01970
Waitlist for new clients
My practice is dedicated to helping clients feel at peace in their bodies and minds. I approach complex issues from a place of non-judgement and encourage creative solutions. I am passionate about helping clients recover from, or survive with, anxiety and depression, as well as many forms of eating disorders and disordered eating. I also treat associated issues such as perfectionism, body image, and difficulties with self esteem.
My practice is dedicated to helping clients feel at peace in their bodies and minds. I approach complex issues from a place of non-judgement and encourage creative solutions. I am passionate about helping clients recover from, or survive with, anxiety and depression, as well as many forms of eating disorders and disordered eating. I also treat associated issues such as perfectionism, body image, and difficulties with self esteem.
(978) 525-0340 View (978) 525-0340
Photo of Skeetz Edinger, Marriage & Family Therapist in Salem, MA
Skeetz Edinger
Marriage & Family Therapist, MS, LMFT-S
Verified Verified
3 Endorsed
Salem, MA 01970
I strive to empower the people that I work with. I believe that the people that I work with are more of an expert on their own lives and experiences than anyone else is. My aim is to provide a space for people's unique strengths and gifts to emerge. I have extensive experience in working with diverse individuals, relationships, and families, and I strive to ensure that everyone feels heard and validated.
I strive to empower the people that I work with. I believe that the people that I work with are more of an expert on their own lives and experiences than anyone else is. My aim is to provide a space for people's unique strengths and gifts to emerge. I have extensive experience in working with diverse individuals, relationships, and families, and I strive to ensure that everyone feels heard and validated.
(339) 330-3722 View (339) 330-3722
Photo of Talissa Casal, Clinical Social Work/Therapist in Salem, MA
Talissa Casal
Clinical Social Work/Therapist, LICSW
Verified Verified
Salem, MA 01970
I believe that any person can make improvements in their life with nonjudgemental acceptance and guidance to increase coping skills, self-worth and a better understanding of themselves and what they are capable of.
I believe that any person can make improvements in their life with nonjudgemental acceptance and guidance to increase coping skills, self-worth and a better understanding of themselves and what they are capable of.
(978) 306-2088 View (978) 306-2088
Photo of Mary Doherty, Clinical Social Work/Therapist in Salem, MA
Mary Doherty
Clinical Social Work/Therapist, LICSW
Verified Verified
Salem, MA 01970
I am licensed independent clinical social worker with over 20 years experience working with adults, youth and families. I currently work with adults and young adults helping to navigate transitions, relationships and life stressors. My approach is collaborative, strength based tailoring treatment to the individual 's needs. I bring expertise and real lived experience to working with issues of divorce, child custody, parenting support, and anxiety and depression. I use both behavioral and interpersonal approaches to therapy. Please feel free to reach out to me for a 15 consultation.
I am licensed independent clinical social worker with over 20 years experience working with adults, youth and families. I currently work with adults and young adults helping to navigate transitions, relationships and life stressors. My approach is collaborative, strength based tailoring treatment to the individual 's needs. I bring expertise and real lived experience to working with issues of divorce, child custody, parenting support, and anxiety and depression. I use both behavioral and interpersonal approaches to therapy. Please feel free to reach out to me for a 15 consultation.
(978) 961-4020 View (978) 961-4020

How does your Therapist compare?

Number of Therapists in Salem, MA

200+

Average cost per session

$150

Therapists in Salem, MA who prioritize treating:

92% Anxiety
88% Depression
86% Relationship Issues
74% Trauma and PTSD
73% Self Esteem
72% Coping Skills
65% Stress

Average years in practice

13 Years

Top 3 insurances accepted

89% BlueCross and BlueShield
60% Optum
57% UnitedHealthcare UHC | UBH

How Therapists in Salem, MA see their clients

61% In Person and Online
39% Online Only

Gender breakdown

81% Female
16% Male
3% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Salem?

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.