Therapists in Ashland, VA

Photo of Sharon Stodulski, Clinical Social Work/Therapist in Ashland, VA
Sharon Stodulski
Clinical Social Work/Therapist, LCSW
Verified Verified
Ashland, VA 23005
Not accepting new clients
There is hope. Are you struggling with uncertainty, sadness, self-critical thoughts or thoughts of perfection? Do you sometimes feel overwhelmed by day to day stresses? You are not alone! Navigating life’s difficulties can be challenging and leave us feeling broken. Sometimes we get stuck, but I believe together we can break the cycle of unhappiness. My goal is to help you identify your strengths and develop practical stepping stones to success so you can really thrive again. You are designed for so much more.
There is hope. Are you struggling with uncertainty, sadness, self-critical thoughts or thoughts of perfection? Do you sometimes feel overwhelmed by day to day stresses? You are not alone! Navigating life’s difficulties can be challenging and leave us feeling broken. Sometimes we get stuck, but I believe together we can break the cycle of unhappiness. My goal is to help you identify your strengths and develop practical stepping stones to success so you can really thrive again. You are designed for so much more.
(804) 376-5301 View (804) 376-5301
Photo of Elmira J King, Clinical Social Work/Therapist in Ashland, VA
Elmira J King
Clinical Social Work/Therapist, LCSW, CSAC, SAP
Verified Verified
Ashland, VA 23005  (Online Only)
I am a licensed clinical social worker with 33 years of counseling experience. I am in private practice under the name Echo Counseling and Professional Services LLC. Our motto is "Reflecting Unlimited Possibility". What if we as individuals practiced reflecting unlimited possibility? If we did, would our life's journey focus on striving to be our best selves? When you select Echo, together we will strive to explore the unlimited possibilities for the changes you seek. We believe that a caring, nonjudgmental, atmosphere provides a solid foundation for developing solution focused, strength based strategies to problem-solving.
I am a licensed clinical social worker with 33 years of counseling experience. I am in private practice under the name Echo Counseling and Professional Services LLC. Our motto is "Reflecting Unlimited Possibility". What if we as individuals practiced reflecting unlimited possibility? If we did, would our life's journey focus on striving to be our best selves? When you select Echo, together we will strive to explore the unlimited possibilities for the changes you seek. We believe that a caring, nonjudgmental, atmosphere provides a solid foundation for developing solution focused, strength based strategies to problem-solving.
(804) 409-8919 View (804) 409-8919
Photo of Eloise McCorkle, Pre-Licensed Professional in Ashland, VA
Eloise McCorkle
Pre-Licensed Professional, MEd
Verified Verified
1 Endorsed
Ashland, VA 23005
You are the expert on your experiences, and I have a genuine interest in knowing your story & working collaboratively with you. I will take the time to acknowledge, understand, and address all aspects of your cultural identity and how this can influence your wellbeing. My warmth and compassion create a safe and non-judgmental environment to help you process significant past events and increase personal insight and awareness. During our time together, you will gain practical strategies to break cyclical habits and develop coping skills to manage adversity & achieve your goals.
You are the expert on your experiences, and I have a genuine interest in knowing your story & working collaboratively with you. I will take the time to acknowledge, understand, and address all aspects of your cultural identity and how this can influence your wellbeing. My warmth and compassion create a safe and non-judgmental environment to help you process significant past events and increase personal insight and awareness. During our time together, you will gain practical strategies to break cyclical habits and develop coping skills to manage adversity & achieve your goals.
(804) 979-2920 View (804) 979-2920
Photo of Debbie P Huntsinger, Pre-Licensed Professional in Ashland, VA
Debbie P Huntsinger
Pre-Licensed Professional, MA, MEd
Verified Verified
Ashland, VA 23005
Hello and welcome. I am a Resident in Counseling at Your Path Counseling Center, Ashland, Virginia. I have over 30 years of various counseling experiences with youth and adults. I recognize how important and valuable counseling is- today- perhaps more than ever- with the demands and stress and pressure of every day, it's not easy to sort things out, and counseling can help. Counseling is the place where you go to talk, learn new strategies, skills, gain insight and understanding, and learn to love, accept, and value who you are so that you can live and find your best life.
Hello and welcome. I am a Resident in Counseling at Your Path Counseling Center, Ashland, Virginia. I have over 30 years of various counseling experiences with youth and adults. I recognize how important and valuable counseling is- today- perhaps more than ever- with the demands and stress and pressure of every day, it's not easy to sort things out, and counseling can help. Counseling is the place where you go to talk, learn new strategies, skills, gain insight and understanding, and learn to love, accept, and value who you are so that you can live and find your best life.
(804) 656-5861 View (804) 656-5861
Photo of Patricia Crowder Horner, Clinical Social Work/Therapist in Ashland, VA
Patricia Crowder Horner
Clinical Social Work/Therapist, LPC, RPT-S, ACS
Verified Verified
1 Endorsed
Ashland, VA 23005
Not accepting new clients
I am not currently accepting new clients. Change is sometimes a difficult challenge for us, and old patterns don't seem to work. Periodically, individuals need to seek outside supports during these times of challenge. I work with children, adults, and families to identify and change or adjust patterns that are out dated, to create positive patterns which last. My work with individuals to develop improved connection with one another, to develop greater self esteem, to address trauma and its effects on present relationships, to establish or maintain more effective communication patterns and increase self reliance.
I am not currently accepting new clients. Change is sometimes a difficult challenge for us, and old patterns don't seem to work. Periodically, individuals need to seek outside supports during these times of challenge. I work with children, adults, and families to identify and change or adjust patterns that are out dated, to create positive patterns which last. My work with individuals to develop improved connection with one another, to develop greater self esteem, to address trauma and its effects on present relationships, to establish or maintain more effective communication patterns and increase self reliance.
(804) 894-9002 View (804) 894-9002
Photo of Elizabeth A Montana, Clinical Social Work/Therapist in Ashland, VA
Elizabeth A Montana
Clinical Social Work/Therapist, LCSW
Verified Verified
Ashland, VA 23005
Taking that first bold step to reach out to a therapist takes courage and strength. As a therapist in a variety of outpatient and school settings, I have provided therapy to children, adolescents and adults for over 20 years. I believe in providing much needed empathy and support but I will also put forth the necessary energy and effort to help challenge you to grow. Sometimes unhealthy patterns and coping strategies from the past are currently interfering in reaching personal goals or in experiencing fulfilling relationships.
Taking that first bold step to reach out to a therapist takes courage and strength. As a therapist in a variety of outpatient and school settings, I have provided therapy to children, adolescents and adults for over 20 years. I believe in providing much needed empathy and support but I will also put forth the necessary energy and effort to help challenge you to grow. Sometimes unhealthy patterns and coping strategies from the past are currently interfering in reaching personal goals or in experiencing fulfilling relationships.
(804) 455-7330 View (804) 455-7330
Photo of Commonwealth Clinical Services, LLP, Psychologist in Ashland, VA
Commonwealth Clinical Services, LLP
Psychologist, PsyD
Verified Verified
1 Endorsed
Ashland, VA 23005
We at CCS work with a wide range of emotional and behavioral issues providing services for adults, adolescents, and children that focus on trauma and PTSD, depression, grief counseling, parenting support, couples counseling and beyond. We provide therapy services to address: Trauma and PTSD, Military and Veteran Concerns, First Responder Concerns (Law Enforcement, Fire, etc.), Depression and Anxiety, Post-Partum Concerns, Stress Management, Substance Use Issues, Mood Disorders and Daily Life Stressors/Adjustment Issues. We also provide psychological assessments and testing.
We at CCS work with a wide range of emotional and behavioral issues providing services for adults, adolescents, and children that focus on trauma and PTSD, depression, grief counseling, parenting support, couples counseling and beyond. We provide therapy services to address: Trauma and PTSD, Military and Veteran Concerns, First Responder Concerns (Law Enforcement, Fire, etc.), Depression and Anxiety, Post-Partum Concerns, Stress Management, Substance Use Issues, Mood Disorders and Daily Life Stressors/Adjustment Issues. We also provide psychological assessments and testing.
(804) 451-6766 View (804) 451-6766
Photo of Catherine D Merchut-Kruger, Clinical Social Work/Therapist in Ashland, VA
Catherine D Merchut-Kruger
Clinical Social Work/Therapist, LCSW
Verified Verified
Ashland, VA 23005
Hello there! I just wanted to start out by saying how courageous you are for taking the step towards growth in your mental health. Please call me "Cathy" and I wanted you to know that I take your journey very seriously. I provide a safe space where collaborative, empathetic and most importantly, person-centered space is available to you.
Hello there! I just wanted to start out by saying how courageous you are for taking the step towards growth in your mental health. Please call me "Cathy" and I wanted you to know that I take your journey very seriously. I provide a safe space where collaborative, empathetic and most importantly, person-centered space is available to you.
(804) 348-0262 x102 View (804) 348-0262 x102
Photo of Heedful Resolutions Behavioral Health Services , Clinical Social Work/Therapist in Ashland, VA
Heedful Resolutions Behavioral Health Services
Clinical Social Work/Therapist, LCSW
Verified Verified
Ashland, VA 23005
As the demands of life are constantly changing and the feelings of uncertainty loom over your day to day activities, one may feel overwhelmed , stuck, anxious, irritated and annoyed to name a few. These feelings may make the simplest of task, seem so difficult. Please know, you are not alone. If you can relate to any of the sentiments above and ready to receive support, allow me the opportunity through various interventions to quiet the mind, so that you can connect to you.
As the demands of life are constantly changing and the feelings of uncertainty loom over your day to day activities, one may feel overwhelmed , stuck, anxious, irritated and annoyed to name a few. These feelings may make the simplest of task, seem so difficult. Please know, you are not alone. If you can relate to any of the sentiments above and ready to receive support, allow me the opportunity through various interventions to quiet the mind, so that you can connect to you.
(804) 207-4516 x101 View (804) 207-4516 x101
Photo of Trisha Voigt, Psychologist in Ashland, VA
Trisha Voigt
Psychologist, PsyD
Verified Verified
Ashland, VA 23005
Are you feeling burdened? Here you or your child can find security, safety, and care. My goal is to give you a safe space to express your emotions and empower you to express an authentic self. We will use attachment and trauma informed techniques to ease your heavy mind. You do not need to bear the stressors of life alone. Breath, we will work lighten the load together.
Are you feeling burdened? Here you or your child can find security, safety, and care. My goal is to give you a safe space to express your emotions and empower you to express an authentic self. We will use attachment and trauma informed techniques to ease your heavy mind. You do not need to bear the stressors of life alone. Breath, we will work lighten the load together.
(804) 361-8538 View (804) 361-8538
Photo of Patricia Grigoryev, Psychologist in Ashland, VA
Patricia Grigoryev
Psychologist, PhD
Verified Verified
1 Endorsed
Ashland, VA 23005
I offer a broad range of psychological services to adults and adolescents of all ages. I have been a practicing, Licensed Clinical Psychologist since 1997. My approach to therapy and counseling is integrative, meaning I provide a blend of cutting edge, evidence-based therapies and interventions which are matched to the specific problems and the needs of the client. My approach is affirming and open and I am experienced working with people from diverse backgrounds of ethnicity, sexual orientation and religious persuasion. I am committed to helping clients find a true and lasting sense of wholeness and well-being.
I offer a broad range of psychological services to adults and adolescents of all ages. I have been a practicing, Licensed Clinical Psychologist since 1997. My approach to therapy and counseling is integrative, meaning I provide a blend of cutting edge, evidence-based therapies and interventions which are matched to the specific problems and the needs of the client. My approach is affirming and open and I am experienced working with people from diverse backgrounds of ethnicity, sexual orientation and religious persuasion. I am committed to helping clients find a true and lasting sense of wholeness and well-being.
(804) 375-4762 View (804) 375-4762
Photo of Yvonne Fall, Licensed Professional Counselor in Ashland, VA
Yvonne Fall
Licensed Professional Counselor, LPC
Verified Verified
Ashland, VA 23005
You have a vision for your life, and despite your best efforts it hasn't yet materialized. You may want more fulfilling relationships, to feel worthy, to feel calmer in your mind and emotions, to focus more on the positive aspects of your life or to make decisions more easily. You may find that long ago or recent experiences continue to bother you even though you think they shouldn't. Maybe you didn't receive the care you needed growing up, were sexually assaulted, experienced medical trauma, or have experienced a loss. You want to heal, grow, and thrive. You may be worried it won't help and you are ready to try therapy.
You have a vision for your life, and despite your best efforts it hasn't yet materialized. You may want more fulfilling relationships, to feel worthy, to feel calmer in your mind and emotions, to focus more on the positive aspects of your life or to make decisions more easily. You may find that long ago or recent experiences continue to bother you even though you think they shouldn't. Maybe you didn't receive the care you needed growing up, were sexually assaulted, experienced medical trauma, or have experienced a loss. You want to heal, grow, and thrive. You may be worried it won't help and you are ready to try therapy.
(804) 509-2534 View (804) 509-2534
Photo of Celeste Kelly, Psychologist in Ashland, VA
Celeste Kelly
Psychologist, PsyD
Verified Verified
1 Endorsed
Ashland, VA 23005
I believe everyone can benefit from therapy. Whether you come to explore your identity, your relationships, a life-changing event, or just the feeling that something is “off,” I believe powerful change can happen in the context of a safe and supportive therapeutic relationship. It can be so difficult to seek out a therapist, and I understand you may have had negative experiences with therapy in the past. I appreciate the inner strength that allowed you to reach out and find this page. Together, we can explore patterns in your life to help illuminate your present and future.
I believe everyone can benefit from therapy. Whether you come to explore your identity, your relationships, a life-changing event, or just the feeling that something is “off,” I believe powerful change can happen in the context of a safe and supportive therapeutic relationship. It can be so difficult to seek out a therapist, and I understand you may have had negative experiences with therapy in the past. I appreciate the inner strength that allowed you to reach out and find this page. Together, we can explore patterns in your life to help illuminate your present and future.
(804) 361-8213 View (804) 361-8213
Photo of Emily Webb Olsen, Licensed Professional Counselor in Ashland, VA
Emily Webb Olsen
Licensed Professional Counselor, LPC
Verified Verified
Ashland, VA 23005  (Online Only)
Waitlist for new clients
Are you ready to embark on a journey of self-discovery, resilience, and deep level healing? I utilize somatic therapy and trauma therapy approaches that helps you recognize our deep connection between the body and mind, offering you a holistic path to emotional well-being. I am committed to creating a safe and empathetic space where you can explore your experiences, uncover your strengths, and build a foundation for lasting transformation. I enjoy working with other mental health professionals and teachers, and I offer sliding scale for those who are just starting their profession.
Are you ready to embark on a journey of self-discovery, resilience, and deep level healing? I utilize somatic therapy and trauma therapy approaches that helps you recognize our deep connection between the body and mind, offering you a holistic path to emotional well-being. I am committed to creating a safe and empathetic space where you can explore your experiences, uncover your strengths, and build a foundation for lasting transformation. I enjoy working with other mental health professionals and teachers, and I offer sliding scale for those who are just starting their profession.
(540) 235-5664 View (540) 235-5664
Photo of Faith Harmon, LCSW, LLC, Clinical Social Work/Therapist in Ashland, VA
Faith Harmon, LCSW, LLC
Clinical Social Work/Therapist, LCSW, RPT
Verified Verified
Ashland, VA 23005
I work with children from 3 to 18 as well as adults, couples and families with issues such as trauma histories, anxiety, depression, school issues, self-esteem issues, anger management, Post Traumatic Stress Disorder, divorce issues, family conflict and parenting. My goal is to provide a safe space where children and adults can feel free to express themselves and in that process develop self-awareness and a skill set to improve relationships with themselves and with others. I do this in a non-judgmental, compassionate and caring way to promote healing and transformation.
I work with children from 3 to 18 as well as adults, couples and families with issues such as trauma histories, anxiety, depression, school issues, self-esteem issues, anger management, Post Traumatic Stress Disorder, divorce issues, family conflict and parenting. My goal is to provide a safe space where children and adults can feel free to express themselves and in that process develop self-awareness and a skill set to improve relationships with themselves and with others. I do this in a non-judgmental, compassionate and caring way to promote healing and transformation.
(804) 374-8798 View (804) 374-8798
Photo of Mary Joelle Messerschmidt, Clinical Social Work/Therapist in Ashland, VA
Mary Joelle Messerschmidt
Clinical Social Work/Therapist, LCSW, CLC
Verified Verified
1 Endorsed
Ashland, VA 23005  (Online Only)
Hello, and thank you for visiting my page. I am a licensed therapist with over 25 years of experience in the field of counseling. I believe in creating a safe space for clients to work through challenges in life. After a thorough bio-psychosocial perspective and assessment, my services consist of diagnosis, treatment (including psychotherapy and counseling), evaluation, and maintenance of recovery. In addition to providing psychotherapy, I am a certified licensure supervisor to new professionals.
Hello, and thank you for visiting my page. I am a licensed therapist with over 25 years of experience in the field of counseling. I believe in creating a safe space for clients to work through challenges in life. After a thorough bio-psychosocial perspective and assessment, my services consist of diagnosis, treatment (including psychotherapy and counseling), evaluation, and maintenance of recovery. In addition to providing psychotherapy, I am a certified licensure supervisor to new professionals.
(804) 538-3894 View (804) 538-3894
Photo of Crystal Driggs, Licensed Professional Counselor in Ashland, VA
Crystal Driggs
Licensed Professional Counselor, MEd, LPC
Verified Verified
Ashland, VA 23005
I help children, adolescents, and teens who are having difficulty managing emotions, struggling with behavior, and/or going through changes in the home. I believe that children can not only communicate issues through play but also learn new skills the best when play therapy techniques are intertwined within their therapy experience. Many adolescents and teens benefit from a neutral sounding board that can provide support and new perspectives.
I help children, adolescents, and teens who are having difficulty managing emotions, struggling with behavior, and/or going through changes in the home. I believe that children can not only communicate issues through play but also learn new skills the best when play therapy techniques are intertwined within their therapy experience. Many adolescents and teens benefit from a neutral sounding board that can provide support and new perspectives.
(804) 485-2630 View (804) 485-2630
Photo of Setera Stevens, Licensed Professional Counselor in Ashland, VA
Setera Stevens
Licensed Professional Counselor, MA, LPC, CPSC
Verified Verified
1 Endorsed
Ashland, VA 23005
Not accepting new clients
Have you been feeling exhausted lately, regardless of the amount of sleep? Are you finding it hard to motivate yourself to do the simplest of task or crying everyday? I know exactly what you're feeling: the irritability for no reason, lack of appetite or over eating, the feeling that the walls are closing in and you need out NOW, but don't know where to turn. I don't want you to have to suffer like that anymore. We are going to take your life back!
Have you been feeling exhausted lately, regardless of the amount of sleep? Are you finding it hard to motivate yourself to do the simplest of task or crying everyday? I know exactly what you're feeling: the irritability for no reason, lack of appetite or over eating, the feeling that the walls are closing in and you need out NOW, but don't know where to turn. I don't want you to have to suffer like that anymore. We are going to take your life back!
(804) 534-2068 x6 View (804) 534-2068 x6
Photo of Larissa Grundmanis, Pre-Licensed Professional in Ashland, VA
Larissa Grundmanis
Pre-Licensed Professional, PsyD
Verified Verified
1 Endorsed
Ashland, VA 23005
Looking to empower your personal growth? Do you want some direction on your journey? Life is an intricate journey filled with countless challenges that test our resilience, shape our character, and push us to grow in ways we never thought possible. The good news is that you don’t have to try to find growth on your own. Allow me to extend a helping hand, to listen, encourage, and empower you in overcoming life’s many challenges.
Looking to empower your personal growth? Do you want some direction on your journey? Life is an intricate journey filled with countless challenges that test our resilience, shape our character, and push us to grow in ways we never thought possible. The good news is that you don’t have to try to find growth on your own. Allow me to extend a helping hand, to listen, encourage, and empower you in overcoming life’s many challenges.
(804) 265-4431 View (804) 265-4431
Photo of Greg Podolak, Supervisee in Clinical Social Work in Ashland, VA
Greg Podolak
Supervisee in Clinical Social Work, MSW
Verified Verified
Ashland, VA 23005
Do you feel as though you can never quite settle down? Does your sarcasm earn you funny looks? Do you seek adrenaline on your days off? Do you like tanks? I might be the counselor for you.
Do you feel as though you can never quite settle down? Does your sarcasm earn you funny looks? Do you seek adrenaline on your days off? Do you like tanks? I might be the counselor for you.
(804) 258-6475 View (804) 258-6475

How does your Therapist compare?

Number of Therapists in Ashland, VA

50+

Average cost per session

$130

Therapists in Ashland, VA who prioritize treating:

96% Anxiety
88% Depression
76% Self Esteem
74% Relationship Issues
74% Trauma and PTSD
74% Coping Skills
72% Grief

Average years in practice

12 Years

Top 3 insurances accepted

87% Aetna
87% Anthem | Elevance
82% Cigna and Evernorth

How Therapists in Ashland, VA see their clients

82% In Person and Online
18% Online Only

Gender breakdown

82% Female
14% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Ashland?

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.