Therapists in Seattle, WA

View neighborhoods in Seattle
Photo of Martha Reynolds, Clinical Social Work/Therapist in Seattle, WA
Martha Reynolds
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Seattle, WA 98119
I provide a professional, confidential setting in which an individual is safe to explore and find personal solutions to the complex problems of emotional life and interpersonal relationships. I believe it is within the context of the therapeutic attachment that positive growth and development are facilitated.
I provide a professional, confidential setting in which an individual is safe to explore and find personal solutions to the complex problems of emotional life and interpersonal relationships. I believe it is within the context of the therapeutic attachment that positive growth and development are facilitated.
(206) 743-9985 View (206) 743-9985
Photo of Brittany Steffen, Marriage & Family Therapist in Seattle, WA
Brittany Steffen
Marriage & Family Therapist, MS, LMFT, AASECT
Verified Verified
24 Endorsed
Seattle, WA 98109
I work with anyone who is feeling stuck in their life- helping them be seen, heard, and understood, as we approach problems with curiosity and empathy. While we can't control what happens to us, we can control how we respond- and therapy is the best way to get all the tools you need to respond to life's ups and downs. If you're motivated and engaged in the process, therapy can give you the set of tools you need to improve (or completely change) your life. I support clients in their goals, applying psycho-education, in-depth therapeutic training, 10+ years of experience, and (always optional) out of session homework.
I work with anyone who is feeling stuck in their life- helping them be seen, heard, and understood, as we approach problems with curiosity and empathy. While we can't control what happens to us, we can control how we respond- and therapy is the best way to get all the tools you need to respond to life's ups and downs. If you're motivated and engaged in the process, therapy can give you the set of tools you need to improve (or completely change) your life. I support clients in their goals, applying psycho-education, in-depth therapeutic training, 10+ years of experience, and (always optional) out of session homework.
(206) 535-1787 View (206) 535-1787
Photo of Timothy Tetrault, Counselor in Seattle, WA
Timothy Tetrault
Counselor, MA, LMHC
Verified Verified
4 Endorsed
Seattle, WA 98116
I believe that we are relational beings, and that health can be cultivated in intentional, honest, and reciprocal relationships that respect and reveal our inherent dignity. Because relationships with others and ourselves hold great promise and power, they can also be the focus of most of our pain as we move through life. The therapeutic relationship we build together acts as a staging ground and microcosm to help you renew the relationships you have with yourself and others in life.
I believe that we are relational beings, and that health can be cultivated in intentional, honest, and reciprocal relationships that respect and reveal our inherent dignity. Because relationships with others and ourselves hold great promise and power, they can also be the focus of most of our pain as we move through life. The therapeutic relationship we build together acts as a staging ground and microcosm to help you renew the relationships you have with yourself and others in life.
(206) 350-9474 View (206) 350-9474
Photo of Meaghan O'Neil, Marriage & Family Therapist Associate in Seattle, WA
Meaghan O'Neil
Marriage & Family Therapist Associate, MA, LMFTA
Verified Verified
1 Endorsed
Seattle, WA 98112
I seek to help all clients get to know themselves better. My style of therapy is friendly, non-judgemental and sprinkled with humor. I aim to create a space where clients feel comfortable to show up as themselves and explore deeper parts of who they are. I collaborate with clients to understand patterns in their thinking, relationships, and behaviors, in order to help them develop coping strategies to live a more grounded and connected life.
I seek to help all clients get to know themselves better. My style of therapy is friendly, non-judgemental and sprinkled with humor. I aim to create a space where clients feel comfortable to show up as themselves and explore deeper parts of who they are. I collaborate with clients to understand patterns in their thinking, relationships, and behaviors, in order to help them develop coping strategies to live a more grounded and connected life.
(206) 594-4741 View (206) 594-4741
Photo of Liz Landry, Clinical Social Work/Therapist in Seattle, WA
Liz Landry
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
1 Endorsed
Seattle, WA 98119  (Online Only)
Tired of living a life that feels less than fulfilling? Never been to therapy before and nervous about trying it out? Struggling to navigate your identity after leaving a religious institution or exploring your sexuality? The good news is, you’re not alone! Many of my clients are processing religious trauma, looking for support in their LGBTQ identity, need help coping with attachment-related stressors, or are processing grief. With the most up-to-date evidence based treatments, I believe in supporting you with an individualized, multi-faceted therapeutic approach to help empower you to live in emotional and mental freedom.
Tired of living a life that feels less than fulfilling? Never been to therapy before and nervous about trying it out? Struggling to navigate your identity after leaving a religious institution or exploring your sexuality? The good news is, you’re not alone! Many of my clients are processing religious trauma, looking for support in their LGBTQ identity, need help coping with attachment-related stressors, or are processing grief. With the most up-to-date evidence based treatments, I believe in supporting you with an individualized, multi-faceted therapeutic approach to help empower you to live in emotional and mental freedom.
(206) 666-4850 View (206) 666-4850
Photo of Amanda Sargent, Counselor in Seattle, WA
Amanda Sargent
Counselor, MA, LMHC
Verified Verified
1 Endorsed
Seattle, WA 98122  (Online Only)
My practice focuses on counseling for depression, anxiety, life's transitions and low self esteem.I believe therapy is an opportunity to take a step towards ones self and that the role of therapy is to bring relief during difficult times and to build strength, stamina, acceptance and the skills necessary to remain engaged with the world around us. I have experience working with young adults looking for independence from their families of origin as well as parents creating new lives for themselves. I offer pre and post commitment counseling for couples facing the challenge of staying connected.
My practice focuses on counseling for depression, anxiety, life's transitions and low self esteem.I believe therapy is an opportunity to take a step towards ones self and that the role of therapy is to bring relief during difficult times and to build strength, stamina, acceptance and the skills necessary to remain engaged with the world around us. I have experience working with young adults looking for independence from their families of origin as well as parents creating new lives for themselves. I offer pre and post commitment counseling for couples facing the challenge of staying connected.
(206) 264-4401 View (206) 264-4401
Aqssa Chaudhry
Counselor, LMHC
Verified Verified
Seattle, WA 98107
I received my Master's in Clinical Mental Health Counseling from Mercer University. Aqssa values Dialectical Behavioral Therapy as well as Existential Therapy, integrated with evidence-based best practice, to create balance and integration in her clients. She believes in guiding the client to their true path and allowing them to know their own power and intuition.
I received my Master's in Clinical Mental Health Counseling from Mercer University. Aqssa values Dialectical Behavioral Therapy as well as Existential Therapy, integrated with evidence-based best practice, to create balance and integration in her clients. She believes in guiding the client to their true path and allowing them to know their own power and intuition.
(206) 759-7761 View (206) 759-7761
Photo of Alice C Campbell, Marriage & Family Therapist in Seattle, WA
Alice C Campbell
Marriage & Family Therapist, MS, LMFT
Verified Verified
Seattle, WA 98122  (Online Only)
Waitlist for new clients
Are you experiencing depression, anxiety, fears, anger, relationship, or family problems? Has balancing personal life and work become too much? These are all examples of our response to stress. Some people are dealing with everyday stressors and others bring traumatic experiences into the mix. When trauma collides with stress, life becomes challenging. Addressing these issues is both rewarding and scary. With compassion/humor I work with each person at their starting point and on the issues they bring. I see myself as the Sherpa who holds the lights and other tools to help make the path safe for you.
Are you experiencing depression, anxiety, fears, anger, relationship, or family problems? Has balancing personal life and work become too much? These are all examples of our response to stress. Some people are dealing with everyday stressors and others bring traumatic experiences into the mix. When trauma collides with stress, life becomes challenging. Addressing these issues is both rewarding and scary. With compassion/humor I work with each person at their starting point and on the issues they bring. I see myself as the Sherpa who holds the lights and other tools to help make the path safe for you.
(206) 966-6138 View (206) 966-6138
Photo of Jordyn Arroyo, Counselor in Seattle, WA
Jordyn Arroyo
Counselor, LMHC, NCC
Verified Verified
1 Endorsed
Seattle, WA 98115  (Online Only)
Hello, I am a queer-identified therapist specialized in LGBTQIA+ mental health. My approach to therapy involves developing a safe and collaborative relationship in which a client can explore various aspects of their life while feeling supported as well as challenged to grow. My theoretical approach is rooted in existentialism, where I work with clients to find and create meaning. I often draw from other therapeutic modalities based on the needs of each individual client.
Hello, I am a queer-identified therapist specialized in LGBTQIA+ mental health. My approach to therapy involves developing a safe and collaborative relationship in which a client can explore various aspects of their life while feeling supported as well as challenged to grow. My theoretical approach is rooted in existentialism, where I work with clients to find and create meaning. I often draw from other therapeutic modalities based on the needs of each individual client.
View
Photo of Kellie Hall, LPC Intern in Seattle, WA
Kellie Hall
LPC Intern
Verified Verified
1 Endorsed
Seattle, WA 98112  (Online Only)
Welcome, I’m glad you’re here. Wherever you find yourself, therapy holds a compassionate space where you no longer have to bear it all alone. Together, we can slow down and give attention to the feelings and experiences that are often pushed aside to meet the demands of daily life. You might be navigating a difficult situation, grappling with anxiety and stress, adjusting to a life transition, grieving a painful loss, working through faith-based or spiritual concerns, or coping with a chronic illness. Life can be incredibly hard, and my desire is to offer kindness, hope, and support in the midst of it.
Welcome, I’m glad you’re here. Wherever you find yourself, therapy holds a compassionate space where you no longer have to bear it all alone. Together, we can slow down and give attention to the feelings and experiences that are often pushed aside to meet the demands of daily life. You might be navigating a difficult situation, grappling with anxiety and stress, adjusting to a life transition, grieving a painful loss, working through faith-based or spiritual concerns, or coping with a chronic illness. Life can be incredibly hard, and my desire is to offer kindness, hope, and support in the midst of it.
(360) 614-2124 x1 View (360) 614-2124 x1
Photo of Caitlyn Liao, Clinical Social Work/Therapist in Seattle, WA
Caitlyn Liao
Clinical Social Work/Therapist, LSWAIC
Verified Verified
Seattle, WA 98119
I help adults and couples who feel lost, disconnected, or stuck in old patterns that no longer serve them. My clients are ready to understand themselves more deeply, pursue meaning, and relate authentically. I can help you embrace your strengths and gain clarity about underlying wounds that affect your thoughts, emotions, and relationships today. Through collaborative exploration in a safe space, we'll partner to process your past, connect insights intellectually and emotionally, and take steps towards the life you want.
I help adults and couples who feel lost, disconnected, or stuck in old patterns that no longer serve them. My clients are ready to understand themselves more deeply, pursue meaning, and relate authentically. I can help you embrace your strengths and gain clarity about underlying wounds that affect your thoughts, emotions, and relationships today. Through collaborative exploration in a safe space, we'll partner to process your past, connect insights intellectually and emotionally, and take steps towards the life you want.
(206) 895-4008 View (206) 895-4008
Photo of W. Scott Greenwood, Clinical Social Work/Therapist in Seattle, WA
W. Scott Greenwood
Clinical Social Work/Therapist, LICSW
Verified Verified
Seattle, WA 98119  (Online Only)
Our reaction to stressors that feel out of our control can vary widely. This is largely based upon our already established internal resources or our sense of psychological safety, the quality of habitual attention we show up with, the quality of communication in our relationships, the clarity of our personal values and the physiological setpoint of our nervous system. Each of these factors are pieces of your experience that I am happy to assess with you.
Our reaction to stressors that feel out of our control can vary widely. This is largely based upon our already established internal resources or our sense of psychological safety, the quality of habitual attention we show up with, the quality of communication in our relationships, the clarity of our personal values and the physiological setpoint of our nervous system. Each of these factors are pieces of your experience that I am happy to assess with you.
(206) 451-1742 View (206) 451-1742
Photo of Daryllyn Harris Renewed Essence Counseling , Clinical Social Work/Therapist in Seattle, WA
Daryllyn Harris Renewed Essence Counseling
Clinical Social Work/Therapist, MSW, LICSW, Phd C
Verified Verified
Seattle, WA 98108  (Online Only)
We all have a story and a journey that has contributed to who we are today. If you have come to a place in your life where you need support for your journey, curious about how to grow through deep pain, want to learn how to center yourself, establish boundaries, and live in liberation Renewed Essence may be a good fit for you.
We all have a story and a journey that has contributed to who we are today. If you have come to a place in your life where you need support for your journey, curious about how to grow through deep pain, want to learn how to center yourself, establish boundaries, and live in liberation Renewed Essence may be a good fit for you.
(253) 499-7395 View (253) 499-7395
Photo of Syzygy Psychotherapy Collective, Marriage & Family Therapist in Seattle, WA
Syzygy Psychotherapy Collective
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Seattle, WA 98134
At Syzygy, we offer a truly holistic path forward through supporting the alignment of your mind, body, and spirit with comprehensive mental health treatments. Our integrated approach to mental wellness combines cutting-edge advances in psychiatry, nutritional support, psychotherapy, psychedelic medicine, movement, yoga, expressive arts, group work, couples/relational therapy, and more. We believe in the healing potential of Non-Ordinary States of Consciousness and Psychedelic-Assisted therapy. We are committed to adequatley preparing you, and supporting the integration of these profoundly transformational experiences.
At Syzygy, we offer a truly holistic path forward through supporting the alignment of your mind, body, and spirit with comprehensive mental health treatments. Our integrated approach to mental wellness combines cutting-edge advances in psychiatry, nutritional support, psychotherapy, psychedelic medicine, movement, yoga, expressive arts, group work, couples/relational therapy, and more. We believe in the healing potential of Non-Ordinary States of Consciousness and Psychedelic-Assisted therapy. We are committed to adequatley preparing you, and supporting the integration of these profoundly transformational experiences.
(206) 231-5953 View (206) 231-5953
Photo of Simon S Connor, Clinical Social Work/Therapist in Seattle, WA
Simon S Connor
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
1 Endorsed
Seattle, WA 98112
I use a variety of approaches ranging from cognitive reframing, exploration of defense mechanisms and automatic thoughts, training in mindfulness, bodily awareness, and examination of feelings, among others. I am interested in the ways in which we each determine our realities, what our minds say to us, and the insight that can be gained from examining those.
I use a variety of approaches ranging from cognitive reframing, exploration of defense mechanisms and automatic thoughts, training in mindfulness, bodily awareness, and examination of feelings, among others. I am interested in the ways in which we each determine our realities, what our minds say to us, and the insight that can be gained from examining those.
(253) 343-1715 View (253) 343-1715
Photo of Helen R Estoque, Clinical Social Work/Therapist in Seattle, WA
Helen R Estoque
Clinical Social Work/Therapist, LICSW
Verified Verified
1 Endorsed
Seattle, WA 98118  (Online Only)
Feelings of loneliness, depression, and isolation are often a surprise when we are surrounded by people at work, home, and in social connections. In over 20 years of practice, I have helped adults and couples to identify and resolve the issues that are obstacles to creating more fulfilling lives and relationships. I bring the qualities of warmth and connection, honesty, sensitivity, creativity, flexibility, humor, clarity and openmindedness, and interactive exchange to sessions. Individual, couples, and group therapy are included in my practice.
Feelings of loneliness, depression, and isolation are often a surprise when we are surrounded by people at work, home, and in social connections. In over 20 years of practice, I have helped adults and couples to identify and resolve the issues that are obstacles to creating more fulfilling lives and relationships. I bring the qualities of warmth and connection, honesty, sensitivity, creativity, flexibility, humor, clarity and openmindedness, and interactive exchange to sessions. Individual, couples, and group therapy are included in my practice.
(206) 693-4315 View (206) 693-4315
Photo of Katie Vigneulle, Counselor in Seattle, WA
Katie Vigneulle
Counselor, MA, LMHCA
Verified Verified
4 Endorsed
Seattle, WA 98107  (Online Only)
Hello there, I’m a trauma-informed therapist based in Seattle. I love working with people healing from past trauma, learning to befriend/ honor their bodies, and growing in self confidence. I enjoy working with issues like anxiety, queer identity formation and processing, grief, and imposter syndrome. - Also, ask about my summer discount for teachers & therapists! I'm honored to care for those who spend their lives in a caring role. I'm offering a lowered rate from May-August for those vital folks. If you're an educator, therapist, or therapist in training who's been thinking about starting therapy, this might be your sign! -
Hello there, I’m a trauma-informed therapist based in Seattle. I love working with people healing from past trauma, learning to befriend/ honor their bodies, and growing in self confidence. I enjoy working with issues like anxiety, queer identity formation and processing, grief, and imposter syndrome. - Also, ask about my summer discount for teachers & therapists! I'm honored to care for those who spend their lives in a caring role. I'm offering a lowered rate from May-August for those vital folks. If you're an educator, therapist, or therapist in training who's been thinking about starting therapy, this might be your sign! -
(206) 984-3283 View (206) 984-3283
Photo of Hyacinth Counseling, Counselor in Seattle, WA
Hyacinth Counseling
Counselor, MACP, LMHC
Verified Verified
Seattle, WA 98112
Welcome! I'm Leyla (she/her) and I work with teens and adults 16+ with a variety of concerns. I love supporting my clients through self-exploration as they build on their strengths and identify/challenge unhelpful patterns and beliefs. I work within a relational-cultural and feminist framework and my approach is trauma-informed and client-centered. Essentially this means I’m interested in learning about you! I want to know about your story, your identities, and how culture and society may have impacted you. My goal is to build a safe and trusting space where we work collaboratively to facilitate healing and inspire growth.
Welcome! I'm Leyla (she/her) and I work with teens and adults 16+ with a variety of concerns. I love supporting my clients through self-exploration as they build on their strengths and identify/challenge unhelpful patterns and beliefs. I work within a relational-cultural and feminist framework and my approach is trauma-informed and client-centered. Essentially this means I’m interested in learning about you! I want to know about your story, your identities, and how culture and society may have impacted you. My goal is to build a safe and trusting space where we work collaboratively to facilitate healing and inspire growth.
(206) 752-6749 View (206) 752-6749
Photo of Jessica Hoekstra, Counselor in Seattle, WA
Jessica Hoekstra
Counselor, LMHC
Verified Verified
1 Endorsed
Seattle, WA 98103
At its core, I believe therapy to be about creating space for change. People come to therapy for a variety of reasons—seeking support and healing, desiring change, looking for relief from pain. With a relational and trauma-informed lens, we’ll look at how you landed here, in an effort to find new ways of being that may be kinder to yourself and more congruent with a whole and healthy life. I work with teens, adults, and couples on issues of trauma, anxiety, grief, relationships, life transitions, and identity formation. I have focused much of my work supporting women recovering from trauma.
At its core, I believe therapy to be about creating space for change. People come to therapy for a variety of reasons—seeking support and healing, desiring change, looking for relief from pain. With a relational and trauma-informed lens, we’ll look at how you landed here, in an effort to find new ways of being that may be kinder to yourself and more congruent with a whole and healthy life. I work with teens, adults, and couples on issues of trauma, anxiety, grief, relationships, life transitions, and identity formation. I have focused much of my work supporting women recovering from trauma.
(206) 207-9372 View (206) 207-9372
Photo of Vanessa Newell, Marriage & Family Therapist in Seattle, WA
Vanessa Newell
Marriage & Family Therapist, MA, LMFTA
Verified Verified
12 Endorsed
Seattle, WA 98119  (Online Only)
Feeling stuck? Maybe you are burnt out, feeling overwhelmed with anxiety or grief, and your relationships are suffering. I help people in their 20's and 30's deal with the major transitions of this time of life: shifting family dynamics, partner relationships, health crises, and the scramble to actualize an authentic and meaningful life. Sometimes we think we should be able to figure it out on our own, or that our problems aren’t as bad as they could be - and we find ourselves hesitant to take the next step. If you are brave enough to give yourself the gift of support, I will meet your vulnerability with compassion and curiosity.
Feeling stuck? Maybe you are burnt out, feeling overwhelmed with anxiety or grief, and your relationships are suffering. I help people in their 20's and 30's deal with the major transitions of this time of life: shifting family dynamics, partner relationships, health crises, and the scramble to actualize an authentic and meaningful life. Sometimes we think we should be able to figure it out on our own, or that our problems aren’t as bad as they could be - and we find ourselves hesitant to take the next step. If you are brave enough to give yourself the gift of support, I will meet your vulnerability with compassion and curiosity.
View

How does your Therapist compare?

Number of Therapists in Seattle, WA

3,000+

Average cost per session

$150

Therapists in Seattle, WA who prioritize treating:

93% Anxiety
86% Depression
79% Relationship Issues
76% Self Esteem
72% Trauma and PTSD
71% Stress
69% Life Transitions

Average years in practice

9 Years

Top 3 insurances accepted

71% Premera
54% Aetna
47% Regence

How Therapists in Seattle, WA see their clients

51% Online Only
49% In Person and Online

Gender breakdown

75% Female
21% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Seattle?

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.