Therapists in Gaithersburg, MD

Photo of Dori Aronson, Clinical Social Work/Therapist in Gaithersburg, MD
Dori Aronson
Clinical Social Work/Therapist, MSW, LICSW, LCSW-C
Verified Verified
Gaithersburg, MD 20882  (Online Only)
Not accepting new clients
My practice is based on the belief that healing and emotional growth take place in an environment of safety, empathy and reflection. Active listening, validation, and mirroring encourage a client to slip past old barriers and reach new levels of self-awareness and self-acceptance. Together, we explore the experiences and expectations that have driven maladaptive patterns, as well as the ways in which emotional wounds power the repetition of unsatisfying behaviors, relationships, and self-defeating life narratives. The joy I've take in my work for 25 years facilitates the bonds that form between me and my clients.
My practice is based on the belief that healing and emotional growth take place in an environment of safety, empathy and reflection. Active listening, validation, and mirroring encourage a client to slip past old barriers and reach new levels of self-awareness and self-acceptance. Together, we explore the experiences and expectations that have driven maladaptive patterns, as well as the ways in which emotional wounds power the repetition of unsatisfying behaviors, relationships, and self-defeating life narratives. The joy I've take in my work for 25 years facilitates the bonds that form between me and my clients.
(301) 288-1885 View (301) 288-1885
Photo of Restorative Focus Counseling , Clinical Social Work/Therapist in Gaithersburg, MD
Restorative Focus Counseling
Clinical Social Work/Therapist, LCSW-C
Verified Verified
Gaithersburg, MD 20878  (Online Only)
Currently accepting new clients! Restorative Focus Counseling Services has a passionate commitment for helping others make positive changes in their lives. The primary passions are helping individuals work through their problems and issues utilizing positive self-talk, mindfulness and grounding. We believe establishing a strong therapeutic rapport with her clients fosters a trusting, collaborative relationship in which clients begin to overcome their obstacles, developing positive coping skills, and achieve their goals.
Currently accepting new clients! Restorative Focus Counseling Services has a passionate commitment for helping others make positive changes in their lives. The primary passions are helping individuals work through their problems and issues utilizing positive self-talk, mindfulness and grounding. We believe establishing a strong therapeutic rapport with her clients fosters a trusting, collaborative relationship in which clients begin to overcome their obstacles, developing positive coping skills, and achieve their goals.
(240) 873-2385 View (240) 873-2385
Photo of Lisa M Joy, Clinical Social Work/Therapist in Gaithersburg, MD
Lisa M Joy
Clinical Social Work/Therapist, LCSW-C
Verified Verified
1 Endorsed
Gaithersburg, MD 20878  (Online Only)
Accepting New Clients! Lisa is a Licensed Certified Social Worker-Clinical & a board-approved clinical supervisor. With thirty years of eclectic clinical experience & eighteen years of behavioral health leadership experience, Lisa has helped a variety of people with diverse needs. This includes children, adolescents, adults, families, couples, parents, groups, communities, students, & professionals experiencing depression, anxiety, ADHD, stress, compassion fatigue, burnout, life changes, & workplace challenges. Empathy, compassion, trust, and unconditional regard are the foundation of the therapeutic relationship with Lisa.
Accepting New Clients! Lisa is a Licensed Certified Social Worker-Clinical & a board-approved clinical supervisor. With thirty years of eclectic clinical experience & eighteen years of behavioral health leadership experience, Lisa has helped a variety of people with diverse needs. This includes children, adolescents, adults, families, couples, parents, groups, communities, students, & professionals experiencing depression, anxiety, ADHD, stress, compassion fatigue, burnout, life changes, & workplace challenges. Empathy, compassion, trust, and unconditional regard are the foundation of the therapeutic relationship with Lisa.
(240) 734-2379 View (240) 734-2379
David Mahoney
Psychologist, PhD
Verified Verified
Gaithersburg, MD 20879
I work IN-PERSON with pre-teens (ages 10-12), adolescents, and adults in individual and family therapy. I help clients develop coping skills for ADHD, anxiety, depression and managing general life stress.
I work IN-PERSON with pre-teens (ages 10-12), adolescents, and adults in individual and family therapy. I help clients develop coping skills for ADHD, anxiety, depression and managing general life stress.
(301) 861-3288 View (301) 861-3288
Photo of Ruchi Bhargava, Psychologist in Gaithersburg, MD
Ruchi Bhargava
Psychologist, PhD
Verified Verified
2 Endorsed
Gaithersburg, MD 20878
Welcome! I am currently accepting new clients. It may have been hard for you to take this first step in seeking help. I want to ease your mind. I believe that treating the whole person is essential to providing the best care. I provide a multifaceted collaborative approach to treatment and concentrate on an individual strengths. Many times we go through life feeling stuck or in a state of limbo, but when we begin to explore the reasons and underlying issues, it can become clear what exactly is standing between oneself and the goal. I provide both therapeutic and assessment services.
Welcome! I am currently accepting new clients. It may have been hard for you to take this first step in seeking help. I want to ease your mind. I believe that treating the whole person is essential to providing the best care. I provide a multifaceted collaborative approach to treatment and concentrate on an individual strengths. Many times we go through life feeling stuck or in a state of limbo, but when we begin to explore the reasons and underlying issues, it can become clear what exactly is standing between oneself and the goal. I provide both therapeutic and assessment services.
(301) 205-5386 View (301) 205-5386
Photo of Quiana Wade, Clinical Social Work/Therapist in Gaithersburg, MD
Quiana Wade
Clinical Social Work/Therapist, LMSW
Verified Verified
Gaithersburg, MD 20877  (Online Only)
Quiana Wade is a compassionate licensed therapist dedicated to guiding clients through life's challenges with empathy and expertise. With her experience, a diverse skill set and passion for holistic healing, she specializing in providing psychotherapy to individuals navigating various mental health struggles, including depression, chronic conditions, anxiety, postpartum depression, racial trauma, severe mental illness and mood disorders. Drawing from her extensive experience, Quiana offers support to a broad spectrum of clients, including postpartum mothers/fathers, women, men and young adults.
Quiana Wade is a compassionate licensed therapist dedicated to guiding clients through life's challenges with empathy and expertise. With her experience, a diverse skill set and passion for holistic healing, she specializing in providing psychotherapy to individuals navigating various mental health struggles, including depression, chronic conditions, anxiety, postpartum depression, racial trauma, severe mental illness and mood disorders. Drawing from her extensive experience, Quiana offers support to a broad spectrum of clients, including postpartum mothers/fathers, women, men and young adults.
(240) 384-5377 View (240) 384-5377
Photo of Pauliann Long, Clinical Social Work/Therapist in Gaithersburg, MD
Pauliann Long
Clinical Social Work/Therapist, LCSW-C
Verified Verified
Gaithersburg, MD 20878
Are you feeling off-center, frustrated, overwhelmed, stuck? Want support in balancing the challenges in your life? Does negativity or anger undermine healthy relationships within your family? Maybe you wish for more effective ways of communicating, or the means to improve your outlook and energy level. Are you experiencing divorce, or the loss of a loved one, and need assistance in moving through the grieving process? Are you in the throes of a major life transition or crisis? I will assist you in developing insight, understanding, and strategies to address your particular issues and help you move toward overall well-being.
Are you feeling off-center, frustrated, overwhelmed, stuck? Want support in balancing the challenges in your life? Does negativity or anger undermine healthy relationships within your family? Maybe you wish for more effective ways of communicating, or the means to improve your outlook and energy level. Are you experiencing divorce, or the loss of a loved one, and need assistance in moving through the grieving process? Are you in the throes of a major life transition or crisis? I will assist you in developing insight, understanding, and strategies to address your particular issues and help you move toward overall well-being.
(240) 339-4737 View (240) 339-4737
Photo of Arvin Sanders, Pre-Licensed Professional in Gaithersburg, MD
Arvin Sanders
Pre-Licensed Professional, PhD
Verified Verified
Gaithersburg, MD 20877  (Online Only)
Not accepting new clients
Do you ever feel like no one really listens to you or understands you? Are you a person of color or a part of the LGBTQIA+ community and feel discriminated against or rejected? Life comes with many challenges and while you may try your hardest to beat those challenges but sometimes you need a little help. So how can I help? My goal is to assist you with self-discovery, self-healing, and empowerment to face life head-on. I specialize in working with adults and adolescents with of various racial identities and/or sexual identities.
Do you ever feel like no one really listens to you or understands you? Are you a person of color or a part of the LGBTQIA+ community and feel discriminated against or rejected? Life comes with many challenges and while you may try your hardest to beat those challenges but sometimes you need a little help. So how can I help? My goal is to assist you with self-discovery, self-healing, and empowerment to face life head-on. I specialize in working with adults and adolescents with of various racial identities and/or sexual identities.
(240) 823-4508 View (240) 823-4508
Photo of Matthew Christian Johnson, Psychologist in Gaithersburg, MD
Matthew Christian Johnson
Psychologist, PhD, ABPP
Verified Verified
1 Endorsed
Gaithersburg, MD 20878  (Online Only)
Oftentimes we find ourselves struggling to break from long-standing patterns that force us to be rigid in the ways we relate to the world around us and the world within in us. These patterns, which seek consistent expression in our daily lives inhibit us from experiencing true presence during the most precious moments of our existence while hindering our pursuit of success. I work with individuals, couples, and families who seek to free themselves from these damaging patterns so that a more flexible, authentic way of relating to the world can emerge.
Oftentimes we find ourselves struggling to break from long-standing patterns that force us to be rigid in the ways we relate to the world around us and the world within in us. These patterns, which seek consistent expression in our daily lives inhibit us from experiencing true presence during the most precious moments of our existence while hindering our pursuit of success. I work with individuals, couples, and families who seek to free themselves from these damaging patterns so that a more flexible, authentic way of relating to the world can emerge.
(202) 804-9651 View (202) 804-9651
Photo of Breighone Brown, Clinical Social Work/Therapist in Gaithersburg, MD
Breighone Brown
Clinical Social Work/Therapist, LMSW
Verified Verified
Gaithersburg, MD 20877
Are you suffering from symptoms of depression, ADHD, anxiety, bipolar, autism spectrum, OCD, and/or PTSD? I'm here to help facilitate your healing process and provide a safe space to voice your deepest concerns freely. Our goal is to significantly improve your self-concept, increase a positive outlook on life, and, most importantly, feel like your best self.
Are you suffering from symptoms of depression, ADHD, anxiety, bipolar, autism spectrum, OCD, and/or PTSD? I'm here to help facilitate your healing process and provide a safe space to voice your deepest concerns freely. Our goal is to significantly improve your self-concept, increase a positive outlook on life, and, most importantly, feel like your best self.
(240) 635-9195 View (240) 635-9195
Daniel C York
Psychologist, PsyD
Verified Verified
Gaithersburg, MD 20877
Because I view each client as unique, I approach each case differently. I work from an integrative theoretical orientation and employ strategies from Cognitive Behavioral, Psychodynamics, Family Systems, and other theories according to the varying needs of each client.
Because I view each client as unique, I approach each case differently. I work from an integrative theoretical orientation and employ strategies from Cognitive Behavioral, Psychodynamics, Family Systems, and other theories according to the varying needs of each client.
(301) 710-9010 View (301) 710-9010
Photo of Taleesa Peck, Psychologist in Gaithersburg, MD
Taleesa Peck
Psychologist, PhD
Verified Verified
Gaithersburg, MD 20878  (Online Only)
Thank you for taking the time to visit my profile. I acknowledge that no matter where you are in life, challenging moments arise. For these moments, I extend an invitation for you to take the next step on your journey toward wellness. I am skilled in using cognitive and behavioral approaches to treat concerns around anxiety, depression, executive dysfunction, social difficulties, academic concerns, behavioral difficulties, and family problems.
Thank you for taking the time to visit my profile. I acknowledge that no matter where you are in life, challenging moments arise. For these moments, I extend an invitation for you to take the next step on your journey toward wellness. I am skilled in using cognitive and behavioral approaches to treat concerns around anxiety, depression, executive dysfunction, social difficulties, academic concerns, behavioral difficulties, and family problems.
(240) 240-6301 View (240) 240-6301
Photo of Madeline Hays Sharp, Clinical Social Work/Therapist in Gaithersburg, MD
Madeline Hays Sharp
Clinical Social Work/Therapist, LCSW-C
Verified Verified
Gaithersburg, MD 20878
Are you feeling stuck and wanting to make a shift to find more happiness and contentment? Seeking help can be challenging, yet so important for healing. Sometimes life gently encourages us to step into change and other times it can be forceful in its approach. I am here to walk along side you through your journey, supporting you by highlighting your strengths and working with you to find the best path towards healing. I am a compassionate, warm, genuine, and caring professional who honors the entire spectrum of human experience. I believe in creating a non-judgmental, safe, and authentic therapeutic relationship to support healing.
Are you feeling stuck and wanting to make a shift to find more happiness and contentment? Seeking help can be challenging, yet so important for healing. Sometimes life gently encourages us to step into change and other times it can be forceful in its approach. I am here to walk along side you through your journey, supporting you by highlighting your strengths and working with you to find the best path towards healing. I am a compassionate, warm, genuine, and caring professional who honors the entire spectrum of human experience. I believe in creating a non-judgmental, safe, and authentic therapeutic relationship to support healing.
(240) 261-0735 View (240) 261-0735
Photo of Integrative Psychological Services, LLC, Psychologist in Gaithersburg, MD
Integrative Psychological Services, LLC
Psychologist, PsyD
Verified Verified
2 Endorsed
Gaithersburg, MD 20877
Dr. Thomas and her team of evaluators strives to provide a comfortable environment where people receive support, guidance, and direction based on their presenting concerns. Psychological evaluation can be utilized as a tool and resource for individuals who have challenges in academic, social, or occupational areas. Testing may be sought for the purpose of clarifying diagnoses, accommodations for school or work, and for understanding executive difficulties. Assessment services include: ADHD/Executive concerns, Developmental Disorders, Mood/Personality Disorders, Learning Disorders, Immigration Evaluation, and Admissions (IQ).
Dr. Thomas and her team of evaluators strives to provide a comfortable environment where people receive support, guidance, and direction based on their presenting concerns. Psychological evaluation can be utilized as a tool and resource for individuals who have challenges in academic, social, or occupational areas. Testing may be sought for the purpose of clarifying diagnoses, accommodations for school or work, and for understanding executive difficulties. Assessment services include: ADHD/Executive concerns, Developmental Disorders, Mood/Personality Disorders, Learning Disorders, Immigration Evaluation, and Admissions (IQ).
(301) 284-3742 View (301) 284-3742
Photo of Fatima Massaquoi in Gaithersburg, MD
Fatima Massaquoi
LMSW
Verified Verified
Gaithersburg, MD 20878
Providing therapy to children, adolescents, and adults, I approach therapeutic engagements from a lens of compassion that helps to allow for the facilitation of safety, security, acknowledgement, and understanding within the therapeutic space; fundamental aspects to human engagement we all need and thrive on.
Providing therapy to children, adolescents, and adults, I approach therapeutic engagements from a lens of compassion that helps to allow for the facilitation of safety, security, acknowledgement, and understanding within the therapeutic space; fundamental aspects to human engagement we all need and thrive on.
(240) 623-2320 View (240) 623-2320
Photo of Azhia-Lin Thompson, Clinical Social Work/Therapist in Gaithersburg, MD
Azhia-Lin Thompson
Clinical Social Work/Therapist, LMSW
Verified Verified
Gaithersburg, MD 20878
If you're feeling overwhelmed, anxious, or trapped in life and need a non-judgmental person to talk to, give me a call to see if we'd be a good fit. I provide therapy to children, adolescents and adults who are dealing with anxiety, depression, trauma, school related concerns and life stressors. I am experienced in working with children with autism and sensory disorders. I can offer useful skills and knowledge for navigating the school system, as well as suggestions for how the family can best support their child. My treatment approach is kind, conversational, and engaging.
If you're feeling overwhelmed, anxious, or trapped in life and need a non-judgmental person to talk to, give me a call to see if we'd be a good fit. I provide therapy to children, adolescents and adults who are dealing with anxiety, depression, trauma, school related concerns and life stressors. I am experienced in working with children with autism and sensory disorders. I can offer useful skills and knowledge for navigating the school system, as well as suggestions for how the family can best support their child. My treatment approach is kind, conversational, and engaging.
(240) 820-2606 View (240) 820-2606
Photo of DMV Life Coaching & Therapy Services in Gaithersburg, MD
DMV Life Coaching & Therapy Services
PhD, CLC, MBA, CBT, NLP
Verified Verified
3 Endorsed
Gaithersburg, MD 20878
Self esteem issues, body image problems, self worth are all originating from early problems that were never addressed. By going to the core of the problem, we can fix the problem that keeps on weighing on the individual and help them find a solution. Digging deep is somewhat needed to understand where it all came from and find a treatment plan to allow the person to let go of the negative and focus on the positive. It is crucial to keep an open communication module between client and therapist so we can both find the best alternative plan that will fit the client needs. I cover all groups, all ethnicity, all races in all my groups.
Self esteem issues, body image problems, self worth are all originating from early problems that were never addressed. By going to the core of the problem, we can fix the problem that keeps on weighing on the individual and help them find a solution. Digging deep is somewhat needed to understand where it all came from and find a treatment plan to allow the person to let go of the negative and focus on the positive. It is crucial to keep an open communication module between client and therapist so we can both find the best alternative plan that will fit the client needs. I cover all groups, all ethnicity, all races in all my groups.
(301) 685-5999 View (301) 685-5999
Photo of JB Counseling Services, LLC, Clinical Social Work/Therapist in Gaithersburg, MD
JB Counseling Services, LLC
Clinical Social Work/Therapist, LCSW-C, ADHD, CAIMHP
Verified Verified
Gaithersburg, MD 20877
Our self-perception and interpersonal perspectives are intricately molded by our past experiences, with childhood and adolescence exerting significant influence on this developmental process. Ideally, individuals should emerge from these formative stages with a robust sense of confidence, a feeling of security, and proficient problem-solving abilities as they navigate the complexities of the world. However, the occurrence of traumatic experiences can disrupt these capacities. Instead of being firmly grounded in the present, our attention is diverted towards the shadows of past distress,
Our self-perception and interpersonal perspectives are intricately molded by our past experiences, with childhood and adolescence exerting significant influence on this developmental process. Ideally, individuals should emerge from these formative stages with a robust sense of confidence, a feeling of security, and proficient problem-solving abilities as they navigate the complexities of the world. However, the occurrence of traumatic experiences can disrupt these capacities. Instead of being firmly grounded in the present, our attention is diverted towards the shadows of past distress,
(240) 685-9774 View (240) 685-9774
Photo of Dr Rick Levy, Psychologist in Gaithersburg, MD
Dr Rick Levy
Psychologist, PhD
Verified Verified
Gaithersburg, MD 20886
I'm a full time clinical psychologist with 30+ years of experience treating the types of problems that plague a majority of people in our area: chronic stress, depression, anxiety, panic, sleeplessness, ADHD, PTSD, relationship problems and divorce, family conflict, trauma, and abuse recovery, for people of all ages. Everyone is unique - I specialize in healing the root cause of complex problems, quickly, and just as importantly, I help people realize their most deeply held aspirations. I also specialize in Mind-Body Medicine - helping people overcome major health problems like heart disease, diabetes, MS, dementia, and cancer.
I'm a full time clinical psychologist with 30+ years of experience treating the types of problems that plague a majority of people in our area: chronic stress, depression, anxiety, panic, sleeplessness, ADHD, PTSD, relationship problems and divorce, family conflict, trauma, and abuse recovery, for people of all ages. Everyone is unique - I specialize in healing the root cause of complex problems, quickly, and just as importantly, I help people realize their most deeply held aspirations. I also specialize in Mind-Body Medicine - helping people overcome major health problems like heart disease, diabetes, MS, dementia, and cancer.
(301) 923-4099 View (301) 923-4099
Photo of Emma Sholtis, Psychologist in Gaithersburg, MD
Emma Sholtis
Psychologist, PsyD
Verified Verified
3 Endorsed
Gaithersburg, MD 20878
Not accepting new clients
Welcome! I work with a wide range of clients and concerns, and enjoy working with teens and young adults. My areas of interest include anxiety, depression, trauma, ADHD, autism, family issues, and social and relationship struggles.
Welcome! I work with a wide range of clients and concerns, and enjoy working with teens and young adults. My areas of interest include anxiety, depression, trauma, ADHD, autism, family issues, and social and relationship struggles.
(240) 450-2738 View (240) 450-2738

See more therapy options for Gaithersburg

How does your Therapist compare?

Number of Therapists in Gaithersburg, MD

400+

Average cost per session

$156

Therapists in Gaithersburg, MD who prioritize treating:

95% Anxiety
92% Depression
82% Relationship Issues
82% Self Esteem
75% Coping Skills
72% Trauma and PTSD
71% Stress

Average years in practice

11 Years

Top 3 insurances accepted

82% BlueCross and BlueShield
77% CareFirst
64% Cigna and Evernorth

How Therapists in Gaithersburg, MD see their clients

57% In Person and Online
43% Online Only

Gender breakdown

79% Female
20% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Gaithersburg?

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.