Therapists in Seattle, WA

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Photo of Michelle Voetberg, Counselor in Seattle, WA
Michelle Voetberg
Counselor, MA, LMHCA, MHP
Verified Verified
Seattle, WA 98119  (Online Only)
I have worked with clients with intellectual and developmental disabilities within community health care environments in various roles over the past 10 years which has led me to become the therapist that I am today. I received my Masters in Clinical Mental Health Counseling from Seattle University and my Bachelor of Science in Psychology from Washington State University. Based upon my professional and personal experiences, I specialize in learning/developmental disabilities, anxiety, depression, trauma, attachment, grief, and co-occurring diagnoses. Above all else, I want you to feel safe and trusting of me as your therapist.
I have worked with clients with intellectual and developmental disabilities within community health care environments in various roles over the past 10 years which has led me to become the therapist that I am today. I received my Masters in Clinical Mental Health Counseling from Seattle University and my Bachelor of Science in Psychology from Washington State University. Based upon my professional and personal experiences, I specialize in learning/developmental disabilities, anxiety, depression, trauma, attachment, grief, and co-occurring diagnoses. Above all else, I want you to feel safe and trusting of me as your therapist.
(206) 207-1491 View (206) 207-1491
Photo of Heal to Glow, LLC, Counselor in Seattle, WA
Heal to Glow, LLC
Counselor, RMCHI, LMCHA
Verified Verified
Seattle, WA 98107  (Online Only)
Waitlist for new clients
Do you struggle with a life-debilitating issue, family chaos, adjustment issues, or self-esteem? You've come to the right place. Life's hurdles can be easy to overcome with someone by your side and with easy access to care. With Heal to Glow Counseling and Therapy, I empower clients who need the privacy, comfort, and convenience of online services.
Do you struggle with a life-debilitating issue, family chaos, adjustment issues, or self-esteem? You've come to the right place. Life's hurdles can be easy to overcome with someone by your side and with easy access to care. With Heal to Glow Counseling and Therapy, I empower clients who need the privacy, comfort, and convenience of online services.
(206) 312-4137 View (206) 312-4137
Photo of Marie Nelson, Counselor in Seattle, WA
Marie Nelson
Counselor, LMHC
Verified Verified
Seattle, WA 98107
Marie is an experienced Licensed Mental Health Counselor working with adults contending with trauma, depression, anxiety and relationship difficulties. She has also worked extensively with individuals recovering from addiction as well as loved ones who are affected by addiction. Marie has worked in the community mental health environment, private practice and substance abuse treatment centers.
Marie is an experienced Licensed Mental Health Counselor working with adults contending with trauma, depression, anxiety and relationship difficulties. She has also worked extensively with individuals recovering from addiction as well as loved ones who are affected by addiction. Marie has worked in the community mental health environment, private practice and substance abuse treatment centers.
(206) 222-5291 View (206) 222-5291
Photo of Morgan Watson, Counselor in Seattle, WA
Morgan Watson
Counselor, MA, LMHC
Verified Verified
Seattle, WA 98102  (Online Only)
You’ve made it this far which lets me know you are brave and likely ready to make some changes in your life. Together we can explore your emotional needs and overcome barriers that limit your full potential, get in the way of your relationships, or keep you stuck. There are many things we can do on our own, but true self-discovery and positive, enduring change is more likely to occur within the context of a caring and committed therapeutic relationship. Together we can pay close attention to what’s bothering you, and to what you need, so that you can begin to develop a healthier self and more loving, fulfilling relationships.
You’ve made it this far which lets me know you are brave and likely ready to make some changes in your life. Together we can explore your emotional needs and overcome barriers that limit your full potential, get in the way of your relationships, or keep you stuck. There are many things we can do on our own, but true self-discovery and positive, enduring change is more likely to occur within the context of a caring and committed therapeutic relationship. Together we can pay close attention to what’s bothering you, and to what you need, so that you can begin to develop a healthier self and more loving, fulfilling relationships.
(206) 203-8819 View (206) 203-8819
Photo of Anca M Boudreaux, Counselor in Seattle, WA
Anca M Boudreaux
Counselor, LMHC, ESA, NCC, CAS
Verified Verified
5 Endorsed
Seattle, WA 98188
Not accepting new clients
Life does not discriminate when it comes to stress, trauma, and pain. We should not bear life's burdens alone, as we all need to be heard, understood, and appreciated. Whether this is your first time seeking counseling or simply looking for a change, know you are doing the right thing for yourself. I love to work with those in need of connection, nurture, and growth. I do so through a style that is direct, yet compassionate, firm, yet empathetic, practical, yet supportive. As your therapist, I work alongside you to provide individualized support based on your presenting problems, needs, and therapeutic goals.
Life does not discriminate when it comes to stress, trauma, and pain. We should not bear life's burdens alone, as we all need to be heard, understood, and appreciated. Whether this is your first time seeking counseling or simply looking for a change, know you are doing the right thing for yourself. I love to work with those in need of connection, nurture, and growth. I do so through a style that is direct, yet compassionate, firm, yet empathetic, practical, yet supportive. As your therapist, I work alongside you to provide individualized support based on your presenting problems, needs, and therapeutic goals.
(206) 578-5714 View (206) 578-5714
Photo of Katherine Shimada, Clinical Social Work/Therapist in Seattle, WA
Katherine Shimada
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Seattle, WA 98117  (Online Only)
I always feel honored when others entrust their story with me, and it is my goal to offer a safe, supportive environment in which to do so. I provide individual therapy to adults, some of whom may be experiencing a significant life transition. Others may be managing acute or chronic symptoms that have affected their quality of life. I commonly work with issues related to depression, anxiety, grief/loss, as well as racial, multicultural and gender identities.
I always feel honored when others entrust their story with me, and it is my goal to offer a safe, supportive environment in which to do so. I provide individual therapy to adults, some of whom may be experiencing a significant life transition. Others may be managing acute or chronic symptoms that have affected their quality of life. I commonly work with issues related to depression, anxiety, grief/loss, as well as racial, multicultural and gender identities.
(206) 222-8273 View (206) 222-8273
Photo of Christopher Duchene, Counselor in Seattle, WA
Christopher Duchene
Counselor, MS, LMHCA
Verified Verified
Seattle, WA 98199  (Online Only)
My passion is people. I center my practice around growth achieved by understanding our full selves through a lens of curiosity and kindness. Our remembered past, and the unseen forces that helped shape who we are today, matter. Uncovering the impact these experiences have on us is a crucial step toward building the internal space needed for growth. We can’t remove these experiences, but we can learn to understand, accept, and reorganize them in a way that creates room for change. Focusing on the person and their experiences, rather than the disorders or labels they’ve been given, allows me to address current symptoms holistically.
My passion is people. I center my practice around growth achieved by understanding our full selves through a lens of curiosity and kindness. Our remembered past, and the unseen forces that helped shape who we are today, matter. Uncovering the impact these experiences have on us is a crucial step toward building the internal space needed for growth. We can’t remove these experiences, but we can learn to understand, accept, and reorganize them in a way that creates room for change. Focusing on the person and their experiences, rather than the disorders or labels they’ve been given, allows me to address current symptoms holistically.
(206) 208-6324 View (206) 208-6324
Photo of Danielle LeVee, Counselor in Seattle, WA
Danielle LeVee
Counselor, LMHC, MA
Verified Verified
Seattle, WA 98103  (Online Only)
I'm once again welcoming new clients. If you are experiencing anxiety, depression, fatigue, or overwhelming emotions, I encourage you to reach out to me. I'm dedicated to helping you minimize and manage stress, understand and navigate your emotions, and develop more effective strategies for these challenging times. I'll pay close nonjudgmental attention to both what is voiced and what lies beneath the surface, responding with empathy, sincerity, and insightful guidance.
I'm once again welcoming new clients. If you are experiencing anxiety, depression, fatigue, or overwhelming emotions, I encourage you to reach out to me. I'm dedicated to helping you minimize and manage stress, understand and navigate your emotions, and develop more effective strategies for these challenging times. I'll pay close nonjudgmental attention to both what is voiced and what lies beneath the surface, responding with empathy, sincerity, and insightful guidance.
(206) 309-4679 View (206) 309-4679
Photo of Amazing Grace Counseling and Counsultation LLC, Clinical Social Work/Therapist in Seattle, WA
Amazing Grace Counseling and Counsultation LLC
Clinical Social Work/Therapist, LICSW
Verified Verified
Seattle, WA 98188
Personal and Professional Profile My name is Dumbe Emmanuel Elessa. I am a Licensed Independent Clinical Social Worker in the State of Washington. I have more than three decades of clinical and leadership work experience in Community Behavioral Health. I also have extensive clinical and supervisory experience in Adult and Geriatric Mental Health as well as in Ethnic Minority issues. I was born in tropical Cameroon. I obtained the Master of Social Work Degree from the University of Washington Graduate School of Social Work in June, 1986.
Personal and Professional Profile My name is Dumbe Emmanuel Elessa. I am a Licensed Independent Clinical Social Worker in the State of Washington. I have more than three decades of clinical and leadership work experience in Community Behavioral Health. I also have extensive clinical and supervisory experience in Adult and Geriatric Mental Health as well as in Ethnic Minority issues. I was born in tropical Cameroon. I obtained the Master of Social Work Degree from the University of Washington Graduate School of Social Work in June, 1986.
(425) 390-8372 View (425) 390-8372
Photo of Sam McGinnis, Psychologist in Seattle, WA
Sam McGinnis
Psychologist, PsyD
Verified Verified
Seattle, WA 98103  (Online Only)
The focus of my private practice is on parents who need support navigating the demands of parenting. These challenges can be related to a number of factors including parent mental health, a child with more challenging behaviors, difficulties between parents, and/or navigating the multiple daily demands parents experience.
The focus of my private practice is on parents who need support navigating the demands of parenting. These challenges can be related to a number of factors including parent mental health, a child with more challenging behaviors, difficulties between parents, and/or navigating the multiple daily demands parents experience.
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Photo of Amy Nickum, Clinical Social Work/Therapist in Seattle, WA
Amy Nickum
Clinical Social Work/Therapist, MSSW, LSWAIC
Verified Verified
Seattle, WA 98107  (Online Only)
Accepting New Clients! Please contact me for a free consultation. Life's challenges can sometimes feel overwhelming. During those times, it's crucial to have the support you need to navigate difficult decisions or life changes. My client-centered approach aims to meet you exactly where you are in your journey and join with you on the path toward healing and fulfillment. By creating a safe and non-judgmental space, this allows you to freely explore your thoughts, emotions, and concerns.
Accepting New Clients! Please contact me for a free consultation. Life's challenges can sometimes feel overwhelming. During those times, it's crucial to have the support you need to navigate difficult decisions or life changes. My client-centered approach aims to meet you exactly where you are in your journey and join with you on the path toward healing and fulfillment. By creating a safe and non-judgmental space, this allows you to freely explore your thoughts, emotions, and concerns.
(206) 944-3590 View (206) 944-3590
Photo of Dave Parnes, Clinical Social Work/Therapist in Seattle, WA
Dave Parnes
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Seattle, WA 98102
I offer psychotherapy and psychoanalysis to adults, children and teens. I am open to working with a range of presenting concerns, including depression, anxiety, relationship difficulties, self-esteem, trauma and emotional regulation. I work with individuals seeking help with transient difficulties as well as those wanting to address more longstanding problems. My role as a therapist includes helping patients: deepen their awareness of their emotional lives; get in touch with aspects of themselves that they are out of touch with; foster the integration of varied aspects of themselves; establish and maintain healthy and satisfying relationships.
I offer psychotherapy and psychoanalysis to adults, children and teens. I am open to working with a range of presenting concerns, including depression, anxiety, relationship difficulties, self-esteem, trauma and emotional regulation. I work with individuals seeking help with transient difficulties as well as those wanting to address more longstanding problems. My role as a therapist includes helping patients: deepen their awareness of their emotional lives; get in touch with aspects of themselves that they are out of touch with; foster the integration of varied aspects of themselves; establish and maintain healthy and satisfying relationships.
(206) 922-4254 View (206) 922-4254
Photo of Canh Tran - Trauma And Relationship Therapy, Clinical Social Work/Therapist in Seattle, WA
Canh Tran - Trauma And Relationship Therapy
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
1 Endorsed
Seattle, WA 98105  (Online Only)
I help people heal from childhood and intergenerational trauma. You struggle in intimate relationships, being vulnerable, feeling good enough, with overwhelming emotions and/or negative thoughts, and the exhaustion of overthinking because of past painful experiences. You’ve been dealing with the same issues for years, tried solving these problems on your own, and realize you need help. You’re looking for long term solutions to long term issues.
I help people heal from childhood and intergenerational trauma. You struggle in intimate relationships, being vulnerable, feeling good enough, with overwhelming emotions and/or negative thoughts, and the exhaustion of overthinking because of past painful experiences. You’ve been dealing with the same issues for years, tried solving these problems on your own, and realize you need help. You’re looking for long term solutions to long term issues.
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Photo of Troy E Fenlason, Psychologist in Seattle, WA
Troy E Fenlason
Psychologist, PsyD
Verified Verified
Seattle, WA 98125
Not accepting new clients
My practice is about creating space... a relational space to be, to reflect, to see, to heal, and imagine anew. Life can often feel overwhelming or bring feelings of hopelessness, but our inner resources are often more than we are able to imagine in the moment of our distress. New strength and connection can be found in parts of yourself that have been cut off or neglected for various reasons. Often we need the presence of someone, like a therapist, who has the potential to reflect back who we are being and what we might be neglecting, in order to see ourselves more clearly and engage life and relationships more fully.
My practice is about creating space... a relational space to be, to reflect, to see, to heal, and imagine anew. Life can often feel overwhelming or bring feelings of hopelessness, but our inner resources are often more than we are able to imagine in the moment of our distress. New strength and connection can be found in parts of yourself that have been cut off or neglected for various reasons. Often we need the presence of someone, like a therapist, who has the potential to reflect back who we are being and what we might be neglecting, in order to see ourselves more clearly and engage life and relationships more fully.
(425) 256-3943 View (425) 256-3943
Photo of Taylor Olson, Counselor in Seattle, WA
Taylor Olson
Counselor, MCP, LMHC
Verified Verified
Seattle, WA 98116  (Online Only)
Mental health challenges can leave us feeling lost, overwhelmed, and unfulfilled. You might be experiencing something that is significantly limiting your quality of life. Therapy can help you reach your goals and cultivate a sense of inner peace and fulfillment. As a therapist, I am focused on encouraging growth in every client by offering supportive and constructive guidance. My goal is to offer a real experience where you are invited into an honest conversation that leads to progress and a deeper connection with yourself. In therapy, we learn how to relate to ourselves, others, and our lives in new ways
Mental health challenges can leave us feeling lost, overwhelmed, and unfulfilled. You might be experiencing something that is significantly limiting your quality of life. Therapy can help you reach your goals and cultivate a sense of inner peace and fulfillment. As a therapist, I am focused on encouraging growth in every client by offering supportive and constructive guidance. My goal is to offer a real experience where you are invited into an honest conversation that leads to progress and a deeper connection with yourself. In therapy, we learn how to relate to ourselves, others, and our lives in new ways
(253) 243-0947 View (253) 243-0947
Photo of Aline Zelenskiy, Counselor in Seattle, WA
Aline Zelenskiy
Counselor, MA, LHMCA
Verified Verified
Seattle, WA 98105  (Online Only)
My calling is to support women who are facing challenges with anxiety, self-esteem, relationships, and trauma, leading towards more fulfilling lives. You may find yourself constantly worried and seeking validation from others to feel okay about yourself. Perhaps you're feeling stuck, overwhelmed, and unsure about what steps to take next. If this resonates with you, and you're ready to address this concern, I'm here to support you. In our session, we'll work together to help you feel more calm, confident, and experience greater self-love.
My calling is to support women who are facing challenges with anxiety, self-esteem, relationships, and trauma, leading towards more fulfilling lives. You may find yourself constantly worried and seeking validation from others to feel okay about yourself. Perhaps you're feeling stuck, overwhelmed, and unsure about what steps to take next. If this resonates with you, and you're ready to address this concern, I'm here to support you. In our session, we'll work together to help you feel more calm, confident, and experience greater self-love.
(206) 594-2368 View (206) 594-2368
Photo of Cat Saunders in Seattle, WA
Cat Saunders
PhD
Verified Verified
1 Endorsed
Seattle, WA 98103
The best way to check me out is to peruse my website (www.drcat.org). If you'd like a "Cliff Notes" version of my style as a therapist, here it is: I believe that YOU are the first, last, and final authority about what is right for you. My job is to help you access and trust your own knowing and help you have the best time possible while doing your work.
The best way to check me out is to peruse my website (www.drcat.org). If you'd like a "Cliff Notes" version of my style as a therapist, here it is: I believe that YOU are the first, last, and final authority about what is right for you. My job is to help you access and trust your own knowing and help you have the best time possible while doing your work.
(206) 312-5849 View (206) 312-5849
Photo of Laura Zucker Counseling, Clinical Social Work/Therapist in Seattle, WA
Laura Zucker Counseling
Clinical Social Work/Therapist, LICSW, CMHS, MHP
Verified Verified
2 Endorsed
Seattle, WA 98103
I currently have had to pause on accepting new patients. I will update my profile when that changes. Everyone experiences difficult times in their lives. Whether it's struggling with a difficult relationship, work or school, anxiety, depression, or problems in your family or social life, you're making an effort now to change. We will work together on ways to resolve the thoughts, beliefs, and behaviors that have prevented you from being who you want and attaining the things in life you really want for yourself. I offer a warm, safe, and confidential setting where we determine what your therapy needs are and how to achieve them.
I currently have had to pause on accepting new patients. I will update my profile when that changes. Everyone experiences difficult times in their lives. Whether it's struggling with a difficult relationship, work or school, anxiety, depression, or problems in your family or social life, you're making an effort now to change. We will work together on ways to resolve the thoughts, beliefs, and behaviors that have prevented you from being who you want and attaining the things in life you really want for yourself. I offer a warm, safe, and confidential setting where we determine what your therapy needs are and how to achieve them.
(206) 535-1755 View (206) 535-1755
Photo of Weston C Pew, Counselor in Seattle, WA
Weston C Pew
Counselor, MA, CC
Verified Verified
Seattle, WA 98108
Life is change. For the past eight years, I have been helping people navigate the uncertain waters of life. Whether it be dealing with illness, addiction, the loss of a loved one, trauma, divorce, or simply working through uncertainty and the anxiety and fear that come with it; my job is to accompany you through the storm and give you the tools and resources necessary to not only survive but thrive. There is a part of you that knows what is possible for your life, and with a bit of curiosity and awareness, we can tap into that wisdom and use it as a guide to not only heal your past but ensure a future that matches your potential.
Life is change. For the past eight years, I have been helping people navigate the uncertain waters of life. Whether it be dealing with illness, addiction, the loss of a loved one, trauma, divorce, or simply working through uncertainty and the anxiety and fear that come with it; my job is to accompany you through the storm and give you the tools and resources necessary to not only survive but thrive. There is a part of you that knows what is possible for your life, and with a bit of curiosity and awareness, we can tap into that wisdom and use it as a guide to not only heal your past but ensure a future that matches your potential.
(206) 208-7279 View (206) 208-7279
Photo of Elisa Kristine, Counselor in Seattle, WA
Elisa Kristine
Counselor, MA, LMHC
Verified Verified
Seattle, WA 98102
I offer psychoanalysis/psychoanalytic therapy for overcoming anxiety, depression and emotional difficulties at all phases of life. For many, a starting place in therapy may be describing concrete symptoms of pain and illness in your body, and/or life stressors such as finances, bills, piles of mail and household clutter. Addressing money stress, and beliefs about money in therapy can be transformative. Braving to ask for help with panic attacks and insomnia, chronic pain, disease/chronic conditions is also transformative. These topical, real-world struggles are important entry points to your emotional world and your inner life.
I offer psychoanalysis/psychoanalytic therapy for overcoming anxiety, depression and emotional difficulties at all phases of life. For many, a starting place in therapy may be describing concrete symptoms of pain and illness in your body, and/or life stressors such as finances, bills, piles of mail and household clutter. Addressing money stress, and beliefs about money in therapy can be transformative. Braving to ask for help with panic attacks and insomnia, chronic pain, disease/chronic conditions is also transformative. These topical, real-world struggles are important entry points to your emotional world and your inner life.
(206) 203-7081 View (206) 203-7081

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.