Therapists in Great Falls, MT

Photo of Ryan Rominger, Counselor in Great Falls, MT
Ryan Rominger
Counselor, PhD, LCPC, CCATP, NCC
Verified Verified
Great Falls, MT 59403  (Online Only)
You struggle with life’s stress. Striving to meet expectations is making you anxious, which can affect your health and even your motivation. As anxiety increases, you find yourself shutting down inside, creating walls in your relationships, managing through unhealthy activities, avoiding stressful situations or people.
You struggle with life’s stress. Striving to meet expectations is making you anxious, which can affect your health and even your motivation. As anxiety increases, you find yourself shutting down inside, creating walls in your relationships, managing through unhealthy activities, avoiding stressful situations or people.
(406) 315-4918 View (406) 315-4918
Photo of Destiny Marie Freiburg, Counselor in Great Falls, MT
Destiny Marie Freiburg
Counselor, LCPC
Verified Verified
Great Falls, MT 59401
Transcendence; to rise above or go beyond the limits of to triumph over the negative restrictive aspects of : overcome to rise above or extend notably beyond ordinary limits. I offer in-office and online counseling. I am devoted to helping to optimize the mental health of individuals in Montana, and improve access to counseling. Online counseling is a great option to engage in counseling and work toward a better quality of life. I have a holistic approach to counseling, and I work with my clients to incorporate their beliefs in counseling such as emotional, spiritual, and physical aspects.
Transcendence; to rise above or go beyond the limits of to triumph over the negative restrictive aspects of : overcome to rise above or extend notably beyond ordinary limits. I offer in-office and online counseling. I am devoted to helping to optimize the mental health of individuals in Montana, and improve access to counseling. Online counseling is a great option to engage in counseling and work toward a better quality of life. I have a holistic approach to counseling, and I work with my clients to incorporate their beliefs in counseling such as emotional, spiritual, and physical aspects.
(406) 412-2758 View (406) 412-2758
Photo of Kelly Keilman, Clinical Social Work/Therapist in Great Falls, MT
Kelly Keilman
Clinical Social Work/Therapist, LCSW
Verified Verified
Great Falls, MT 59401
Not accepting new clients
In therapy I hope to build a safe, trusting relationship that can help guide you to find your way through the difficulties and transitions that life has to offer. I believe we are all capable of becoming more self aware and, although healing can take time and work, that we are all able to heal from trauma and difficult experiences that shape us. The most content people are those who keep growing and learning!
In therapy I hope to build a safe, trusting relationship that can help guide you to find your way through the difficulties and transitions that life has to offer. I believe we are all capable of becoming more self aware and, although healing can take time and work, that we are all able to heal from trauma and difficult experiences that shape us. The most content people are those who keep growing and learning!
(406) 412-5375 View (406) 412-5375
Photo of Olive Branch Psychotherapy LLC, Counselor in Great Falls, MT
Olive Branch Psychotherapy LLC
Counselor, DMFT, LCPC, EMDR, II
Verified Verified
Great Falls, MT 59401
In therapy, Dr. Parrish maintains an integrative approach, incorporating Cognitive-Behavioral, Narrative and Solution-Focused therapies predicated from a Christian perspective. He also places strong emphasis on self-care and mindfulness. Dr. Parrish appreciates the difficulties associated with living and being human. He also appreciates the importance of "being" with clients wherever they are in their journey. He feels honored and excited to witness clients' self-discovery of their own "inner-expert" through the therapeutic process.
In therapy, Dr. Parrish maintains an integrative approach, incorporating Cognitive-Behavioral, Narrative and Solution-Focused therapies predicated from a Christian perspective. He also places strong emphasis on self-care and mindfulness. Dr. Parrish appreciates the difficulties associated with living and being human. He also appreciates the importance of "being" with clients wherever they are in their journey. He feels honored and excited to witness clients' self-discovery of their own "inner-expert" through the therapeutic process.
(406) 924-1860 View (406) 924-1860
Photo of Shirley J Cayko, LCSW, Clinical Social Work/Therapist in Great Falls, MT
Shirley J Cayko, LCSW
Clinical Social Work/Therapist, LCSW
Verified Verified
Great Falls, MT 59401  (Online Only)
Not accepting new clients
Grief and sadness in life has multiplied since the Covide-19 outbreak. You are not alone. Let's Talk. Call me and we can meet.
Grief and sadness in life has multiplied since the Covide-19 outbreak. You are not alone. Let's Talk. Call me and we can meet.
(406) 296-5341 View (406) 296-5341
Photo of Georgia Hansen, Counselor in Great Falls, MT
Georgia Hansen
Counselor, MEd, LCPC
Verified Verified
Great Falls, MT 59401
Not accepting new clients
Life is full of battles and challenges that can sometimes feel impossible to face alone. I offer individual and family therapy to help my clients overcome life's challenges and feel empowered. I have found that not one theory of therapy works for all clients. For that reason, I have studied and practiced cognitive behavioral therapy, rational emotive behavior therapy, dialectical behavioral therapy, and person-centered therapy as best suited for each client. I also have a level III certification in Eating Disorder Intuitive Therapy.
Life is full of battles and challenges that can sometimes feel impossible to face alone. I offer individual and family therapy to help my clients overcome life's challenges and feel empowered. I have found that not one theory of therapy works for all clients. For that reason, I have studied and practiced cognitive behavioral therapy, rational emotive behavior therapy, dialectical behavioral therapy, and person-centered therapy as best suited for each client. I also have a level III certification in Eating Disorder Intuitive Therapy.
(406) 540-6420 View (406) 540-6420
Photo of Dana M DelGuerra, Counselor in Great Falls, MT
Dana M DelGuerra
Counselor, LCPC, MSc, ATR, RYT
Verified Verified
Great Falls, MT 59401
Often people are searching for new ways to find their potential. Through counseling, I help people to explore, understand self limiting thinking and behaviors to live more meaningful and purposeful lives. I use an Eclectic therapeutic approach to serve each client's need to assist the process of working toward balance.
Often people are searching for new ways to find their potential. Through counseling, I help people to explore, understand self limiting thinking and behaviors to live more meaningful and purposeful lives. I use an Eclectic therapeutic approach to serve each client's need to assist the process of working toward balance.
(406) 564-4022 View (406) 564-4022
Jessica Pruitt
Counselor, LMFT, LCPC
Verified Verified
Great Falls, MT 59401
Within my 10 years of counseling experience, I have worked with a wide-range of patients from all ages with many different difficulties. I was trained in family therapy, and throughout my career have focused on couple's therapy as a specialization. In 2012, I began working with veterans and survivors of trauma using a combination of narrative and cognitive-behavioral therapies. I have continued to work with a variety of patients, as well as, having the freedom in my practice to continue specializing in couples and trauma survivors.
Within my 10 years of counseling experience, I have worked with a wide-range of patients from all ages with many different difficulties. I was trained in family therapy, and throughout my career have focused on couple's therapy as a specialization. In 2012, I began working with veterans and survivors of trauma using a combination of narrative and cognitive-behavioral therapies. I have continued to work with a variety of patients, as well as, having the freedom in my practice to continue specializing in couples and trauma survivors.
(406) 604-0759 View (406) 604-0759
Photo of Sheila Murray, LCPC, LLC , Counselor in Great Falls, MT
Sheila Murray, LCPC, LLC
Counselor, MA, LCPC
Verified Verified
1 Endorsed
Great Falls, MT 59405
Do you feel overwhelmed or stuck with a life change, loss or trauma? Are you desiring change and fearing it at the same time? When we go through life changes, loss or trauma we can get turned around and have a hard time finding our ground again. Sometimes we lose touch gradually, over years of not being seen or heard. Not feeling safe enough to speak our truth or be who we really are. This can show up as depression, anxiety, or feeling stuck and unable to trust ourselves. Sometimes it’s just a feeling of emptiness on the inside, even though things look good on the outside.
Do you feel overwhelmed or stuck with a life change, loss or trauma? Are you desiring change and fearing it at the same time? When we go through life changes, loss or trauma we can get turned around and have a hard time finding our ground again. Sometimes we lose touch gradually, over years of not being seen or heard. Not feeling safe enough to speak our truth or be who we really are. This can show up as depression, anxiety, or feeling stuck and unable to trust ourselves. Sometimes it’s just a feeling of emptiness on the inside, even though things look good on the outside.
(406) 426-5123 View (406) 426-5123
Photo of Wanmdiwi Rose, Psychologist in Great Falls, MT
Wanmdiwi Rose
Psychologist, PhD
Verified Verified
Great Falls, MT 59401
I work with my clients to develop treatment goals that will decrease distress and improve overall mental health. I focus on helping clients reach their goals by recognizing the complex interactions between thoughts, behaviors, and emotions. I am generalized in my approach to therapy and recognize the uniqueness of individuals I treat. I often utilize evidence based practice, mindfulness, stress management, and supportive therapy in treatment. I believe in helping clients find confidence in their abilities and recognition of their self-worth. I strive to provide a therapeutic environment that is warm, open, and non-judgmental.
I work with my clients to develop treatment goals that will decrease distress and improve overall mental health. I focus on helping clients reach their goals by recognizing the complex interactions between thoughts, behaviors, and emotions. I am generalized in my approach to therapy and recognize the uniqueness of individuals I treat. I often utilize evidence based practice, mindfulness, stress management, and supportive therapy in treatment. I believe in helping clients find confidence in their abilities and recognition of their self-worth. I strive to provide a therapeutic environment that is warm, open, and non-judgmental.
(406) 296-4672 View (406) 296-4672
Photo of River City Counseling LLC, Counselor in Great Falls, MT
River City Counseling LLC
Counselor, MA, LCPC, LAC
Verified Verified
Great Falls, MT 59405
Life can be painful. All of us experience struggles and have battles to face throughout our lives. You don’t have to do it alone though. We want to walk with you through these struggles, give you support, offer hope, and empower you on your journey of healing. Through a collaborative, focused approach designed to meet your specific needs, we can assist you in getting on track to leading a happier, more fulfilling life by assisting you in gaining new skills to utilize in building a more efficient and confident way of managing life’s challenges. Together, we can get you there.
Life can be painful. All of us experience struggles and have battles to face throughout our lives. You don’t have to do it alone though. We want to walk with you through these struggles, give you support, offer hope, and empower you on your journey of healing. Through a collaborative, focused approach designed to meet your specific needs, we can assist you in getting on track to leading a happier, more fulfilling life by assisting you in gaining new skills to utilize in building a more efficient and confident way of managing life’s challenges. Together, we can get you there.
(406) 219-0362 View (406) 219-0362
Photo of Megan Dunlap, Counselor in Great Falls, MT
Megan Dunlap
Counselor, MA, PCLC
Verified Verified
1 Endorsed
Great Falls, MT 59401
I am so glad you are here! This moment of seeking help is an incredibly brave step in healing. I believe there is healing for one’s relationship with their body and food. You are more than the number on a scale or jean size. I understand the grip an eating disorder can have on your body, heart, soul, and mind, especially when you are wrestling with other mental health struggles. Together, we can navigate the ins and outs of taking the next steps to healing.
I am so glad you are here! This moment of seeking help is an incredibly brave step in healing. I believe there is healing for one’s relationship with their body and food. You are more than the number on a scale or jean size. I understand the grip an eating disorder can have on your body, heart, soul, and mind, especially when you are wrestling with other mental health struggles. Together, we can navigate the ins and outs of taking the next steps to healing.
(406) 642-8665 View (406) 642-8665
Photo of Ryanne Stellingwerf, Counselor in Great Falls, MT
Ryanne Stellingwerf
Counselor, MS, LCPC, CCTP
Verified Verified
3 Endorsed
Great Falls, MT 59401
You are great at working. You are a successful, professional woman. You enjoy your career and are inspired by each challenge. You feel the rush of success and achievement. You wake every morning with purpose and ambition and may have never looked beyond having a successful career. But now you are finding that your life is a bit out of balance. You wouldn’t say you are “depressed.” You don’t have “anxiety.” And you probably don’t fit the “diagnostic criteria” for a mental health diagnoses. But you are noticing that the career stress is taking its toll. Your relationships or health may be suffering and you don’t have hobbies.
You are great at working. You are a successful, professional woman. You enjoy your career and are inspired by each challenge. You feel the rush of success and achievement. You wake every morning with purpose and ambition and may have never looked beyond having a successful career. But now you are finding that your life is a bit out of balance. You wouldn’t say you are “depressed.” You don’t have “anxiety.” And you probably don’t fit the “diagnostic criteria” for a mental health diagnoses. But you are noticing that the career stress is taking its toll. Your relationships or health may be suffering and you don’t have hobbies.
(406) 944-0136 View (406) 944-0136
Photo of One Beautiful Life Wellness and Therapy, Counselor in Great Falls, MT
One Beautiful Life Wellness and Therapy
Counselor, MA, LCPC
Verified Verified
Great Falls, MT 59405  (Online Only)
You have taken the first step toward achieving your wellness goals, and I am so happy for you! Therapy can seem intimidating at first, but with my help, you can be on your way to living your best life quickly. I have been a licensed therapist for 25 years, and specialize in anxiety, depression, trauma, and chronic health issues such as fibromyalgia. Because I hold a certification in Integrative Medicine, I can help you improve all aspects of wellness: social, spiritual, physical, mental, and emotional health. I work with compassion and nonjudgement, and I look forward exploring your journey with you!
You have taken the first step toward achieving your wellness goals, and I am so happy for you! Therapy can seem intimidating at first, but with my help, you can be on your way to living your best life quickly. I have been a licensed therapist for 25 years, and specialize in anxiety, depression, trauma, and chronic health issues such as fibromyalgia. Because I hold a certification in Integrative Medicine, I can help you improve all aspects of wellness: social, spiritual, physical, mental, and emotional health. I work with compassion and nonjudgement, and I look forward exploring your journey with you!
(406) 302-8012 View (406) 302-8012
Photo of Trish McCoy, Counselor in Great Falls, MT
Trish McCoy
Counselor, LCPC, NCC, CHT
Verified Verified
Great Falls, MT 59404  (Online Only)
Your choice in considering assistance to overcome personal obstacles and progress forward indicates a level of commitment to improving your sense of well-being and overall contentment. Together, we can achieve your personal goals. Combining conventional and alternative approaches, a variety of styles and techniques are employed to incorporate what will be the most beneficial for the individual client. With sensitivity and compassion, I assist clients in discovering solutions to a wide range of life challenges and psychological issues. Specializing in adolescent issues, depression, anxiety, and relationship issues.
Your choice in considering assistance to overcome personal obstacles and progress forward indicates a level of commitment to improving your sense of well-being and overall contentment. Together, we can achieve your personal goals. Combining conventional and alternative approaches, a variety of styles and techniques are employed to incorporate what will be the most beneficial for the individual client. With sensitivity and compassion, I assist clients in discovering solutions to a wide range of life challenges and psychological issues. Specializing in adolescent issues, depression, anxiety, and relationship issues.
(406) 412-6203 View (406) 412-6203
Photo of Kelli O'Brien, Counselor in Great Falls, MT
Kelli O'Brien
Counselor, LCPC
Verified Verified
Great Falls, MT 59404
Waitlist for new clients
My focus is to help each individual gain self-awareness, self-compassion, and overall confidence in his, her, or their ability to understand and manage overwhelming emotions, stress, and ongoing psychological and behavioral problems. When we are defeated or don’t feel like ourselves, it is easy to focus on the negatives; I help individuals, couples, and families rediscover their strengths and the positive attributes that empower them toward growth and happiness. I am passionate about kids, women’s issues, building healthy relationships, increasing self-esteem, and healing family dynamics (including teaching parenting skills).
My focus is to help each individual gain self-awareness, self-compassion, and overall confidence in his, her, or their ability to understand and manage overwhelming emotions, stress, and ongoing psychological and behavioral problems. When we are defeated or don’t feel like ourselves, it is easy to focus on the negatives; I help individuals, couples, and families rediscover their strengths and the positive attributes that empower them toward growth and happiness. I am passionate about kids, women’s issues, building healthy relationships, increasing self-esteem, and healing family dynamics (including teaching parenting skills).
(406) 760-1784 View (406) 760-1784
Photo of Sylvia Lindinger-Sternart, Counselor in Great Falls, MT
Sylvia Lindinger-Sternart
Counselor, PhD, MS, MA, LCPC, CRC
Verified Verified
Great Falls, MT 59404  (Online Only)
"My approach is empowering, respectful, and creative to assist you in being in charge of change. My clinical experience includes individual, couple, and group counseling in institutional settings such as an inpatient substance abuse clinic, a college counseling center, psychiatric clinics, a community mental health center and private practice. I work with diverse populations across the globe and love travelling to engage with other cultures. My theoretical counseling approach is integrative and includes Cognitive Behavioral Therapy (CBT, REBT, DBT), Existential Therapy, and Emotion-Focused Couple Therapy. I also integrate mindfulness and positive psychology to support your strengths."
"My approach is empowering, respectful, and creative to assist you in being in charge of change. My clinical experience includes individual, couple, and group counseling in institutional settings such as an inpatient substance abuse clinic, a college counseling center, psychiatric clinics, a community mental health center and private practice. I work with diverse populations across the globe and love travelling to engage with other cultures. My theoretical counseling approach is integrative and includes Cognitive Behavioral Therapy (CBT, REBT, DBT), Existential Therapy, and Emotion-Focused Couple Therapy. I also integrate mindfulness and positive psychology to support your strengths."
View
Photo of Big Sky Counseling LLC, Counselor in Great Falls, MT
Big Sky Counseling LLC
Counselor, MS, LCPC
Verified Verified
1 Endorsed
Great Falls, MT 59404  (Online Only)
Welcome to Big Sky Counseling, a compassionate space to move toward healing. Our primary areas of focus include OCD and related Anxiety Disorders (see below for details on expanded areas of support we offer) . We approach treatment by integrating structured ERP (Exposure and Response Prevention Therapy), ACT (Acceptance and Commitment Therapy), and CBT/ICBT (Cognitive Behavioral Therapy) to disrupt the obsessive-compulsive cycle and return to values-based living. We are currently scheduling new telehealth clients for folks residing in MT with Ashley Schwartzman, PCLC, under the clinical supervision of Kelli Smith, LCPC.
Welcome to Big Sky Counseling, a compassionate space to move toward healing. Our primary areas of focus include OCD and related Anxiety Disorders (see below for details on expanded areas of support we offer) . We approach treatment by integrating structured ERP (Exposure and Response Prevention Therapy), ACT (Acceptance and Commitment Therapy), and CBT/ICBT (Cognitive Behavioral Therapy) to disrupt the obsessive-compulsive cycle and return to values-based living. We are currently scheduling new telehealth clients for folks residing in MT with Ashley Schwartzman, PCLC, under the clinical supervision of Kelli Smith, LCPC.
(406) 296-5204 View (406) 296-5204
Photo of Patricia Cooper, Counselor in Great Falls, MT
Patricia Cooper
Counselor, LCPC, LPC, NCC
Verified Verified
1 Endorsed
Great Falls, MT 59404  (Online Only)
Have you been struggling with OCD, ongoing anxiety, phobias, or trauma symptoms that have become a barrier to connection and success? I love to work with those who experience anxiety, OCD, and trauma and strive to provide therapeutic support to get you where you want to be. I am currently only accepting telehealth clients.
Have you been struggling with OCD, ongoing anxiety, phobias, or trauma symptoms that have become a barrier to connection and success? I love to work with those who experience anxiety, OCD, and trauma and strive to provide therapeutic support to get you where you want to be. I am currently only accepting telehealth clients.
(406) 909-4146 View (406) 909-4146
Photo of Lindsay Cooper, Counselor in Great Falls, MT
Lindsay Cooper
Counselor, LCPC, LAC
Verified Verified
Great Falls, MT 59401
I trust you will be successful within your daily life practicing skills you develop through your therapeutic journey. Within a supportive environment, you can pursue your goals to help you succeed in living your life to the fullest. My goal is to create a safe and secure environment to develop a therapeutic relationship. I believe a therapeutic relationship is one of the most important steps of the treatment process. You will develop techniques and skills to help you succeed in your daily life along with developing and pursuing your goals. I believe being in the present moment is helpful within our daily lives.
I trust you will be successful within your daily life practicing skills you develop through your therapeutic journey. Within a supportive environment, you can pursue your goals to help you succeed in living your life to the fullest. My goal is to create a safe and secure environment to develop a therapeutic relationship. I believe a therapeutic relationship is one of the most important steps of the treatment process. You will develop techniques and skills to help you succeed in your daily life along with developing and pursuing your goals. I believe being in the present moment is helpful within our daily lives.
(406) 445-1201 View (406) 445-1201

How does your Therapist compare?

Number of Therapists in Great Falls, MT

80+

Average cost per session

$170

Therapists in Great Falls, MT who prioritize treating:

93% Anxiety
88% Depression
79% Trauma and PTSD
75% Self Esteem
73% Relationship Issues
71% Coping Skills
70% Grief

Average years in practice

10 Years

Top 3 insurances accepted

93% BlueCross and BlueShield
75% Cigna and Evernorth
74% Allegiance

How Therapists in Great Falls, MT see their clients

69% In Person and Online
31% Online Only

Gender breakdown

83% Female
17% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Great Falls?

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.