Therapists in Durham, NC

Photo of Keturah Davis, Clinical Social Work/Therapist in Durham, NC
Keturah Davis
Clinical Social Work/Therapist, LCSWA
Verified Verified
1 Endorsed
Durham, NC 27701
Are you overwhelmed with the complexities of life that you feel an urge to shut down? Do you find yourself constantly reevaluating your decisions to get on the “right track”? As a therapist, it is my goal to assist clients in unpacking their trauma, challenges of daily living, and overarching negative thoughts to identify healthy ways of coping yielding a positive way of navigating through life. With over two years of experience working in various mental health settings such as outpatient therapy, psychosocial rehabilitation, and intensive in home, I have developed a passion for empowering adult women to work through trauma.
Are you overwhelmed with the complexities of life that you feel an urge to shut down? Do you find yourself constantly reevaluating your decisions to get on the “right track”? As a therapist, it is my goal to assist clients in unpacking their trauma, challenges of daily living, and overarching negative thoughts to identify healthy ways of coping yielding a positive way of navigating through life. With over two years of experience working in various mental health settings such as outpatient therapy, psychosocial rehabilitation, and intensive in home, I have developed a passion for empowering adult women to work through trauma.
(919) 769-6973 View (919) 769-6973
Photo of Rebecca Martinez Fitzgerald, Clinical Social Work/Therapist in Durham, NC
Rebecca Martinez Fitzgerald
Clinical Social Work/Therapist, LCSW
Verified Verified
Durham, NC 27707
Loneliness is the worst. Isolation shows up in many forms, including shame, stress, mistrust, and unproductive conflict. People grow and heal in the context of secure relationships, and I aim to help clients create and sustain them. It's my pleasure to work with couples, partnerships and individuals who are experiencing distress, coping with trauma, or struggling with identity development.
Loneliness is the worst. Isolation shows up in many forms, including shame, stress, mistrust, and unproductive conflict. People grow and heal in the context of secure relationships, and I aim to help clients create and sustain them. It's my pleasure to work with couples, partnerships and individuals who are experiencing distress, coping with trauma, or struggling with identity development.
(919) 626-9715 View (919) 626-9715
Photo of Stephanie Kesner, LCMHC Associate in Durham, NC
Stephanie Kesner
LCMHC Associate, MS, LCMHCA
Verified Verified
Durham, NC 27705  (Online Only)
Welcome! Oftentimes when life gets too hard or too overwhelming, it's difficult to know what to do or who to turn to for help. In fact, letting others know you need help is often the most difficult. But you're here. You've taken the first step to healing and I'm so glad you did. I practice from a person-centered perspective, meaning I walk alongside you in your journey at your pace. I also incorporate skills from other modalities as needed. You are the expert of your life and it's my job to honor that, to help provide clarity, and to offer tools to navigate life's most difficult challenges.
Welcome! Oftentimes when life gets too hard or too overwhelming, it's difficult to know what to do or who to turn to for help. In fact, letting others know you need help is often the most difficult. But you're here. You've taken the first step to healing and I'm so glad you did. I practice from a person-centered perspective, meaning I walk alongside you in your journey at your pace. I also incorporate skills from other modalities as needed. You are the expert of your life and it's my job to honor that, to help provide clarity, and to offer tools to navigate life's most difficult challenges.
(919) 739-4709 View (919) 739-4709
Photo of Sam Terry, Lic Clinical Mental Health Counselor Associate in Durham, NC
Sam Terry
Lic Clinical Mental Health Counselor Associate, LCMHCA
Verified Verified
2 Endorsed
Durham, NC 27705
Welcome! I'm so excited that you're here! I am a queer cisgender counselor based in Durham, NC, offering individual and couples therapy both in-person and virtually. Couples and partnerships that want to deepen their intimate dynamics & explore alternative relationship styles are my ideal clients. I enjoy work focused on improving communication in partnerships to help couples deepen their connection and effectiveness in sharing. I work with individuals with a variety of concerns, including depression, anxiety, relationship challenges, and the effects of growing up in a dysfunctional family.
Welcome! I'm so excited that you're here! I am a queer cisgender counselor based in Durham, NC, offering individual and couples therapy both in-person and virtually. Couples and partnerships that want to deepen their intimate dynamics & explore alternative relationship styles are my ideal clients. I enjoy work focused on improving communication in partnerships to help couples deepen their connection and effectiveness in sharing. I work with individuals with a variety of concerns, including depression, anxiety, relationship challenges, and the effects of growing up in a dysfunctional family.
(919) 635-4767 View (919) 635-4767
Photo of Louis Sawyer, Psychologist in Durham, NC
Louis Sawyer
Psychologist, PhD
Verified Verified
Durham, NC 27705
Doing psychotherapy is a lot like playing jazz: The challenge for me as therapist is to stay in tune with the patient's own creative, self-healing process and to provide a safe container ("rhythm section"). The patient's life narratives are the "melodies" to be composed, developed, & improvised. My ideal patient is motivated to show up and do the work involved in creating/healing and to allow the therapeutic relationship to support the work. My private practice (The Androgyny Center) serves adult patients of all genders. I also do consultations with families and professionals regarding developmental issues re gender and sexual orientation.
Doing psychotherapy is a lot like playing jazz: The challenge for me as therapist is to stay in tune with the patient's own creative, self-healing process and to provide a safe container ("rhythm section"). The patient's life narratives are the "melodies" to be composed, developed, & improvised. My ideal patient is motivated to show up and do the work involved in creating/healing and to allow the therapeutic relationship to support the work. My private practice (The Androgyny Center) serves adult patients of all genders. I also do consultations with families and professionals regarding developmental issues re gender and sexual orientation.
(984) 369-9160 View (984) 369-9160
Photo of Karlee Strickland, Clinical Social Work/Therapist in Durham, NC
Karlee Strickland
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Durham, NC 27707
Not accepting new clients
My goal is to provide a safe nonjudgmental space to help you work through what brings you here. As a licensed clinical social worker I believe it is vital to acknowledge the person’s strengths in the face of systematic barriers, stigma, and discrimination. My approach to therapy is integrative and collaborative which allows us to work together to identify and make progress towards goals that are most important to you. Helping you to align with your most authentic self and to process what may be getting in the way of this is what I strive to help you with.
My goal is to provide a safe nonjudgmental space to help you work through what brings you here. As a licensed clinical social worker I believe it is vital to acknowledge the person’s strengths in the face of systematic barriers, stigma, and discrimination. My approach to therapy is integrative and collaborative which allows us to work together to identify and make progress towards goals that are most important to you. Helping you to align with your most authentic self and to process what may be getting in the way of this is what I strive to help you with.
(919) 813-7856 View (919) 813-7856
Photo of Hannah Crouse, Counselor in Durham, NC
Hannah Crouse
Counselor, LCMHC, LCAS-A
Verified Verified
3 Endorsed
Durham, NC 27709  (Online Only)
You’ve likely spent plenty of time and effort trying to figure out how to improve your life in one way or another. If you're still finding yourself stuck in the same old patterns, I’d like to support you in the process of opening up to new ways of creating positive change in your life. I believe that you and I can work together to discover a more peaceful and meaningful life. This means working together to uncover new strategies for managing painful thoughts, memories and emotions.
You’ve likely spent plenty of time and effort trying to figure out how to improve your life in one way or another. If you're still finding yourself stuck in the same old patterns, I’d like to support you in the process of opening up to new ways of creating positive change in your life. I believe that you and I can work together to discover a more peaceful and meaningful life. This means working together to uncover new strategies for managing painful thoughts, memories and emotions.
(919) 355-9575 View (919) 355-9575
Photo of Heath Williams, Clinical Social Work/Therapist in Durham, NC
Heath Williams
Clinical Social Work/Therapist, LCSW
Verified Verified
Durham, NC 27701
Waitlist for new clients
Psychotherapy should be collaborative and flexible, based on you and your specific story. Whether you have been through things in your life that are just coming to the surface or are feeling stuck and struggling to find joy and connection, I can help you gain clarity and find new ways to move through old challenges. Together, we will work toward deepening your connection to your core self and engaging more fully in the life you want. I provide an affirming and supportive space to process family of origin issues, grief, loss, relationship struggles and feelings of worry or anxiety.
Psychotherapy should be collaborative and flexible, based on you and your specific story. Whether you have been through things in your life that are just coming to the surface or are feeling stuck and struggling to find joy and connection, I can help you gain clarity and find new ways to move through old challenges. Together, we will work toward deepening your connection to your core self and engaging more fully in the life you want. I provide an affirming and supportive space to process family of origin issues, grief, loss, relationship struggles and feelings of worry or anxiety.
(919) 899-4949 View (919) 899-4949
Photo of Katelyn Chapman, Clinical Social Work/Therapist in Durham, NC
Katelyn Chapman
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Durham, NC 27707
Taking the first step towards therapy is hard, and taking that first step when your concerns are sex-related can feel even harder. Most of us are taught from a young age that sex is a shameful topic that is not to be discussed openly— that any concerns, difficulties, or dissatisfaction you may experience related to sex, sexuality, or gender are to be ashamed of. I’m here to tell you that that is not true! Issues and concerns with sex and sexuality are very common, and it is healthy to talk to a therapist about them.
Taking the first step towards therapy is hard, and taking that first step when your concerns are sex-related can feel even harder. Most of us are taught from a young age that sex is a shameful topic that is not to be discussed openly— that any concerns, difficulties, or dissatisfaction you may experience related to sex, sexuality, or gender are to be ashamed of. I’m here to tell you that that is not true! Issues and concerns with sex and sexuality are very common, and it is healthy to talk to a therapist about them.
(919) 296-0919 View (919) 296-0919
Photo of Deja Buckner, Psychological Associate in Durham, NC
Deja Buckner
Psychological Associate, LPA
Verified Verified
1 Endorsed
Durham, NC 27713
As a psychotherapist, I am passionate about empowering others to move towards the future with clarity, confidence, and serenity. My practice, The Peace Space Therapy, centers around helping clients challenge maladaptive thoughts and behaviors that interfere with their pursuit of a more peaceful, authentic, and aligned life. I hold a Master's in Clinical Psychology and have over ten years of professional experience in the mental health field serving child, adolescent, and adult populations.
As a psychotherapist, I am passionate about empowering others to move towards the future with clarity, confidence, and serenity. My practice, The Peace Space Therapy, centers around helping clients challenge maladaptive thoughts and behaviors that interfere with their pursuit of a more peaceful, authentic, and aligned life. I hold a Master's in Clinical Psychology and have over ten years of professional experience in the mental health field serving child, adolescent, and adult populations.
(919) 823-2651 View (919) 823-2651
Photo of Paula Sanders Newman, Licensed Clinical Mental Health Counselor in Durham, NC
Paula Sanders Newman
Licensed Clinical Mental Health Counselor, PhD, LCMHCS, NCC
Verified Verified
1 Endorsed
Durham, NC 27705
I am a Licensed Professional Counselor and Educational Psychologist who serves children and adolescents and their families in Durham, Wake, and Johnston counties. I take a strengths-based approach to help children and families develop the insight and skills necessary to meet personal and situational challenges; and, improve functionality. I enjoy helping children and families identify and achieve their goals. I employ elements from a range of therapeutic techniques (i.e. Play Therapy, CBT, TFCBT, Behavioral Therapy, Positive Psychology). I welcome extended family members, members of faith communities, and any other supports families want to utilize in the treatment process.
I am a Licensed Professional Counselor and Educational Psychologist who serves children and adolescents and their families in Durham, Wake, and Johnston counties. I take a strengths-based approach to help children and families develop the insight and skills necessary to meet personal and situational challenges; and, improve functionality. I enjoy helping children and families identify and achieve their goals. I employ elements from a range of therapeutic techniques (i.e. Play Therapy, CBT, TFCBT, Behavioral Therapy, Positive Psychology). I welcome extended family members, members of faith communities, and any other supports families want to utilize in the treatment process.
(919) 330-0079 View (919) 330-0079
Photo of Ellen Gray, Clinical Social Work/Therapist in Durham, NC
Ellen Gray
Clinical Social Work/Therapist, PhD, LCSW
Verified Verified
Durham, NC 27705  (Online Only)
You want more out of life. Your relationships are stale, unfulfilling or toxic. You have a vision of yourself, but cannot behave yourself into that vision. Or, you have recurrent distressing thoughts that plague and distract you from the tasks and rewards of life. You are sad, scared or worried about your past and future. Releasing your potential requires a set of technologies to liberate you from all these human dilemmas. Luckily, these tools exist--now more than ever before. I combine the contributions of neuroscience, energy psychology and Eastern metaphysical thought into a supportive, gently directive and respectful practice.
You want more out of life. Your relationships are stale, unfulfilling or toxic. You have a vision of yourself, but cannot behave yourself into that vision. Or, you have recurrent distressing thoughts that plague and distract you from the tasks and rewards of life. You are sad, scared or worried about your past and future. Releasing your potential requires a set of technologies to liberate you from all these human dilemmas. Luckily, these tools exist--now more than ever before. I combine the contributions of neuroscience, energy psychology and Eastern metaphysical thought into a supportive, gently directive and respectful practice.
(919) 648-4172 View (919) 648-4172
Photo of Alyssa Rodgers, Licensed Clinical Mental Health Counselor in Durham, NC
Alyssa Rodgers
Licensed Clinical Mental Health Counselor, LCMHC
Verified Verified
Durham, NC 27707  (Online Only)
Hello, I am Alyssa and I believe it is possible for you to move forward and live. My passion is to inspire people as they progress and develop through life.
Hello, I am Alyssa and I believe it is possible for you to move forward and live. My passion is to inspire people as they progress and develop through life.
(919) 267-3295 View (919) 267-3295
Photo of Kisha D Bardonille, Clinical Social Work/Therapist in Durham, NC
Kisha D Bardonille
Clinical Social Work/Therapist, MSW, LCSW, CSSW
Verified Verified
Durham, NC 27713
I want to be the reason you feel welcomed, seen, valued and loved. I want to help you find the joy you have been searching for! I want to help you be intentional, mindful and overcome hurdles that have stopped you from reaching desired goals in the past. I utilize 30 years of experience in the mental health field my to help you increase self awareness and self acceptance. If you are a woman of color seeking to improve relationships, manage stress, or in a life transition, I'm your therapist.
I want to be the reason you feel welcomed, seen, valued and loved. I want to help you find the joy you have been searching for! I want to help you be intentional, mindful and overcome hurdles that have stopped you from reaching desired goals in the past. I utilize 30 years of experience in the mental health field my to help you increase self awareness and self acceptance. If you are a woman of color seeking to improve relationships, manage stress, or in a life transition, I'm your therapist.
(919) 626-8872 View (919) 626-8872
Photo of Ben Shechet, Counselor in Durham, NC
Ben Shechet
Counselor, MS, LCMHCA
Verified Verified
2 Endorsed
Durham, NC 27707  (Online Only)
My approach to therapy is rooted in the view that we are all, at the deepest level, whole and complete; we all have wisdom, love, compassion, and the capacity for connection within us. My job as a therapist is not to fix or to change anyone—it is to help and support you in connecting with your own knowing, power, and ability to grow and meet your goals. I work with adults and older teens seeking assistance with a wide range of concerns, including depression, anxiety, trauma, grief and loss, life transitions, and identity development and change.
My approach to therapy is rooted in the view that we are all, at the deepest level, whole and complete; we all have wisdom, love, compassion, and the capacity for connection within us. My job as a therapist is not to fix or to change anyone—it is to help and support you in connecting with your own knowing, power, and ability to grow and meet your goals. I work with adults and older teens seeking assistance with a wide range of concerns, including depression, anxiety, trauma, grief and loss, life transitions, and identity development and change.
(919) 635-1751 View (919) 635-1751
Photo of Karyn A Louritt, Counselor in Durham, NC
Karyn A Louritt
Counselor, MS, LCMHC-A
Verified Verified
2 Endorsed
Durham, NC 27705
Being a parent is hard. Being a kid is hard. I can help navigate the hard! If your child is struggling with big emotions, difficult behavior, trauma or ongoing stress, play therapy may be a good fit for your family. Your child will receive play therapy and caregivers will be provided with necessary support.
Being a parent is hard. Being a kid is hard. I can help navigate the hard! If your child is struggling with big emotions, difficult behavior, trauma or ongoing stress, play therapy may be a good fit for your family. Your child will receive play therapy and caregivers will be provided with necessary support.
(984) 464-8122 View (984) 464-8122
Photo of Ariel Rogers, Marriage & Family Therapist in Durham, NC
Ariel Rogers
Marriage & Family Therapist, LMFT
Verified Verified
3 Endorsed
Durham, NC 27707  (Online Only)
I work with individuals and couples to enhance their ability to cope in times of hardship, transitional periods and to problem solve life's many nuanced experiences. We collaborate and explore how the dynamic of engagement with self and others are connected to the most pressing issues.
I work with individuals and couples to enhance their ability to cope in times of hardship, transitional periods and to problem solve life's many nuanced experiences. We collaborate and explore how the dynamic of engagement with self and others are connected to the most pressing issues.
(984) 205-7570 x703 View (984) 205-7570 x703
Photo of Deepa Bhatt-Mackin, Licensed Clinical Mental Health Counselor in Durham, NC
Deepa Bhatt-Mackin
Licensed Clinical Mental Health Counselor, MA, LCMHC
Verified Verified
1 Endorsed
Durham, NC 27707  (Online Only)
As a licensed clinical mental health counselor, I offer telehealth sessions for adolescents, families, and adults. For children under 13, I offer parenting support, consultation, and parent-child sessions. I assist clients with a variety of presenting issues, including anxiety, depression, neurodivergence (Giftedness/LD/ADHD/2e), relationship problems, and identity development. My extensive training includes a variety of therapeutic approaches, such as psychodynamic, attachment-based, Internal Family Systems, cognitive behavioral therapy, and solution-focused. I also provide ADHD and executive functioning skills coaching.
As a licensed clinical mental health counselor, I offer telehealth sessions for adolescents, families, and adults. For children under 13, I offer parenting support, consultation, and parent-child sessions. I assist clients with a variety of presenting issues, including anxiety, depression, neurodivergence (Giftedness/LD/ADHD/2e), relationship problems, and identity development. My extensive training includes a variety of therapeutic approaches, such as psychodynamic, attachment-based, Internal Family Systems, cognitive behavioral therapy, and solution-focused. I also provide ADHD and executive functioning skills coaching.
(919) 343-0027 View (919) 343-0027
Photo of Aja Johnson, Counselor in Durham, NC
Aja Johnson
Counselor, MA, LCMHC
Verified Verified
Durham, NC 27705
My specialty is working with individuals within their family dynamic as they transition through life's phases. I appreciate providing therapeutic services to clients as young as nine years old along with young adults and retiree's. I enjoy helping parent's improve their relationship and exploring their child/parent relationship. If applicable, I can provide individual session to both the parent and child. At the correct time we will come together in family sessions to explore understanding of each other and figure out ways to rectify any underlying issues.
My specialty is working with individuals within their family dynamic as they transition through life's phases. I appreciate providing therapeutic services to clients as young as nine years old along with young adults and retiree's. I enjoy helping parent's improve their relationship and exploring their child/parent relationship. If applicable, I can provide individual session to both the parent and child. At the correct time we will come together in family sessions to explore understanding of each other and figure out ways to rectify any underlying issues.
(919) 759-5973 View (919) 759-5973
Photo of Helen Svoboda-Barber, Counselor in Durham, NC
Helen Svoboda-Barber
Counselor, MA, DMin, LCMHCA
Verified Verified
3 Endorsed
Durham, NC 27705
Hi. I’m Helen and I am here to help you Heal, Grow and Go. You are here because you or someone you love is ready to heal and grow. I work with clients to create goals which lead them into their preferred future and a more sustainable way of being. Many of my clients are going through life transitions, struggling with work/life balance, healing from religious trauma, or are exhausted from parenting. Partners see me together to work on their communication and connection. I work with adults (18-80+) both individually and in relationships, and have a few spots for children 10 and under.
Hi. I’m Helen and I am here to help you Heal, Grow and Go. You are here because you or someone you love is ready to heal and grow. I work with clients to create goals which lead them into their preferred future and a more sustainable way of being. Many of my clients are going through life transitions, struggling with work/life balance, healing from religious trauma, or are exhausted from parenting. Partners see me together to work on their communication and connection. I work with adults (18-80+) both individually and in relationships, and have a few spots for children 10 and under.
(984) 538-7058 View (984) 538-7058

How does your Therapist compare?

Number of Therapists in Durham, NC

1,000+

Average cost per session

$150

Therapists in Durham, NC who prioritize treating:

92% Anxiety
86% Depression
78% Relationship Issues
77% Self Esteem
70% Coping Skills
70% Stress
67% Trauma and PTSD

Average years in practice

11 Years

Top 3 insurances accepted

82% BlueCross and BlueShield
71% Aetna
51% Cigna and Evernorth

How Therapists in Durham, NC see their clients

65% In Person and Online
35% Online Only

Gender breakdown

80% Female
17% Male
3% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Durham?

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.