Therapists in La Mesa, CA

Photo of Trish Franzblau, Clinical Social Work/Therapist in La Mesa, CA
Trish Franzblau
Clinical Social Work/Therapist, LCSW
Verified Verified
La Mesa, CA 91941
'It's never too late to have a happy childhood.' As a nurturing therapist, I believe my role is to provide support, guidance, and a SAFE place to share, vent, scream, cry, laugh or just sit quietly. I also believe it's not what happens to people that's most important, but what they do about it. Our background and circumstances may have influenced who we are, but we are responsible for who we become. Though daunting, this realization can be extremely EMPOWERING--You are in charge of your life and your future happiness! With this knowledge, change can unfold.
'It's never too late to have a happy childhood.' As a nurturing therapist, I believe my role is to provide support, guidance, and a SAFE place to share, vent, scream, cry, laugh or just sit quietly. I also believe it's not what happens to people that's most important, but what they do about it. Our background and circumstances may have influenced who we are, but we are responsible for who we become. Though daunting, this realization can be extremely EMPOWERING--You are in charge of your life and your future happiness! With this knowledge, change can unfold.
(805) 214-8832 View (805) 214-8832
Photo of Tiffany Cox, Marriage & Family Therapist in La Mesa, CA
Tiffany Cox
Marriage & Family Therapist, PsyD, LMFT
Verified Verified
La Mesa, CA 91942
I enjoy working with clients who want more than the traditional “talk” therapy. I have an active, curious style when examining symptoms of distress. For example, if we were to explore feelings of anxiety, I may ask questions to identify where you sense those feelings in your body, discuss the implications of stress, and investigate the triggers for it. This will enable you to create greater self-awarenes and have better control over your symptoms. My philosophy is deeply rooted in the mind-body connection and our interconnectedness with the world around us.
I enjoy working with clients who want more than the traditional “talk” therapy. I have an active, curious style when examining symptoms of distress. For example, if we were to explore feelings of anxiety, I may ask questions to identify where you sense those feelings in your body, discuss the implications of stress, and investigate the triggers for it. This will enable you to create greater self-awarenes and have better control over your symptoms. My philosophy is deeply rooted in the mind-body connection and our interconnectedness with the world around us.
(619) 824-1805 View (619) 824-1805
Photo of Mary Nelsen Tamborski, Marriage & Family Therapist in La Mesa, CA
Mary Nelsen Tamborski
Marriage & Family Therapist, MA, LMFT, CPDT
Verified Verified
1 Endorsed
La Mesa, CA 91941
Waitlist for new clients
It isn't problems that determine health and well-being, but what we do about them. I believe that problems provide opportunities for personal growth and development. My mission is to help clients find solutions through awareness and possibilities they might not see on their own. I respect the inner health in each person that sometimes becomes buried behind the filters of the thought system. Understanding how you created your thought system frees you to access your inner wisdom instead of allowing your thought system to control you. If you have questions about how I might help you, please contact me.
It isn't problems that determine health and well-being, but what we do about them. I believe that problems provide opportunities for personal growth and development. My mission is to help clients find solutions through awareness and possibilities they might not see on their own. I respect the inner health in each person that sometimes becomes buried behind the filters of the thought system. Understanding how you created your thought system frees you to access your inner wisdom instead of allowing your thought system to control you. If you have questions about how I might help you, please contact me.
(858) 375-1175 View (858) 375-1175
Photo of Kenya Taylor, Marriage & Family Therapist in La Mesa, CA
Kenya Taylor
Marriage & Family Therapist, LMFT
Verified Verified
La Mesa, CA 91942
Kenya Taylor has more than 20 years of experience in mental health while including anxiety and depression interventions for chronic health conditions, pain management, first responders and their families, women's health, and successful aging to enhance individual, couples and family therapy. She continues to promote wellness in urban, rural and suburban communities.
Kenya Taylor has more than 20 years of experience in mental health while including anxiety and depression interventions for chronic health conditions, pain management, first responders and their families, women's health, and successful aging to enhance individual, couples and family therapy. She continues to promote wellness in urban, rural and suburban communities.
(858) 500-1602 View (858) 500-1602
Photo of Darryl K Moore, Psychologist in La Mesa, CA
Darryl K Moore
Psychologist, PhD, CSAT, CMAT
Verified Verified
2 Endorsed
La Mesa, CA 91942
I work with individuals and couples coping with sex addiction or the discovery of sex addiction in a partner. I also facilitate a recovery group for men dealing with sex addiction. The group is open to all men dealing with sex addiction. It is not required that you be a registered individual client. My practice has focused on men's issues with sexual and other addictions as well as anger and behavior management. Other areas of focus include relational issues and the associated problems of stress, anxiety, and depression and betrayal issues. Emphasis is on the Carns model using the texts Facing the Shadows and Facing Heartbreak.
I work with individuals and couples coping with sex addiction or the discovery of sex addiction in a partner. I also facilitate a recovery group for men dealing with sex addiction. The group is open to all men dealing with sex addiction. It is not required that you be a registered individual client. My practice has focused on men's issues with sexual and other addictions as well as anger and behavior management. Other areas of focus include relational issues and the associated problems of stress, anxiety, and depression and betrayal issues. Emphasis is on the Carns model using the texts Facing the Shadows and Facing Heartbreak.
(619) 457-6419 View (619) 457-6419
Photo of Linda Jeter, Marriage & Family Therapist in La Mesa, CA
Linda Jeter
Marriage & Family Therapist, LMFT
Verified Verified
La Mesa, CA 91942  (Online Only)
Linda Jeter is a Licensed Marriage and Family Therapist in California who has been practicing since 2018. She is a Recipient of a SAMHSA-Minority Fellowship Award. Linda is experienced in Trauma Focused CBT, EMDR, Addictions-Alcohol/Substance Use Disorders, Co-Occurring Disorders, Depression and Anxiety Disorders, Individual, Group, and Couples Therapy. Outside of work, Linda enjoys gardening, arts/crafts, outdoor activities, and pets.
Linda Jeter is a Licensed Marriage and Family Therapist in California who has been practicing since 2018. She is a Recipient of a SAMHSA-Minority Fellowship Award. Linda is experienced in Trauma Focused CBT, EMDR, Addictions-Alcohol/Substance Use Disorders, Co-Occurring Disorders, Depression and Anxiety Disorders, Individual, Group, and Couples Therapy. Outside of work, Linda enjoys gardening, arts/crafts, outdoor activities, and pets.
(619) 900-6223 View (619) 900-6223
Photo of Stephanie Danial, Marriage & Family Therapist in La Mesa, CA
Stephanie Danial
Marriage & Family Therapist, LMFT
Verified Verified
La Mesa, CA 91942
Many people struggle with complex emotional issues and negative patterns of behavior and thought. I believe my clients are very powerful and brave to begin the journey of self-discovery and healing. As your therapist and partner in this work, I hold a safe space for you to approach your struggles by working together to understand your goals, develop greater insight and create the coping skills and strategies for a more satisfying and emotionally harmonious life.
Many people struggle with complex emotional issues and negative patterns of behavior and thought. I believe my clients are very powerful and brave to begin the journey of self-discovery and healing. As your therapist and partner in this work, I hold a safe space for you to approach your struggles by working together to understand your goals, develop greater insight and create the coping skills and strategies for a more satisfying and emotionally harmonious life.
(619) 724-4184 View (619) 724-4184
Photo of Whittney Robertson, Marriage & Family Therapist in La Mesa, CA
Whittney Robertson
Marriage & Family Therapist, LMFT
Verified Verified
La Mesa, CA 91941  (Online Only)
Life circumstances and relationships can sometimes be difficult to navigate. Whether you are dealing with new stressors, ongoing challenges, seeking clarity in relationship dynamics, or wanting to learn more about yourself, I am here to provide help! My belief is that through a supportive and safe environment, people can work through and process their personal challenges while recognizing their strengths and abilities. My passion is to help others help themselves through addressing both mind and body on the journey of moving from suffering to supportive healing.
Life circumstances and relationships can sometimes be difficult to navigate. Whether you are dealing with new stressors, ongoing challenges, seeking clarity in relationship dynamics, or wanting to learn more about yourself, I am here to provide help! My belief is that through a supportive and safe environment, people can work through and process their personal challenges while recognizing their strengths and abilities. My passion is to help others help themselves through addressing both mind and body on the journey of moving from suffering to supportive healing.
(858) 302-4049 View (858) 302-4049
Photo of Carly Zomick, Marriage & Family Therapist Associate in La Mesa, CA
Carly Zomick
Marriage & Family Therapist Associate, MA, AMFT
Verified Verified
La Mesa, CA 91942  (Online Only)
Are you looking to improve your relationship with yourself and the world around you? Do you want to focus on healing and growth but aren’t sure where to start or where to go next? Does starting therapy for the first time or starting with a new therapist seem overwhelming? 
I work with a wide range of clients struggling with self-esteem issues, anxiety and depression. I also work with couples to improve communication and mutual support. Whether you have been in therapy before or you have no idea what to expect, I will do my best to make sure you feel as prepared and comfortable as possible beginning this next step of your journey.
Are you looking to improve your relationship with yourself and the world around you? Do you want to focus on healing and growth but aren’t sure where to start or where to go next? Does starting therapy for the first time or starting with a new therapist seem overwhelming? 
I work with a wide range of clients struggling with self-esteem issues, anxiety and depression. I also work with couples to improve communication and mutual support. Whether you have been in therapy before or you have no idea what to expect, I will do my best to make sure you feel as prepared and comfortable as possible beginning this next step of your journey.
(619) 314-6117 View (619) 314-6117
Photo of Kathryn Shafer, Marriage & Family Therapist in La Mesa, CA
Kathryn Shafer
Marriage & Family Therapist, LMFT
Verified Verified
La Mesa, CA 91941  (Online Only)
Hi there! My name is Kathryn Shafer (She, Her, Hers). I am a licensed Marriage and Family Therapist with 10 years of experience in the field. I provide individual, couples and family therapy to children, teens and adults with a variety of concerns. I specialize in working with diverse populations who have anxiety, depression, relational problems and every day life stressors.
Hi there! My name is Kathryn Shafer (She, Her, Hers). I am a licensed Marriage and Family Therapist with 10 years of experience in the field. I provide individual, couples and family therapy to children, teens and adults with a variety of concerns. I specialize in working with diverse populations who have anxiety, depression, relational problems and every day life stressors.
(619) 626-1331 View (619) 626-1331
Photo of Ivette Gonzalez, Marriage & Family Therapist in La Mesa, CA
Ivette Gonzalez
Marriage & Family Therapist, LMFT
Verified Verified
La Mesa, CA 91942
I am a licensed Marriage and Family Therapist with over 8 years of clinical experience providing therapy. I have worked with children, teens, adults, couples, and families. I have experience working in community mental health agencies and private practice settings. I have provided therapy in both English and Spanish. My experience and specialty areas include; ADHD, Anxiety disorders, Depressive Disorders, relationship issues, marital conflict, infidelity, postpartum support, Trauma disorders, generational trauma, women's issues, self-esteem, attachment issues, codependency, stress management, and co-parenting/parenting support.
I am a licensed Marriage and Family Therapist with over 8 years of clinical experience providing therapy. I have worked with children, teens, adults, couples, and families. I have experience working in community mental health agencies and private practice settings. I have provided therapy in both English and Spanish. My experience and specialty areas include; ADHD, Anxiety disorders, Depressive Disorders, relationship issues, marital conflict, infidelity, postpartum support, Trauma disorders, generational trauma, women's issues, self-esteem, attachment issues, codependency, stress management, and co-parenting/parenting support.
(619) 457-4173 View (619) 457-4173
Photo of Tracey Rodriguez, Psychological Associate in La Mesa, CA
Tracey Rodriguez
Psychological Associate, PsyD, LPA
Verified Verified
La Mesa, CA 91942
I am honored to welcome you on this journey toward self-discovery and growth. I am dedicated to creating a safe and empathetic space where you can explore your thoughts and feelings without judgment. Together, we will navigate the challenges you face, fostering resilience and empowering you to lead a more fulfilling life. Trust is the foundation of our therapeutic relationship, and I am committed to providing compassionate support as you embark on this transformative path.
I am honored to welcome you on this journey toward self-discovery and growth. I am dedicated to creating a safe and empathetic space where you can explore your thoughts and feelings without judgment. Together, we will navigate the challenges you face, fostering resilience and empowering you to lead a more fulfilling life. Trust is the foundation of our therapeutic relationship, and I am committed to providing compassionate support as you embark on this transformative path.
(619) 367-8961 View (619) 367-8961
Photo of Ethan John Messer, Marriage & Family Therapist in La Mesa, CA
Ethan John Messer
Marriage & Family Therapist, MA
Verified Verified
2 Endorsed
La Mesa, CA 91942
I am currently accepting new clients for in-person counseling. I am able to provide counseling services for couples, families, individuals, children & adolescents. I have experience in helping individuals with depression, anxiety, self-esteem issues, suicidal thoughts and in counseling children who are experiencing negative effects from divorce and have extensive experience in working with children/adolescents in a wide variety of settings.
I am currently accepting new clients for in-person counseling. I am able to provide counseling services for couples, families, individuals, children & adolescents. I have experience in helping individuals with depression, anxiety, self-esteem issues, suicidal thoughts and in counseling children who are experiencing negative effects from divorce and have extensive experience in working with children/adolescents in a wide variety of settings.
(619) 536-0812 View (619) 536-0812
Photo of Cara Silva, Marriage & Family Therapist in La Mesa, CA
Cara Silva
Marriage & Family Therapist, MA, LMFT
Verified Verified
1 Endorsed
La Mesa, CA 91942
My passion is to empower those that have not found their potential. We all have our own stories and experiences which makes us perfect candidates for success when we have the right support. Whether you have lived it, experienced it or witnessed it, the effects of trauma are devastating. Quit beating yourself up. It is time to heal. With 20 years experience in addiction and over 10 working with trauma, it is time to recover from the past, survive the present, and flourish into the future. It all starts with you.
My passion is to empower those that have not found their potential. We all have our own stories and experiences which makes us perfect candidates for success when we have the right support. Whether you have lived it, experienced it or witnessed it, the effects of trauma are devastating. Quit beating yourself up. It is time to heal. With 20 years experience in addiction and over 10 working with trauma, it is time to recover from the past, survive the present, and flourish into the future. It all starts with you.
(619) 304-0863 View (619) 304-0863
Photo of Christina Vlasis, Marriage & Family Therapist in La Mesa, CA
Christina Vlasis
Marriage & Family Therapist, MA, LMFT
Verified Verified
La Mesa, CA 91942
I am accepting new clients in my La Mesa office. I work with children, adolescents, adults, couples, and families. I believe that everyone has the answers within themselves and just need someone to sit with them as they explore possibilities. I will collaboratively help clients build a client plan using MAPS goals for measuring gains for the purpose of helping clients reach their goals and improve their mental health and wellbeing.
I am accepting new clients in my La Mesa office. I work with children, adolescents, adults, couples, and families. I believe that everyone has the answers within themselves and just need someone to sit with them as they explore possibilities. I will collaboratively help clients build a client plan using MAPS goals for measuring gains for the purpose of helping clients reach their goals and improve their mental health and wellbeing.
(619) 393-4516 View (619) 393-4516
Photo of Maxine Dumser, Marriage & Family Therapist in La Mesa, CA
Maxine Dumser
Marriage & Family Therapist, LMFT, RPTS
Verified Verified
1 Endorsed
La Mesa, CA 91942
Not accepting new clients
I provide a safe and supportive environment for clients to share and feel heard. Every client has his or her unique way of relating to others and learning, which impacts what kind of therapy, will be effective. I come alongside my clients to explore, encourage, and support them in the therapeutic process while developing skills to take with them as they continue on their own personal journey. I utilize different theoretical concepts including Cognitive Behavioral (CBT), Acceptance/Commitment (ACT) Solution Focus and Play/Art therapies, while consistently viewing clients through the lens of developmental stages and attachment styles.
I provide a safe and supportive environment for clients to share and feel heard. Every client has his or her unique way of relating to others and learning, which impacts what kind of therapy, will be effective. I come alongside my clients to explore, encourage, and support them in the therapeutic process while developing skills to take with them as they continue on their own personal journey. I utilize different theoretical concepts including Cognitive Behavioral (CBT), Acceptance/Commitment (ACT) Solution Focus and Play/Art therapies, while consistently viewing clients through the lens of developmental stages and attachment styles.
(619) 493-3918 View (619) 493-3918
Photo of Katherine Morrill, Clinical Social Work/Therapist in La Mesa, CA
Katherine Morrill
Clinical Social Work/Therapist, LCSW
Verified Verified
La Mesa, CA 91941
I have been a practicing clinician for over 20 years. I recently obtained a sport social work certification from University of Michigan and now specialize in working with high-school and collegiate student-athletes on sports performance. I have treated both youth and adults and work towards goals of healing, growth, and wellness. I provide individual and family therapy and have focused on clinical areas such as trauma, depression, anxiety, anger management, divorce and relationship conflict. I utilize a collaborative approach that is both strength-based and solution-focused.
I have been a practicing clinician for over 20 years. I recently obtained a sport social work certification from University of Michigan and now specialize in working with high-school and collegiate student-athletes on sports performance. I have treated both youth and adults and work towards goals of healing, growth, and wellness. I provide individual and family therapy and have focused on clinical areas such as trauma, depression, anxiety, anger management, divorce and relationship conflict. I utilize a collaborative approach that is both strength-based and solution-focused.
(978) 767-4916 View (978) 767-4916
Photo of Saranne Wilson, Marriage & Family Therapist in La Mesa, CA
Saranne Wilson
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
La Mesa, CA 91942
I believe that everyone has wounded places in their hearts that could benefit from counseling. Many people at some point realize that the challenges of life are too much to manage on their own and decide to seek help from a professional that can support them as they navigate the challenges that life can bring at times. My work is based on helping people to heal from the wounds of the past and deal with present stressors in an environment of safety and acceptance. My passion is to provide support as they work toward fulfillment in their lives.
I believe that everyone has wounded places in their hearts that could benefit from counseling. Many people at some point realize that the challenges of life are too much to manage on their own and decide to seek help from a professional that can support them as they navigate the challenges that life can bring at times. My work is based on helping people to heal from the wounds of the past and deal with present stressors in an environment of safety and acceptance. My passion is to provide support as they work toward fulfillment in their lives.
(619) 259-5145 View (619) 259-5145
Photo of Joyce V James, Clinical Social Work/Therapist in La Mesa, CA
Joyce V James
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
La Mesa, CA 91942
My clients often start from a place of anxiety, sadness, feeling overwhelmed with the demands of daily life. Through our work, they learn to manage their emotions, find resources within themselves to sort out issues and move through their lives with new skills. We clear traumas from childhood and adulthood, leaving them feeling lighter, happier. I integrate the perspective of resiliency and take a strength-based approach to inspire change. It is not so much what happens in life as how we respond to life events that shapes our future. Through our work together, you can experience an improved quality of life.
My clients often start from a place of anxiety, sadness, feeling overwhelmed with the demands of daily life. Through our work, they learn to manage their emotions, find resources within themselves to sort out issues and move through their lives with new skills. We clear traumas from childhood and adulthood, leaving them feeling lighter, happier. I integrate the perspective of resiliency and take a strength-based approach to inspire change. It is not so much what happens in life as how we respond to life events that shapes our future. Through our work together, you can experience an improved quality of life.
(619) 369-1770 View (619) 369-1770
Photo of Bannia Gomez, Clinical Social Work/Therapist in La Mesa, CA
Bannia Gomez
Clinical Social Work/Therapist, LCSW
Verified Verified
La Mesa, CA 91942
My name is Bannia Gomez. I am a bilingual Licensed Clinical Social Worker in the state of California. Hablo Español. Individuals, Couples, and Family Therapy. Adults only. Experience in the areas of depression, PTSD, anxiety, cultural stressors, domestic violence, stress, anger management, and so many other mental health stressors. I use a narrative approach where the client is allowed to tell their stories without feeling ashamed or judge.
My name is Bannia Gomez. I am a bilingual Licensed Clinical Social Worker in the state of California. Hablo Español. Individuals, Couples, and Family Therapy. Adults only. Experience in the areas of depression, PTSD, anxiety, cultural stressors, domestic violence, stress, anger management, and so many other mental health stressors. I use a narrative approach where the client is allowed to tell their stories without feeling ashamed or judge.
(619) 966-4294 View (619) 966-4294

How does your Therapist compare?

Number of Therapists in La Mesa, CA

200+

Average cost per session

$150

Therapists in La Mesa, CA who prioritize treating:

93% Anxiety
88% Depression
74% Relationship Issues
69% Self Esteem
68% Trauma and PTSD
65% Coping Skills
63% Stress

Average years in practice

12 Years

Top 3 insurances accepted

78% Aetna
75% Cigna and Evernorth
67% UnitedHealthcare UHC | UBH

How Therapists in La Mesa, CA see their clients

75% In Person and Online
25% Online Only

Gender breakdown

78% Female
21% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in La Mesa?

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.