Therapists in Tulsa, OK

Destiny Hillhouse
Licensed Professional Counselor, LCSW
Verified Verified
1 Endorsed
Tulsa, OK 74105
I believe in empowering my clients to do the work they need to do to achieve their goals. I believe that the things that are worth having in life are often challenging. I am here to support you as you move out of your comfort zone and toward what you want for your life. I specialize in working with people under 12 and adults. For me there is nothing more fulfilling than helping young people navigate the challenges of life and overcome the obstacles in their way.
I believe in empowering my clients to do the work they need to do to achieve their goals. I believe that the things that are worth having in life are often challenging. I am here to support you as you move out of your comfort zone and toward what you want for your life. I specialize in working with people under 12 and adults. For me there is nothing more fulfilling than helping young people navigate the challenges of life and overcome the obstacles in their way.
(918) 338-6186 x4 View (918) 338-6186 x4
Photo of Savannah Cook, Licensed Professional Counselor in Tulsa, OK
Savannah Cook
Licensed Professional Counselor, LPC
Verified Verified
Tulsa, OK 74136
We all get stuck in life, but that does not mean you have to remain stuck. My practice is focused on providing a secure environment where adult individuals can reprocess overwhelming experiences, address underlying negative beliefs about self, and focus on living their desired life with a future they can embrace. Having over 5 years of counseling experience in the Tulsa area, and being an EMDR Basic Trained therapist, I utilize various approaches in counseling such as Client Centered Therapy, EMDR Therapy, Solution Focused Therapy, and Narrative Therapy that help to meet you where you are.
We all get stuck in life, but that does not mean you have to remain stuck. My practice is focused on providing a secure environment where adult individuals can reprocess overwhelming experiences, address underlying negative beliefs about self, and focus on living their desired life with a future they can embrace. Having over 5 years of counseling experience in the Tulsa area, and being an EMDR Basic Trained therapist, I utilize various approaches in counseling such as Client Centered Therapy, EMDR Therapy, Solution Focused Therapy, and Narrative Therapy that help to meet you where you are.
(539) 210-3847 View (539) 210-3847
Photo of Katrina Mondragon, PLLC, Licensed Professional Counselor in Tulsa, OK
Katrina Mondragon, PLLC
Licensed Professional Counselor, MS, LPC
Verified Verified
2 Endorsed
Tulsa, OK 74114
Waitlist for new clients
It's hard to be strong for everyone all the time. You feel life is pulling in too many directions and there is no time to just stop and breathe. Your thoughts won't even shut up long enough to get some sleep. Life wasn't always this hard, but you may not even remember the last time something was actually fun. Feeling broken and beaten by the world is exhausting. It may seem hopeless now, but you haven't met me yet.
It's hard to be strong for everyone all the time. You feel life is pulling in too many directions and there is no time to just stop and breathe. Your thoughts won't even shut up long enough to get some sleep. Life wasn't always this hard, but you may not even remember the last time something was actually fun. Feeling broken and beaten by the world is exhausting. It may seem hopeless now, but you haven't met me yet.
(539) 202-7245 View (539) 202-7245
Photo of Merrie L Knox, Clinical Social Work/Therapist in Tulsa, OK
Merrie L Knox
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Tulsa, OK 74136
We all want to feel connected, nurtured and loved in our relationships. When disconnection happens, we experience both emotional and physical pain; loneliness and isolation keep us distant. We get trapped in negative cycles and aren’t sure how to reconnect in love and trust. Emotionally Focused Therapy (EFT) can help you stop the cycle, heal the relationship pain that keeps you stuck, improve communication and bring love and connection back into your relationship. In addition to being an EFT therapist, I am also a national provider for Cognitive Processing Therapy (CPT) a model that treats trauma and PTSD.
We all want to feel connected, nurtured and loved in our relationships. When disconnection happens, we experience both emotional and physical pain; loneliness and isolation keep us distant. We get trapped in negative cycles and aren’t sure how to reconnect in love and trust. Emotionally Focused Therapy (EFT) can help you stop the cycle, heal the relationship pain that keeps you stuck, improve communication and bring love and connection back into your relationship. In addition to being an EFT therapist, I am also a national provider for Cognitive Processing Therapy (CPT) a model that treats trauma and PTSD.
(918) 913-0235 View (918) 913-0235
Photo of Dr. Kelly Ann James, Licensed Professional Counselor in Tulsa, OK
Dr. Kelly Ann James
Licensed Professional Counselor, COACH, PSYCHK®, BodyCod, CPC, EMDR
Verified Verified
Tulsa, OK 74133  (Online Only)
Are you living your dream life? Are you going the direction that you want in life? Do you want to achieve greater fulfillment in all areas of your life - professional, peer relationships, friendships, and your love life? Let's focus on your strengths and discover the blocks that are preventing you having exactly the life you have envisioned.
Are you living your dream life? Are you going the direction that you want in life? Do you want to achieve greater fulfillment in all areas of your life - professional, peer relationships, friendships, and your love life? Let's focus on your strengths and discover the blocks that are preventing you having exactly the life you have envisioned.
(323) 970-2891 View (323) 970-2891
Photo of Glennetta M Mayes, Pre-Licensed Professional in Tulsa, OK
Glennetta M Mayes
Pre-Licensed Professional, MS, LPC-C, BSN, RN
Verified Verified
1 Endorsed
Tulsa, OK 74145  (Online Only)
I am a highly dedicated and passionate individual, with a unique combination of skills as a Registered Nurse and a newly licensed Professional Counselor. With a strong background in healthcare, I have gained invaluable experience in providing compassionate care to patients in need. However, my desire to make a deeper impact on individuals' mental and emotional well-being led me to pursue a career in counseling. As a Registered Nurse, I have developed exceptional communication and empathy skills, allowing me to connect with patients on a profound level.
I am a highly dedicated and passionate individual, with a unique combination of skills as a Registered Nurse and a newly licensed Professional Counselor. With a strong background in healthcare, I have gained invaluable experience in providing compassionate care to patients in need. However, my desire to make a deeper impact on individuals' mental and emotional well-being led me to pursue a career in counseling. As a Registered Nurse, I have developed exceptional communication and empathy skills, allowing me to connect with patients on a profound level.
(539) 221-2736 View (539) 221-2736
Photo of Emily A Feller, Licensed Professional Counselor in Tulsa, OK
Emily A Feller
Licensed Professional Counselor, LPC
Verified Verified
2 Endorsed
Tulsa, OK 74136  (Online Only)
Life is tough and extremely complex. When it comes to seeking help, it can be hard to find someone that you can trust and be able to discuss the intense "stuff". Therapy is a way to gain tools that will help guide you through this life. People come in different shapes and sizes, with so many different experiences and trauma. There isn't a specific criteria that can define a person to one thing. Therefore, anyone is welcome. Come one, come all.
Life is tough and extremely complex. When it comes to seeking help, it can be hard to find someone that you can trust and be able to discuss the intense "stuff". Therapy is a way to gain tools that will help guide you through this life. People come in different shapes and sizes, with so many different experiences and trauma. There isn't a specific criteria that can define a person to one thing. Therefore, anyone is welcome. Come one, come all.
(539) 666-6436 View (539) 666-6436
Photo of Cari Gibson, Licensed Professional Counselor in Tulsa, OK
Cari Gibson
Licensed Professional Counselor, MS, LPC-S
Verified Verified
Tulsa, OK 74135
Cari Gibson, LPC has worked in the field of counseling for over 26 years. Cari has worked with children, teens, adults and families in the schools, home and agency settings, addressing parenting, relationship problems, behavioral problems, trauma, depression, anxiety and suicidal thoughts and behaviors. Cari has managed and supervised other therapists providing services to others for 13 years as well. Cari specifically practices a strengths based approach for each individual focusing on in helping others move towards and achieve their best self. A provider for BCBS, United, & Healthchoice ins, or take private pay at $150/hr.
Cari Gibson, LPC has worked in the field of counseling for over 26 years. Cari has worked with children, teens, adults and families in the schools, home and agency settings, addressing parenting, relationship problems, behavioral problems, trauma, depression, anxiety and suicidal thoughts and behaviors. Cari has managed and supervised other therapists providing services to others for 13 years as well. Cari specifically practices a strengths based approach for each individual focusing on in helping others move towards and achieve their best self. A provider for BCBS, United, & Healthchoice ins, or take private pay at $150/hr.
(539) 866-2257 View (539) 866-2257
Photo of Tina Francis, Clinical Social Work/Therapist in Tulsa, OK
Tina Francis
Clinical Social Work/Therapist, MSW, LCSW, EMDR
Verified Verified
Tulsa, OK 74105
I am a Licensed Clinical Social Worker with experience in treating adults with trauma, PTSD, depression, anxiety, phobias, addiction, grief and many other issues. I utilize a holistic and strength’s-based approach while providing a safe, compassionate and non-judgmental environment. I work collaboratively with my clients to help meet their goals and increase overall well-being. My approach is eclectic and I vary my techniques to meet each individual’s unique needs.
I am a Licensed Clinical Social Worker with experience in treating adults with trauma, PTSD, depression, anxiety, phobias, addiction, grief and many other issues. I utilize a holistic and strength’s-based approach while providing a safe, compassionate and non-judgmental environment. I work collaboratively with my clients to help meet their goals and increase overall well-being. My approach is eclectic and I vary my techniques to meet each individual’s unique needs.
(918) 805-1973 View (918) 805-1973
Photo of Alice Bucher, Clinical Social Work/Therapist in Tulsa, OK
Alice Bucher
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Tulsa, OK 74136  (Online Only)
Are negative thoughts ruining your joy and happiness? Do you find yourself focused on negative thoughts constantly, unable to stop running them through your mind? You are not alone and do not have to face this alone. There is hope and change is possible. You will overcome this and be able to have joy and happiness again. Just looking for a therapist you have already taken a big step toward a better tomorrow, be proud of yourself for that, I am. I look forward to talking to you soon, do not wait any longer, you deserve a happy tomorrow!.
Are negative thoughts ruining your joy and happiness? Do you find yourself focused on negative thoughts constantly, unable to stop running them through your mind? You are not alone and do not have to face this alone. There is hope and change is possible. You will overcome this and be able to have joy and happiness again. Just looking for a therapist you have already taken a big step toward a better tomorrow, be proud of yourself for that, I am. I look forward to talking to you soon, do not wait any longer, you deserve a happy tomorrow!.
(918) 471-4970 View (918) 471-4970
Photo of Revive Counseling, Licensed Professional Counselor in Tulsa, OK
Revive Counseling
Licensed Professional Counselor, MEd, LPC
Verified Verified
1 Endorsed
Tulsa, OK 74133
Josh is a Licensed Professional Counselor at Revive Counseling. He specializes in treating OCD and other anxiety related problems. He utilizes evidence-based approaches including cognitive-behavioral therapy (CBT) and exposure and response prevention (ERP) and has four years of mental health experience. He works with clients of all ages to achieve their goals. Josh is a graduate of the University of Oklahoma, with his Masters in counseling. He has a range of clinical experiences including school-based counseling and private practice. Josh works with kids, teens, and adults.
Josh is a Licensed Professional Counselor at Revive Counseling. He specializes in treating OCD and other anxiety related problems. He utilizes evidence-based approaches including cognitive-behavioral therapy (CBT) and exposure and response prevention (ERP) and has four years of mental health experience. He works with clients of all ages to achieve their goals. Josh is a graduate of the University of Oklahoma, with his Masters in counseling. He has a range of clinical experiences including school-based counseling and private practice. Josh works with kids, teens, and adults.
(918) 844-4148 View (918) 844-4148
Photo of Adair Welsh, Clinical Social Work/Therapist in Tulsa, OK
Adair Welsh
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
Tulsa, OK 74114  (Online Only)
Waitlist for new clients
I have a strong passion to help women, non-binary and transgender individuals struggling with their bodies and relationship with food. I enjoy working with those who have experienced trauma and complex trauma, to help you find healing and to become the true authentic human you were meant to be. I can also provide a safe space to process the complicated emotions and challenges that arise from chronic illness. Additionally, I have a special interest in and enjoy working alongside those living with autism and lower support needs.
I have a strong passion to help women, non-binary and transgender individuals struggling with their bodies and relationship with food. I enjoy working with those who have experienced trauma and complex trauma, to help you find healing and to become the true authentic human you were meant to be. I can also provide a safe space to process the complicated emotions and challenges that arise from chronic illness. Additionally, I have a special interest in and enjoy working alongside those living with autism and lower support needs.
(918) 347-4024 View (918) 347-4024
Photo of Cristopher Douglas Hicks, Clinical Social Work/Therapist in Tulsa, OK
Cristopher Douglas Hicks
Clinical Social Work/Therapist, LCSW
Verified Verified
Tulsa, OK 74136
If you are looking for a new way to address your mental health issues that traditional talk therapy could not fully treat on an emotional level then Brainspotting could be your solution. BSP is a brain based therapy designed where the client can bypass their thinking brain (Cerebrum) and access the brain stem (Medulla oblongata) where we hold our deep memories and feelings of past events, traumas and fears. I have been a practicing therapist for 20 years and have been practicing BSP for over 3 years and have completed Phase II of BSP training. If you are ready to explore your emotional issues with me then contact my office.
If you are looking for a new way to address your mental health issues that traditional talk therapy could not fully treat on an emotional level then Brainspotting could be your solution. BSP is a brain based therapy designed where the client can bypass their thinking brain (Cerebrum) and access the brain stem (Medulla oblongata) where we hold our deep memories and feelings of past events, traumas and fears. I have been a practicing therapist for 20 years and have been practicing BSP for over 3 years and have completed Phase II of BSP training. If you are ready to explore your emotional issues with me then contact my office.
(918) 203-6604 View (918) 203-6604
Photo of Liz Lamers, Licensed Professional Counselor in Tulsa, OK
Liz Lamers
Licensed Professional Counselor, MA, LPC, MBA
Verified Verified
Tulsa, OK 74105
We all face difficult life situations and challenges. I counsel adults and adolescents dealing with anxiety, depression, managing work/academic stressors, adjustment issues, parent-child relational issues, sport psychology and insomnia. I use a practical and behavioral approach to coping with problems. I believe in solution focused strategies for the individual. Counseling can teach individuals new ways to cope, communicate, change perspective and establish healthy patterns. Treatment can be brief with positive results to help people live a happier and more fulfilling life.
We all face difficult life situations and challenges. I counsel adults and adolescents dealing with anxiety, depression, managing work/academic stressors, adjustment issues, parent-child relational issues, sport psychology and insomnia. I use a practical and behavioral approach to coping with problems. I believe in solution focused strategies for the individual. Counseling can teach individuals new ways to cope, communicate, change perspective and establish healthy patterns. Treatment can be brief with positive results to help people live a happier and more fulfilling life.
(918) 948-9298 View (918) 948-9298
Photo of Green Country EMDR Therapy PLLC, Licensed Professional Counselor in Tulsa, OK
Green Country EMDR Therapy PLLC
Licensed Professional Counselor, MA, LPC-S
Verified Verified
2 Endorsed
Tulsa, OK 74171  (Online Only)
Are you tired of constantly feeling on edge? This is not your fault. You are not broken. Your body is trying to heal itself by processing the stressful/traumatic situations you have been through. Your nervous system is getting flooded (unintended overwhelm) while your body is trying to process the situations you have been through. Because the nervous system is flooded, your brain is unable to file the memories as things that happened in the past. This is where I come in. I help you navigate these memories in ways that do not overwhelm your nervous system so that you are able to file the memories as things that happened in the past.
Are you tired of constantly feeling on edge? This is not your fault. You are not broken. Your body is trying to heal itself by processing the stressful/traumatic situations you have been through. Your nervous system is getting flooded (unintended overwhelm) while your body is trying to process the situations you have been through. Because the nervous system is flooded, your brain is unable to file the memories as things that happened in the past. This is where I come in. I help you navigate these memories in ways that do not overwhelm your nervous system so that you are able to file the memories as things that happened in the past.
(918) 400-3540 View (918) 400-3540
Photo of Brandi Inda, Clinical Social Work/Therapist in Tulsa, OK
Brandi Inda
Clinical Social Work/Therapist, LCSW
Verified Verified
Tulsa, OK 74145  (Online Only)
Do you feel like life is overwhelming and you have no one to talk to? Do you feel as if you are not worthy of others time to ask for help? Or is it as if you have forgotten how to take care of yourself or never even knew how to begin with?
Do you feel like life is overwhelming and you have no one to talk to? Do you feel as if you are not worthy of others time to ask for help? Or is it as if you have forgotten how to take care of yourself or never even knew how to begin with?
(539) 800-3059 View (539) 800-3059
Photo of Laura Savage, Counselor in Tulsa, OK
Laura Savage
Counselor, MS, LPC, LADC
Verified Verified
6 Endorsed
Tulsa, OK 74107
Through my role as a professional counselor, I've been privileged to be allowed access to the most deeply held thoughts and beliefs of many who are suffering. I've been honored to bear witness to that suffering... and to the healing that ensues. I continue to accept new clients and to look forward to accompanying all of them on their healing journeys.
Through my role as a professional counselor, I've been privileged to be allowed access to the most deeply held thoughts and beliefs of many who are suffering. I've been honored to bear witness to that suffering... and to the healing that ensues. I continue to accept new clients and to look forward to accompanying all of them on their healing journeys.
(539) 208-1830 View (539) 208-1830
Photo of Kira Floyd, Licensed Professional Counselor in Tulsa, OK
Kira Floyd
Licensed Professional Counselor, MS, LPC, NCC
Verified Verified
1 Endorsed
Tulsa, OK 74137
I have a heart for others, and believe that every person has the ability to change, grow, and overcome through what seemingly can feel like life’s biggest challenges. I believe therapy is a safe place to address trauma, negative thoughts, and overcome areas of life that have been challenging.
I have a heart for others, and believe that every person has the ability to change, grow, and overcome through what seemingly can feel like life’s biggest challenges. I believe therapy is a safe place to address trauma, negative thoughts, and overcome areas of life that have been challenging.
(918) 387-8836 View (918) 387-8836
Photo of Raquel D. Colbert-Dawson, Licensed Professional Counselor in Tulsa, OK
Raquel D. Colbert-Dawson
Licensed Professional Counselor, MS, LPC-S, CHT, RM
Verified Verified
Tulsa, OK 74114
I provide holistic therapy and wellness services for women and couples of Generation X. I have an Indepth understanding of the unique challenges and experiences that Gen Xers face, because I am a Gen Xer. To the women of Generation X, life may have brought a multitude of roles, responsibilities and change from hyper independence, relationships, career demands, aging parents; empty nest; grief, personal growth journeys; health challenges and the nagging question of what's next. I help you navigate life's complexities with new skills, insight, inspiration, and empowerment.
I provide holistic therapy and wellness services for women and couples of Generation X. I have an Indepth understanding of the unique challenges and experiences that Gen Xers face, because I am a Gen Xer. To the women of Generation X, life may have brought a multitude of roles, responsibilities and change from hyper independence, relationships, career demands, aging parents; empty nest; grief, personal growth journeys; health challenges and the nagging question of what's next. I help you navigate life's complexities with new skills, insight, inspiration, and empowerment.
(918) 396-8261 View (918) 396-8261
Photo of Rashmi Singh, Licensed Professional Counselor in Tulsa, OK
Rashmi Singh
Licensed Professional Counselor, PhD, MS, LPC, NCC
Verified Verified
Tulsa, OK 74105
I believe each child and their family’s circumstances are unique. With support of personalized therapeutic approach and involvement of family, clients can work through their mental health struggles towards healing. My client centered therapeutic approach is guided by my doctoral and post-doctoral background in biomedical sciences and neuroinflammation. I support mental and emotional healing in children, adolescents, young adults and adults using interventions based on developments in the field of psychology and neurobiology. I am trained in EMDR, Sandtray-EMDR, TF-CBT and CAMS.
I believe each child and their family’s circumstances are unique. With support of personalized therapeutic approach and involvement of family, clients can work through their mental health struggles towards healing. My client centered therapeutic approach is guided by my doctoral and post-doctoral background in biomedical sciences and neuroinflammation. I support mental and emotional healing in children, adolescents, young adults and adults using interventions based on developments in the field of psychology and neurobiology. I am trained in EMDR, Sandtray-EMDR, TF-CBT and CAMS.
(918) 303-5379 View (918) 303-5379

How does your Therapist compare?

Number of Therapists in Tulsa, OK

600+

Average cost per session

$130

Therapists in Tulsa, OK who prioritize treating:

91% Anxiety
87% Depression
78% Trauma and PTSD
74% Relationship Issues
74% Self Esteem
70% Coping Skills
68% Stress

Average years in practice

11 Years

Top 3 insurances accepted

79% BlueCross and BlueShield
68% Health Choice
67% UnitedHealthcare UHC | UBH

How Therapists in Tulsa, OK see their clients

80% In Person and Online
20% Online Only

Gender breakdown

80% Female
19% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Tulsa?

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.