Therapists in Richmond, VA

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Photo of Robert Staaf, Clinical Social Work/Therapist in Richmond, VA
Robert Staaf
Clinical Social Work/Therapist, LCSW
Verified Verified
Richmond, VA 23225  (Online Only)
I am a licensed therapist with a wealth of experience helping people with issues such as anxiety, depression, anger management, men's issues, and relationship issues. I focus on meeting my clients where they are and helping them gain insight and, most importantly, self-acceptance.
I am a licensed therapist with a wealth of experience helping people with issues such as anxiety, depression, anger management, men's issues, and relationship issues. I focus on meeting my clients where they are and helping them gain insight and, most importantly, self-acceptance.
(804) 391-7632 View (804) 391-7632
Photo of Jaeron-Rae "R Jay" Dukes, Licensed Professional Counselor in Richmond, VA
Jaeron-Rae "R Jay" Dukes
Licensed Professional Counselor, LPC
Verified Verified
Richmond, VA 23222  (Online Only)
I have worked with clients with a wide range of concerns including depression, anxiety, incarceration, dissociation, trauma and abuse, PTSD, career challenges, and eating issues. I have a special interest in working with LGBTQIA+ clients with specialized training for supporting transgender clients as well as cult recovery/religious deconstruction. My therapy style is warm, interactive and person centered. I believe everyone has the ability to find healing and you are the expert on you! My role is to support you. It takes courage to reach out and ask for support. That courage will serve you well as you work towards feeling better.
I have worked with clients with a wide range of concerns including depression, anxiety, incarceration, dissociation, trauma and abuse, PTSD, career challenges, and eating issues. I have a special interest in working with LGBTQIA+ clients with specialized training for supporting transgender clients as well as cult recovery/religious deconstruction. My therapy style is warm, interactive and person centered. I believe everyone has the ability to find healing and you are the expert on you! My role is to support you. It takes courage to reach out and ask for support. That courage will serve you well as you work towards feeling better.
(804) 494-7922 View (804) 494-7922
Photo of Tiffany P. Olds, Clinical Social Work/Therapist in Richmond, VA
Tiffany P. Olds
Clinical Social Work/Therapist, LCSW, MSW
Verified Verified
Richmond, VA 23223  (Online Only)
Are you feeling exhausted and overwhelmed? Are you struggling with imposter syndrome, or fighting continuous negative thoughts? Do you find it challenging to get through daily tasks due to a crisis, trauma, or grief? Are you feeling like you could use someone to talk to? I am here to create a non-judgemental safe space where you can feel heard, seen, respected, and supported. My ultimate goal and passion is to help you work through life's challenges, while finding solutions and developing a toolbox of healthy coping skills to lead a happier healthier life.
Are you feeling exhausted and overwhelmed? Are you struggling with imposter syndrome, or fighting continuous negative thoughts? Do you find it challenging to get through daily tasks due to a crisis, trauma, or grief? Are you feeling like you could use someone to talk to? I am here to create a non-judgemental safe space where you can feel heard, seen, respected, and supported. My ultimate goal and passion is to help you work through life's challenges, while finding solutions and developing a toolbox of healthy coping skills to lead a happier healthier life.
(804) 294-4584 View (804) 294-4584
Photo of John H Weaver, Licensed Professional Counselor in Richmond, VA
John H Weaver
Licensed Professional Counselor, LPC, CAADC, CSAC, CCTP
Verified Verified
1 Endorsed
Richmond, VA 23225
Waitlist for new clients
Life’s challenges may cause us to react and respond in many different ways. Our current situation may or may not be in our immediate control, but when we look at our life, long-term, it will be the decisions that we make today that set the course of the overall outcome. Experiencing depression, anxiety, grief, confusion, and frustration (to name a few) may be a part of that journey, but you do not have to go down that road alone. It's important to have a safe and confidential space to work through challenges, become more resilient, and come out on the other side with confidence and skills to manage the situations you face.
Life’s challenges may cause us to react and respond in many different ways. Our current situation may or may not be in our immediate control, but when we look at our life, long-term, it will be the decisions that we make today that set the course of the overall outcome. Experiencing depression, anxiety, grief, confusion, and frustration (to name a few) may be a part of that journey, but you do not have to go down that road alone. It's important to have a safe and confidential space to work through challenges, become more resilient, and come out on the other side with confidence and skills to manage the situations you face.
(804) 315-2893 View (804) 315-2893
Photo of Jennifer Rose (Miller) in Richmond, VA
Jennifer Rose (Miller)
MA
Verified Verified
1 Endorsed
Richmond, VA 23222  (Online Only)
Not accepting new clients
Do you feel like you’re just trying to catch your breath or don’t know which way to turn? My passion is supporting individuals regain a sense of calm and direction. Hi, I'm Jen and I’m here to help you find peace in the moment so you can thrive in your pursuits. I work with clients in managing anxious and depressive states that come with experiencing trauma and major life transitions. Life can feel overwhelming when faced with: new responsibilities as a young adult, becoming a parent, re-entering the workforce or switching careers, ending a relationship, or grieving loss. Together we can embrace the overwhelm and find your compass.
Do you feel like you’re just trying to catch your breath or don’t know which way to turn? My passion is supporting individuals regain a sense of calm and direction. Hi, I'm Jen and I’m here to help you find peace in the moment so you can thrive in your pursuits. I work with clients in managing anxious and depressive states that come with experiencing trauma and major life transitions. Life can feel overwhelming when faced with: new responsibilities as a young adult, becoming a parent, re-entering the workforce or switching careers, ending a relationship, or grieving loss. Together we can embrace the overwhelm and find your compass.
(703) 705-7901 View (703) 705-7901
Photo of Kimberly Embe-Mamong, Pre-Licensed Professional in Richmond, VA
Kimberly Embe-Mamong
Pre-Licensed Professional, MSW, LMSW
Verified Verified
1 Endorsed
Richmond, VA 23222  (Online Only)
Step into a sanctuary of healing and personal development! I'm deeply committed to offering guidance to individuals of all ages and genders as they navigate life's hurdles. Whether you're grappling with bullying, depression, anxiety, self-esteem, the transition to college, or marital discord, I'm here to accompany you on your journey. I strive to create a space where they can explore their identities, navigate life transitions, and address challenges unique to their experiences. Whether it's managing career changes, relationship issues, or balancing multiple roles, I'm here to offer guidance and support.
Step into a sanctuary of healing and personal development! I'm deeply committed to offering guidance to individuals of all ages and genders as they navigate life's hurdles. Whether you're grappling with bullying, depression, anxiety, self-esteem, the transition to college, or marital discord, I'm here to accompany you on your journey. I strive to create a space where they can explore their identities, navigate life transitions, and address challenges unique to their experiences. Whether it's managing career changes, relationship issues, or balancing multiple roles, I'm here to offer guidance and support.
(804) 465-9795 View (804) 465-9795
Photo of Renee Reynolds, Clinical Social Work/Therapist in Richmond, VA
Renee Reynolds
Clinical Social Work/Therapist, LCSW
Verified Verified
Richmond, VA 23225  (Online Only)
Hi, my name is Renée and I have over 10 years of experience working in the field of mental health. Do you feel you are in need of help with everyday relationship skills and/or emotional issues. Relationships are the heart of life, and I am passionate about the skill of connecting with each other in order to learn not only about our relationships but to truly understand our own minds as well.
Hi, my name is Renée and I have over 10 years of experience working in the field of mental health. Do you feel you are in need of help with everyday relationship skills and/or emotional issues. Relationships are the heart of life, and I am passionate about the skill of connecting with each other in order to learn not only about our relationships but to truly understand our own minds as well.
(804) 575-5530 View (804) 575-5530
Photo of Claudia Bracey, Resident in Counseling in Richmond, VA
Claudia Bracey
Resident in Counseling, NCC, MS
Verified Verified
2 Endorsed
Richmond, VA 23229
I have experience working with adults struggling with addiction, anxiety, depression, trauma, PTSD, communication difficulties, low self-esteem, multicultural issues, and interpersonal relationship conflict. In addition, I have a background in facilitating family therapy, couples counseling, and group processes. I specialize in working with women (teens, young mothers, adults, minorities). I am also working toward specializing in women’s health counseling, perinatal counseling, and other specific women’s issues.
I have experience working with adults struggling with addiction, anxiety, depression, trauma, PTSD, communication difficulties, low self-esteem, multicultural issues, and interpersonal relationship conflict. In addition, I have a background in facilitating family therapy, couples counseling, and group processes. I specialize in working with women (teens, young mothers, adults, minorities). I am also working toward specializing in women’s health counseling, perinatal counseling, and other specific women’s issues.
(804) 889-2798 View (804) 889-2798
Photo of Angel Bryant, Licensed Professional Counselor in Richmond, VA
Angel Bryant
Licensed Professional Counselor, LPC
Verified Verified
Richmond, VA 23234
Ms. Angel Bryant LPC — strength, base, positive psychology, person center, resolution focus in order to reach sustainable mental health wellness. I believe and Affirm I am truly a representation of the clients I support/advocate with daily. This resilient population consists of LGBTQIA+ individuals with diverse disabilities, women of color, business professionals, and military/veterans. Based on some recent reviews, the therapeutic room I create offers an experience of comfort, support, congruency, and unconditional regard, in a safe and humble atmosphere…
Ms. Angel Bryant LPC — strength, base, positive psychology, person center, resolution focus in order to reach sustainable mental health wellness. I believe and Affirm I am truly a representation of the clients I support/advocate with daily. This resilient population consists of LGBTQIA+ individuals with diverse disabilities, women of color, business professionals, and military/veterans. Based on some recent reviews, the therapeutic room I create offers an experience of comfort, support, congruency, and unconditional regard, in a safe and humble atmosphere…
(540) 418-3852 View (540) 418-3852
Photo of Margaret Sheehan, Marriage & Family Therapist in Richmond, VA
Margaret Sheehan
Marriage & Family Therapist, LMFT
Verified Verified
Richmond, VA 23226
Are you feeling overwhelmed by your responsibilities to others? Do you feel like you are on "automatic," frustrated with not living the life you once wanted for yourself? Such a lonely place! I can help you move towards healing & transformation. I am here to witness the development of your unique & authentic voice as you create the life you want. Within the framework of a strengths-based & hope-focused perspective, I equip individuals & couples, at any stage of commitment, with strategies to create & maintain healthy relationships now & in the future. Change is possible! Find the life you have dreamed of living! It's within you.
Are you feeling overwhelmed by your responsibilities to others? Do you feel like you are on "automatic," frustrated with not living the life you once wanted for yourself? Such a lonely place! I can help you move towards healing & transformation. I am here to witness the development of your unique & authentic voice as you create the life you want. Within the framework of a strengths-based & hope-focused perspective, I equip individuals & couples, at any stage of commitment, with strategies to create & maintain healthy relationships now & in the future. Change is possible! Find the life you have dreamed of living! It's within you.
(804) 250-4458 x1 View (804) 250-4458 x1
Photo of Blair Marini Bowman, Clinical Social Work/Therapist in Richmond, VA
Blair Marini Bowman
Clinical Social Work/Therapist, LCSW, CEDS-S
Verified Verified
1 Endorsed
Richmond, VA 23220
Eating challenges, whether yours or your loved ones, can feel lonely, confusing, and shameful. And yet, for many, they can also feel stabilizing and familiar, or simply unavoidable. The relationships we keep with our food and body can be incredibly complex and influenced by a multitude of factors. After years of experience working with eating disorders at all levels of care, I understand those complexities and the sensitive nature of this type of work. I offer a collaborative space for those individuals and families who are ready to work towards a life where eating is intuitive, connective, and safe.
Eating challenges, whether yours or your loved ones, can feel lonely, confusing, and shameful. And yet, for many, they can also feel stabilizing and familiar, or simply unavoidable. The relationships we keep with our food and body can be incredibly complex and influenced by a multitude of factors. After years of experience working with eating disorders at all levels of care, I understand those complexities and the sensitive nature of this type of work. I offer a collaborative space for those individuals and families who are ready to work towards a life where eating is intuitive, connective, and safe.
(804) 805-4578 View (804) 805-4578
Photo of Rahikya Wilson, Clinical Social Work/Therapist in Richmond, VA
Rahikya Wilson
Clinical Social Work/Therapist, MSW, LCSW, LICSW
Verified Verified
Richmond, VA 23224  (Online Only)
Not accepting new clients
I am a Licensed Clinical Social Worker with over 25 years experience in the Mental health field. I wholeheartedly believe in people's capacity for change. I bring this belief and enthusiasm to my practice. As a foundation, I work with my clients looking at their early relationships, and how it impacts current relationships. In reviewing relationship patterns we come to understand information below the surface of consciousness. We work together toward awareness, insight and behavioral change."
I am a Licensed Clinical Social Worker with over 25 years experience in the Mental health field. I wholeheartedly believe in people's capacity for change. I bring this belief and enthusiasm to my practice. As a foundation, I work with my clients looking at their early relationships, and how it impacts current relationships. In reviewing relationship patterns we come to understand information below the surface of consciousness. We work together toward awareness, insight and behavioral change."
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Photo of Suzanne Day, Clinical Social Work/Therapist in Richmond, VA
Suzanne Day
Clinical Social Work/Therapist, LCSW
Verified Verified
Richmond, VA 23225  (Online Only)
I am a Licensed Clinical Social Worker that practices Behaviorism. What that means is that we will work together to target behaviors that can help you improve your current mental state. I want to help you see quantifiable progress from our work together.
I am a Licensed Clinical Social Worker that practices Behaviorism. What that means is that we will work together to target behaviors that can help you improve your current mental state. I want to help you see quantifiable progress from our work together.
(804) 251-3299 View (804) 251-3299
Photo of Christopher Wallace, Clinical Social Work/Therapist in Richmond, VA
Christopher Wallace
Clinical Social Work/Therapist, LCSW
Verified Verified
Richmond, VA 23225  (Online Only)
Hello, I'm a Board Certified Diplomate in Clinical Social Work and Licensed Clinical Social Worker.
Hello, I'm a Board Certified Diplomate in Clinical Social Work and Licensed Clinical Social Worker.
(804) 373-7576 View (804) 373-7576
Photo of Amy Thomas, Clinical Social Work/Therapist in Richmond, VA
Amy Thomas
Clinical Social Work/Therapist, LCSW
Verified Verified
4 Endorsed
Richmond, VA 23231
Waitlist for new clients
I am a Licensed Clinical Social Worker who has specialized in working with children, adolescents, adults, and families for over 9 years. My background and experiences include work in the public school systems, child welfare systems (child protective services, adoptions, and foster care), private counseling center for adolescents and families, therapeutic recreational services, intensive in-home counseling, and an emergency diagnostic residential facility. I have experience working with individuals and families who have experienced trauma, grief & loss, divorce, single parenting, job loss, family conflict, stress, domestic violence, substance abuse, and crisis situations. If you are currently in crisis call 911.
I am a Licensed Clinical Social Worker who has specialized in working with children, adolescents, adults, and families for over 9 years. My background and experiences include work in the public school systems, child welfare systems (child protective services, adoptions, and foster care), private counseling center for adolescents and families, therapeutic recreational services, intensive in-home counseling, and an emergency diagnostic residential facility. I have experience working with individuals and families who have experienced trauma, grief & loss, divorce, single parenting, job loss, family conflict, stress, domestic violence, substance abuse, and crisis situations. If you are currently in crisis call 911.
(804) 419-4014 View (804) 419-4014
Photo of Erin Janovec, Licensed Professional Counselor in Richmond, VA
Erin Janovec
Licensed Professional Counselor, LPC
Verified Verified
Richmond, VA 23220
Hello! My name is Erin Janovec. I am a licensed professional counselor in Virginia. My approach to therapy is a humanistic and integrated approach that considers each individual's unique needs. I am certified in EMDR and trained in TF-CBT. I have worked with clients ranging from young to old with varying diagnoses. I have experience working with individuals with substance use disorders, depression, anxiety, bipolar, OCD, PTSD, ADHD, and more.
Hello! My name is Erin Janovec. I am a licensed professional counselor in Virginia. My approach to therapy is a humanistic and integrated approach that considers each individual's unique needs. I am certified in EMDR and trained in TF-CBT. I have worked with clients ranging from young to old with varying diagnoses. I have experience working with individuals with substance use disorders, depression, anxiety, bipolar, OCD, PTSD, ADHD, and more.
(804) 373-2360 View (804) 373-2360
Photo of Alimatu Mustapha-Palmer, Licensed Professional Counselor in Richmond, VA
Alimatu Mustapha-Palmer
Licensed Professional Counselor, LPC
Verified Verified
Richmond, VA 23234
I am Alimatu Mustapha- Palmer (nee Alima Palmer),PhD., NCC, LPC, MAC, CSAC, BCC. I have been in the world of behavioral health and services for the past 25 years. I am experienced and well-credentialed including several board certifications, awards, and recognitions. My experience includes conducting trainings, workshops, and assessments and working with individuals, families, groups, non-profits, local and international government agencies including DSS- CPS, law enforcement, minority populations, specific women and children’s issues, spirituality, cultural dynamics, marriage, divorce, life transitions, coaching and more.
I am Alimatu Mustapha- Palmer (nee Alima Palmer),PhD., NCC, LPC, MAC, CSAC, BCC. I have been in the world of behavioral health and services for the past 25 years. I am experienced and well-credentialed including several board certifications, awards, and recognitions. My experience includes conducting trainings, workshops, and assessments and working with individuals, families, groups, non-profits, local and international government agencies including DSS- CPS, law enforcement, minority populations, specific women and children’s issues, spirituality, cultural dynamics, marriage, divorce, life transitions, coaching and more.
(804) 626-5653 View (804) 626-5653
Photo of Tameka Adebayo - Comprehensive Clinical Solutions, Clinical Social Work/Therapist in Richmond, VA
Tameka Adebayo - Comprehensive Clinical Solutions
Clinical Social Work/Therapist, LMSW
Verified Verified
Richmond, VA 23220  (Online Only)
Ms. Adebayo served in the United States Army before retiring at the rank of 1SG (E-8). She's a graduate of the University of Southern California where she received her Master of Social Work with a concentration in Adult Mental Health and Wellness and holds a Bachelor of Science in Criminal Justice. As a Master Level Clinical Social Worker, she is deeply committed to serving individuals, families, and couples in their mental health and wellness journey. She continues to have strong counseling abilities, helping clients recognize and identify behavioral patterns, troubling emotions, and thoughts.
Ms. Adebayo served in the United States Army before retiring at the rank of 1SG (E-8). She's a graduate of the University of Southern California where she received her Master of Social Work with a concentration in Adult Mental Health and Wellness and holds a Bachelor of Science in Criminal Justice. As a Master Level Clinical Social Worker, she is deeply committed to serving individuals, families, and couples in their mental health and wellness journey. She continues to have strong counseling abilities, helping clients recognize and identify behavioral patterns, troubling emotions, and thoughts.
(703) 291-8339 View (703) 291-8339
Photo of Denise M Hill, Licensed Professional Counselor in Richmond, VA
Denise M Hill
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Richmond, VA 23219  (Online Only)
Making the first step is the most difficult but the most rewarding. Do you possess an open mind? Do you desire personal growth? Have you started to think that "something has to change?" I am here for you. Let us explore your full potential with a goal-oriented mindset.
Making the first step is the most difficult but the most rewarding. Do you possess an open mind? Do you desire personal growth? Have you started to think that "something has to change?" I am here for you. Let us explore your full potential with a goal-oriented mindset.
(804) 376-8677 View (804) 376-8677
Photo of John D Boyd, Psychologist in Richmond, VA
John D Boyd
Psychologist, PhD, ABPP, ABPH
Verified Verified
Richmond, VA 23230
Entering psychotherapy is one of the most important decisions a person can make in life, requiring courage, humility and a powerful desire to resolve one's difficulties and become the person you want to be. I know because I've done it several times! It is a privilege to join with you in a collaborative process of unlocking your inner resources and reaching your personal goals. I intend to earn your trust, make you feel comfortable and offer a personalized approach to psychotherapy. Please visit my website to learn more about me. (johnboydphd.com)
Entering psychotherapy is one of the most important decisions a person can make in life, requiring courage, humility and a powerful desire to resolve one's difficulties and become the person you want to be. I know because I've done it several times! It is a privilege to join with you in a collaborative process of unlocking your inner resources and reaching your personal goals. I intend to earn your trust, make you feel comfortable and offer a personalized approach to psychotherapy. Please visit my website to learn more about me. (johnboydphd.com)
(434) 374-7319 View (434) 374-7319

How does your Therapist compare?

Number of Therapists in Richmond, VA

1,000+

Average cost per session

$135

Therapists in Richmond, VA who prioritize treating:

93% Anxiety
88% Depression
75% Self Esteem
74% Coping Skills
70% Trauma and PTSD
68% Relationship Issues
67% Stress

Average years in practice

11 Years

Top 3 insurances accepted

78% Aetna
77% UnitedHealthcare UHC | UBH
76% Cigna and Evernorth

How Therapists in Richmond, VA see their clients

56% In Person and Online
44% Online Only

Gender breakdown

83% Female
16% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Richmond?

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.