Therapists in Columbia City, Seattle, WA

Photo of Angela Day, Marriage & Family Therapist in Columbia City, Seattle, WA
Angela Day
Marriage & Family Therapist, MA, MS, LMFT
Verified Verified
Columbia City, Seattle, WA 98118
Everyone should have the mental health resources to live their best lives, which includes a strong sexual voice and confident gender expression. There is an immense amount of guilt and shame in our culture that negatively affects how we perceive and receive sex, sexuality, and gender. Vulnerable populations have been targeted with specific, hurtful sexual and gendered stereotypes that can increase psychological distress. As a person of color, I am happy to contribute my perspective and lived experience to the field and your choice of therapists. Sex affects everyone, and it merits focused attention in the mental health field.
Everyone should have the mental health resources to live their best lives, which includes a strong sexual voice and confident gender expression. There is an immense amount of guilt and shame in our culture that negatively affects how we perceive and receive sex, sexuality, and gender. Vulnerable populations have been targeted with specific, hurtful sexual and gendered stereotypes that can increase psychological distress. As a person of color, I am happy to contribute my perspective and lived experience to the field and your choice of therapists. Sex affects everyone, and it merits focused attention in the mental health field.
(206) 202-2932 View (206) 202-2932
Photo of Christy Stewart, Psychologist in Columbia City, Seattle, WA
Christy Stewart
Psychologist, PsyD
Verified Verified
1 Endorsed
Columbia City, Seattle, WA 98118
I envision our work together to as a collaborative process of exploration, discovery, and progress. You bring to this process your unique perspectives, experiences, memories, worldview, and energy for growth. I bring extensive training and experience in psychological processes, assessment, life span development, understanding of how people change, and a genuine interest in helping you. Together, we will set goals and explore thoughts, feelings, experiences, and perceptions to further your personal development and psychological well-being. You will find me patient, attuned to your experience, and truly interest in understanding your perspective.
I envision our work together to as a collaborative process of exploration, discovery, and progress. You bring to this process your unique perspectives, experiences, memories, worldview, and energy for growth. I bring extensive training and experience in psychological processes, assessment, life span development, understanding of how people change, and a genuine interest in helping you. Together, we will set goals and explore thoughts, feelings, experiences, and perceptions to further your personal development and psychological well-being. You will find me patient, attuned to your experience, and truly interest in understanding your perspective.
(206) 452-1676 View (206) 452-1676
Photo of Robin Eastman, Clinical Social Work/Therapist in Columbia City, Seattle, WA
Robin Eastman
Clinical Social Work/Therapist, LSWAIC, MBA
Verified Verified
1 Endorsed
Columbia City, Seattle, WA 98118  (Online Only)
I am very open and accepting. I will believe your experiences and help you navigate a world that is neither just nor equitable. I focus on being kind, curious, and compassionate, rather than judgmental of your experiences and challenges.
I am very open and accepting. I will believe your experiences and help you navigate a world that is neither just nor equitable. I focus on being kind, curious, and compassionate, rather than judgmental of your experiences and challenges.
(206) 472-1770 View (206) 472-1770
Stefanie Talmadge
Clinical Social Work/Therapist, LICSW
Verified Verified
Columbia City, Seattle, WA 98118
I believe that every individual has the ability to make change, heal and grow. I will create a supportive environment where you will be heard, new skills can be learned and also practiced. My treatment methods are grounded in evidence-based models, while allowing for the flexibility to individualize to best meet your needs. I want to make therapy work for you and know that no approach is perfect for everyone. I primarily use Cognitive Behavioral Therapy (CBT), exposure, Mindfulness techniques and Acceptance and Commitment Therapy (ACT). Together we will decide what works for you.
I believe that every individual has the ability to make change, heal and grow. I will create a supportive environment where you will be heard, new skills can be learned and also practiced. My treatment methods are grounded in evidence-based models, while allowing for the flexibility to individualize to best meet your needs. I want to make therapy work for you and know that no approach is perfect for everyone. I primarily use Cognitive Behavioral Therapy (CBT), exposure, Mindfulness techniques and Acceptance and Commitment Therapy (ACT). Together we will decide what works for you.
(206) 207-4676 View (206) 207-4676
Photo of Kyla Burford, Clinical Social Work/Therapist in Columbia City, Seattle, WA
Kyla Burford
Clinical Social Work/Therapist, MSW, LICSW, ESA
Verified Verified
2 Endorsed
Columbia City, Seattle, WA 98118  (Online Only)
Often times, the only way out is through. You don’t have to make that journey alone. I will teach you skills to cope with your immediate challenges & I’ll support you with identifying & processing past experiences that are getting in the way of the life you want to live. Real change can be a scary, & sometimes painful, process but I will be in your corner, cheering you on & helping you access your strengths to move forward. Whether you are experiencing issues related to depression, anxiety, racial identity, ADHD, trauma, blended family, parenting, or something else, I would be honored to be part of your journey.
Often times, the only way out is through. You don’t have to make that journey alone. I will teach you skills to cope with your immediate challenges & I’ll support you with identifying & processing past experiences that are getting in the way of the life you want to live. Real change can be a scary, & sometimes painful, process but I will be in your corner, cheering you on & helping you access your strengths to move forward. Whether you are experiencing issues related to depression, anxiety, racial identity, ADHD, trauma, blended family, parenting, or something else, I would be honored to be part of your journey.
(360) 404-7239 View (360) 404-7239
Photo of Jamie Katz, Counselor in Columbia City, Seattle, WA
Jamie Katz
Counselor, MSW, LMHC
Verified Verified
Columbia City, Seattle, WA 98118
Welcome! For some, seeking help from a mental health professional can feel overwhelming, intimidating. Finding an understanding therapist who is best suited to your needs can be the first step towards a happier and more meaningful life. I work with adults and adolescents from a place of respect and compassion and believe that real transformation happens within the context of the therapeutic relationship. I value approaches that have been researched and proven to be effective, and tailor treatment to meet the needs of each individual. I have experience treating anxiety, depression, PTSD, sexual abuse, and gender dysphoria.
Welcome! For some, seeking help from a mental health professional can feel overwhelming, intimidating. Finding an understanding therapist who is best suited to your needs can be the first step towards a happier and more meaningful life. I work with adults and adolescents from a place of respect and compassion and believe that real transformation happens within the context of the therapeutic relationship. I value approaches that have been researched and proven to be effective, and tailor treatment to meet the needs of each individual. I have experience treating anxiety, depression, PTSD, sexual abuse, and gender dysphoria.
(206) 210-3557 View (206) 210-3557
Photo of Sara Ramos-Amador, Counselor in Columbia City, Seattle, WA
Sara Ramos-Amador
Counselor, LMHC
Verified Verified
Columbia City, Seattle, WA 98188
Waitlist for new clients
I am an artist/poet turned therapist. My method is to slowly build a therapeutic relationship, uncover strengths, and move toward client-identified treatment goals. I support clients to externalize problematic narratives or inner states they are stuck in through creative mediums. Once clients are resourced and can see, and then interact with their patterns and parts they make changes. Together we discover and incorporate parts of the self that had to go underground due to trauma or oppression. Clients emerge from their work, whole and empowered.
I am an artist/poet turned therapist. My method is to slowly build a therapeutic relationship, uncover strengths, and move toward client-identified treatment goals. I support clients to externalize problematic narratives or inner states they are stuck in through creative mediums. Once clients are resourced and can see, and then interact with their patterns and parts they make changes. Together we discover and incorporate parts of the self that had to go underground due to trauma or oppression. Clients emerge from their work, whole and empowered.
(206) 678-0215 View (206) 678-0215
Photo of Shaquille Sinclair, Counselor in Columbia City, Seattle, WA
Shaquille Sinclair
Counselor, LMHCA
Verified Verified
4 Endorsed
Columbia City, Seattle, WA 98118  (Online Only)
Therapy is about learning how to tell our stories. It is deepening our courage to look ourselves in the face and tell the truth of what we find. It is taking in the bountiful love in the world though it sometimes seems impossible to find. It is learning to savor the taste of a good meal and laughter with others. It is knowing the name of our sadness whether or not we can find our tears. It is being. Just as we are with hope for more to come.
Therapy is about learning how to tell our stories. It is deepening our courage to look ourselves in the face and tell the truth of what we find. It is taking in the bountiful love in the world though it sometimes seems impossible to find. It is learning to savor the taste of a good meal and laughter with others. It is knowing the name of our sadness whether or not we can find our tears. It is being. Just as we are with hope for more to come.
View
Photo of Ann Marie Roepke, Psychologist in Columbia City, Seattle, WA
Ann Marie Roepke
Psychologist, PhD
Verified Verified
3 Endorsed
Columbia City, Seattle, WA 98118
Not accepting new clients
I love helping people with anxiety, including panic, stress, social anxiety, OCD, and posttraumatic stress. I also help with issues that often come with anxiety, including insomnia, depression, alcohol/substance use, and a desire for greater resilience. I primarily offer cognitive-behavioral therapies with good scientific backing, and I combine non-judgmental support + practical skills. Finding a therapist who is a good "fit” is important, so I offer a free 20-minute phone consult to help you decide if my approach is a good match for you. Apart from therapy, I offer professional coaching to help people do well + feel well at work.
I love helping people with anxiety, including panic, stress, social anxiety, OCD, and posttraumatic stress. I also help with issues that often come with anxiety, including insomnia, depression, alcohol/substance use, and a desire for greater resilience. I primarily offer cognitive-behavioral therapies with good scientific backing, and I combine non-judgmental support + practical skills. Finding a therapist who is a good "fit” is important, so I offer a free 20-minute phone consult to help you decide if my approach is a good match for you. Apart from therapy, I offer professional coaching to help people do well + feel well at work.
(206) 204-5292 View (206) 204-5292
Photo of Ron Anders, Clinical Social Work/Therapist in Columbia City, Seattle, WA
Ron Anders
Clinical Social Work/Therapist, LICSW
Verified Verified
Columbia City, Seattle, WA 98118  (Online Only)
Awareness is everything. How often do we ask ourselves: "How did I get back here again?" - repeating patterns of self-defeating behavior. Raising our awareness of these patterns can help free us from re-engaging in them. The rewards of this exploration are bountiful - as we watch new, healthier behaviors emerge. We get a glimpse of the gifts that life can offer us by simply getting out of our own way. In my practice, I have had the privilege of witnessing the emotional freedom that change can bring and its powerful healing of depression, anxiety and trauma.
Awareness is everything. How often do we ask ourselves: "How did I get back here again?" - repeating patterns of self-defeating behavior. Raising our awareness of these patterns can help free us from re-engaging in them. The rewards of this exploration are bountiful - as we watch new, healthier behaviors emerge. We get a glimpse of the gifts that life can offer us by simply getting out of our own way. In my practice, I have had the privilege of witnessing the emotional freedom that change can bring and its powerful healing of depression, anxiety and trauma.
(206) 743-9323 View (206) 743-9323
Photo of Rachel Pody, Counselor in Columbia City, Seattle, WA
Rachel Pody
Counselor, MA, LMHC
Verified Verified
1 Endorsed
Columbia City, Seattle, WA 98118
Not accepting new clients
I love working with children and their families! I offer individual counseling for children aged 4-12 to address a range of issues including anxiety, anger, grief, trauma, and significant life transitions. Many families I see are seeking support for their children in the area of executive function skills such as staying focused and regulating emotions and impulses. I enjoy helping parents feel more confident and joyful and working with them to strengthen their connections with their children.
I love working with children and their families! I offer individual counseling for children aged 4-12 to address a range of issues including anxiety, anger, grief, trauma, and significant life transitions. Many families I see are seeking support for their children in the area of executive function skills such as staying focused and regulating emotions and impulses. I enjoy helping parents feel more confident and joyful and working with them to strengthen their connections with their children.
(206) 339-3183 View (206) 339-3183
Photo of Alford Counseling and Recovery, PLLC, Counselor in Columbia City, Seattle, WA
Alford Counseling and Recovery, PLLC
Counselor, MA, LMHCA, SUDP
Verified Verified
2 Endorsed
Columbia City, Seattle, WA 98118
My approach is tailored to meet your goals and may include helping you solve your problems, develop your strengths, and provide skills to increase your daily life effectiveness. Often, this process involves giving attention to the thoughts, feelings, behaviors, and experiences that hinder living a balanced and meaningful life. My deliverance when working with clients is client-centered, collaborative, and non-judgmental.
My approach is tailored to meet your goals and may include helping you solve your problems, develop your strengths, and provide skills to increase your daily life effectiveness. Often, this process involves giving attention to the thoughts, feelings, behaviors, and experiences that hinder living a balanced and meaningful life. My deliverance when working with clients is client-centered, collaborative, and non-judgmental.
(206) 333-0503 View (206) 333-0503
Photo of Brook Avidon, Counselor in Columbia City, Seattle, WA
Brook Avidon
Counselor, MA, LMHC
Verified Verified
Columbia City, Seattle, WA 98118  (Online Only)
Are you creative? In transition? Depressed? Different? Parenting? Re-discovering YOU? Are you wanting to make changes in your life or to heal from old wounds? Do you want to develop self-compassion? Do you want to learn how to be present for your life, to learn mindfulness to help you through the tough times? If so, let’s see if we can create a compassionate, interactive and authentic therapeutic relationship to work collaboratively towards healing. In therapy, I can help you identify your goals, look at what is and isn't working for you, explore your stories, emotions, and experiences (past and present), develop new skills, and embrace your learning styles and talents. I also provide consultation and supervision to therapists.
Are you creative? In transition? Depressed? Different? Parenting? Re-discovering YOU? Are you wanting to make changes in your life or to heal from old wounds? Do you want to develop self-compassion? Do you want to learn how to be present for your life, to learn mindfulness to help you through the tough times? If so, let’s see if we can create a compassionate, interactive and authentic therapeutic relationship to work collaboratively towards healing. In therapy, I can help you identify your goals, look at what is and isn't working for you, explore your stories, emotions, and experiences (past and present), develop new skills, and embrace your learning styles and talents. I also provide consultation and supervision to therapists.
(206) 823-0431 View (206) 823-0431
Photo of Jennifer B. Henderson, Counselor in Columbia City, Seattle, WA
Jennifer B. Henderson
Counselor, MA, LMHC, ATR, EMMHS
Verified Verified
Columbia City, Seattle, WA 98118  (Online Only)
My practice has a special focus on women of color and their relationships with their children, partners and families. I look forward to working with those who are motivated to explore, express, understand and love themselves while creating positive life changes. Sometimes our past continues to impact our present life. Other times life creates conflict and tension for us and our families. For BIPOC there's the stress of navigating racial bias, discrimination and racism in our world. And of course, intergenerational trauma adds another challenge to our healing journeys. I feel honored to walk this path with you!
My practice has a special focus on women of color and their relationships with their children, partners and families. I look forward to working with those who are motivated to explore, express, understand and love themselves while creating positive life changes. Sometimes our past continues to impact our present life. Other times life creates conflict and tension for us and our families. For BIPOC there's the stress of navigating racial bias, discrimination and racism in our world. And of course, intergenerational trauma adds another challenge to our healing journeys. I feel honored to walk this path with you!
(206) 966-4353 View (206) 966-4353
Photo of Scott Shillito, Marriage & Family Therapist in Columbia City, Seattle, WA
Scott Shillito
Marriage & Family Therapist, LMFT
Verified Verified
Columbia City, Seattle, WA 98118
Are you ready for a stronger relationship? Maybe communication with your partner has broken down, or there always seems to be another painful conflict? There are many different ways a relationship can become derailed, but it can get better, and you have taken the first step.
Are you ready for a stronger relationship? Maybe communication with your partner has broken down, or there always seems to be another painful conflict? There are many different ways a relationship can become derailed, but it can get better, and you have taken the first step.
(206) 502-0949 View (206) 502-0949
Photo of Lydia Carrick: EMDR Intensives, Counselor in Columbia City, Seattle, WA
Lydia Carrick: EMDR Intensives
Counselor, LMHC, LPC, NCC
Verified Verified
Columbia City, Seattle, WA 98118
I am a certified EMDR therapist and Approved EMDR Consultant. I enjoy working with complex trauma, attachment issues, and dissociative disorders. I have experience in the community mental health setting, jail system, and teaching in the community college level. I've settled into private practice because I love being with and connecting with clients.
I am a certified EMDR therapist and Approved EMDR Consultant. I enjoy working with complex trauma, attachment issues, and dissociative disorders. I have experience in the community mental health setting, jail system, and teaching in the community college level. I've settled into private practice because I love being with and connecting with clients.
(206) 222-9144 View (206) 222-9144
Photo of Dana Kahn, Clinical Social Work/Therapist in Columbia City, Seattle, WA
Dana Kahn
Clinical Social Work/Therapist, LICSW, MSW
Verified Verified
Columbia City, Seattle, WA 98118  (Online Only)
Not accepting new clients
Through my life and work experience, I learned to view my work through the lens of anti-oppression: I acknowledge the impact that systemic, cultural, and societal expectations have on our daily existence and sense of self. We all carry with us a unique set of intersecting identities, which, taken together, influence our life experiences and shape our worldview. I believe that the foundation of mental health exists in the exploration of these identities and the radical acceptance of our whole selves.
Through my life and work experience, I learned to view my work through the lens of anti-oppression: I acknowledge the impact that systemic, cultural, and societal expectations have on our daily existence and sense of self. We all carry with us a unique set of intersecting identities, which, taken together, influence our life experiences and shape our worldview. I believe that the foundation of mental health exists in the exploration of these identities and the radical acceptance of our whole selves.
(206) 966-6341 View (206) 966-6341
Photo of Leslie Gilbert, Clinical Social Work/Therapist in Columbia City, Seattle, WA
Leslie Gilbert
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Columbia City, Seattle, WA 98118  (Online Only)
Everyone has the potential to feel secure and connected. We will work collaboratively to identify sources of stress, embrace difficult feelings, question limiting thought and behavior patterns, and develop both internal and external resources for finding more joy and fulfillment in life. I have a passion for working with people experiencing life transitions, including but not limited to life stages, pregnancy and postpartum, career, relationships, and illness.
Everyone has the potential to feel secure and connected. We will work collaboratively to identify sources of stress, embrace difficult feelings, question limiting thought and behavior patterns, and develop both internal and external resources for finding more joy and fulfillment in life. I have a passion for working with people experiencing life transitions, including but not limited to life stages, pregnancy and postpartum, career, relationships, and illness.
(206) 800-6516 View (206) 800-6516
Photo of Elly Staton, Counselor in Columbia City, Seattle, WA
Elly Staton
Counselor, LMHC
Verified Verified
Columbia City, Seattle, WA 98118
Not accepting new clients
Hello! I specialize in working with LGBTQIA+ identities, anxiety, depression, attachment issues, and trauma. If you choose to work with me for counseling, you can expect collaboration, humor, and a warm, relational framework. I incorporate a variety of healing modalities into my practice, particularly dialectical behavior therapy (DBT), polyvagal theory, somatic mindfulness, and acceptance and commitment therapy (ACT).
Hello! I specialize in working with LGBTQIA+ identities, anxiety, depression, attachment issues, and trauma. If you choose to work with me for counseling, you can expect collaboration, humor, and a warm, relational framework. I incorporate a variety of healing modalities into my practice, particularly dialectical behavior therapy (DBT), polyvagal theory, somatic mindfulness, and acceptance and commitment therapy (ACT).
(206) 350-6470 View (206) 350-6470
Photo of Ray DeChant, Counselor in Columbia City, Seattle, WA
Ray DeChant
Counselor, LMHC
Verified Verified
1 Endorsed
Columbia City, Seattle, WA 98118
As a licensed mental health counselor, I work primarily with teens and young adults. I love the opportunity to support young people as they grow and overcome challenges in their lives. I believe that you and your family are doing the best you can with the tools you have, and if you’re searching for a therapist, you likely need more support to thrive. I'm especially skilled at working with youth who have experienced trauma or who struggle with anxiety, depression and/or self-harm. As of April 2024, I have some limited availability for in-person services.
As a licensed mental health counselor, I work primarily with teens and young adults. I love the opportunity to support young people as they grow and overcome challenges in their lives. I believe that you and your family are doing the best you can with the tools you have, and if you’re searching for a therapist, you likely need more support to thrive. I'm especially skilled at working with youth who have experienced trauma or who struggle with anxiety, depression and/or self-harm. As of April 2024, I have some limited availability for in-person services.
(206) 339-4693 View (206) 339-4693

See more therapy options for Columbia City, Seattle

How does your Therapist compare?

Number of Therapists in Columbia City, Seattle, WA

50+

Average cost per session

$150

Therapists in Columbia City, Seattle, WA who prioritize treating:

95% Anxiety
89% Depression
82% Relationship Issues
80% Trauma and PTSD
71% Grief
71% Self Esteem
69% Life Transitions

Average years in practice

9 Years

Top 3 insurances accepted

84% Premera
45% LifeWise
42% BlueCross and BlueShield

How Therapists in Columbia City, Seattle, WA see their clients

57% In Person and Online
43% Online Only

Gender breakdown

72% Female
22% Male
6% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Columbia City, Seattle?

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.