Therapists in Piedmont Avenue, Oakland, CA
Grady M Fort
Marriage & Family Therapist, MFT
Verified Verified
2 Endorsed
Piedmont Avenue, Oakland, CA 94611
I specialize in both individual trauma and grief work, as well as work with couples. I am a certified Emotionally Focused Couples Therapist, (CEFT) and I specialize in working with couples to address and remedy destructive communication, breaches in trust, infidelity issues, premarital counseling, and sexual incompatibility. My approach helps couples to reestablish a sense of connection by allowing couples to better understand the areas in their relationship where they have difficulty feeling that they each see eye-to-eye, by facilitating clearer communication of what both are needing from each other in order to feel more connected.
I specialize in both individual trauma and grief work, as well as work with couples. I am a certified Emotionally Focused Couples Therapist, (CEFT) and I specialize in working with couples to address and remedy destructive communication, breaches in trust, infidelity issues, premarital counseling, and sexual incompatibility. My approach helps couples to reestablish a sense of connection by allowing couples to better understand the areas in their relationship where they have difficulty feeling that they each see eye-to-eye, by facilitating clearer communication of what both are needing from each other in order to feel more connected.
Dr. Toni Li
Psychologist, PsyD
Verified Verified
3 Endorsed
Piedmont Avenue, Oakland, CA 94611
Do you describe yourself as a “people pleaser”? Perhaps frozen from imposter syndrome or perfectionism? Feeling dissatisfied with your life or work? Or are you a parent who is worried about your child? I've worked with adults, children, teens and families experiencing anxiety, depression, and stress. Additionally, I have experience in working with people diagnosed with ADHD, as they often need support for feelings of inadequacy, regret, anxiety, and depression.
Do you describe yourself as a “people pleaser”? Perhaps frozen from imposter syndrome or perfectionism? Feeling dissatisfied with your life or work? Or are you a parent who is worried about your child? I've worked with adults, children, teens and families experiencing anxiety, depression, and stress. Additionally, I have experience in working with people diagnosed with ADHD, as they often need support for feelings of inadequacy, regret, anxiety, and depression.
Eva Healy
Associate Marriage & Family Therapist, AMFT, MA
Verified Verified
Piedmont Avenue, Oakland, CA 94611 (Online Only)
Welcome! By landing here, you’ve taken a momentous first step towards loving and trusting yourself more fully. Whether you want to deepen your intimate relationships, express yourself more authentically, cultivate inner peace, heal from abuse or trauma, explore polyamory, address issues specific to your sexuality or gender identity, or so much more, I am here to help. With my collaborative approach, we will unlock your potential to set healthy boundaries, shift limiting beliefs, make peace with your body, navigate uncertainty, embrace paradox, transcend polarities, embrace “good enough,” and learn to dance in the rain so to speak.
Welcome! By landing here, you’ve taken a momentous first step towards loving and trusting yourself more fully. Whether you want to deepen your intimate relationships, express yourself more authentically, cultivate inner peace, heal from abuse or trauma, explore polyamory, address issues specific to your sexuality or gender identity, or so much more, I am here to help. With my collaborative approach, we will unlock your potential to set healthy boundaries, shift limiting beliefs, make peace with your body, navigate uncertainty, embrace paradox, transcend polarities, embrace “good enough,” and learn to dance in the rain so to speak.
Jianne Gimian
Psychologist, PhD
Verified Verified
Piedmont Avenue, Oakland, CA 94611
If you are having difficulty with relationships, at work, with parents or children, I can help you identify the issues causing discomfort and learn new strategies for coping, managing and getting more joy in life. If you need someone to talk openly with about your challenges in life, I can listen and help you gain insight so that you can choose the best ways to proceed. If you feel isolated and judged, I can help you build confidence. If you are stuck in grief, I can help you get through it. I can help you see pathways where you might be inclined to see barriers.
If you are having difficulty with relationships, at work, with parents or children, I can help you identify the issues causing discomfort and learn new strategies for coping, managing and getting more joy in life. If you need someone to talk openly with about your challenges in life, I can listen and help you gain insight so that you can choose the best ways to proceed. If you feel isolated and judged, I can help you build confidence. If you are stuck in grief, I can help you get through it. I can help you see pathways where you might be inclined to see barriers.
Gina Delucca
Psychologist, PsyD
Verified Verified
Piedmont Avenue, Oakland, CA 94611
Clients who typically feel drawn to work with me tend to prefer a more action-oriented and present-focused approach to therapy. While developing self-understanding in therapy can be very powerful by itself, I like to try to empower my clients to use their insight to create concrete change in their lives. I also like working with clients who are interested in setting goals, willing to experiment with new behaviors and thinking patterns, and motivated to do homework between sessions. My specialty areas include anxiety, perfectionism, impostor syndrome, low self-esteem, disordered eating, stress, and work-life balance.
Clients who typically feel drawn to work with me tend to prefer a more action-oriented and present-focused approach to therapy. While developing self-understanding in therapy can be very powerful by itself, I like to try to empower my clients to use their insight to create concrete change in their lives. I also like working with clients who are interested in setting goals, willing to experiment with new behaviors and thinking patterns, and motivated to do homework between sessions. My specialty areas include anxiety, perfectionism, impostor syndrome, low self-esteem, disordered eating, stress, and work-life balance.
Lizzie Pfeiffer
Marriage & Family Therapist Associate, MA
Verified Verified
1 Endorsed
Piedmont Avenue, Oakland, CA 94611
I work from a trauma-informed, relational, and client-centered lens. I integrate psychodynamic and attachment based theoretical approaches. I believe the relationship we build as client and therapist, as well as exploring your relationships outside of therapy, are important avenues for growth. You are the expert on your own life; I am here to listen to you and work collaboratively to empower your inherent strength and resilience. I use warmth, compassion, and humor to cultivate an affirming, non-judgemental, and trusting connection with my clients.
I work from a trauma-informed, relational, and client-centered lens. I integrate psychodynamic and attachment based theoretical approaches. I believe the relationship we build as client and therapist, as well as exploring your relationships outside of therapy, are important avenues for growth. You are the expert on your own life; I am here to listen to you and work collaboratively to empower your inherent strength and resilience. I use warmth, compassion, and humor to cultivate an affirming, non-judgemental, and trusting connection with my clients.
Robert Deady
Psychologist, PsyD
Verified Verified
Piedmont Avenue, Oakland, CA 94611
The decision to pursue therapy is not one taken easily. Many possibilities lead a person to this point: A recent disruption or crisis in your life, a long struggle with troubling emotions and behaviors, and/or a fundamental desire to better know yourself. I have experience treating frequently occurring issues such as depression, trauma, interpersonal difficulties, and anxiety. Additionally, I have expertise in working with people who have survived childhood abuse, who experience feelings of alienation and estrangement from others, and those who identify as LGBTQ+.
The decision to pursue therapy is not one taken easily. Many possibilities lead a person to this point: A recent disruption or crisis in your life, a long struggle with troubling emotions and behaviors, and/or a fundamental desire to better know yourself. I have experience treating frequently occurring issues such as depression, trauma, interpersonal difficulties, and anxiety. Additionally, I have expertise in working with people who have survived childhood abuse, who experience feelings of alienation and estrangement from others, and those who identify as LGBTQ+.
Dolores Moorehead
Pre-Licensed Professional, MS, APCC
Verified Verified
Piedmont Avenue, Oakland, CA 94611
Deciding to make changes in your life and to grow is not easy, but you don’t always have to do it by yourself. I will walk by your side as a client-centered empathic clinician as you explore a new path in your life. I’m committed to meeting you where you are and to supporting your healing. I will help you to recognize your inherent strengths and resiliency as we work together to utilize them in creating the change you seek in your life going forward.
Deciding to make changes in your life and to grow is not easy, but you don’t always have to do it by yourself. I will walk by your side as a client-centered empathic clinician as you explore a new path in your life. I’m committed to meeting you where you are and to supporting your healing. I will help you to recognize your inherent strengths and resiliency as we work together to utilize them in creating the change you seek in your life going forward.
I am retired and do not work with any patients!!
Psychologist
Verified Verified
2 Endorsed
Piedmont Avenue, Oakland, CA 94610 (Online Only)
Not accepting new clients
Over 40 years of diverse practice has taught me that when people are in psychotherapy they create ingenious ways to grow, to resolve internal/social conflict and to improve their sense of personal fulfillment. They are innovative and sincere. Therapy is more than a serious, shared introspection. It is also a playful interaction. It usually involves a full range of emotions that includes a sharing of ideas and a mutual exchange, which almost always involves a lively conversation. There seems to be one common theme, namely that each person is seeking to find a sense of truth and well-being.
Over 40 years of diverse practice has taught me that when people are in psychotherapy they create ingenious ways to grow, to resolve internal/social conflict and to improve their sense of personal fulfillment. They are innovative and sincere. Therapy is more than a serious, shared introspection. It is also a playful interaction. It usually involves a full range of emotions that includes a sharing of ideas and a mutual exchange, which almost always involves a lively conversation. There seems to be one common theme, namely that each person is seeking to find a sense of truth and well-being.
Judith Muschel
Marriage & Family Therapist, LMFT
Verified Verified
Piedmont Avenue, Oakland, CA 94611
Choosing a therapist is a significant decision, and one in which it is crucial to trust your feelings. I am a very engaging, warm and thoughtful person. My approach is eclectic and interactive, and is adapted to the unique needs of each individual or couple. Humor, respectful listening, honest dialogue and collaboration are all important aspects of my work. My priority is to provide a safe connection as a foundation for growth, enhanced self-esteem, and well-being. Habitual patterns causing impasses, lack of passion, anxiety and depression, can shift once underlying needs and feelings are legitimized and given voice.
Choosing a therapist is a significant decision, and one in which it is crucial to trust your feelings. I am a very engaging, warm and thoughtful person. My approach is eclectic and interactive, and is adapted to the unique needs of each individual or couple. Humor, respectful listening, honest dialogue and collaboration are all important aspects of my work. My priority is to provide a safe connection as a foundation for growth, enhanced self-esteem, and well-being. Habitual patterns causing impasses, lack of passion, anxiety and depression, can shift once underlying needs and feelings are legitimized and given voice.
Jeffrey Gianelli
Clinical Social Work/Therapist, LCSW
Verified Verified
3 Endorsed
Piedmont Avenue, Oakland, CA 94611
Waitlist for new clients
I am EDMR certified and Internal Family Systems (IFS) Level 1 trained. I use these powerful tools and others like ACT to help you tap into your mind and uncover and transform limiting patterns and beliefs. Healing is about bringing the unconscious to the conscious level, which allows our true self to emerge, and my techniques are designed for this purpose. I create a safe space for you to explore the links between past and present, to see what you are still holding onto and to help you finally let go. I also teach a variety of skills and tools. Perhaps you've tried talk therapy and are ready to go deeper. If so, this may be for you.
I am EDMR certified and Internal Family Systems (IFS) Level 1 trained. I use these powerful tools and others like ACT to help you tap into your mind and uncover and transform limiting patterns and beliefs. Healing is about bringing the unconscious to the conscious level, which allows our true self to emerge, and my techniques are designed for this purpose. I create a safe space for you to explore the links between past and present, to see what you are still holding onto and to help you finally let go. I also teach a variety of skills and tools. Perhaps you've tried talk therapy and are ready to go deeper. If so, this may be for you.
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Marriage & Family Therapist, LMFT, LPCC
Verified Verified
Piedmont Avenue, Oakland, CA 94611 (Online Only)
Do you struggle with feeling like you belong? Are you carrying hurts and wounds from your family of origin or other close relationships? Do you wonder about your purpose and the meaning of your life? Or maybe you have worked hard on yourself throughout your life, but still struggle to connect with others or lead a life that has intention and meaning. I would be happy to meet with you and hear more about your situation and what you believe is blocking you. Together we can explore what holds you back and create a plan to engage your life in a way that feels more purpose driven and connected to your unique soul.
Do you struggle with feeling like you belong? Are you carrying hurts and wounds from your family of origin or other close relationships? Do you wonder about your purpose and the meaning of your life? Or maybe you have worked hard on yourself throughout your life, but still struggle to connect with others or lead a life that has intention and meaning. I would be happy to meet with you and hear more about your situation and what you believe is blocking you. Together we can explore what holds you back and create a plan to engage your life in a way that feels more purpose driven and connected to your unique soul.
Alissa Blackman
Marriage & Family Therapist, MA, LMFT
Verified Verified
1 Endorsed
Piedmont Avenue, Oakland, CA 94611
When difficulties are too much to handle or the next level of growth seems just out of reach, you may find yourself living with pain & stress. Some stress in life helps people grow, but chronic stress has a negative effect on your mind, body, emotions & spirit. You may find yourself using old mental, physical & emotional coping tools to survive, yet feel unable to make real change. Your ally in holistic healing, I offer a supportive, warm presence so you can explore what's difficult, hone your strengths, & gain simple yet powerful mind/body tools.
When difficulties are too much to handle or the next level of growth seems just out of reach, you may find yourself living with pain & stress. Some stress in life helps people grow, but chronic stress has a negative effect on your mind, body, emotions & spirit. You may find yourself using old mental, physical & emotional coping tools to survive, yet feel unable to make real change. Your ally in holistic healing, I offer a supportive, warm presence so you can explore what's difficult, hone your strengths, & gain simple yet powerful mind/body tools.
Zachary Weiss
Marriage & Family Therapist Associate, AMFT
Verified Verified
Piedmont Avenue, Oakland, CA 94611
Therapy is a life-changing process of growth, transformation, and healing. It is a safe, confidential space where you can unburden yourself. Where you can begin to unpack the ways of being and doing that no longer serve you. It is a place where you can share your pain. Where wounds are found, held, and tended with care. Where you can connect with your own vitality and dare to live a fuller, more meaningful life. It isn't always easy, nor quick, but it's almost always worthwhile.
Therapy is a life-changing process of growth, transformation, and healing. It is a safe, confidential space where you can unburden yourself. Where you can begin to unpack the ways of being and doing that no longer serve you. It is a place where you can share your pain. Where wounds are found, held, and tended with care. Where you can connect with your own vitality and dare to live a fuller, more meaningful life. It isn't always easy, nor quick, but it's almost always worthwhile.
Eva Lyons
Marriage & Family Therapist, MA, LMFT
Verified Verified
Piedmont Avenue, Oakland, CA 94611 (Online Only)
I believe that our minds and hearts, like our bodies, possess an innate wisdom and ability to heal, given the right environment and structure. Sometimes we get stuck in old patterns and beliefs that helped us in the circumstances we learned them in, but need to be updated in order to allow us to fully embody our best, most authentic and empowered selves. Therapy can assist us in learning more about what automatic programs our system is running, and give us the tools to make these changes.
I believe that our minds and hearts, like our bodies, possess an innate wisdom and ability to heal, given the right environment and structure. Sometimes we get stuck in old patterns and beliefs that helped us in the circumstances we learned them in, but need to be updated in order to allow us to fully embody our best, most authentic and empowered selves. Therapy can assist us in learning more about what automatic programs our system is running, and give us the tools to make these changes.
Liz M Fitzgerald
Marriage & Family Therapist, LMFT, PPS
Verified Verified
1 Endorsed
Piedmont Avenue, Oakland, CA 94611
Not accepting new clients
I create a trusting and safe space for your child to express their thoughts and feelings, without judgment, and I will normalize their experiences and help you have a deeper understanding of what your child is going through. We will work together collaboratively. You as parents are the expert on your child and family. I am there as a support and facilitator- making the first step in asking for help is the most crucial step in the journey of repairing.
I create a trusting and safe space for your child to express their thoughts and feelings, without judgment, and I will normalize their experiences and help you have a deeper understanding of what your child is going through. We will work together collaboratively. You as parents are the expert on your child and family. I am there as a support and facilitator- making the first step in asking for help is the most crucial step in the journey of repairing.
Megan Parker
Psychologist, PsyD
Verified Verified
2 Endorsed
Piedmont Avenue, Oakland, CA 94611 (Online Only)
Waitlist for new clients
As our world re-opens, many people are experiencing anxiety, depression, and stress due to recent social isolation and the unpredictability of the future. It can be a highly stressful time for people re-entering the world and for parents and teens. I provide individual adult therapy, teen/young adult therapy, and parent coaching. I am knowledgeable with non-traditional family structures (single parent, multiple caregiver, polyamorous, & LGBT families), transgender adolescent/child issues, anxiety, and neurodiversity . I’ve also begun working with the emotional effects of long Covid and chronic fatigue.
As our world re-opens, many people are experiencing anxiety, depression, and stress due to recent social isolation and the unpredictability of the future. It can be a highly stressful time for people re-entering the world and for parents and teens. I provide individual adult therapy, teen/young adult therapy, and parent coaching. I am knowledgeable with non-traditional family structures (single parent, multiple caregiver, polyamorous, & LGBT families), transgender adolescent/child issues, anxiety, and neurodiversity . I’ve also begun working with the emotional effects of long Covid and chronic fatigue.
David Pingitore
Psychologist, PhD
Verified Verified
Piedmont Avenue, Oakland, CA 94611
I have worked in the field of psychology for over twenty years. In my psychotherapy work, I provide a safe and respectful setting where you can discuss current challenges, and understand how particular feelings and patterns contribute to these challenges. Often these challenges develop out of prior dysfunctional relationships, and it is in the psychotherapy relationship that new and more satisfying goals and behaviors can be discussed and developed. In our initial appointments I actively listen and engage with patients to develop a psychological framework to understand their challenges, and then set concise goals to address in the therapy.
I have worked in the field of psychology for over twenty years. In my psychotherapy work, I provide a safe and respectful setting where you can discuss current challenges, and understand how particular feelings and patterns contribute to these challenges. Often these challenges develop out of prior dysfunctional relationships, and it is in the psychotherapy relationship that new and more satisfying goals and behaviors can be discussed and developed. In our initial appointments I actively listen and engage with patients to develop a psychological framework to understand their challenges, and then set concise goals to address in the therapy.
Joan A Pezanoski
Marriage & Family Therapist, MA, MFT
Verified Verified
1 Endorsed
Piedmont Avenue, Oakland, CA 94611
I am a warm and caring human being with a clear understanding that therapy is not a "one size fits all" process. I fully appreciate the uniqueness of each individual, couple and family and will work with you to develop a plan that makes sense to you and addresses the realities of your life. Whether your goal is to improve your relationships, alleviate undesirable symptoms, bring more purpose and fulfillment to your life, rid yourself of unwanted behaviors, or experience more joy in your life, I can help you achieve these goals. Experienced in working with the LGBTQ community.
I am a warm and caring human being with a clear understanding that therapy is not a "one size fits all" process. I fully appreciate the uniqueness of each individual, couple and family and will work with you to develop a plan that makes sense to you and addresses the realities of your life. Whether your goal is to improve your relationships, alleviate undesirable symptoms, bring more purpose and fulfillment to your life, rid yourself of unwanted behaviors, or experience more joy in your life, I can help you achieve these goals. Experienced in working with the LGBTQ community.
Sarah Brekke-Velázquez
Clinical Social Work/Therapist, LCSW
Verified Verified
Piedmont Avenue, Oakland, CA 94611
I believe in healing ourselves and each other as the first step toward healing our planet. My intention as a therapist is to guide people toward empowerment and healing in order to live their fullest and most joyful lives possible. I believe that we all have this capacity within us, and therapy can help us to move through our past trauma, oppressive social conditioning, anxieties and other stresses to be our best selves.
I believe in healing ourselves and each other as the first step toward healing our planet. My intention as a therapist is to guide people toward empowerment and healing in order to live their fullest and most joyful lives possible. I believe that we all have this capacity within us, and therapy can help us to move through our past trauma, oppressive social conditioning, anxieties and other stresses to be our best selves.
See more therapy options for Piedmont Avenue, Oakland
Nearby Searches for Piedmont Avenue, Oakland
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How does your Therapist compare?
Number of Therapists in Piedmont Avenue, Oakland, CA
100+
Average cost per session
$200
Therapists in Piedmont Avenue, Oakland, CA who prioritize treating:
92% | Anxiety |
89% | Depression |
87% | Relationship Issues |
76% | Trauma and PTSD |
76% | Self Esteem |
69% | Coping Skills |
67% | Grief |
Average years in practice
12 Years
Top 3 insurances accepted
50% | Aetna |
50% | Other |
28% | Optum |
How Therapists in Piedmont Avenue, Oakland, CA see their clients
70% | In Person and Online | |
30% | Online Only |
Gender breakdown
81% | Female | |
18% | Male | |
1% | Non-Binary |
FAQs - About Therapy and Counseling
How can I find a therapist in Piedmont Avenue, Oakland?
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
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.
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.
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.