Getting Started
What the First Few Sessions Are Like
Starting therapy with Vanessa Gross, LMFT, begins with a free 15-minute phone consultation and a 60-minute first session by secure video. Over the next few sessions, your goals take clearer shape, and you decide how much to share at each stage.
The Free 15-Minute Phone Consultation
The Work With Me page has a form for requesting the consultation. The call gives you a chance to describe what is going on in your own words and to hear how Vanessa might approach it.
Bring any questions you have. Fees are discussed on this call, and you can also ask how online sessions work or whether Vanessa has worked with concerns like yours. If you both think it is a good fit, you can schedule the first full session.
Setting Up for Video Sessions
Every session happens by secure video, so it helps to sort out the practical side before your first appointment. Pick a spot where you can talk freely without being overheard, and check that your camera and sound work a few minutes ahead of time.
You also need to be physically in Texas during each session, since that is where Vanessa is licensed. Giving yourself a few quiet minutes beforehand, with notifications silenced, makes it easier to shift out of the rest of your day.
What Happens in the First 60-Minute Session
The first session runs the full 60 minutes, the same length as every session after it, and most of it is conversation. Vanessa will want to understand what brought you to therapy now and what a hard day looks like for you. She will also ask what you would like to be different.
From there, the conversation widens to your work, your relationships, the people you rely on, and anything you have tried before. That includes past therapy, and what did or did not help. Questions about your history and family are part of it too, and you can answer in as much or as little detail as feels right.
Leave time for your own questions. You might ask how Vanessa would approach your situation or what a typical session looks like. It is also fair to ask how the two of you will know whether therapy is helping.
Going at Your Own Pace
You do not have to tell your whole story in the first hour. If a topic feels like too much to open yet, you can say "I'm not ready to talk about that." That also tells Vanessa something useful about where to start.
Vanessa adjusts the pace to what you can manage. She will also tell you when a comfortable habit seems to be keeping you stuck.
Therapy here does not include crisis support, so if you are in crisis or thinking about suicide, call or text 988, or call 911 if you are in immediate danger.
How Goals Take Shape Over the First Few Sessions
After the first session, you will usually have a rough sense of what to focus on. Over the next few sessions, Vanessa helps turn that into goals in everyday language. Examples might be "stop lying awake replaying the workday" or "say no to extra projects without feeling sick about it."
This is also when she suggests an approach and explains why it fits what you described. It may be a mix, such as CBT for a specific worry alongside psychodynamic work on an old pattern. Goals can change as you learn more, and checking in on them every so often keeps the work aimed where you want it.
Cancellations and Payment
If you need to cancel a session, give at least 24 hours' notice, because a fee applies to late cancellations and missed sessions.
Sessions are private pay, which means you pay for them directly. If your plan includes out-of-network mental health benefits, Vanessa can provide a superbill you submit for possible reimbursement. Any reimbursement depends on your plan's rules. As a private-pay client, you are also entitled to a Good Faith Estimate of costs, and the rates page covers fees and payment in more detail.
Questions
Frequently Asked Questions
That is common, and it is fine to say so at the start of the session. Some people find it easier to open up from their own space, while others need a session or two to settle in. Small things help, like sitting somewhere comfortable and keeping water nearby. If something about the setup bothers you, tell Vanessa so the two of you can adjust it.
Sessions can only happen while you are physically in Texas. If a trip is coming up, tell Vanessa at least 24 hours before the session so it can be moved without a late cancellation fee. The work picks up again once you are back in the state.
Say so, either at the end of that session or at the start of the next one. Sometimes a change in pace or approach is enough. If it turns out a different therapist would suit you better, that is a reasonable outcome too. The guide to choosing a therapist can help you think about what to look for.
Related Pages
Free Consultation
What happens on Vanessa's free 15-minute phone consultation, what to ask, what the call covers and leaves out, and what comes next.Read MoreHow Online Therapy Works
The practical side of online therapy in Texas: the free phone consultation, video setup, privacy at home, location rules and dropped connections.Read More
Superbills Explained
What out-of-network benefits are, what a superbill includes, how to submit one, and what to ask your plan before counting on reimbursement.Read More
FAQ
Read MoreA gentler next step
You don't have to know exactly what to say.
A free 15-minute phone consultation is a simple place to begin.