The first session is a chance for us to get to know your family, and for you to get to know us.

We'll start by listening. Your clinician will want to hear about your child's history, what you've been noticing at home, what you've already tried, and what you're hoping life looks like on the other side of this. There are no wrong answers, and you don't need to have everything figured out before you come in. Many parents arrive with a mix of concern, nervousness, and exhaustion, and a cautious sense of hope that things can get better. All of that is welcome.

Depending on your child's age and comfort level, the first session may be just with you as the parent or with both of you together. If your child is present, your clinician will follow your child's lead and won't push for more than they're ready for.

For some families, one intake session is enough to get a clear picture. For others, particularly when there is a longer history of symptoms, multiple diagnoses, or a lot of ground to cover, the intake may extend across two to three sessions. Either way, your clinician will let you know what they need and why, so the process always feels transparent and purposeful rather than open-ended.

As the intake comes to a close, you won't leave with more questions than you came in with. Your clinician will share their initial impressions, explain what they think is going on, and begin to outline recommendations for a clear path forward. You'll have a sense of what treatment will look like, what to expect along the way, and what's possible for your child.

Most parents tell us they leave the first session feeling lighter than when they walked in. That's exactly what we're aiming for.

Treatment length varies depending on what your child is struggling with, how severe the symptoms are, and how consistently they are able to engage in therapy. For most childhood anxiety disorders, research suggests families begin to see meaningful progress within 12 to 16 sessions. OCD treatment follows a similar timeline, typically ranging from 12 to 20 sessions, though the work is highly structured and specialized, and some children with more complex presentations or entrenched symptoms will benefit from additional time. Your clinician will discuss realistic timelines with you early in treatment and check in on progress regularly, so you always have a clear picture of where things stand and what comes next.

This is more common than you might think, and it makes complete sense when you understand what's driving it. For anxious kids, therapy can feel like walking straight into everything they've been working hard to avoid. The anticipation alone, not knowing what will happen, whether they'll be put on the spot, or whether someone will try to make them do something scary, can be enough to trigger significant resistance. Their refusal isn't defiance. It's anxiety doing exactly what anxiety does.

A few things that can help before the first session:

• Be matter-of-fact rather than overselling it. Telling a child therapy will be "fun" or "no big deal" can backfire if they don't believe you. A simple, honest framing works better: "We're going to meet someone whose job is to help kids who worry a lot. You don't have to do anything you're not ready for."

• Avoid negotiating or over-explaining. The more a parent engages with an anxious child's "but why do I have to go" spiral, the more it signals that their resistance might work. A calm, warm, matter-of-fact stance is more effective than a lengthy debate.

• Let them know they're in control. Anxious kids often comply more readily when they feel some agency. Letting them choose what to wear, where to sit, or whether to bring something familiar can reduce the sense of being dragged somewhere against their will.

Once your child is in the room, our therapists won't dive straight into the hard stuff. Building trust comes first. For younger children that might mean games, drawing, or just talking about whatever they're interested in. For teens it might mean talking about music, sports, or school before anything else. Many kids who arrive arms-crossed and silent leave their first session willing to come back, simply because the experience wasn't what they feared.

If your child's resistance feels insurmountable, that's what SPACE is for. SPACE (Supportive Parenting for Anxious Childhood Emotions) is a structured, evidence-based program that works entirely through the parent, with no child participation required. It focuses on changing how parents respond to their child's anxiety, and research shows it produces meaningful improvement in children's symptoms even without direct child involvement. Your child doesn't have to be ready for therapy for your family to start making progress.

We are an out-of-network provider, which means we do not bill insurance directly.

When a therapist works within insurance networks, treatment decisions are often shaped by what insurance will and won't cover: how many sessions are approved, what diagnoses are covered, and how frequently your child can be seen. As an out-of-network practice, those decisions stay where they belong: between your family and your clinician. Your child gets the treatment they actually need, for as long as they need it, with the specialist who is the right fit for their specific situation rather than whoever happens to be in-network.

Some families also choose to go out of network for privacy reasons. When insurance is billed, a formal diagnosis becomes part of your child's health record. While the ACA prevents this from affecting health insurance coverage, it can have implications for life insurance applications and certain career paths later in life, including military service, federal employment, and security clearances. Paying privately keeps your child's records between your family and your clinician.

On the practical side, out-of-network care is often more affordable than families expect. Many PPO plans reimburse between 50-80% of out-of-network costs. We provide superbills that you can submit directly to your insurance company for reimbursement if you would like to use your insurance benefits. HSA and FSA funds can typically be used to cover session fees as well.

Yes. We offer online therapy for children and teens throughout Texas. Online therapy can be a good fit for families with busy schedules, those who live outside the Austin or Round Rock area, or teens who are more comfortable engaging from home. Our clinicians are experienced delivering ERP, CBT, and ACT effectively via telehealth.