Starting therapy can feel overwhelming, especially if you’re not sure what to expect. If you’re looking for in-person and virtual therapy in Texas, this page will walk you through what the process looks like at Elko Counseling and how to take the next step with confidence.
What happens during the first session?
The first session is primarily a conversation. We’ll spend time understanding what brought you in, what you’re hoping to work on, and what feels most important right now.
You won’t be pressured to share everything at once. You get to set the pace.
By the end of the session, we’ll begin identifying goals and discussing what therapy might look like moving forward.
Do I have to know exactly what’s wrong before I start?
No. Many clients come in feeling overwhelmed, stuck, or unsure how to describe what’s happening. That’s completely okay. Part of our work together is clarifying what’s going on and creating a plan that makes sense for you.
How is Elko Counseling different?
We intentionally keep our practice small and personal.
At many large practices, you might interact with an intake coordinator, a billing department, a scheduler, and then your therapist. At Elko Counseling, your experience is much more direct. With the exception of initial contact being reviewed by our owner to ensure the right fit, your therapist handles your care personally.
That means your therapist knows your goals, your schedule, your progress, and your needs. We don’t believe therapy should feel corporate or overly clinical. It should feel human, relational, and grounded.
Our therapists are direct, honest, and collaborative. We value real conversations over excessive “therapy language.” Sessions are structured and goal-oriented, and we care deeply about helping clients make measurable progress.
You can expect clarity, accountability, warmth, and a space that feels inviting rather than institutional.
Will therapy just be talking about feelings?
Therapy includes processing emotions, but it also includes learning tools, building insight, and creating tangible change. Depending on your needs, therapy may also include somatic approaches like EMDR. We work with you to identify patterns, develop coping strategies, and move toward clear goals.
How In-Person and Virtual Therapy in Texas Works
Some therapists offer in-person sessions in our Dallas office, some offer hybrid, and some may offer virtual sessions in Texas depending on availability. We can help you determine what option works best for you so you can choose the format that feels most comfortable and accessible for your schedule and lifestyle.
What happens after I submit the contact form?
When you reach out through our contact page, your message is reviewed by our owner to help ensure you are matched with the therapist who best fits your needs. We take this step seriously because we know the right therapeutic relationship matters.
After that, your assigned therapist will communicate with you directly regarding scheduling, insurance, paperwork, and next steps.
We don’t outsource communication or pass you through multiple departments. Our goal is for the process to feel clear, personal, and supportive from the very beginning.
If at any point you have questions about fit, availability, or session format, we will talk through it with you. We want you to feel confident in your decision before your first appointment.
What if I feel nervous about starting therapy?
That’s normal. Most clients feel some level of anxiety before their first session. You’re stepping into something vulnerable. We aim to make the process feel as comfortable and grounded as possible.
How long will therapy take?
That depends on your goals. Some clients come for short-term support around a specific issue. Others prefer longer-term work. We will discuss expectations early on so you feel clear about the direction of therapy.
Do you accept insurance?
We accept Blue Cross Blue Shield, UnitedHealthcare, and Aetna. We also work with clients who plan to use out-of-network benefits.
Our office handles billing and submits claims on your behalf when applicable. We review your coverage and financial details before or during your first appointment so there are no surprises.
EMDR
What is EMDR?
EMDR stands for Eye Movement Desensitization and Reprocessing. It’s a research-supported therapy that helps people heal from trauma and other distressing life experiences.
Sometimes painful experiences don’t fully process in the brain. Instead of feeling like something in the past, they can continue to feel present and overwhelming. EMDR is designed to help your brain process those experiences in a way that reduces their emotional intensity.
EMDR should always be provided by a therapist who has been properly trained in this approach.
How does it work?
When something very upsetting happens, your brain can go into survival mode. In those moments, it doesn’t always store memories the way it normally would. That’s why certain memories can feel “stuck” or frozen in time.
EMDR helps your brain reprocess those stuck memories. During sessions, your therapist guides you through structured steps that allow your brain to do what it naturally wants to do: heal.
After successful EMDR work, you’ll still remember what happened. The difference is that it no longer feels as overwhelming, intense, or intrusive.
For more information on EMDR, visit the EMDR International Association Website.
CBT
Cognitive Behavioral Therapy is based on a simple but powerful idea: the way we think affects the way we feel and behave.
When we’re stressed or overwhelmed, our thoughts can get more extreme without us realizing it. CBT helps you slow that process down.
In therapy, we notice thinking patterns, check whether they’re fully accurate, and build more balanced ways of responding so you can feel more in control.
For more information, visit the Beck Institute website.
Gottman Method Couples Counseling
The Gottman Method is a research-based approach to couples therapy that helps partners feel more connected, understood, and supported.
Together, we look at the patterns that keep you stuck and build practical skills you can use in real life.
- Break negative communication cycles
- Increase empathy and understanding
- Rebuild closeness and emotional safety
- Repair past hurts
- Strengthen friendship and shared goals
For more information, visit the Gottman Method website.
DBT
Dialectical Behavior Therapy (DBT) is a skills-based approach that helps people manage intense emotions and improve relationships.
- Mindfulness: staying present
- Distress tolerance: getting through hard moments without making them worse
- Emotion regulation: understanding and managing strong feelings
- Interpersonal effectiveness: communicating clearly and setting healthy boundaries
For more information on DBT, visit the DBT resource page.
Thinking About Starting Therapy?
If you’re considering in-person or virtual therapy in Texas, the next step is simple. Reach out through our contact page or call the office to schedule a consultation.
You don’t have to commit to long-term therapy before speaking with someone. We’re here to answer your questions and help you feel comfortable moving forward.