The first hour, minute by minute.

Before the appointment

Booking happens through Headway or by reaching out directly for a free 15-minute consult first. Most people do the consult, because a short call is a lower bar than a full session when you are not sure yet. If you are using insurance or an EAP, benefits are verified as part of booking through Headway, so you know what you are paying before you show up rather than after.

You will receive intake paperwork electronically: consent to treatment, practice policies, the limits of confidentiality, and a short set of background questions. Filling it in beforehand gives you more of the first hour for the actual conversation. You will also get the secure video link.

Setting yourself up

You need to be physically located in Texas, Maryland or Massachusetts at the time of the session, which is a licensure requirement rather than a preference. Beyond that: a private space where you will not be overheard, a device with a working camera, headphones, and a stable connection. A parked car counts, and it is what a fair number of clients use. Keep water nearby and try to give yourself ten or fifteen minutes afterward before you have to be somewhere.

The first ten minutes

Introductions, a check that the video and audio are working, and a walk through the practical ground: how sessions run, confidentiality and its limits, cancellations, and how to reach the practice between appointments. Zandria will also ask where you are physically located and for an emergency contact, which is standard telehealth safety practice, not a formality.

The middle of the session

This is where you talk about what brought you in. There is no correct way to do it. Some people arrive with a chronological account, some with a single sentence and no idea what comes next. Both are fine. Zandria will ask about your current symptoms, how long this has been going on, what your days look like, what has helped before and what has not, and what your life would look like if this were less of a problem.

She will ask some routine screening questions, including about safety, mood, sleep, alcohol and substance use. These are asked of everyone. They are not a judgment and they are not a trap.

You are not required to describe a trauma in detail in the first session. If you want to say "that happened, I am not ready to go into it," that is a complete answer and it will be respected.

The last ten minutes

Zandria offers an initial read on what is going on and what approach makes sense, whether that is trauma-focused work with EMDR or CPT, CBT-based skills work, or a sequence of both. You will agree on a starting direction and a rough cadence, usually weekly at first. If she does not think she is the right provider for what you have described, she will say so and point you elsewhere. The session closes deliberately, so you are not ending on the rawest thing you said.

Afterward

A first session can leave you lighter, tired, or oddly flat, and any of those is a normal response. Do not schedule anything demanding straight afterward if you can help it. Most people book their next appointment before they log off.

What to bring

Nothing mandatory. If it is useful to you, jot down the two or three things you most want to change, any medications you take and who prescribes them, and any questions you want answered about the approach. If your mind goes blank when the call starts, which happens often, a written note is a good backstop.

Read the wider process, browse the FAQ, or book your free consult. Booking is also available directly on Headway.

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