What to Expect in Your First Online Therapy Session

Reviewed by Rory Nicol, RP on Sep 1, 2021

Taking the First Step

Deciding to start online therapy is a big step toward better mental health and wellbeing. It is normal to feel a mix of emotions such as fear, excitement, or even pride knowing that you are choosing to take care of yourself in a meaningful way.

At the same time, you might feel nervous about starting online therapy. This is common and shows how much you care about your mental health. The best way to calm those worries is to prepare ahead of time. In this guide, you will learn what to expect from your first online therapy session and how to make it a positive experience.

Choose the right online therapy therapist for your goals

Finding the right therapist for online therapy can feel overwhelming, but remember that you have options. Just as you would compare other services, you are allowed to “shop around” for the right professional.

• Ask your doctor for a referral.

• Talk to trusted family members or friends for recommendations.

• Visit therapists’ websites to read about their approach and areas of expertise.

If you are hoping to work on a specific issue try to find a therapist with expertise in that area. Many list their specialties or areas of focus on their websites. There are therapists who specialize in relationship issues, anxiety, post-traumatic stress disorder (PTSD), parenting, anger management, childhood trauma, or sexuality/LGBTQ2S+ —pretty much any issue, goal, or situation you can imagine. If you’re not sure about someone’s expertise, just call them and ask. If they can’t be of assistance with your issue, they may be able to refer you to someone who can.  

Ask for a consultation first

Every therapist is different, every client is unique, and every therapist-client relationship is distinct as well—which means that there is no universal description of a therapy session. Online Therapy is really about whatever you need—a one-time conversation, a temporary source of support during a life transition, or an ongoing experience to optimize health physically, mentally, emotionally and spiritually. Having a consultation before you begin online therapy is an option, not a requirement. However, it is more than acceptable to request a phone consultation with a potential therapist before officially beginning sessions. In fact, most therapists expect it because they understand that choosing a therapist is a big decision and that the anticipation of your first session can be nerve-racking. This is the time to pose any of the questions that you may have about therapy and to decide whether the therapist and the services they provide are the right fit for you.

Here are some helpful questions to ask during your initial consultation*:

• How do you approach helping people?
• Do you have experience working with people who have concerns like mine?
• What can I expect during our sessions?
• What will you expect of me? Will I have homework?
• How will we work together to establish goals and evaluate my progress?
• How often will we we meet and how hard will it be to get an appointment?
• How much will this cost?
• Will my insurance cover the costs of therapy?
• Is there any opportunity to pay on a sliding scale?

Following your consultation, ask yourself:

Do I feel comfortable with this person? Even if this person has a good reputation or a high level of education, the most important thing is whether you can work well together. What "vibe" did you get? The personal questions a mental health professional asks may make you feel uncomfortable sometimes, but the person shouldn't make you uncomfortable. You should feel that this person is on your side. Also, if having a therapist who understands and respects your cultural background is important to you, do you think they demonstrate that kind of perspective? It’s ok if the first therapist you talk to “doesn’t feel right” or lacks the experience with your particular mental health issue(s). You are not obligated to start treatment just because you had an initial consultation. Remember that you're recruiting someone who can help you with your treatment long-term. With a little persistence, you'll find the right person who will listen to you, take your perspective into consideration, and work with you to improve your sense of well-being.  

Preparing for your first online therapy session

The first visit with any therapist can feel a bit awkward… you are meeting with a stranger to discuss things you might be uncomfortable talking about. Where do you even begin? Rest assured, your therapist is an educated and skilled helper who will gently put you at ease and guide the first session. That first session is basically an interview where your therapist asks you a lot of questions about you, how you cope, and your symptoms. It might feel intimidating at first to talk about some of these topics. We advise writing a list ahead of time of what you want to discuss during the first session. Having it with you when you meet with your therapist will help keep you centered and focused. Keep in mind that honesty is paramount to successful therapy. In order for your therapist to help, they need to know what you’re experiencing. Therapists aren’t there to judge you. They chose their profession so they can help people improve mental health and wellbeing—not to make things worse.

Consider the following:

• The challenges you are currently facing that you’d like to explore as mentioning topics upfront will help the therapist guide future sessions
• Recent changes in yourself or life circumstances that prompted you to seek therapy
• Things you have already tried in order to feel better
• Observations from family or friends (have they expressed concern about certain behaviors or moods, for example?)
• Information about your personal background (your family situation, significant events, etc.)
• How long have you been experiencing your current difficulties? (If you’re bothered by social anxiety, for instance, has this plagued you for years or is it new?)

 

What to expect during your first online therapy session

Get connected and comfortable

Online therapy means you don’t have to travel or sit in a waiting room before your session. You can literally have your online session anywhere as long as there is an internet connection and privacy. However, there is still some prep work to do to get ready for your appointment. You will need to have a cellphone, tablet or computer and access to the internet. We also recommend finding a quiet, private place that allows you to speak freely without distractions. Lastly, it’s a good idea to have a notebook ready to jot down any notes from your session. Now, get comfortable on your favourite chair with a coffee, tea, or beverage of choice, you are ready to go.

Set aside some time before and after your first session

The first session you have will probably leave you feeling emotionally drained. Often, just anticipating a therapy session can cause stress and anxiety. Blocking out some extra time before and after your session can relieve unnecessary stress and allow time for you to process what you and your therapist discussed during the session. The most important thing to do after your first therapy session is check in with yourself. Ask yourself how you felt your first session went, and see how you would feel about going to another one with this therapist. Remember: there’s no such thing as a one-session cure, so you may feel a little better or relieved, but your symptoms won’t immediately disappear. Consider how you felt about your therapist specifically. Did you feel comfortable talking with them? Did you feel like the two of you could work together over a long-term time frame? Therapy is an incredibly individualized process, so not every therapist is going to be the right fit for you and that’s ok. Additionally, you may have some “homework” from your therapist before your next session. This could be anything from journaling throughout the week to doing a little reading that may help provide context for your next session. Remember: whatever work you do between sessions is about making you feel healthier and happier, not about getting a good grade. Devoting part of your time post-session to journaling can lead to deeper insights or new goals.

Getting logistics out of the way

During the first session, your therapist will address all those practical topics like consent forms, privacy and confidentiality, scheduling and fees and payment.

Getting to know each other

You’ll most likely spend the first part of your online therapy session just getting to know one another. Your relationship with your therapist is just like any other—it helps if you’re able to connect with one another on a personal level initially. You don’t have to leap into your deepest darkest secrets immediately—feel free to talk casually at first to get a sense of how the two of you will communicate with one another.

Question time

Your therapist doesn’t know much about you yet; therefore, they will likely ask you many questions as they start to understand you and what you’re experiencing. Your therapist will need to know why you’re seeking online therapy. They may ask what kinds of needs or issues you’d like to address in your treatment together as well as what you’ve done to manage your mental health in the past. They’ll want to talk through what worked and what didn’t to get an understanding of how best to help you. Depending on the therapist and their approach to therapy, you might be asked questions about your childhood, education, job, relationships, thoughts, feelings, or actions. All your responses help your therapist understand you and know how best to help you.

Managing your expectations

Your initial session is often more helpful to your therapist than it is to you. For this and other reasons, your first session can be somewhat disappointing or frustrating if you don’t know what to expect. It’s important to have realistic expectations for the therapeutic process in general and the first session specifically. Online Therapy isn’t a quick-fix. Quite likely, you won’t discover solutions at your first session because mental health is complex. Just as it takes time for problems to develop and begin interfering in your life, it takes time to work through and unravel those challenges. It is unlikely that you emerge from session one feeling transformed. It is, however, realistic to expect that after your first meeting you will feel a sense of hope that, in time and with work, therapy will help your mental health and quality of life. Because it does take time to develop a relationship with your therapist and begin to feel positive movement toward your goals, it’s advisable to be patient and try a few sessions with a therapist before deciding whether to continue working with them. If, after three or four sessions you feel frustrated, it’s more than ok to find a new therapist to work with.

Signs that this therapist isn’t for you include:

• You feel disconnected from the therapist
• You don’t notice any progress toward change
• Each session has ended with you feeling confused or discouraged

 

The do’s and don’ts* to maximize your online therapy

Mental health online therapy is a gradual but steady process of developing insights, overcoming obstacles, setting and achieving goals, and enhancing wellbeing and the quality of your life. The first session is just the beginning of what can be a rewarding journey. With preparation and realistic expectations, you and your therapist can start to develop rapport, trust, and an important sense of hope for healing.

Here are a few tips to help you:

Do

• Be kind to yourself. Therapy can be emotional; you’re allowed to have big feelings.

• Be honest. There’s no reason to be vague or hide the reasons you’ve decided to try therapy. The more honest you are, the faster your therapist can identify and help you resolve the issues that are challenging you.
• Be willing to reflect on your own thoughts and behaviors. A good therapist will challenge you to look inward and it may be difficult to acknowledge your role and responsibilities. But that’s what it’s all about, putting in the work to make progress towards your goals.
• Close your session with a plan. Do you have homework before your next session? Some new behavior to try? Setting aside the time required (outside of your sessions) to make therapy a consistent priority is essential making and maintaining your progress.
• Give therapy at least a few tries. It does get easier, and the first session is often just about providing background info, which means it may not be as helpful as you would have hoped.

Don’t

• Put up a wall. Therapy only works if you commit to leaning in with your therapist.

• Ask personal questions about your therapist. Healthy professional boundaries mean your sessions should be focused on you.
• Lie. Therapy won’t do you any good if you aren’t willing to tell the truth.
• Drop a bomb on your way out the door. While some sessions may be packed with things to talk about, try to prioritize the big things at the beginning. When you reveal big topics as your session is ending, you’re doing both yourself and your therapist a disservice. Share while there’s still plenty of time to discuss!
• Stick with a therapist you don’t feel a connection with. Just as in life, you won’t always mesh with everyone you meet. You’re allowed to search for a new therapist you feel comfortable with, rather than sticking with one you don’t.
• Sabotage yourself with unrealistic expectations. Therapy is not a quick fix. It will take time and effort to reach your goals, so don’t give up if things don’t change immediately.

 

We’re here if you need help.

Online Therapy is a valuable tool that can help you to solve problems, set and achieve goals, improve your communication skills, or teach you new ways to track your emotions and keep your stress levels in check. It can help you to build the life, career, and relationship that you want. Does everybody need it? No. But if you are curious about working with a therapist, that curiosity is worth pursuing.

We know it takes a great amount of courage to examine your life and to decide that there are things you would like to change. And it takes more courage to do something about it. Support from a trusted adult, a counsellor, or a therapist can make a real difference in how you feel day to day.

At The Dot, we can help. We offer free consultations for anyone in Ontario considering individual or couples counselling, online at The Dot. We will go through any of your questions and concerns to help you decide whether online counselling is the right choice for you.

 

Book Your Consultation Today!

Visit our therapist match form to let us match you to the therapist with the skills you need. 

---

SOURCES National Alliance on Mental Health NAMI Finding a Mental Health Professional PsychCentral Things to Expect (and Not!) in Your First Therapy Session Psychology Today What Really Happens in a Therapy Session