What Happens in Your First Online Therapy Session? A Beginner’s Guide

Going to a new therapist for the first time can be uncomfortable. The discomfort may be stronger if it’s your first time doing virtual therapy. Through my years of experience offering online therapy in California, I have received some questions repeatedly when it comes to online sessions. I’ve created this guide to help explain what happens in your first online therapy session in the hopes it eases some nervousness.

We will cover what you need to prepare before the session, what the session may look like, and the closing of the first session. Remember that the first session is generally about getting comfortable with each other and understanding what brings you to therapy.

Before Your First Session

Before getting to the first session, there are generally a few steps that must be taken. Your therapist will be able to help with these; don’t hesitate to reach out with any questions you have.

Paperwork and Forms

Most therapists will require a few forms to be filled out before starting the first session. Ideally you can fill these forms out before showing up for the first session. Forms may include:

• An Informed Consent

• Emergency Contact

• Card Authorization

• ROI where necessary

Preparing Your Space

Before arriving your first online therapy session, you’ll want to have a space set up. What works may vary from individual to individual, but you generally will want to find a private space that is comfortable. The session will be best if you are in a location without interruptions or distractions.

You may want to silence notifications on your phone or computer. Get water, a notebook/journal if you feel it’s useful, and let anyone else in your home know that you will be unavailable for an hour. One of the benefits of online therapy is being able to participate from the comfort of your own space, so make sure to take some time to create a safe and comfortable environment.

Checking Technology

To be best prepared for your session, it can be helpful to get everything handled with technology ahead of time. Make sure your internet connection is stable, set up your headphones and/or microphone, and log into Zoom early to be ready to go.

Introductions

On to the actual first session. Although you may have done a free consultation and briefly chatted with your therapist before, the session will often start with both parties introducing one another. This may seem like the awkward phase, but fret not. Your therapist has done this many times, and will make the transition into the new therapeutic relationship as natural as possible.

Discussing History and Background

During your first session, your therapist may ask for some background information and history to better understand what brings you to therapy. You may be asked about what brings you to therapy, if you’ve been in therapy before, any challenges you’re experiencing, and a bit about daily life.

As this is your first session, you do not need to tell your entire life story. You can share what you are comfortable sharing. Remember your therapist is present to support you and understand, not to judge.

Clarifying Therapeutic Goals

Therapy is not just about focusing on the issues; your therapist will ask you about your goals and intentions. Whether you want to learn more about why you are so emotional recently, learn to set healthy boundaries with family, or engage in some harm reduction therapy for your drinking, now is the time to share your goals.

As it is only the first session, your goals don’t need to be overly specific. Goals will likely change as therapy progresses, and therapy is a collaborative process between your therapist and you.

Explanations of Therapy

Depending on what you are dealing with and your goals, your therapist may offer an explanation of the type of therapy and expectations. They may explain CBT, EMDR, ACT, or any other modalities they utilize. If you’re seeing online therapy for anxiety, the therapist may offer an explanation of the process and what growth looks like. Ideally, the therapist will adapt their specialty to your specific needs.

Closing the Session

At the end of the session, the therapist will likely summarize what was discussed, reiterate initial goals, and discuss the therapeutic process. You’ll have time to ask any questions, schedule future sessions, and clarify any topics discussed.

When the session does close, remember that a range of emotions may arise. Therapy can be tiring, so allow yourself a few minutes to settle. You might feel some relief, vulnerability, hope, uncertainty, or just simple emotional exhaustion.

What You Don’t Need During Your First Virtual Therapy Session

You really do not need to do much other than prepare your space for your first online therapy session. Therapists do not expect you to have everything figured out, know exactly what is wrong, or have perfect answers to every question. You also don’t need to share more than you are comfortable at the beginning, tell your deepest secrets, or prove that you need help in any way.

Tips to Get the Most Out of Online Therapy

You’re paying for therapy. You spend time and energy to show up. You want to find support. It can be helpful to know what to do (or not to do) in order to get the most out of your sessions.

Be Honest - Honesty goes a long way in therapy. Again, you don’t need to share too much that you feel unsafe. But more honesty means you can dig into deeper issues with more authenticity. Therapy simply doesn’t work if you are lying or omitting important pieces of truth.

Give Feedback - If your therapist says something that is useful, let them know. If they say something that doesn’t feel helpful, let them know. Therapy takes two to work, and your therapist can benefit from correction, feedback, and a point in the right direction.

Attend Consistently - Consistency is important when it comes to therapy. Research shows that consistent attendance and work is correlated with better treatment outcomes. Try to find a schedule that works for both you and your therapist, and make your sessions regularly.

Incorporate and Practice - The work of many types of individual therapy doesn’t stop when the session ends. Take what you’ve learned in session, and try to bring it to your everyday life. If you’re not sure how to do so, ask your therapist for pragmatic and accessible tips and suggestions.

Be Patient - Therapy takes time. Although you may leave a session with some insight or clarity, every session won’t be like this. For change to take place, a bit of patience is required. Recognize that progress often comes in the forms of steps in the right direction, not necessarily leaps and bounds.