What Can a First Timer to Online Therapy Expect?

If you don’t have any experience with therapy or mental health treatment in general, it can be pretty daunting to schedule to see a therapist. In fact, I think finding the courage to look up therapists, make some calls or send some emails, and schedule that first appointment is probably much more frightening than going! If you’ve got that far and are now wondering what your online appointment is going to be like, I applaud you for taking that big step in caring for yourself. If you’re still contemplating and doing your research, hopefully this will help ease some fears as well.

Every therapist will have some differences in how they approach sessions, but all should have some basic aspects involved. Here are some things to expect from your first online therapy session.

1. Informed Consent: this is essentially a fancy way of saying that you have a right to know how things work, what confidentiality means and when it might have to be broken, fees and how they will be collected, and how to contact your therapist outside of appointments. Your therapist should provide you with an informed consent document that you will sign prior to the session, and they will also go over important highlights with you and answer any questions in that first appointment.
2. Therapist Introduction: your therapist will likely let you know how the session is going to go and tell you a bit about their background.
3. Rules: There will likely be a discussion about important ways to approach therapy to keep you and your information safe. Your therapist will discuss making sure you are in a private space for your online therapy appointments, not driving during your appointments, cancellations, etc.
4. Information Gathering: there are a lot of ways to do this, but most of your first session time will be spent exploring your history and the history of the problems you are coming to therapy for. Some therapists have a formal interview process with specific questions they’ll ask, and others invite you to speak about what’s going on and will ask questions throughout.
5. A Plan: Typically any formal goal setting won’t happen until your second or third session, but before you leave the two of you will likely discuss what your main goals are (“What do you want to get out of your therapy experience?”). You’ll also establish your appointment time(s) for going forward. Your therapist will likely describe a bit about how they work and what therapy might look like for the two of you.

Some other important notes:

• You can expect warmth, openness, and non-judgment in your appointment. If you don’t feel those things, it may be an indication that this therapist isn’t the right match for you.
• A therapist generally won’t tell you what they think you should do, or give advice or opinions. They will likely nudge you to examine your own values, ethics, and desires to find the right answers for you.
• You do not have to prepare for session or know what you are going to say or talk about. You might begin by talking about recent events and find it leads you to what’s important to discuss. In fact, the sessions in which people say they don’t have much to talk about often end up being some of the most rewarding and insightful!
• There will be a lot of forms. Therapists don’t really like them either, but they’re a necessary part of the process.
• It can be extremely intimidating to think about having to talk about our greatest fears, regrets, shame, or trauma. You should never be forced to discuss anything you aren’t ready to, and part of therapy is centered around finding ways to create a safe relationship where you can trust your provider. It is okay to say, “I’m not ready to talk about that just yet” and set your own boundaries.
• It is important to note that it is common for people to sometimes feel a bit worse before they feel better, as therapy can bring up the difficult stuff. Talk with your therapist about it if you’re feeling worse than when you started, and the two of you can make a plan together.
• You sometimes have to give it 2-3 sessions to really know if a therapist is a good fit for you. The first session is all about getting to know each other and of course, “taking care of business” (paperwork). Unless there is a big red flag, see how you feel after you settle in a bit.

Overall, going to therapy should be a helpful experience where you feel safe enough to explore your authentic self and work through any concerns you have. Depending on your insurance or financial situation, going to therapy simply for self exploration can be a wonderful experience. Online therapy offers the opportunity for busy people, those in smaller areas without access to in-person offices, or those who have difficulty leaving their home to explore themselves and grow. Whatever your reasons for seeking a therapist, don’t be afraid to ask or give feedback if something doesn’t feel right, and happy growing!

Abigail R Hitchen PsyD

Photo credit: Abigail Hitchen, “Aquí eres libre” ~ “Here you are free”