What to Expect in Your First Online Therapy Session

A clear, calming guide to what happens in your first online therapy session, how to prepare, and what to expect before, during, and after your appointment.

A woman smiling while looking at her laptop during an online therapy session.

First Time in Therapy?

If you’ve decided to start therapy, you’ve already accomplished your first goal! Making that decision can be challenging, especially if you’ve never been to therapy before. It’s natural to have questions including:

  • What will therapy be like?
  • How is seeing a therapist online different from seeing one for in-person sessions?
  • Will therapy even work?

These are all common concerns. Online therapy offers the same benefits as in-person therapy, with the added convenience of meeting from the comfort of your own home.

Before Your First Session – Getting Started

Many therapists offer a free 15-minute phone call to briefly discuss what you’re looking for, and answer any questions that you may have. The therapist may also ask you a few questions to ensure that you’re in the right place. These might include:

  • Have you been in therapy before?
  • What has worked and what hasn’t?
  • When was the last time that you wanted to harm yourself?
  • Do you have preferences in a therapist’s personality or approach?

Therapists have different training, approaches, and styles of how they show up in therapy. Some clients prefer a therapist who incorporates humor, and others may look for a therapist with specific expertise. It’s okay to have your preferences! A good therapist will want to make sure that you get the best fit for you, even if that means referring you to someone else. Review the therapist’s website and their About page prior to your call. If during the call it seems like a good fit, you’ll be able to schedule your first full intake session.

You’re Scheduled! What Next?

Once you’re scheduled, you’ll receive:

  • Paperwork to complete online. This includes contact info, practice policies, and a short questionnaire about your history and goals. Many therapists require this paperwork to be completed at least 24 hours before your first session.
  • A secure link to your online video session. No need to download extra apps! Just click the link from your reminder email at your appointment time.
  • Guidance on setting up for your online session. A few simple steps can make your session feel more comfortable and go smoothly.

Tips on How to Prepare For Your Online Therapy Session

Image of laptop, notepad and pen, and a coffee with a heart lattee art to take notes while preparing for first online therapy session with Shepherd Therapy.

Find a quiet and private space

Start by finding a room with a closed door, comfy seating arrangement, and eliminate as many distractions as possible. This will help you feel more at ease.

Check your internet and your device

It is best to have a stable internet connection, along with a computer (or phone) with good camera and microphone.

Use headphones if needed

This can improve sound quality for both you and the therapist, as well as enhancing your privacy.

Grab a notepad and your water

Just like an in-person session, you may want to jot down any thoughts, and to stay hydrated.

During Your First Online Therapy Session

Your first therapy session is about making sure that you feel comfortable, and you and your therapist getting to know each other a bit better. Here are some things you can expect to go over in the first session:

What brings you to therapy?

There’s no right or wrong way to start. Just speak when you feel ready.

Your history

Share only what you’re comfortable with. This isn’t the session to do a deep dive into trauma history, so don’t worry about that!

Discuss your goals

Whether it’s managing anxiety, processing trauma, or navigating a life transition, therapy will be tailored to your individual needs.

Ask your questions!

You can ask any questions that you want such as wondering how online therapy works, what to expect next, how often you might meet. Now is the time to ask.

Your therapist should also provide a brief overview of

  • Therapy and practice policies, cancellations, fees, and any questions about the forms
  • Payment options
  • Confidentiality and it’s limitations

Online therapy makes mental health support accessible, flexible, and just as effective as in-person care.

After Your First Session

Dandelion seeds blowing away, like stress relief, in a therapy session - Shepherd Therapy

You might leave feeling lighter, or you may feel like there’s a lot to process. Either way, that’s okay! Therapy is about the journey, and it is not a quick fix (especially in regards to EMDR!). Here are a few things to reflect on after your first session:

  • Did you feel comfortable? Having a strong connection with your therapist matters.
  • Do you want to continue? If so, you can schedule your next session.
  • Give yourself grace! Starting therapy is a courageous step.

Common Questions

A few quick answers to help you know what to expect in your first online session.

Yes, all sessions are private, encrypted, and follow professional ethical standards.

Most therapists provide intake forms online for you to complete. Filling them out ahead of time can help the therapist focus in on your specific needs.

Your therapist can guide the conversation. You don’t need to prepare topics in advance unless you would like to.

Thinking about Therapy?

If you’re thinking about starting online therapy and would like an integrative approach, I’m here to come along side you in your journey. Schedule a free 15-minute consultation call to learn more!


Jen Shepherd, MSW, LICSW, LCSW, is a therapist and clinical aromatherapist in the Twin Cities. Through Shepherd Therapy, she provides online therapy for women in Minnesota and Wisconsin, specializing in integrative health, anxiety, trauma, recovery, and chronic health issues. At Shepherd Wellness, she offers professional consultation to mental health providers on incorporating aromatherapy into their practice.

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