How to Prepare for Your First Online Therapy Session
A step-by-step guide to preparing for your first online therapy session, including technical setup, space preparation, mindset tips, and what to do during and after.
Online Therapy Works Best When You Set Yourself Up for It
Starting therapy is already a big step. Starting it online adds a layer of logistical questions that can make the whole thing feel more complicated than it needs to be. Where should you sit? What if the technology fails? Is it going to feel awkward talking to a screen?
These are normal concerns. The good news is that a little preparation goes a long way. Most of the things that make an online session feel strange or difficult are fixable with a few minutes of setup before your appointment.
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Step 1: Handle the Technical Setup (The Day Before)
Do not leave this for the last five minutes before your session. Test everything the day before so you have time to troubleshoot.
Check your internet connection. Video therapy needs a reasonably stable connection — at least 5 Mbps up and down. If your Wi-Fi is unreliable, consider using an ethernet cable, moving closer to your router, or using your phone's cellular data as a backup.
Test the platform. Your therapist will send you a link to their video platform (common ones include SimplePractice, Doxy.me, or Zoom for Healthcare). Click the link ahead of time to make sure it loads. Some platforms require you to download an app or allow camera and microphone access in your browser. Do this before session day.
Check your camera and microphone. Open your device's camera app to make sure the camera works and the angle is reasonable. Test your microphone — many platforms have a test feature, or you can record a short voice memo on your phone.
Charge your device. If you are using a laptop or tablet, make sure it is fully charged or plugged in. A dead battery mid-session is a common and completely avoidable disruption.
Have a backup plan. Know your therapist's phone number in case the video connection fails. Most therapists will switch to a phone call if technology issues arise.
Step 2: Set Up Your Space (30 Minutes Before)
Your physical environment has a bigger impact on your session than most people expect.
Find a private room. This is the single most important thing. You need a space where you will not be overheard and will not be interrupted. A bedroom with a closed door works well. If you live with others, let them know you will be unavailable for the duration of your session.
Reduce noise. Close windows if there is street noise. Turn off any music or television. If you are worried about being overheard through thin walls, a white noise machine or fan outside the door helps.
Use headphones. This keeps your therapist's voice private and also improves audio quality on your end. Any headphones with a built-in microphone work well — earbuds are fine.
Position your camera at eye level. Prop your laptop on a stack of books or use a phone stand so the camera is roughly at your eye height. This feels more natural than looking down at a device in your lap, and it helps your therapist see your facial expressions clearly.
Mind the lighting. Face a window or lamp so light falls on your face. Avoid sitting with a window behind you, which creates a silhouette and makes it hard for your therapist to see you.
Have water and tissues nearby. Therapy can be emotional, and you may be talking for 45 to 60 minutes. Keep a glass of water within reach, and have tissues available if you think you might need them.
Put your phone on silent. Notifications during your session are distracting for both you and your therapist.
Step 3: Prepare Yourself Mentally (15 Minutes Before)
Know what paperwork is done. Most therapists send intake forms to complete before your first session. These typically include a consent form, a brief questionnaire about your symptoms and history, and insurance or payment information. Complete these ahead of time so your session can be spent talking, not filling out forms.
Think about what you want to say — but do not script it. It helps to have a general idea of why you are seeking therapy and what you hope to get out of it. But you do not need a prepared speech. Your therapist will guide the conversation and ask questions. A few notes jotted on paper can help if you are worried about blanking.
Give yourself a buffer. Do not schedule your session between two back-to-back meetings or right before a stressful obligation. Give yourself at least 15 minutes before to settle in and 15 minutes after to process.
Expect it to feel a little awkward at first. Almost everyone finds the first few minutes of video therapy slightly strange. You are talking to a person on a screen about personal things. That feeling passes quickly, usually within the first session. Your therapist is experienced in building rapport through a screen.
Step 4: During Your Session
Keep your camera on. Therapists rely on visual cues — facial expressions, body language, eye contact — to do their work effectively. While some therapists will accommodate audio-only sessions, video is preferred for the therapeutic relationship, especially in early sessions.
It is okay to look at your therapist's image, not the camera. You do not need to stare at the camera dot to simulate "eye contact." Looking at your therapist's face on screen is natural and helps you connect.
Tell your therapist if something is not working. If you cannot hear them, if there is lag, if you are uncomfortable — say so. Therapists who work online are used to troubleshooting, and they would rather know about a problem than have you sit through a frustrating session in silence.
Take notes if it helps. Some people find it useful to jot down things that come up during session — homework assignments, insights, questions for next time. Keep a notebook nearby if that appeals to you.
Be honest about the online format. If video therapy feels weird, limited, or like something is missing, tell your therapist. They can adjust their approach — some therapists use more check-ins, longer pauses, or different techniques to account for the screen barrier.
Step 5: After Your Session
Give yourself transition time. One of the strange things about online therapy is that you go from an intense emotional conversation to being immediately back in your regular environment. There is no drive home from the office. Try to build in 10 to 15 minutes after your session to sit quietly, take a walk, or decompress before jumping back into your day.
Reflect briefly. Many therapists suggest spending a few minutes after each session noting what came up, how you are feeling, and anything you want to remember or bring up next time. A simple notebook or phone note works.
Complete any homework. If your therapist gave you exercises, readings, or things to track between sessions, write them down while they are fresh.
Lock your device. If you share a computer or tablet with others, close the browser tab and log out of any patient portal to protect your privacy.
A Quick Pre-Session Checklist
Use this the day of your appointment:
- Device charged or plugged in
- Platform link tested and working
- Camera and microphone working
- Headphones connected
- Private room with door closed
- Lighting on your face (not behind you)
- Camera at eye level
- Phone on silent
- Water and tissues nearby
- Intake paperwork completed
- 15 minutes of buffer time before and after
Common Concerns (and Why They Are Usually Fine)
Therapists expect this. Crying in therapy is completely normal and happens just as often in online sessions as in-person ones. Your therapist will not be uncomfortable, and they know how to hold space for you through a screen. Have tissues nearby and know that it is part of the process.
Let your household know in advance that you need uninterrupted time. A sign on the door helps. If someone does walk in, it is not a disaster — just pause, handle the interruption, and continue. Your therapist understands that home environments are imperfect.
Your therapist will have a protocol for this. Typically they will wait a minute, then call you by phone to either continue the session or reschedule. Whatever you were discussing will not be lost — you will pick it back up. Technology interruptions happen regularly in online therapy and therapists are well practiced in handling them.
Yes, and many people do. A parked car in a quiet location is actually a good option if you cannot find privacy at home. Make sure you are parked (not driving), that you have decent cell signal, and that you are using headphones. Your phone propped on the dashboard or a phone mount works for the camera.
No. Wear whatever you are comfortable in. Your therapist does not care what you look like. The goal is for you to feel at ease. Most people attend sessions in casual clothes, and therapists often do the same.
The Bottom Line
Preparing for your first online therapy session comes down to three things: making sure the technology works, creating a private and comfortable space, and giving yourself permission for it to feel a little odd at first. Handle the logistics ahead of time so you can focus on the conversation itself. Most people find that within a session or two, talking to their therapist through a screen feels surprisingly natural. For more information about finding a therapist or understanding your options, visit the NAMI guide to mental health resources.
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