8 Tips for an Online Therapy Session

Medically Reviewed By William C. Lloyd III, MD, FACS
  • Online counseling has been around for years, but the COVID-19 crisis is driving an increase in telemental health—to both decrease potential disease spread between providers and clients and because the crisis is affecting people’s mental well-being.

    If you already have a relationship with a therapist, moving your sessions online will require some adjustments. If you’ve never booked a counseling appointment, online therapy is a great option—you get professional help in a comfortable, familiar setting.

    Here’s how to get the most out online therapy.

  • 1
    Choose a licensed provider.
    portrait of confident smiling female psychologist sitting on sofa

    According to the American Psychological Association, the words “therapist” and “psychotherapist” aren’t legally protected in most states, which means that just about anyone can claim to be a therapist.

    It’s in your best interest to choose a highly qualified, licensed provider. Look for a psychologist, licensed professional counselor (LPC), licensed clinical social worker (LCSW), psychiatric nurse or other licensed professional with mental health training. It’s OK to ask a prospective therapist for their license number. Check their credentials using your state’s online searchable database of licensed providers, if available.

  • 2
    Check your insurance coverage.
    middle aged man talking on phone while on laptop computer

    Most health insurance plans cover mental health care, including counseling sessions. Check the details, though: some only cover a limited number of visits. You’ll also want to check if your plan covers telemental health, including therapy-by-phone or videoconferencing. In light of the COVID-19 pandemic, many states have issued emergency orders to increase access to online therapy.

    Some popular online counseling services do not accept insurance payments; instead, clients pay out-of-pocket. A typical online appointment may cost $60-$100. Some sites offer financial assistance.

  • 3
    Ensure privacy and security.
    man using tablet while sitting on bright green couch in living area

    A therapist’s office is a safe space. You and your therapist are the only ones in the room, and your therapist is legally obligated to keep confidential anything you share (unless the therapist thinks you are a threat to yourself or others.)

    Online therapists are bound by the same ethical rules, but both client and provider must take a few additional steps to protect your privacy. Look for a therapist who uses a secure or encrypted communication system. Find a private area before settling in for an appointment, and use headphones.

  • 4
    Jot down a few notes.
    Young woman wearing rings writing in journal on train

    Before your appointment, think about what you want to discuss and make a few notes. That way, you’ll be able to effectively use your time with the therapist.

    Not sure where to start? Think about what’s bothering you. Jot down your feelings and any changes you’ve noticed. (Are you sleeping less? More?) If you’re working towards a goal, record your progress and setbacks.

    Have your notes on hand during your appointment.

  • 5
    Do a tech check.
    senior man smiling at computer webcam

    Before your first online therapy session, check the tech requirements. Some counselors use Skype, Zoom or Facetime; others use novel software, so ask what you’ll need. (A webcam? Microphone?)

    Be sure your phone, tablet, laptop or computer is fully charged. It’s a good idea to have a backup device on hand, so you can connect with your provider by phone, for instance, if your laptop crashes or you lose WiFi. Close all other internet-using programs on your device; they’ll only slow things down.

  • 6
    Get comfy.
    young woman with laptop on sofa with feet up

    Therapists’ offices are designed to be comfortable, soothing spaces. Try to recreate that environment for yourself. Instead of sitting at your desk, settle into a comfy chair with a fluffy blanket draped over your lap. Light a candle and dim the overhead lights, if soft light helps you relax. Pour yourself a beverage—a cup of hot tea is a great choice.

    It’s a good idea to have tissues within reach. (Crying is a good thing!)

  • 7
    Build in transition time.
    Close-up from behind of woman's feet wearing running shoes

    Counseling is an incredibly intimate experience, and it can be emotionally draining. Don’t expect yourself to jump right back into normal life. If possible, give yourself some time to process your appointment and gradually get your head back to thinking about everyday concerns. Aim for a transition time of at least 10 to 30 minutes.

    Some people find it helpful to exercise or go on a solitary walk after an online counseling appointment.

  • 8
    Be persistent.
    smiling woman waving at laptop in the middle of a video conference call

    It takes time to see significant gains. Your first (and second) online therapy appointment might feel weird. That’s totally normal. Note and accept your discomfort and try again. After 2 to 3 appointments, you should feel your discomfort easing; hopefully, you’ll also note some progress. (Discuss appointment frequency with your therapist.)

    If you continue to feel uncomfortable, tell your therapist; perhaps the two of you can work together to address the issue. You can also switch to another provider, if needed.

Was this helpful?
  1. What You Need to Know Before Choosing Online Therapy. American Psychological Association. https://www.apa.org/helpcenter/online-therapy
  2. 4 Tips to Make the Most Out of Online Counseling. UNC Health. https://healthtalk.unchealthcare.org/4-tips-to-make-the-most-out-of-online-counseling/
  3. Does Online Therapy Work? Psychology Today. https://www.psychologytoday.com/us/blog/what-mentally-strong-people-dont-do/201911/does-online-therapy-work
  4. How to Prepare for Your Online Therapy Sessions: Tips for Clients. ARC Counseling and Wellness. https://www.arccounselingandwellness.com/how-to-prepare-for-your-online-therapy-sessions-tips-for-clients/
  5. Therapy. Depression and Bipolar Support Alliance. https://www.dbsalliance.org/wellness/treatment-options/therapy/
  6. Telehealth Guidance by State During COVID-19. American Psychological Association. https://www.apaservices.org/practice/clinic/covid-19-telehealth-state-summary?_ga=2.86459358.794299649.1587933399-468654633.1587933399
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Apr 29
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