Note: This was originally posted in Psychology Today.
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Key Points:
The therapy landscape has changed significantly over the past year. Going to therapy can be intimidating in person, but consumers are now forced to navigate teletherapy as well.
Teletherapy has so many benefits. It allows busy people to fit appointments into their workday. It cuts down on travel time. It has provided better access to mental health care.
But it also requires access to a computer or cellphone. It requires vulnerability to meet someone for the first time over a computer screen, especially when that person is your new therapist and the conversation is about your innermost challenges. And it requires being a little savvier about the process, Here’s how to prepare yourself for your first teletherapy visit.
Housekeeping procedures
Your therapist has an ethical duty to go through an informed consent process. This essentially means that the therapist needs to give you enough information about therapy so you can make an informed decision to participate. Ideally, informed consent is reviewed both written and verbally; most therapists will have you complete a form either ahead of time or in the waiting room. This is your opportunity to ask as many questions as needed.
At a minimum, your therapist should cover confidentiality of sessions and documentation, limits to confidentiality, how your health information will be stored and shared (or not shared), fee and insurance policies, and any other pertinent information relevant to the clinic. Your therapist should also share information about the treatment they’re providing, potential risks and benefits, and their personal credentials and experience.
How to prepare: Come ready with any questions you have about fees and policies, the process of therapy, and any other topics you’re curious about. If your therapist does not talk to you about confidentiality, ask explicitly, because this is crucial information for your working relationship.
“What brings you in today?”
A large portion of the first visit is dedicated to getting to know you as a person and understanding what you’d like to get out of therapy. Each therapist will have a different approach to this session, but generally, therapists will want to know about your struggles, your strengths, and some history about your life. They will likely ask a lot of questions. These questions can be challenging, but they’re meant to help the therapist determine how best to help you. Your best course of action is to be thoughtful, honest, and genuinely yourself.
How to prepare: Be ready to answer this question. I know that most of the time when you’re seeking help, you have no idea what you actually need help with — that’s why you’re paying a therapist. But at the same time, it’s immensely helpful to come to the session with a sense of what you’re struggling with and what you’d like to accomplish.
If you don’t know what you need out of therapy, that’s okay. You can jot down some ideas by asking yourself these questions:
Remember the first session is a starting point. Your therapist can guide you from there.
Prep your space
Give your mind space by setting up your physical space. Your physical space should represent a purposeful transition to wellness — an intention to take care of yourself for the next hour.
How to prepare: First, make sure your computer or device is fully charged. Be close enough to the internet router to have a good working connection for a 50-minute video call. Log in to your call about 10–15 minutes early, and give yourself time to troubleshoot any connectivity or platform issues. The extra time will also allow you to get in the mindset for therapy.
Set aside a specific physical space designed for purposeful relaxation. If you can, choose a different spot than your usual workplace, so your therapy isn’t associated with another work meeting. Choose a comfortable chair (bonus points for comfy pillows/blankets), and settle in. You might even take a few minutes of silence or deep breaths before you start to collect your thoughts. Ultimately, you want your therapy space to feel inviting and safe so you can engage in helpful introspection.
Take charge of your care
You have a basic human right to understand the care you are receiving. Your therapist should be open and honest with you about the process, but it’s also important that you ask lots of questions.
As a therapist, I want people to clearly understand the type of therapy they are receiving, and what they can expect from the process (the journey) and outcome (the destination/end goal). Make sure you leave that first visit with all your informational needs met.
Think of it as an interview: Your therapist is asking you questions to get a sense of what’s going on, but also to make sure they’re the right fit for you. You are also interviewing your therapist to ensure that you feel they’re a good fit for your needs. This is crucially important for an effective therapeutic alliance.
How to prepare: If you aren’t sure what questions to ask, here are some ideas:
Just be yourself
Your therapist is not going to judge you. We are actually trained in Non-judgmental Stance, a skill that allows us to avoid judging and understand the unique wisdom of each client. We love to see your true, authentic self. What’s more, being yourself helps us accurately assess your needs.
Try not to minimize problems. Although it’s natural to downplay challenges, the more forthcoming you can be, the better we can help you. At the same time, you don’t need to share anything you don’t feel comfortable disclosing. Just let us know there are some additional concerns you’ll bring up once trust is built.
You’re ready
Telehealth can be scary, but it doesn’t have to be. By arming yourself with information, you can get the most out of your first session. First and foremost, it’s important that you be honest and upfront about what you want and need. If you don’t yet know, that’s alright too. Allow your therapist to guide you, and make sure you ask lots of questions. Remember that preparing for your first teletherapy sessions is not only about preparing mentally, but also about preparing your physical space. Make sure you have a safe, confidential spot set up for therapy, and that your technology is working optimally.
With teletherapy, we have more access to mental health services than ever before. Use that access to your advantage to be an informed consumer of the therapy process. Your future self will thank you for it.