Last updated: October 23, 2026 · Reviewed by a Registered Psychotherapist (Qualifying)
Your first online therapy session is mostly about getting to know each other. Your therapist will explain consent and confidentiality, ask what brings you in, learn a little about your life and talk with you about what you hope will change. You do not need to share everything, have the right words or know where to start.
Key takeaways
- A first session usually covers consent, confidentiality, what brings you in, some background and your goals.
- A private spot, headphones and a charged device do more for a good session than any special setup.
- “I’m not sure where to start” is a perfectly good opening line.
- You can ask about your therapist’s approach, training and registration. In Ontario you can check registration on the CRPO public register.
- Research suggests therapy by video works about as well as in-person therapy for many people.
Booking a first session can bring up a mix of relief and nerves. Many people spend more time worrying about the first appointment than about the problem that made them book it. Knowing what usually happens can take some of that weight off.
Before Your First Session
Start with a free consultation
A short consultation call lets you ask questions, get a feel for the therapist and decide whether you want to book. It is not a therapy session, and there is no pressure to continue. You can book a free 15-minute consultation to start.
Set up your space
- Find a private spot where you will not be overheard. Some people use a bedroom, a parked car or a quiet office with the door closed.
- Use headphones so the conversation stays between you and your therapist.
- Charge your device and test your camera, microphone and internet a few minutes early.
- Agree on a backup plan with your therapist in case the video call drops.
- Keep water and tissues nearby, and give yourself a few quiet minutes before and after if you can.
Jot down a few notes
You do not need a script. A few lines can help if your mind goes blank: what has been hardest lately, roughly when it started, what you have already tried and what you would like to be different. Questions for your therapist can go on the same list.
Check registration and benefits
In Ontario, psychotherapists are regulated by the College of Registered Psychotherapists of Ontario (CRPO). You can confirm a therapist’s registration on the CRPO public register. A Registered Psychotherapist (Qualifying) is authorized to practise and does so with ongoing clinical supervision (CRPO).
If you have extended health benefits, check your plan before you start. Coverage depends on your plan, and coverage for a Registered Psychotherapist (Qualifying) varies, so ask your provider what is included.
Also read: Is Psychotherapy Covered by OHIP in Ontario?
What Happens in a First Online Therapy Session
Every therapist works a little differently, but most first sessions follow a similar shape.
| Part of the session | What it usually involves |
|---|---|
| Settling in | A quick check that sound and video work, and a moment to arrive |
| Consent and confidentiality | How therapy works, how your information is kept, and the limits of confidentiality |
| What brings you in | What has been happening, how long it has been going on and how it affects your life |
| Some background | Gentle questions about family, relationships, work, health, culture and supports |
| Hopes and goals | What you would like to feel or do differently, even if it is still vague |
| Your questions and next steps | Time to ask anything, and a conversation about how often to meet |
Confidentiality and its limits
What you share in therapy is kept private, with a few legal exceptions your therapist will explain at the start. These usually include a serious risk of harm to you or someone else, a court order for records, and situations where a child may need protection. In Ontario, the law requires suspected child abuse or neglect to be reported to a children’s aid society (Government of Ontario). It is always fine to ask questions about this before you share.
What to Say in Your First Therapy Session
There is no right way to begin. If you are stuck, any of these can open the door:
- “I’m not sure where to start, but I know something feels off.”
- “Lately I’ve been feeling…, and it’s been getting in the way of…”
- “I’ve been thinking about therapy for a while because…”
- “I’d like to be able to… without feeling…”
- “I’m nervous about this.”
You can also say “I’m not ready to talk about that yet.” A good therapist will respect your pace. Trust builds over time, and you decide what to share and when.
Questions to Ask Your Therapist
- What is your approach, and how might it fit what I am going through?
- What training do you have with concerns like mine?
- How often do people usually meet, and how will we know if therapy is helping?
- What happens if the video call drops or I need to reschedule?
- Can sessions be in a language other than English?
- How do you bring culture, family and identity into the work?
Still unsure whether therapy is right for you? A free 15-minute consultation is a no-pressure way to ask questions like these before you book.
How You Might Feel Afterwards
People leave a first session feeling all sorts of ways: relieved, tired, raw, hopeful or simply unsure. Talking about hard things can stir up feelings for a few hours or even a day. That is common and usually settles. A gentle walk, a glass of water or some quiet time can help.
Fit matters. Research consistently links a strong working relationship between client and therapist with better outcomes (Flückiger et al., 2018). It can take a few sessions to know whether a therapist feels right, and it is okay to say so or to look for someone else.
Does Online Therapy Work as Well as In-Person?
For many people, yes. A meta-analysis of 57 studies found that mental health services delivered by video produced outcomes largely similar to in-person care, while noting that more high-quality trials are still needed (Batastini et al., 2021).
The relationship with your therapist can grow over video too. One review found that people rated the working relationship slightly lower over video than in person, yet symptom improvement was similar (Norwood et al., 2018). Naming what feels awkward about video early on can help.
Online sessions can also remove barriers such as travel, parking, childcare and the worry of being seen walking into a clinic. Some people find it easier to open up from a space that already feels familiar. Others prefer in-person care, and that is a valid choice too.
Also read: Online Therapy for Anxiety
Online Therapy With Hayat Embodied Therapy
Hayat Embodied Therapy offers online sessions by private video for people across Ontario, including Oshawa, Whitby, Ajax, Pickering, Clarington and Toronto. Sessions are available in English, Urdu, Hindi and Punjabi, with a culturally responsive, body-based approach. Breathe, Feel, Heal.
Depending on what you bring, sessions may draw on approaches such as Cognitive Behavioural Therapy (CBT), Emotion-Focused Therapy (EFT), Internal Family Systems (IFS), attachment-based and somatic work. Support is available through:
- Individual therapy for adults
- Therapy for teens and preteens
- Couples therapy
- Culturally responsive support for South Asian and BIPOC clients
When to Seek Support
You do not need to be in crisis to start therapy. It may be a good time to reach out if:
- Stress, worry or low mood have lasted for weeks and are affecting sleep, work or relationships.
- You keep running into the same patterns and want to understand them.
- A loss, life change or past experience still feels heavy.
- You simply want a space that is just for you.
Online therapy is not an emergency service. If you are not safe right now, use the crisis options below rather than waiting for a session.
If you need help right now
This practice doesn’t provide crisis or emergency services. If you are in crisis or thinking about suicide, call or text 9-8-8 (Suicide Crisis Helpline) any time. In an emergency, call 911 or go to your nearest emergency department. Young people can reach Kids Help Phone at 1-800-668-6868 or text CONNECT to 686868.
Frequently Asked Questions
What happens in the first therapy session?
Most first sessions cover consent and confidentiality, what brings you in, some background about your life and what you hope will change. There is also time for your questions and a conversation about next steps. You do not have to share everything at once.
What should I say in my first therapy session?
Anything honest is a good start. Many people begin with “I’m not sure where to start” or describe what has felt hardest lately. You can also say you are nervous, or that you are not ready to talk about something yet.
How should I prepare for my first online therapy session?
Find a private space, use headphones, charge your device and test your camera and internet a few minutes early. It can also help to jot down what has been hardest lately and any questions you want to ask.
What questions should I ask a therapist in the first session?
You might ask about their approach, their training with concerns like yours, how often people usually meet, how you will know if therapy is helping and whether sessions are available in your language.
Is online therapy as effective as in-person therapy?
For many people and many concerns, research suggests video therapy produces outcomes similar to in-person therapy. The relationship with your therapist and your comfort with the format matter more than the setting.
Will my insurance cover online therapy with a Registered Psychotherapist (Qualifying)?
It depends on your extended health benefits plan. Coverage for a Registered Psychotherapist (Qualifying) varies between plans, so check with your provider before you start. Psychotherapy is generally not covered by OHIP.
The First Conversation Can Just Be a Conversation
Starting therapy is not about becoming a different person or having everything figured out. It can simply be a first conversation with someone who listens carefully, at a pace that feels right to you.
Take the first step at your own pace
Online therapy in Ontario, by private video, in English, Urdu, Hindi or Punjabi. Start with a free 15-minute consultation.
Reviewed by Laiba Hayat, Registered Psychotherapist (Qualifying), BA-HON, MACP
CRPO #19694 · Last reviewed: October 23, 2026
Laiba is the founder of Hayat Embodied Therapy in Oshawa, Ontario, offering online therapy in English, Urdu, Hindi and Punjabi with an embodied, culturally responsive approach. She practises with ongoing clinical supervision, as the College requires. More about Laiba
This article is for educational purposes only and is not a substitute for professional diagnosis or treatment.
References
- College of Registered Psychotherapists of Ontario. (n.d.). Registered Psychotherapist status check. https://crpo.ca/resources/registered-psychotherapist-status-check/
- Government of Ontario. (n.d.). Report child abuse and neglect. https://www.ontario.ca/page/report-child-abuse-and-neglect
- Batastini, A. B., Paprzycki, P., Jones, A. C. T., & MacLean, N. (2021). Are videoconferenced mental and behavioral health services just as good as in-person? A meta-analysis of a fast-growing practice. Clinical Psychology Review, 83, 101944. https://doi.org/10.1016/j.cpr.2020.101944
- Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316-340. https://doi.org/10.1037/pst0000172
- Norwood, C., Moghaddam, N. G., Malins, S., & Sabin-Farrell, R. (2018). Working alliance and outcome effectiveness in videoconferencing psychotherapy: A systematic review and noninferiority meta-analysis. Clinical Psychology & Psychotherapy, 25(6), 797-808. https://pubmed.ncbi.nlm.nih.gov/30014606/
