Get Your Tech Ready

Most online therapy in the UK uses Zoom. Download the app (free) on your device — laptop, tablet, or smartphone all work well. Test your camera and microphone before the session. A reliable internet connection is important; if your home WiFi is inconsistent, move closer to your router or use a wired connection. If you are using a phone, prop it up so you are not holding it throughout the session.

Headphones or earbuds significantly improve audio quality and privacy — they also reduce the chance of others in your household overhearing the session.

Find a Private Space

Privacy is the most important practical element. Find a space where you will not be interrupted or overheard. If you live with others, let them know you have an appointment and ask not to be disturbed. If you cannot guarantee privacy at home, consider attending from your car (parked privately), a quiet room at work, or anywhere you can speak freely.

Being overheard — or worrying about being overheard — significantly inhibits what you feel able to say. Making privacy a priority allows you to engage fully.

Prepare What You Want to Talk About

You do not need a formal agenda for counselling — but having a rough sense of what you want to focus on helps, particularly in early sessions. Jot down what has been most difficult since you last spoke (or, in the first session, what has brought you to therapy now). What do you most want your therapist to understand about your experience? What outcome are you hoping for?

In CBT, your therapist will likely set an agenda for each session. In counselling, the content is more client-led. Either way, a few notes beforehand helps you make the most of the time.

Plan for After the Session

Therapy sessions can be emotionally demanding. Plan to have some quiet time afterwards if possible — avoid booking a difficult work meeting or social event immediately after your session. Have something comforting available: a warm drink, a brief walk, time to decompress. It is completely normal to feel tired, emotional, or reflective after a session.

What to Expect in the First Session

The first session is usually an assessment — your therapist will ask about your current difficulties, history, what you are hoping to get from therapy, and any risk factors. You will not be expected to solve anything in session one. It is primarily about your therapist understanding your situation and you gauging whether the fit feels right.

Technical Preparation

Technical issues are the most common source of disruption to online therapy sessions — and almost all of them are preventable with 5 minutes of preparation. Before your first session: download Zoom and run the built-in camera/microphone test; ensure your internet connection is stable (sit close to your router or use a wired connection if your WiFi is unreliable); charge your device; close other applications that might use bandwidth (video streaming, large downloads); and have your therapist's phone number saved so they can call you immediately if the connection drops. Agree the backup plan before the session starts — "if we lose connection, call my mobile on [number]."

Creating the Right Environment

Privacy is the most important environmental factor. Being concerned about being overheard significantly inhibits what you feel able to say, which directly reduces the therapeutic benefit. If you live with others, let them know you need uninterrupted privacy for 50 minutes — you do not need to explain why. Put a note on your door. Use headphones or earbuds, which both improve audio quality and significantly reduce the chance of being overheard. If your home genuinely does not offer a private space, discuss alternatives with your therapist — a parked car is a surprisingly effective option used by many online therapy clients.

Comfort matters too. Have water nearby. Some people find it helpful to have a notebook for jotting things down during session. Sitting at a desk or table with the camera at eye level (rather than looking up at the screen from a sofa) creates a more focused session environment and better non-verbal communication.

Emotional Preparation

Give yourself transition time before and after sessions. The 10 minutes before a session are not a good time to be dealing with a stressful work email or a difficult phone call. Arriving at the session already activated or distracted reduces your capacity to engage. Similarly, scheduling something immediately after a session — a demanding meeting, a difficult conversation — means you have no time to process what came up in therapy. Ideally build in 20–30 minutes after each session for a brief walk, some quiet time, or journaling before returning to daily demands.

Between sessions, your therapist will typically assign homework — thought records, exposure tasks, behavioural experiments, or reading. The between-session work is where the majority of therapeutic change happens. Treating it as an integral part of therapy rather than optional extra significantly accelerates progress. If a homework task feels unmanageable or unclear, bring this to the next session rather than simply not completing it — the barrier is clinically useful information.

What the First Session Is Really For

The first session is an assessment, not a deep dive into your most difficult material. Your therapist is trying to understand your presentation, your history, your goals, and whether this particular therapeutic relationship and approach is the right fit. You are trying to assess whether this person feels safe, competent, and right for you. Both of these things take precedence over covering ground quickly. Do not worry if you leave the first session feeling like you have not started "the real work" yet — the foundation laid in assessment sessions is what makes the real work possible.