Best Practices for Teletherapy Session Preparation: How to Prepare for Online Therapy

Why Preparing for Teletherapy Matters

Preparing for a teletherapy session—whether it’s your first online counseling appointment or part of an ongoing treatment plan—makes the time you spend with your therapist more productive, safer, and less stressful. Good preparation supports progress toward therapy goals and helps you make the most of each session.

The benefits of effective teletherapy session preparation

• Better outcomes and stronger rapport. When clients arrive with clear intentions and a stable environment, therapists can focus on clinical work rather than logistics. Studies and clinical reports show remote therapy produces outcomes comparable to in-person care for many conditions when delivered well.
• Reduced anxiety and improved focus. Preparing your space, tech, and agenda reduces anticipatory stress so you can be present emotionally.
• Efficient use of session time. Having notes, questions, and relevant logs ready means more time for meaningful exploration and problem-solving.

According to the U.S. Centers for Disease Control and Prevention (CDC), telehealth use surged during the COVID-19 pandemic, illustrating both demand and the importance of reliable teletherapy practices (see CDC telehealth summary).1

Common concerns: what to expect in teletherapy

• Typical first-session flow. Expect introductions, informed consent or confidentiality discussion, a technology check, and an intake or assessment. Your therapist will ask about history, current concerns, and goals—similar to in-person therapy but with added tech and safety checks.
• Technology expectations. You will likely connect via a video platform (Zoom for Healthcare, Doxy.me, or a proprietary system). A quick audio/video test and permission for camera/mic use are standard.
• Privacy, confidentiality, and emergency planning. Therapists should review limits of confidentiality, how they handle emergencies remotely (local emergency contacts or crisis plans), and platform security.

Tip: If you’ve wondered “what to expect in teletherapy,” ask your provider to send a short guide or FAQ before your first appointment.

How telehealth therapy preparation supports therapeutic goals

• Set intentions and measurable goals. Before each session, pick 1–3 things you want to address. This helps convert general progress into measurable steps.
• Clear therapist and client roles. Effective teletherapy preparation clarifies what the therapist will provide (clinical skills, interventions) and what the client will bring (engagement, homework, honesty).
• Examples: If your goal is reducing panic attacks, come prepared with a symptom log, the triggers you’ve noticed, and a short breathing exercise to try during the session.

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Creating the Right Physical Environment

A comfortable, private space is the foundation of effective teletherapy preparation. The environment affects your ability to engage, disclose sensitive material, and follow therapeutic instructions.

Choosing a private, comfortable space for online therapy

• Select a room or corner where you can be alone or reasonably assured of privacy for the session length.
• Use a closed door and place a “do not disturb” note if housemates need to know.
• If you live with others, negotiate a 45–50 minute window where interruptions are minimized.

Considerations for shared living situations:

• Napkins or a curtain to create a visual divider.
• Use a parked car for privacy if home options are limited and weather/safety permit.
• Book a private room in a community center or a friend’s home (with consent) if possible.

Lighting, background, and camera framing for teletherapy

• Face a soft light source (natural window or lamp) so your face is visible. Avoid strong backlighting that creates silhouettes.
• Keep your background tidy and neutral—or choose a virtual background only if your platform supports it without glitching.
• Position the camera at eye level to maintain natural eye contact. Aim to appear framed from head to upper torso.
• Accessibility considerations: If you have low vision or hearing loss, enlarge interface elements, use closed captions if available, and check that the platform supports assistive technologies.

Managing interruptions and household logistics

• Communicate boundaries: let family or roommates know your session time and ask them to avoid contacting you during that window.
• Have a backup plan for pets or young children (short supervised activity, quiet toy box).
• Quiet distractions: use headphones to reduce room noise and increase privacy.
• If an interruption happens, pause and briefly explain to the therapist—most clinicians are prepared to resume when ready.

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Technology and Connectivity Guidelines

Technology can be a barrier or an enabler. Effective teletherapy session preparation includes a reliable device, a stable internet connection, and a basic troubleshooting plan.

Essential tech checklist for teletherapy session preparation

• Device: laptop, tablet, or smartphone with camera and microphone.
• Power: have your charger nearby and device at adequate battery level.
• Internet: stable broadband or 4G/5G connection. Wired connections (Ethernet) are more reliable for video.
• Headphones or earbuds with a microphone to reduce echo and improve privacy.
• Updated browser or app and any required permissions (camera/mic access).
• Test link: join a platform test call ahead of time if available.

Troubleshooting common teletherapy technical problems

• Audio issues: ensure mic permissions are enabled, unplug and replug headphones, or switch input device in settings.
• Video problems: refresh the browser, switch to a different camera source, close other apps consuming CPU.
• Connectivity drops: turn off video to preserve audio, move closer to the router, switch to mobile data if needed.
• If problems persist, contact your provider via the phone number in your intake packet or email per their instructions.

Sample quick tech fixes:
1. Refresh page or re-open app
2. Confirm mic/camera permissions in browser settings
3. Switch to headphones if echo is present
4. If connection fails, call provider’s backup phone number

Security and privacy: protecting your teletherapy session

• Use a secure, HIPAA-compliant platform when available (providers should specify the platform).
• Avoid public Wi‑Fi. If you must use it, enable a reputable VPN.
• Use strong passwords and two-factor authentication for accounts.
• Read your provider’s privacy policy and informed consent about telehealth.
• Understand platform encryption: most clinical platforms use end-to-end or transport encryption, but ask your clinician what protections they use.

For official guidance on telehealth privacy, see the U.S. Department of Health & Human Services telehealth guidance.2

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Preparing Emotionally and Clinically

Mental and emotional readiness affects therapy quality. A short pre-session ritual helps you transition from daily life to therapeutic work.

Mental and emotional pre-session routines

• Short grounding exercises: box breathing (4–4–4–4), a 60-second body scan, or 3 things you can see, hear, feel.
• Brief journaling prompts: “One thing I want to understand today,” “One small win this week,” or a symptom log item.
• Use a 5-minute pre-session routine: hydrate, sit comfortably, review your notes, and do one calming breath.

Organizing notes, questions, and progress tracking

• Keep a dedicated therapy journal or secure digital note that follows your goals and homework.
• Use a teletherapy session checklist and a prompts list to guide the session.
• Track metrics relevant to your goals (e.g., sleep hours per night, number of panic episodes, mood rating from 1–10).
• Bring relevant documents: medication lists, referrals, or assessment results.

When to seek additional resources or emergency help

• Recognize red flags: suicidal ideation with intent/plan, severe intoxication, psychosis, or risk of harm to others.
• If an emergency arises during teletherapy and immediate safety is at risk, call local emergency services (e.g., 911 in the U.S.) or go to the nearest emergency room.
• Discuss crisis planning with your therapist ahead of time so there is a clear plan if symptoms escalate.

If you live outside your therapist’s state or country, confirm emergency procedures and local resources before serious crises occur.

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Practical Session Tips and Communication Strategies

Strong communication helps overcome the slight awkwardness that video can create.

Teletherapy session preparation tips for better communication

• Use clear verbal cues like “I want to add something” to handle slight audio lag.
• Speak in short segments and pause to allow your therapist to respond—this reduces talking over each other.
• Practice active listening: summarize what your therapist reflected before moving to a new point.
• If technology causes a lag, check in: “I didn’t hear that—can you repeat?” This keeps the dialogue collaborative.

Setting boundaries and expectations with your therapist

• Clarify session length, start/end times, and missed-session policies up front.
• Discuss rescheduling procedures and cancellation fees if applicable.
• Revisit confidentiality limits, especially around mandated reporting, and the use of recordings if that applies.
• Ask about follow-up communication norms: secure messaging, email, or phone texts for scheduling only.

Cultural, age, and accessibility adaptations

• Tailor sessions for diverse populations: discuss cultural values, language preferences, and religious considerations.
• Child/adolescent teletherapy: involve parents in logistics, craft age-appropriate activities, and use visual tools.
• Older adults: choose larger fonts and simple platforms, and allow more time for tech setup.
• Neurodivergent clients: establish predictable session structure, visual agendas, and written summaries.

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A Ready-to-Use Teletherapy Session Preparation Checklist

Below is a practical teletherapy session checklist you can adapt for your own use. This brings together technology, environment, emotional readiness, and follow-up.

Pre-session checklist (30–60 minutes before)

• Confirm appointment time and platform link.
• Charge your device and plug in the charger.
• Find a private, quiet space and set up camera at eye level.
• Put on headphones and do a quick mic/camera test.
• Review brief notes: 1–3 items to address and any homework.
• Do a 3–5 minute grounding practice or breathing exercise.
• Prepare a glass of water and a tissue if needed.

Immediately before and during the session

• Open the video link 5 minutes early to resolve last-minute tech issues.
• Ensure lighting is good and background is appropriate.
• Share a concise agenda with your therapist: “Today I’d like to focus on X, Y, Z.”
• Keep notes visible for quick reference but avoid reading line-by-line.
• Practice turn-taking: signaling when you want to speak if audio lags.
• If you need to pause or end early because of tech issues or an emergency, agree on next steps.

Post-session follow-up actions

• Summarize key takeaways and homework in your therapy journal within 24 hours.
• Schedule the next session and confirm payment/insurance as needed.
• Track symptom changes and complete any assigned worksheets.
• If an action or referral was promised, set reminders to follow up.

Sample checklist you can copy/save:

Teletherapy Session Preparation Checklist
Pre-session (30–60 min):
- Confirm link/time
- Charge device + headphones
- Private space + tidy background
- Quick tech test
- One-sentence intention
- 3-min grounding

During session:
- Join early
- Share agenda
- Keep notes handy
- Signal when speaking
- Agree on wrap-up time

Post-session:
- Log insights (within 24 hrs)
- Do assigned homework
- Book next appt
- Follow up on referrals

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Conclusion

Recap of essential teletherapy session preparation guidelines

Preparing for online therapy involves more than turning on a camera. Effective teletherapy preparation covers your environment, technology, emotional readiness, communication strategies, and safety planning. When you follow teletherapy session guidelines—tech checks, private space, brief pre-session routines, and a post-session reflection—you set the stage for productive work and measurable progress.

Encouragement to personalize and iterate your routine

Every client-therapist pair is unique. Use the checklists and tips here as a starting point, then iterate: try different lighting, adjust the timing of your grounding routine, or create a habit that signals the start of therapy (a cup of tea, a five-minute playlist). Personalization makes teletherapy feel safer, more efficient, and more effective.

Resources and next steps

• U.S. Centers for Disease Control and Prevention — Telehealth guidance:
• U.S. Department of Health & Human Services — Telehealth and HIPAA:
• American Psychological Association — Telepsychology resources:

If you’d like a printable teletherapy session checklist or a customizable template, contact your provider or download common templates from reputable mental health organizations. Start by trying one new preparation habit next session—notice how it changes your focus and engagement.

If you found this guide helpful, consider sharing it with someone preparing for online therapy, or bookmark it for your next teletherapy session. For more templates and tips, subscribe to trusted mental health resources or ask your clinician for a personalized teletherapy plan.

Call to action: Save or print the teletherapy session checklist above, try it for three sessions, and note any changes in outcome—then adjust based on what works best for you and your therapist.

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  About The Author Jaye Kelly-Johnston

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