Online counselling: what a first video session is really like
Booking a first counselling session takes a certain amount of courage, and booking one online can add a layer of uncertainty on top. Will it feel awkward talking to a screen? What if the connection drops? Do I need special software? This post walks through what actually happens in a first video session at Marking Therapy, from the moment you book to the moment you close the call, so that none of it comes as a surprise.
Prefer to listen? You can hear this article read by Kingsley as a NormShift episode (8 minutes).
Before the session
Online sessions are booked through the website in the same way as in person appointments. You choose a live video session, pick a time that suits you, and receive a confirmation email with the details. Individual video sessions run for 45 minutes; couples sessions run for an hour. Sessions take place on Microsoft Teams, and the link arrives in your booking confirmation and again in the reminder. You do not need to create an account: on a computer the link opens in your web browser with nothing to install, and on a phone or tablet the free Teams app does the job. A phone, tablet or computer with a camera is enough, and our online sessions page sets out the practical side in full, so that nothing about it is a surprise on the day.
The most useful preparation has nothing to do with technology. Find a space where you can speak freely for the length of the session. A parked car, a bedroom with the door shut or a home office all work. Headphones help in two ways: they make the audio clearer, and they keep the therapist’s side of the conversation private to you. It is worth joining a minute or two early to check that your camera and microphone are working, in the same way you might allow time to find a parking space before an in person appointment.
The first few minutes
A first session begins with the practical foundations rather than deep exploration. Confidentiality is explained properly: what stays private, and the limited circumstances in which a therapist is required to act on something you share. There is space to ask anything about how therapy works, how sessions are structured and what happens if you need to cancel or rearrange. Because the therapist cannot see the room you are in, you are also asked for the address you will usually be at during sessions and the name and number of someone who could be contacted in an emergency; these details are held in your record and used only for that purpose. None of this is hurried, because a clear agreement at the start is part of what makes the work feel safe later.
After that, the session turns to you. A first conversation usually covers what has brought you to therapy now, how things have been recently, and what you would want to be different. Some people arrive with a clear goal; others only know that something is not right. Both are normal starting points, and neither is better than the other.
Does it feel different from being in the room?
Yes, a little, especially in the first few minutes. In practice, the strangeness usually fades once the conversation is under way. Some people find the screen makes opening up easier rather than harder: being in your own familiar space, with your own cup of tea, can take some of the edge off a first meeting. Others simply value not having to travel, arrange childcare or explain an absence.
The therapeutic work itself is the same. The approach at Marking Therapy is integrative, which means the way of working is fitted to you rather than you being fitted to a single method. That does not change over video. One of the most consistent research findings in therapy is that a good working relationship between you and the therapist is associated with better outcomes, and a large meta-analysis found much the same association in internet-based therapy as in the room (Flückiger et al., 2018). Reviews that compare video sessions directly with in-person sessions find comparable results, even where clients rate the relationship a little lower over video (Batastini et al., 2021; Norwood et al., 2018). The relationship still builds in the same way: through being listened to properly, week after week.
Being in your own familiar space, with your own cup of tea, can take some of the edge off a first meeting.
When the connection misbehaves
Technology occasionally fails, and it is sensible to know in advance what happens if it does. Before we begin, we agree together what we will do if the connection fails. If the video drops, come back to the same link: the therapist waits and tries to reconnect, and if that does not work telephones the number on your booking so that the session can continue by phone. If neither works, the session is rebooked without charge, and the time lost is not counted against you. A wobbly connection is an inconvenience, not a crisis, and it is never treated as your fault.
Is online counselling right for you?
Video sessions suit people with busy or unpredictable schedules, people who live far from the practice, and people who simply feel more at ease working from their own space. They also remove the travel time that can turn a 45 minute session into a two hour undertaking. There are situations where online work is not the best fit, and where that is the case it is discussed openly, with alternatives suggested rather than pressing on regardless.
If you have been putting off counselling because getting to a therapy room felt like one obstacle too many, online sessions remove that obstacle. You can read more about how video sessions work, or book a first appointment, on our online therapy page.
In brief
- Video sessions are booked on the website like any other, run for 45 minutes (an hour for couples), take place on Microsoft Teams, and need nothing more than a phone, tablet or computer with a camera.
- The first few minutes cover confidentiality and how sessions work; then the conversation turns to what has brought you here.
- It can feel a little different for the first few minutes. The work itself is the same, and research finds the results comparable.
- If the connection drops, you rejoin or the session continues by phone. It is never treated as your fault.
References
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, Article 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://doi.org/10.1002/cpp.2315
Evidence last reviewed 07/09/2026. This article describes how sessions work at Marking Therapy and is for general information; it does not provide a diagnosis or replace individual medical, psychological or legal advice.