7 minute read
Starting therapy takes courage.
Not the dramatic, headline kind of courage. The quieter kind — the kind it takes to admit that something isn’t right, to decide you’re worth investing in, and then to actually do something about it.
For a lot of people, the bit between making that decision and sitting down in a first session is the hardest part. Not because the session itself is scary, but because they don’t know what to expect. And the unknown is almost always worse than the reality.
So this post is here to take that uncertainty away. Here’s exactly what happens when you start online integrative therapy — before the first session, during it, and in the weeks that follow.
Before you begin — the free consultation
Before we ever have a formal first session, I offer a free initial consultation. This is a short call — usually around 20 minutes — where you can get a feel for how I work, ask any questions you have, and decide whether it feels like the right fit.
There’s no assessment happening in this call. No judgement. No commitment required. It’s simply a chance for us to meet — to see whether there’s enough of a sense of ease and safety to do the kind of work therapy asks of you.
A lot of people feel nervous before this call. That’s completely normal. Most people find that within a few minutes, the nerves settle — because it’s just a conversation, not a performance.
If the consultation feels right for both of us, we’ll arrange the first full session.
What online sessions actually look like
Sessions take place via video call — you can use whatever platform works best for you, on a phone, tablet, or computer.
The practical side is simple: a stable internet connection, somewhere reasonably private where you won’t be interrupted, and 50 minutes of uninterrupted time. That’s genuinely all you need.
A lot of people worry that online therapy won’t feel as real or as connected as sitting with someone in person. In practice, most people find the opposite. You’re in your own space — your home, your environment, your chair. There’s no commute beforehand and no need to hold yourself together on the drive home afterwards. Many people find it easier to be honest and open in a familiar setting than they would be sitting in a stranger’s office.
Research consistently supports this. For most of the things people come to therapy with — anxiety, low mood, relationship difficulties, low self-worth, life transitions — online therapy is just as effective as face-to-face. The relationship is what matters most. And a strong therapeutic relationship builds just as well through a screen as it does in a room.
The first session — what actually happens
The first session is not about jumping straight into the deep end. It’s an introduction — a chance for me to start understanding who you are and what’s brought you here, and for you to get a feel for how I work.
Here’s what you can expect.
You don’t need to have it all figured out. A lot of people arrive at a first session worried they won’t say the right things, or that they don’t have a clear enough problem to justify being there. You don’t need a neat diagnosis or a fully formed explanation of what’s wrong. Coming in with a vague sense that something isn’t right, or that you’ve been feeling off for a while, is a completely valid starting point. That vagueness often points toward exactly the things worth exploring.
I’ll ask some opening questions. Not a formal questionnaire — just a conversation. I’ll want to understand what’s brought you to therapy now, what’s been going on for you, and what you’re hoping to get from the work. I might ask a little about your background — your relationships, your life, what’s shaped you — but only at a pace that feels comfortable. Nothing is forced.
You set the pace. There’s no pressure to go further or faster than feels right. If something feels too raw to talk about yet, that’s fine. The first session is about building the beginning of a foundation — not excavating everything at once.
There’s space for your questions too. Wondering how I work, what approach I’ll use, how long therapy tends to take, what confidentiality means in practice — these are all fair questions and the first session is a good time to ask them. Therapy works best when you understand what you’re involved in.
By the end, we’ll have a sense of direction. Not a rigid plan, but enough of a shared understanding to know roughly what we’re working toward and how we might get there. We’ll agree on a regular time to meet and talk about how often makes sense for your situation.
How the sessions that follow tend to unfold
The first few sessions are still about building the relationship and deepening understanding. Things take time to settle — and that’s normal. It sometimes takes two or three sessions before you really start to feel at ease, to trust the space, to let things surface that you’ve been carrying quietly.
As that trust builds, the work deepens.
Because I work integratively, no two clients’ journeys look the same. With some people, the most useful thing is to work with the thought patterns and behaviours that are causing difficulty right now — drawing on CBT-based thinking to identify what’s maintaining a cycle and how to break it. With others, it’s more important to slow down and really sit with what’s present emotionally — to feel heard and understood before anything else shifts — which is where person-centred work carries most of the weight. And with others still, what’s needed is to go further back — to understand how patterns that formed earlier in life are still driving things today — which is where psychodynamic thinking comes in.
Often it’s all three, at different moments.
What stays constant across all of it is the relationship. Sessions feel like a real conversation — not a clinical transaction, not a lecture, not homework supervision. There’s warmth, honesty, and space to be yourself. That’s not incidental to the work. It’s the ground the work stands on.
How long does therapy take?
This is one of the most common questions people ask, and the honest answer is: it depends.
Some people come with a specific, relatively contained issue — a period of anxiety, a difficult transition, something they need to process and move through. For them, a shorter course of perhaps eight to twelve sessions can make a real difference.
Others come with things that are more deeply rooted — longstanding patterns, low self-worth that goes back years, relationship difficulties that keep repeating. That kind of work tends to take longer, and trying to rush it doesn’t serve anyone well.
What I’d say is this: most people notice something shifting — a bit more clarity, a bit more ease — within the first few sessions. That doesn’t mean everything is resolved, but it’s often enough to feel like the work is doing something. And from that point, you and I can keep a running conversation about where things are and what makes sense going forward.
There’s no obligation to keep going beyond what feels useful. You’re always in control of that.
A note on confidentiality
Everything you share in sessions is confidential. I won’t discuss your sessions with anyone without your knowledge and consent.
There are a small number of legal and ethical exceptions — if there were a serious and immediate risk to your safety or someone else’s — but these are rare, and I’ll explain the full framework clearly before we begin. Most clients never encounter these limits because they never need to.
The point is: what you say in sessions stays in sessions. That privacy is part of what makes it possible to be honest.
Ready to take the first step?
You don’t need to feel ready. Most people don’t, the first time they reach out. You just need to be willing — willing to show up, to talk, to see what happens.
If you’ve been sitting on the idea of starting therapy for a while, this might be the nudge. The first session is genuinely low pressure. It’s a conversation, not a commitment.
If you’re still weighing things up, this guide on how to choose the right therapist online might help you think it through. And if you want to understand more about what integrative therapy involves before you begin, the hub post on integrative talking therapy has everything you need.
I work online with individuals across the UK and internationally. I offer a free initial consultation — no obligation, no pressure, just a conversation.
[Book your free consultation here] — online sessions available worldwide
Gareth Taylor is a Professional Accredited Member of the NCPS (PNCPS Acc.) and a qualified counselling supervisor, working online with individuals across the UK and internationally. He blends person-centred, CBT, psychodynamic, and Gestalt approaches to support people with anxiety, depression, low self-worth, relationship difficulties, and life transitions.
