Starting therapy for the first time brings up a lot of questions. What will I say? What will they ask me? What if I do not know where to begin? That uncertainty is often enough to make people put it off longer than they should. This post tells you exactly what to expect so the unknown becomes familiar before you even log on.
What Online Therapy at Lakewood Child and Family Counseling Actually Looks Like
Online therapy at Lakewood Child and Family Counseling is held over a secure, HIPAA compliant video platform. It is not phone-based. It is not chat or messaging. It is a real, face to face conversation with a licensed therapist, held from wherever you are most comfortable in Washington State.
Sessions are 53 minutes. There is no consultation call before your first appointment. You schedule directly using the Book Now button, complete a brief intake form, and receive a private link to join your session. The relationship and the real work both begin in that first hour. There is no warmup period, no trial run, and no waiting to see if this might eventually be helpful.
Before Your First Session: What to Do
You will receive your intake paperwork through our electronic client portal after booking. Complete it before your session so your therapist has useful context going in. The paperwork covers basic background, your current concerns, and what you are hoping to get from therapy. You do not need to have it perfectly articulated. Just answer honestly and the therapist will take it from there.
On the day of your session, find a private space where you can talk without being overheard. Your home office, bedroom, or a parked car all work well. Using headphones helps with both audio quality and privacy. Test your internet connection and make sure the camera and microphone on your device are working. Log on a couple of minutes early so you are settled when your therapist joins.
What Actually Happens in Your First Session
Your therapist will start by introducing themselves and briefly explaining how they work. They will cover confidentiality, what it means, and what the rare exceptions are. Then they will open it up to you.
The first session is primarily your therapist getting to know you. They will ask about what brought you to therapy right now, what has been going on, and what you would like to be different. They may ask about your background, your relationships, your work situation, and your emotional history. You do not need to share everything at once. You share what feels right, and the therapist follows your lead.
By the end of the first session, you will have a clearer sense of how your therapist works and whether the fit feels right. Your therapist will begin to outline how they think about what you have shared and what the work might look like going forward. It is the beginning of a working relationship, not a one-time assessment.
What You Do Not Need to Have Figured Out Before Starting
You do not need to know exactly what is wrong. Many people start therapy without a clear diagnosis or a tidy explanation of why they are struggling. That is what therapy is partly for. You do not need to have the right words. Your therapist is trained to help you find them. You do not need to be in crisis. Many of the most effective therapy clients are high-functioning adults who simply know something is off and want to address it before it gets worse.
You also do not need to have tried everything else first. Therapy is not a last resort. It is a resource, and it works best when you access it before you are completely depleted.
Common Questions About Online Therapy
Is online therapy as effective as in-person therapy? Yes. Research consistently shows that online therapy produces outcomes equivalent to in-person care for anxiety, depression, stress, trauma, and most other concerns adults seek therapy for. Many clients find it easier to open up and stay consistent when attending from a space that feels safe and familiar.
What if my internet cuts out or there is a technical issue? Your therapist will have a plan for this and will communicate it during the first session. Typically, if a connection drops, one or both of you will attempt to rejoin, and if that does not work, your therapist will reach out to reschedule or continue by phone for that session.
Is it private? Yes. Sessions are conducted over a HIPAA compliant platform and are not recorded. If privacy is a concern related to insurance, many of our clients choose private pay to keep mental health care off their Explanation of Benefits. We also accept HSA and FSA cards. You can learn more about our fees and accepted insurance here.
Do I need a referral or a diagnosis to start? No. You book directly and there is no referral required. You do not need a diagnosis to begin therapy. Many adults start because they feel off and want to understand why.
Getting Started with Online Therapy in Washington State
Lakewood Child and Family Counseling offers online therapy for adults across Washington State, including Bellevue, Mercer Island, Sammamish, Seattle, Tacoma, Olympia, Spokane, and surrounding communities. We are in network with select insurance plans including Regence, Premera, Lifewise, VA, Tricare, and others, and we offer private pay for clients who prefer that option.
If you have been considering therapy and wondering what it is actually like, now you know. The first session is a conversation. You do not have to have it all figured out. You just have to show up.
Use the Book Now button to schedule your first session directly. No consultation call, no waiting period. The work begins from day one. Take the next step!