QUICK ANSWER: Your first online therapy session with Real Help happens by secure video from home in Massachusetts, Rhode Island, New Hampshire, or New York. Your therapist will ask what brought you in, learn about your history and goals, and talk with you about a plan. You only need a phone, tablet, or computer and a private spot. Book through the Connect Now page or call (844) 399-9898.
Feeling nervous before a first therapy session is normal. Talking to someone new about personal things can feel like a lot, and doing it on a screen adds a few new questions. Will the link work? What do I say? What if I cry?
This guide walks you through what a first session with Real Help looks like, step by step, so you know what to expect before you click the link.
How do I book my first session?
It starts with a short form or a phone call. Go to the Connect Now page, choose your state, and send your name, phone, email, and state. Or call (844) 399-9898. Real Help serves Massachusetts, Rhode Island, New Hampshire, and New York, and Connecticut adults on a self-pay basis.
When our team reaches out, they will ask what kind of help you want and check your insurance. Real Help offers individual, couples, family, and group counseling, plus medication management. You can see all of them on our services page. If you are not sure which fits, just describe what is going on and we will help you choose.
Does insurance cover online therapy?
Many plans cover therapy and psychiatry, including online visits. Federal parity law, the Mental Health Parity and Addiction Equity Act, says mental health benefits must be on equal footing with physical health benefits. The Centers for Medicare & Medicaid Services explains this on its mental health parity page.
Your cost depends on your plan, deductible, and network status. Our team will check your benefits before your first session, and our insurance FAQs explain the common terms. State rules differ a bit too. We wrote about online therapy in Massachusetts and telehealth in Rhode Island and New Hampshire if you want the details for your state.
How should I get ready at home?
You do not need any fancy setup. Real Help sends you a secure link, and you click it when it is time to start. A little prep helps:
Charge your phone, tablet, or computer
Test your camera and microphone the day before
Find a private spot where others cannot hear you
Use headphones if people are home
Join a few minutes early so you are not rushed
Some people sit in a parked car or a bedroom with the door closed. Keep water and tissues nearby. If you are a parent, plan for kids to be busy or cared for during the hour if you can.
It can also help to jot down a few notes before the session. What made you reach out now? What do you hope will be different in a few months? You do not have to use the notes, but they can help if your mind goes blank.
What will my therapist ask?
The first session is mostly about getting to know you. Your therapist may ask:
What brought you to therapy right now
How long you have been feeling this way
How it affects sleep, work, school, or relationships
What you have tried before, and what helped
Your health history and any medications
What you want to get out of therapy
You can share as much or as little as you want. As our FAQ page says, you do not need a script or a big plan. Your therapist will guide the conversation.
Your therapist may also ask a few safety questions, like whether you have had thoughts of hurting yourself. These are standard and help your therapist understand how best to support you.
What if I start to feel uncomfortable?
That is okay. You can pause, ask a question, or say you are not ready to talk about something yet. Real Help aims to make each session feel safe and judgment free. Crying, long pauses, and not knowing what to say are all normal parts of therapy.
Privacy is a common worry with online sessions. Real Help uses secure, private platforms, and your therapist will explain confidentiality and its legal limits.
What happens at the end of the first session?
Near the end, your therapist will talk with you about next steps. That usually includes:
A starting plan based on your goals
How often you will meet
Small goals to work on between sessions
Whether other services, like medication management or couples counseling, might help
Real Help sets small goals with you to work on between sessions so you can make progress at your own pace. Schedules are flexible, so you can find times that work around school, work, and family. If you are interested in medication, read our guide to online medication management.
What happens after the first session?
Your second session usually feels easier. You know how the link works, you have met your therapist, and you have a starting plan. From here, sessions focus on the goals you set together. Some weeks will feel like big steps and others will feel slow, and both are part of the process. If something comes up between sessions, reach out to the practice rather than waiting.
What if I do not click with my therapist?
Finding the right fit can take time, and that is okay. If you do not feel connected, Real Help can help you find someone who is a better match. You can meet our therapists any time to learn more about the team.
Is the first session different for couples?
A little. In a first couples session, the therapist will want to hear from both partners about what is going on and what each of you hopes for. Both of you should join from a private space, ideally on the same screen. You can learn more in our post on whether online couples counseling works.
If you are in crisis, call or text 988 to reach the 988 Suicide and Crisis Lifeline, free and open 24 hours a day. In Massachusetts, you can also call or text the Behavioral Health Help Line at 833-773-2445. If you are in immediate danger, call 911 or go to your nearest emergency room.
Frequently asked questions
How long is the first online therapy session?
First sessions are often a bit longer than later ones because there is more to cover. Our team will tell you the scheduled length when you book.
What do I need for an online therapy session?
A phone, tablet, or computer with a camera, an internet connection, and a private spot. Real Help sends you a secure link to join.
Do I need a referral for my first session?
You can usually reach out to Real Help directly. Some insurance plans require a referral, and our team can check that when we verify your benefits.
What if I do not know what to talk about?
That is normal. Your therapist will guide the conversation, and you can share as much or as little as you want.
Is online therapy private?
Real Help uses secure, private platforms, and your therapist will explain confidentiality and its legal limits. Pick a private spot on your end too.
Which states does Real Help serve?
Massachusetts, Rhode Island, New Hampshire, and New York, plus Connecticut adults on a self-pay basis.
Can I switch therapists after the first session?
Yes. If the fit is not right, Real Help can help you find a better match.
Ready for your first session? Connect with Real Help or call (844) 399-9898 to book from home.