Virtual Therapy Doesn’t Have to Be Scary: Here’s What Happens
Many people wonder what therapy is really like — and even more wonder what happens in virtual therapy. Since I get this question often, let me walk you through what an initial online session looks like with me. Fair warning: yes, there’s paperwork involved, but don’t worry. That’s my job to guide you through. Leave the executive functioning to me!
Before Your Session
You’ll already have made a secure account on my online platform, TherapyNotes. A few minutes before your appointment, find a comfortable, private space to talk, your living room, bedroom, your office or even your car. Virtual sessions give you flexibility, as long as you’re physically in Pennsylvania.
I recommend choosing somewhere quiet where you feel at ease. Pets, fidgets, snacks, or a cozy drink are welcome companions. Bring along a notebook if you like taking notes, but don’t stress, if you forget something, you can always grab it during the session.
Once you’re settled, you’ll log in and click your session link. The system will ask for a quick photo of you so that I can see that it really is you who is being allowed into the “room” as another layer of security. Then, you’ll see me on screen, ready to begin.
The Paperwork (I Promise It’s Not Homework)
We’ll briefly go over your initial paperwork together. I send it ahead of time as a courtesy, not as an assignment. It includes:
Client Information Form
Consent for Treatment
HIPAA Explanation (what you share with me stays confidential and secure)
Payment and Attendance Policies (so expectations are clear)
Release of Information Form (if you’d like anyone else involved in your care)
Your Treatment Plan
By your first full session, I’ll have developed a treatment plan based on your consultation. This focuses on the goals you identify, such as:
Reducing ADHD symptoms like impulsivity, hyperactivity, and inattention
Learning strategies to sustain focus and reduce impulsive behaviors
Building coping skills for anxiety (a common secondary symptom of unmanaged ADHD)
Increasing positive self-image, self-esteem, and self-awareness
Understanding how ADHD impacts your daily life, and responding with self-compassion
Developing practical systems for executive dysfunction that work long-term
Strengthening emotional regulation and frustration tolerance
Assessment (If Time Allows)
Sometimes we’ll also do a brief assessment to understand your executive functioning strengths and challenges. This ensures the systems we build together are grounded in your real strengths — not trying to patch a weak spot with another weak spot.
If you want to get a head start, you can explore the Executive Skills Questionnaire created by Drs. Peg Dawson and Richard Guare, who have over 40 years of experience working with ADHD children, teens, and adults. (PDF Assessment here)
Takeaway
Your first therapy session isn’t about judgment, tests, or proving anything. It’s about building trust, setting goals that matter to you, and laying a foundation for success. Virtual therapy is flexible, secure, and designed to meet you where you are. Whether you’re on your couch, at your desk, or with your furry companion by your side, therapy is here to meet you where you are. Let’s get started today.