What to Expect from Online CBT Therapy

A Therapist’s Guide to How It Works and What It Feels Like

Online therapy meets you where you are — even on the hard days. CBT can begin from your own space, offering clarity, structure and support without needing to leave home.

If you’ve been considering therapy, but you’re unsure how online CBT actually works, you’re not alone. Many people I work with have questions like:

• What do we actually do in sessions?

• Is it awkward talking on Zoom?

• What if I don’t know what to say?

• Will it help me feel better — or just stir things up?

  
  

These are thoughtful, valid questions. Whether you’re dealing with anxiety, OCD, or low mood, it’s completely normal to want clarity before taking that next step.

In this post, I’ll walk you through what to expect from online CBT, including:

• How sessions are structured

• What we talk about (and what we don’t)

• What the early stages look like

• And why many people find it easier than they imagined

• 
  

How Does Online CBT Work?

I work with clients over Zoom — a secure, encrypted video platform that lets us meet from wherever you feel most comfortable.

This means:

• You don’t need to travel, find parking, or sit in a waiting room

• You can attend from your home, your office, or even your car (I’ve seen it all!)

• You can use any device: laptop, tablet, or phone

Most clients find it surprisingly easy to settle into the format. It still feels personal — and it offers the flexibility to fit therapy into real life.

What Happens in a First CBT Session?

The first session is about getting a clear picture of what’s going on for you.

There’s no pressure to say everything perfectly — I’ll guide the conversation with curiosity and respect. Some people bring notes, others just talk. You can take your time.

We’ll explore:

• What you’re struggling with right now

• When it tends to show up

• What you’ve already tried

• How it’s affecting your life

You’re welcome to ask questions, share concerns, or simply tell me what’s on your mind. The goal of this session isn’t to “fix” anything — it’s to understand the shape of the problem, so we can begin planning how to address it together.

What Do Ongoing CBT Sessions Look Like?

In the first two or three sessions, we’ll spend time exploring:

• What’s maintaining the problem — thoughts, behaviours, patterns

• How it’s showing up in your day-to-day life

• What feels most important to change
  

Then, we’ll start shaping this into a shared plan — usually a small number of clear goals. From there, CBT becomes a collaborative process of:

• Understanding what’s keeping you stuck

• Learning new tools and perspectives

• Problem-solving any obstacles that come up along the way

• Building confidence as things begin to shift
  

Every session includes space to reflect, learn, and — when it’s helpful — try out practical strategies between sessions. These are never “homework” in the traditional sense; they’re invitations to try something new in real life, with support.

Common Questions People Ask About Online CBT

What if I don’t know what to say? That’s more common than you’d think. My job is to help guide the conversation — you don’t need to come prepared with a speech.

Will I be asked to do things I’m uncomfortable with? Never without consent. CBT is structured but flexible — we’ll agree together on the pace and focus. You’re in control.

Is CBT just worksheets and coping techniques? No. While we might use some tools, CBT is about understanding the patterns beneath the symptoms — not just managing surface-level distress.

What Makes CBT Effective?

CBT works because it’s structured, practical, and focused on the present — but it’s also collaborative. It doesn’t assume one-size-fits-all answers. Instead, it asks:

• What makes sense to you?

• What are you noticing?

• What’s getting in the way of change?
  

By bringing together your insight and my clinical knowledge, we create a space that’s both safe and purposeful.

Final Thoughts: Therapy That Fits Real Life

If you’ve been feeling stuck, overwhelmed, or unsure whether things can change — CBT can help you make sense of what’s happening and move forward with clarity.

Online therapy makes this support more accessible than ever. You don’t need to commute, rearrange your life, or pretend to be “fine.” You just need a quiet space and a willingness to start the conversation.

If you’d like to know more, or ask whether CBT might be a good fit for what you’re dealing with, feel free to get in touch. I’ll be happy to answer any questions you may have.

Written by Ellie Pickett CBT Therapist | Online CBT UK