The Awkwardness Is Real — and Worth Understanding

Starting teletherapy can feel oddly stilted, even for people who regularly use video calls for work or socializing. The setting is familiar, but the purpose is different — and that gap often creates friction that surprises people. Knowing where the discomfort tends to come from can make it easier to push through the early sessions rather than assume the format simply isn't for you.

Several myths surround teletherapy, including the assumption that initial awkwardness means it won't work. In reality, research consistently suggests that teletherapy can be as effective as in-person therapy for many people — but the adjustment period is real, and it's worth taking seriously rather than pushing through without addressing it.

1

Choosing a space that lacks privacy or is frequently interrupted.

Why it happens: Many people underestimate how much an open or shared environment affects their ability to speak freely. It can feel manageable at first, but inhibits the kind of candid conversation therapy relies on.

How to avoid: Before your first session, identify the most private space available to you — even a parked car or a room with a white-noise machine running outside the door can work. Let others in your household know you're unavailable during session time.
2

Not testing audio and video settings before the session begins.

Why it happens: People often assume their usual device setup will work without checking, then spend the first several minutes of a session troubleshooting — which disrupts the mood and wastes limited time.

How to avoid: Log into your platform five to ten minutes early and run a quick check on your microphone, speakers, and camera. Many platforms have a built-in test function. Having a backup plan — such as a phone number to call if the connection fails — also reduces anxiety.
3

Feeling self-conscious on camera and letting it suppress openness.

Why it happens: Seeing your own face in the corner of a video screen activates a degree of self-monitoring that doesn't happen in person. Research on "Zoom fatigue" suggests this self-focus is cognitively taxing.

How to avoid: Most video platforms allow you to hide your self-view. Try turning it off and notice whether that reduces self-consciousness. You can also ask your therapist whether audio-only sessions are an option — some clients find this format actually feels more intimate.
4

Treating the session as background to other activities.

Why it happens: Because teletherapy happens at home — a space associated with multitasking and informal behavior — it's easy to respond to a notification, eat, or half-monitor something else during the call.

How to avoid: Close unneeded applications, put your phone face-down, and if possible use a dedicated space that you only use for sessions. The more deliberately you separate the session from your usual home routine, the easier it is to engage fully.
5

Quitting after one or two uncomfortable sessions without raising the issue.

Why it happens: When something feels awkward, the instinct is often to exit rather than investigate. People may assume the discomfort signals a mismatch with the therapist rather than an adjustment to the format itself.

How to avoid: Most clinicians recommend giving a new therapist and format at least three to five sessions before drawing firm conclusions. Initial discomfort is expected in nearly every form of therapy. If something specific is bothering you, name it to your therapist — that conversation is itself part of the therapeutic work.

What Tends to Help After the First Few Sessions

Most of the discomfort that people describe in early teletherapy sessions responds well to deliberate, small changes. The key is identifying which friction point is actually bothering you rather than labeling the whole format as wrong.

80%+

Client satisfaction with teletherapy outcomes

Multiple reviews published in peer-reviewed journals have found client satisfaction rates for video-based therapy broadly comparable to in-person care across several conditions.

3–5

Sessions before comfort typically improves

Clinicians commonly note that the adjustment period for a new therapist or format tends to stabilize within the first few sessions, though individual variation is significant.

Treat it like a session, not a call. One of the most effective shifts is creating a brief pre-session routine — closing other browser tabs, silencing your phone, and taking a few minutes to transition mentally. This signals to your brain that something different is about to happen, which can reduce the sense that therapy is bleeding into everyday life.

Tell your therapist what feels off. Therapists who work online are generally accustomed to clients raising format concerns. Mentioning that you feel self-conscious on camera, or that your connection keeps dropping, gives your therapist useful information and can lead to practical accommodations — including, in some cases, switching to audio-only for part of a session.

If you're still finding the format genuinely limiting after several weeks, it's worth exploring whether a hybrid arrangement is possible, or whether in-person therapy is a more realistic fit for your circumstances. Many first-time therapy clients find the early discomfort fades faster once they share their concerns openly. And as early sessions in any format often feel draining, it's useful to separate format-specific friction from the normal adjustment to therapy itself.

Don't Mistake Format Discomfort for Therapeutic Mismatch

Feeling awkward on a video call is not the same as having the wrong therapist. Before attributing unease to the therapeutic relationship, consider whether practical issues — privacy, technology, environment — are the more likely cause. Raising format concerns directly with your therapist is a reasonable and often productive step.

This article is for informational purposes only and does not constitute medical or mental health advice. If you have concerns about your mental health or treatment, please speak with a qualified healthcare professional.