What to expect from your first counselling session

The thought of starting therapy can be daunting.

If you've never had therapy, you might be uncertain about how it works and what's expected of you. If you have had therapy before, but you're starting with a new counsellor, how might they do things differently from your previous counsellor?

Whether you’re seeking help for anxiety, low mood, relationship issues, trauma, or simply looking for personal growth, it’s completely normal to feel unsure or nervous about what the first session might involve. Understanding what to expect can help ease some of that uncertainty and help you feel more prepared and empowered.

Here’s a look at what typically happens in a first counselling session:

Initial introductions and building rapport

When you first meet your therapist, whether in person, online, or over the phone, the goal at this early stage is to start building a connection, which is essential for the therapeutic process. 

Building rapport doesn’t mean you need to share everything right away. Rather, it’s about beginning to establish a sense of safety and trust. The therapist may explain a little about themselves and how they work, as well as ask questions about what brought you to therapy and how you’re feeling about starting this process. There is no pressure to “perform” or share everything —this space is for you, and the pace is yours to set.

Discussion of confidentiality and boundaries

An important factor to discuss in the first session is confidentiality. Your therapist will explain how your information and what you choose to share within sessions is kept private, and the specific legal and ethical boundaries of confidentiality. For example, they’ll likely mention that what you say stays between the two of you, with some exceptions, such as if there is a risk of serious harm to yourself or others, or if there are legal obligations.

Boundaries are also likely to be discussed, such as session length (usually 50 minutes or an hour), cancellation policies, and how communication outside of sessions is handled. These guidelines are there to create a consistent, safe, and professional therapeutic environment.

Assessment and information gathering

In most first sessions, the therapist will conduct an initial assessment. This isn’t a test but rather a way of gathering important background information. The therapist may ask questions like:

- What brings you to therapy now?

- What would you like to get out of therapy?

- Have you been to therapy before? If so, what did you find useful?

- Are you currently taking any medications?

- What’s your family or support system like?

- How have you been coping with your difficulties?

These types of questions aim to help the therapist understand your situation, mental health history, and any relevant medical or life factors. It also gives them insight into the best therapeutic approach to support you. It’s important to remember that you can share as much or as little as you’re comfortable with in this first session. Therapy is a process, and your story can unfold gradually over time. You are in control of how much you disclose.

Exploring your goals for therapy

While some clients come to therapy with a very clear issue they want to work on, others may be unsure or simply know that they don’t feel right. Either scenario is perfectly valid. A good therapist will help you clarify your goals and identify what you’d like to get out of therapy. Goals might be specific, like managing panic attacks or navigating a breakup, or broader, such as improving self-esteem, exploring identity, or gaining insight into and support with changing patterns of behaviour. You don’t need to have all the answers upfront. The first session is a time to begin exploring what matters to you and how therapy can support your journey.

The therapist’s approach and next steps

There are several different theoretical models counsellors can use, such as cognitive-behavioural therapy, psychodynamic therapy, person-centred therapy, etc. During the first session, the counsellor may explain their general approach and how they think they can support you. If they feel that another therapist or type of therapy might be more appropriate, they may discuss a referral. 

You may also discuss the potential frequency of sessions (weekly, biweekly, etc.), the expected duration of therapy, and how progress might be monitored. This helps establish a sense of structure and commitment, which can be helpful for maintaining consistency and momentum.

Your role and rights as a client

It’s also important to understand your role in therapy. While the therapist guides the process, therapy is a collaborative journey. Your participation, honesty, feedback, and willingness to engage will shape the experience and outcomes. You also have rights as a client. You have the right to ask questions, express concerns, take breaks, and end therapy if it’s not the right fit for you. If something doesn’t feel right, such as the therapist’s style, the pace of therapy, or any discomfort, you are encouraged to speak up. A good therapist will welcome your feedback and adjust their approach to support your needs.

Emotional responses and reactions

It’s completely normal to feel a wide range of emotions during and after your first session. You might feel relieved, anxious, exposed, hopeful, or even uncertain. Talking about difficult topics, even in a safe space, can bring up complex feelings. Give yourself space to process. Some people find it helpful to journal, rest, or talk with a trusted friend after a counselling session. Over time, therapy often becomes a place of comfort and growth, but the initial step can stir up emotions, especially if you’ve kept things bottled up for a long time.

Are you a good fit?

After your first session, it’s helpful to reflect on how the session felt for you. Ask yourself:

- Did I feel heard and respected?

- Was the therapist easy to talk to?

- Did I feel emotionally safe?

- Do I feel like this person could support me?

Therapy is a deeply personal experience, and the therapeutic relationship is one of the most important factors when it comes to making progress in therapy. If the first session didn’t feel quite right, that’s okay. Sometimes it takes a few sessions to build trust, but if it continues to not feel right, it may be worth trying a different therapist. The most important thing is that you feel safe and supported.

Final thoughts

The first counselling session is a starting point - a step towards healing, self-understanding, and making positive change. It’s a time for connection, exploration, and laying the foundation for the therapeutic journey ahead. While it may bring up nerves or uncertainties, it also holds the potential for relief, clarity, and hope.

Remember: starting therapy is a courageous act. Whether you walk away from the first session feeling lighter or simply more curious, you’ve taken an important step toward prioritising your well-being.