What Happens in Your First Counselling Session?
- Alex Jurgensen
- Jun 3
- 6 min read
For many people, one of the hardest parts in therapy is not the therapy itself, but deciding to book that first appointment.
Starting therapy can feel like a big step. Well, that's because it is a big step! You're finally ready to work on yourself, to be honest, to uncover what had been buried, to open the many cans of worms you've hidden. That's huge, well done you!
If you’ve never been to counselling (or therapy, it's the same thing!) before, it’s completely normal to wonder what will happen, what you’ll be expected to talk about, or whether you’ll say the “right” thing.
The good news is that there is no right or wrong way to begin therapy. A first counselling session is simply an opportunity for you and your counsellor to meet and have a "vibe check" of each other. Us counsellors, we will want to know who you are and what brought you to therapy, and will be prepared to explain how we work and what's important for us in the therapy itself.
Why People Feel Nervous Before Their First Session
In my experience as a therapist, many people will feel anxious before attending their first counselling session - it's inevitable! Some people worry that they won’t know what to say. Others fear becoming emotional, being judged, or being asked questions they aren’t ready to answer. Some people spend weeks or even months debating whether they should book an appointment at all.
These concerns are all extremely common. Most people arrive feeling uncertain about what to expect. By the end of the first session, however, many are surprised by how natural and conversational the experience felt – and by how quickly the time did pass! "Oh that's 50 minutes gone?! Already? I could continue talking for hours!..." If this is how you feel, rejoice! You have found the right counsellor!
What's important to keep in mind is that therapy isn’t a job interview or a test. There are no right or wrong answers. There is no expectation that you should arrive with everything figured out. That's exactly what therapy is there for!
What Happens at the Beginning of the Session?
At the start of the first session, your counsellor will usually spend some time helping you settle in and explaining how the process works.
This often includes discussing:
How long the session will take and what will be covered.
Confidentiality and its limits.
How counselling works.
Practical arrangements such as session length and fees.
Any questions you may have about the process.
The purpose of this conversation is to help you feel informed and comfortable before exploring your reasons for seeking therapy.
What Will the Counsellor Ask?
Of course, every counsellor works differently, but most first sessions involve exploring what has brought you to therapy, and a general overview of you as a person.
You might be asked questions such as:
What made you decide to seek counselling now?
What difficulties are you currently experiencing?
How long have these difficulties been affecting you?
What would you like to gain from therapy?
What do you think I (the therapist) should need to know about you?
You are not expected to have all the answers, and you can take your time to think before you speak.
Many people will begin with something simple, such as:
“I’ve been feeling overwhelmed lately.”
“I’ve been struggling with anxiety.” “My Dad died last year.”
“I’m not really sure what’s wrong, but I know something needs to change.”
“My partner says I could benefit from talking to a professional.”
These starting points are more than enough to begin with. All we therapists really need is a string to pull from. As long as you give us that, you're doing all that's needed from you.
What If I Don’t Know What to Talk About?
This is one of the most common worries people have before therapy.
Many people assume they need a clear explanation of their problems before attending counselling. In reality, a great part of the therapeutic process involves helping you make sense of what's going on. If we can answer why you came, we're already halfway there.
It's perfectly okay not to know where to begin. It's also perfectly okay to take a few seconds, even minutes, to think of what to say. Your counsellor will wait patiently, and if they see you struggling for words, they'll help with easier questions.
A counsellor will try to find a balance between helping to guide the conversation and staying silent so that you have the space to explore, think, and (most importantly!) feel. Often, what feels unclear at the beginning becomes much easier to understand as the conversation unfolds.
Do I Have to Talk About My Childhood?
Not necessarily.
Some people arrive worried that therapy involves immediately analysing childhood experiences or discussing deeply personal memories.
While your past may become relevant at some stage (this also depends on the therapist's approach), therapy generally starts with what feels important to you right now.
Some clients spend most of their early sessions focusing on current challenges such as anxiety, relationships, stress, work difficulties, confidence issues, or low mood.
A good counsellor will initially work at a pace that feels manageable rather than pushing you into topics you aren’t ready to discuss. Later down the line, they will start trying to push you further into the uncomfortable topics (gently, of course!).
What If I Become Emotional?
It means you're doing it excellently.
It’s a great thing to become emotional during therapy. That's exactly what the therapist will try to help you do: to express!
For some people, the counselling room is the first place they have felt able to speak openly about what they’ve been carrying. Emotions that have been pushed aside for months or years may naturally begin to surface.
Crying is not unusual, it is allowed, even encouraged. Same as for feeling angry, frustrated, relieved, or vulnerable. All of these will be allowed, that's the space you and your therapist are trying to create. A counsellor’s role is not to judge these emotions but to provide a safe and supportive space where they can be explored.
What If I Feel Awkward?
Many people worry about feeling awkward during their first session.
The reality is that most counsellors work with people who are attending therapy for the first time. Feeling nervous, uncertain, or self-conscious is something counsellors encounter regularly.
You do not need to impress your therapist or present yourself in a particular way.
Therapy works best when you can gradually allow yourself to be honest about your experience, even if that honesty begins with saying: “I feel quite awkward being here.”
It's probably inevitable that you will feel awkward or some type of tension. Eventually, you'll show yourself that you can navigate these feelings, too. Same as with anxiety, panic, depression, or whatever else you might be initially struggling with.
How Does the First Session End?
Most frequently the last five minutes of every session will be used to finish with a summary of what was discussed.
You'll usually be invited to reflect on how the experience felt, and what you think should be flagged as key takeaways from the session. At the end of the first session we may discuss:
Any thoughts or feelings that emerged.
Whether you would like to continue working together.
When we will meet again (ideally next week).
What you could reflect on ahead of our next session.
How Do I Know if a Counsellor Is The Right One for Me?
Research consistently shows that one of the strongest predictors of successful therapy is the quality of the relationship between counsellor and client.
Qualifications and experience matter, but so does feeling understood, respected, and comfortable enough to be yourself.
After your first session, it can be helpful to ask yourself:
Did I feel listened to?
Did I feel understood?
Did I feel comfortable speaking openly?
Could I imagine continuing this conversation?
Is this the person I could eventually share my darkest thoughts with?
If the answer is yes to one or more of these, that’s often a positive sign.
Frequently Asked Questions
How long does a first counselling session last?
Most counselling sessions last around 50 minutes, although this can vary depending on the therapist.
Do I need to prepare anything?
No special preparation is required. Simply attending and being willing to engage in conversation is enough.
What if I don’t know exactly why I’m struggling?
Many people start therapy without a clear understanding of what’s wrong. Exploring that uncertainty is often an important part of the process.
How many sessions will I need?
This varies from person to person. Some people attend for a relatively short period, while others choose longer-term therapy. Your needs and goals will help determine what feels appropriate.
What if therapy isn’t for me?
It’s okay to decide that a particular counsellor or therapeutic approach isn’t right for you. Finding the right fit is an important part of the process.
Taking the First Step
If you’re considering counselling, it’s worth remembering that you don’t need to have everything figured out before reaching out for support. You don’t need the perfect explanation for how you’re feeling. You don’t need to know exactly what to say. You don’t even need to be certain that therapy is the answer.
Often, the first session is simply about creating space to explore what’s going on and discovering whether counselling might be able to help.
For many people, taking that first step turns out to be far less intimidating than they imagined, and in the long-term, far more rewarding.
If you're based in London (or Reading!) and would like to take that first step, I offer a free initial session with no pressure and no obligation.
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