How Do Counselling Sessions Work? What to Expect From Therapy

by Suzie Booth, Counsellor/Psychotherapist, MSc. MBACP (Accred).

Starting counselling can feel daunting.

For many people, the hardest part isn't making the appointment, it's not knowing what will actually happen once they walk through the door.

Will you have to talk about your childhood immediately? Will the therapist tell you what to do? What if you don't know where to start? What if you cry?

These are completely normal questions.

Whether you're seeking support for anxiety, stress, relationships, parenting, grief or simply feeling overwhelmed, understanding what counselling sessions look like can help you feel much more comfortable taking that first step.

Your First Counselling Session

Your first session is about getting to know each other.

We'll spend some time exploring what's brought you to therapy and what you're hoping might feel different in your life. As well as getting some background information about your life - this is so that the therapist can understand more about you and how your previous experiences and current circumstances might link together. There is no pressure to tell your whole life story or share anything you're not ready to discuss.

You can expect us to talk about:

• What has been happening recently

• The difficulties you're experiencing

• Your relationships and support network

• What you would like to get from counselling

• Any questions or concerns you have about therapy

• A brief run through of your life up until now

The first session is also your opportunity to decide whether I feel like the right therapist for you. Research consistently shows that the relationship between therapist and client is one of the biggest predictors of successful therapy, so it's important that you feel safe, understood and comfortable.

Do I Have to Know What to Talk About?

Not at all.

Many people arrive saying things like:

"I don't even know where to begin."

"Everything just feels like a mess."

"I don't know why I'm crying."

That's absolutely ok.

Part of my role is helping you make sense of experiences that currently feel confusing or overwhelming. You don't need to organise your thoughts before coming to therapy, that's something we do together.

Will You Give Me Advice?

This is probably one of the questions I'm asked most often.

The short answer is, not usually.

It might seem surprising, but lasting change really doesn't comes from someone telling us what we should do.

Instead, therapy helps you understand yourself more deeply.

Together we'll be curious about the patterns you've developed, the beliefs you've come to hold about yourself, and the ways you've learned to cope throughout your life.

Often, our difficulties make perfect sense when we understand where they came from.

Rather than simply managing symptoms, therapy creates space to understand the root of what's happening so that change becomes more meaningful and long-lasting.

What Happens During Regular Sessions?

Each session is led by what feels most important for you.

Some sessions may focus on something that happened yesterday. Others may explore patterns you've noticed throughout your life.

We might spend time:

• Understanding difficult emotions

• Exploring relationship patterns

• Looking at unhelpful beliefs about yourself

• Making sense of anxiety or overwhelm

• Processing painful experiences

• Building greater self-compassion

• Finding healthier ways of responding rather than simply reacting

There is no set script. Therapy evolves with you.

What If I Cry?

Crying is incredibly common in counselling, there's always a box of tissues available. For many people, therapy is one of the few places where they don't have to hold everything together. There is never any expectation to stop crying, apologise or 'be ok'.

Sometimes people cry

Sometimes they laugh

Sometimes they sit quietly while trying to find the words

All of those experiences are welcome

Is Everything Confidential?

Confidentiality is one of the foundations of counselling.

What you share in therapy remains private, with a small number of legal and ethical exceptions relating to serious risk of harm, which will always be explained clearly during your first session.

Creating a safe, confidential space allows you to speak openly without fear of judgement.

How Many Sessions Will I Need?

There isn't a single answer to this. Some people come for a small number of sessions to work through a specific issue.

Others choose longer-term therapy to explore deeper patterns, relationships and personal growth.

We'll regularly review how therapy is feeling and whether it's meeting your needs. There is no expectation that you commit to a fixed number of sessions.

My Approach to Counselling

I'm an integrative psychotherapist, working from Clarkson's relational model of therapy.

What that actually means is that rather than viewing people through one single psychological theory, this approach brings together ideas from a number of well-established therapeutic models. Each offers a different way of understanding why we think, feel and relate as we do. Together, they create a richer, more complete picture of your experiences.

At the heart of my work is the therapeutic relationship itself. Research consistently shows that one of the strongest predictors of successful therapy isn't a particular technique, it's the quality of the relationship between therapist and client. My aim is to create a space where you feel safe enough to explore difficult thoughts and emotions, understood without judgement, and gently challenged when old patterns are keeping you stuck.

Rather than simply learning ways to cope, we'll work towards a deeper understanding of your patterns so that lasting change becomes possible.

Therapy isn't about me having the answers. It's about creating a relationship in which new understanding, self-compassion and change can emerge.

Thinking About Starting Counselling?

Beginning therapy can feel like a big step, but you don't have to have everything figured out before you start.

You don't need the right words.

You don't need to know exactly what's wrong.

You just need to be willing to start.

If you're considering counselling and would like to explore whether we're the right fit, I'd be delighted to hear from you.

You can find out more about my counselling sessions, or get in touch to arrange an initial appointment or ask any questions you might have. If you are accessing therapy through private health insurance you can find out more here.