What to Expect from Your First Counselling Session (and How to Get the Most Out of It)

Starting therapy can feel like a big (and sometimes intimidating) step. You’ve done your research; know where you can access therapy, found a type of therapy that feels like a good fit, the right therapist and you've booked your first appointment. But what actually happens in that initial session, and how do you know if it’s right for you?

Let’s walk through what to expect and how to make the most of the process.

What is an Initial Assessment?

Your first meeting with a therapist might be called an initial consultation or an assessment session. This doesn’t mean you’re being tested. The therapist is assessing whether the therapy they offer is the right type of support for you, and whether you’re a good fit to work together. At the same time, you’re assessing whether they feel like the right therapist for you.

What Happens in the First Session?

During your first session, your therapist will:

• Ask for some basic information and go over the therapy contract, including confidentiality and its limits (e.g. if there’s risk of serious harm).

  
  

• Explore what’s bringing you to therapy now; what you’re struggling with and what stage of life you’re in.

  
  

• Ask about your background and history, such as your family relationships, school experiences, past challenges, and significant life events.

  
  

Even if some of these things don’t seem relevant to your current issues, they help your therapist understand you as a whole person.

There’s No Pressure

After the session, you don’t have to commit to ongoing therapy if it doesn’t feel right. You’re free to take your time, reflect, or even meet with other therapists before deciding. A good therapist will understand and support your choice.

How Sessions Usually Work

Most therapy sessions are scheduled weekly at the same time and day, though there can be flexibility depending on your circumstances. Sessions are usually around 50 minutes, and they start and end on time. These boundaries aren’t meant to be strict for the sake of it, they create a consistent, safe structure.

It can feel strange at first to open up about your life to someone you don’t know well, especially when your therapist doesn’t share much about themselves. This one-way relationship is intentional: it helps keep the focus on you.

Therapy Isn’t Always Comfortable

Therapy can stir up difficult emotions. You might talk about things you’ve long avoided or re-experience painful memories. Sometimes, you’ll leave a session feeling worse before you feel better. That’s all part of the process; it’s about sitting with discomfort, exploring it, and gradually untangling what’s going on underneath.

Progress isn’t always linear. Some weeks it might feel like nothing is changing. That’s okay. Therapy takes time.

Five Tips to Get the Most Out of Therapy

1. Turn up fully

   Be physically present, but also mentally and emotionally ready to engage. Regular attendance is essential.

   
   

2. Be genuine

   Let your therapist see the real you. Your honesty helps build a clearer understanding of your needs.

   
   

3. Be honest

   If something isn’t working for you, say so. Therapy is a safe place to express frustrations, doubts, or disagreements.

   
   

4. Reflect between sessions

   The work doesn’t end in the therapy room. Keep noticing your patterns, thoughts, and emotions outside of sessions.

   
   

5. Be patient

   Change takes time. Give yourself, and the process, the space to unfold.

   

   
   

Still Have Questions?

If you’re still unsure about what therapy involves or how to take the next step, feel free to get in touch. Whether you’re exploring your options or ready to begin, you don’t have to navigate it alone.

Starting therapy is a brave step. Hopefully, this guide helps make it a little less daunting.

by Suzie Booth (Psychotherapist/Counsellor) MSc. MBACP

www.sbcounselling.org

@theparent_therapist