What to Expect in an Initial Counseling Session: A Guide for First-Timers

If you're considering counseling for the first time, you may feel a mix of emotions; ranging from excitement, relief and nervousness. This mixture of emotions is completely normal. Therapy is a personal journey and understanding what happens in the first meeting can help you feel more prepared.

Although each therapist may have their own individualized practice, based on the modalities they use or the types of clients they work with, in general, this is what you can expect during your first counseling session:

1. A Safe, Welcoming Environment

The moment you walk into a counseling office, you should feel a sense of safety and privacy. Whether you’re seeing a counselor in-person or via an online platform, the environment is designed to be comfortable and non-judgmental. Your counselor is there to support you, and they will create a space where you feel free to open up at your own pace.

Expect the space to be calm and confidential, allowing you to share openly. If you’re unsure about the online experience, many therapists use video sessions that offer the same level of care and confidentiality, just through a screen.

As a relational therapist, the comfort that a client feels is a top priority of mine. Showing up as my authentic self (including comfortable clothes and a coffee nearby!) can help clients also feel comfortable showing up genuinely. I take priority in setting a comforting and easy-going environment, which can include taking your shoes off, curling up in a chair or enjoying your own snack/drink.

2. Introductions and Setting the Tone

At the beginning of your session, your counselor will likely introduce themselves and explain their role. They may also ask you to tell a little bit about yourself and what led you to seek counseling. This is the time for you to share your current challenges or goals, but don't feel pressured to reveal everything in the first meeting. It takes time to build rapport and feel comfortable sharing history or other details about yourself- this is normal and an expected part of therapy.

Your therapist may explain their therapeutic approach, how they work, and what you can expect from the process.

Feel free to ask any questions that you may have! This is your space to get to know the therapy process and continue to verify that this is the right therapeutic fit for you.

3. Paperwork and Consent Forms

In our current day and age of electronic health records, most counselors will ask you to fill out some basic paperwork before your first session. This paperwork might include providing your contact information, insurance details, and any medical history relevant to your mental health. You’ll likely be asked to sign consent forms that explain your rights as a client.

Don’t worry; the paperwork is standard and ensures that both you and the therapist are on the same page regarding your treatment. The paperwork will likely overview the therapists’ specific policies on cancellations, late fees, scheduling and contact in-between sessions.

If you didn’t complete this paperwork ahead of your initial appointment, expect to complete this at this time.

4. Talking About Your Goals

One of the main focuses of your first counseling session is to get an understanding of what you hope to achieve. You may be dealing with anxiety, depression, relationship issues, or looking for support towards personal growth. The therapist will want to know about your concerns so they can help you set clear goals for therapy.

You don’t need to have everything figured out before the session. It's normal if you’re unsure of exactly what you want or need. Your counselor will help guide this conversation, and together, you can begin identifying the issues that matter most to you.

5. Building Trust and Rapport

A significant part of the initial session is establishing a trusting relationship. Your counselor will listen actively and without judgment, helping you feel comfortable and heard. The more honest and open you can be, the more effective the therapy will be, but this takes time.

During this session, don't worry if you don’t feel an instant connection. Building rapport is a process, and it’s completely okay to take time to feel comfortable with your therapist. If at any point you feel like your therapist is not the right fit, that’s okay too. You have the option to discuss your concerns or even find another professional if needed.

6. Therapeutic Techniques

Depending on the counselor’s approach, you may get a taste of the therapeutic techniques they use. Some therapists may ask questions to explore your thoughts and feelings, while others may use specific exercises to help you reflect on your experiences. This could involve discussing patterns in your thinking, examining past experiences, or learning coping strategies.

The first session is generally more about listening and gathering information than diving into deep therapeutic work. Expect to have more of a conversation rather than engaging in heavy therapeutic interventions.

7. Assessing Your Needs

Your therapist will likely take some time to assess your emotional, mental, and physical health during the first session. They might ask you questions about your background, current emotional state, any challenges you’ve faced, and your history with mental health or therapy (if applicable). This is important for them to understand your needs and tailor your treatment plan accordingly.

This evaluation helps determine what type of therapy or treatment approach will work best for you.

8. Next Steps and Planning

By the end of the session, your counselor will likely discuss the next steps and how often you will meet. Remember that therapy is an ongoing process. Although you will create goals in your initial sessions, you will continue to work with your therapist to establish or re-work goals as needed to best fit what you want or need out of therapy.

You’ll leave the first session with a clearer idea of what therapy will look like moving forward.

Tips for Making the Most of Your First Counseling Session:

• Be honest: It’s okay if you don’t know exactly what you need. Just sharing your thoughts and feelings honestly will help the therapist understand how best to support you.

• Ask questions: Don’t hesitate to ask your counselor about their approach, confidentiality policies, or any other concerns you may have.

• Set realistic expectations: Therapy is a process, and it takes time to see results. Be patient with yourself and with the process.

• Come prepared: Think about any challenges or topics you’d like to discuss beforehand to help guide the conversation.

The first counseling session is the beginning of a journey toward greater self-understanding and healing. It’s normal to feel unsure at first, but remember that your therapist is there to support you every step of the way. Whether you are facing a specific issue or seeking personal growth, the counselor is there to help guide you through the process with empathy, understanding, and professional knowledge. By the end of your first session, you should feel more comfortable and equipped to continue the path toward mental and emotional well-being.

If you’re ready to take the first step, know that you are not alone. Therapy is a powerful tool that can help you gain insight, build resilience, and improve your overall quality of life.

If you are located in South Dakota or Colorado and want to start your counseling journey, reach out here. If you are located outside of these states, searching Psychology Today for a therapist in your area can be a great first step!