What To Expect In A First Counseling Session

Medically reviewed by Laura Angers Maddox, NCC, LPC
Updated May 13, 2024by BetterHelp Editorial Team
Please be advised, the below article might mention trauma-related topics that include suicide, substance use, or abuse which could be triggering to the reader.
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Signing up for counseling might feel intimidating if you have never seen a therapist before. It is not unusual for someone to be nervous about contacting a therapist and making an appointment; you might not know what to expect. You may be worried that the interactions will be awkward or intimidating, which can cause anxiety. These concerns are typical, and learning about what happens at the first therapy session is one way to prepare and reduce your stress.

There are many reasons to see a therapist, whether for individual counseling, group counseling, or specialized therapy sessions. A mental health professional can help you navigate any life situations that need counseling, and therapists can provide specialized care in many areas. For example, if you need assistance with relationship problems and work disputes, or if you have a substance use problem, you can turn to a dedicated professional with experience and education in these specific areas.

Whether you're seeking counseling sessions or just a one-time contact, a guidance counselor can give you emotional support and objective feedback in a non-judgmental way. You do not have to have a diagnosed mental health condition to benefit from seeing a counselor. Instead, many people seek help because they are facing a difficult life challenge and want to benefit from a professional’s guidance and support.

Are you wondering what to expect if you start counseling?

The therapist will get to know you

During your initial counseling sessions, your counselor will spend time getting to know you. The initial session is also an opportunity to get to know the counselor. Many mental health experts, including those from the American Psychological Association, agree that the rapport between a counselor and client is even more crucial than the experience and background of the counselor. Rapport can take time to build, so it is often necessary to give your counselor more than one session to determine whether it is a good fit.

Your counselor may send you some forms before the first session or ask you to come to your appointment early to complete them, just as a new doctor usually does. These forms will likely contain information about the counselor’s practice, information, and assessment questions for you to answer.

When you first talk with a therapist, they will also ask questions about your life and background. These questions could include things such as your occupation, your academic experience, and your hobbies. Aside from general questions, the counselor will also ask about your life situation. Questions about your relationships will come up, and all of your answers will help them understand you and your life situation.

These types of questions are necessary so that the therapist can get to know you, make an initial assessment, and plan how best to help you. Initial conversations are often more about discovering the concerns that have led you to seek counseling rather than immediately jumping into more profound issues. Even if you don’t feel noticeably different or better after your first session, it does not indicate that you will not have a successful treatment if you keep going.

Discussing your challenges and why you are seeking counseling

Of course, the counselor will also want to hear the reasons why you are seeking counseling. Even if you do not discuss these issues in detail during the first session, they can be addressed in-depth during later conversations. You determine what you want to tell and work on and the level and pace comfortable for you. You do not have to tell your counselor your deepest secrets or anything that you are not ready to reveal. 

Being able to talk openly about your reasons for seeking counseling is essential. For example, some people have severe stress and anxiety due to a demanding career. If this is the case, your counselor may wish to discuss some of the challenging aspects of your job to get a better picture of why these issues are happening and how they affect you.

Your initial visit might include discussions about the types of therapy the counselor specializes in. The counselor may also work with you to develop goals for therapy, which can be personalized as you achieve specific milestones. Over time, you may also realize problems beneath the surface that you were unaware of until you started talking to a counselor.

According to the Centers for Disease Control and Prevention (CDC), if you have a mental health condition, you are not alone. In 2019, over 19 % of adults in the US sought out help for a mental health condition during the previous 12 months. In addition, nearly 10 % received ongoing counseling to help them resolve their symptoms.

Discussing your symptoms


Mental health symptoms often impact many areas of life and functioning. The counselor may wish to discuss how your symptoms carry over into other aspects of life, such as sleep, work, health, and relationships. Sometimes people get nervous talking about their symptoms. If this is a problem for you, you can tell the therapist, and they can put you at ease by doing things at a comfortable pace.

Try to be open and honest

Feeling embarrassed when discussing uncomfortable information is common, and being completely honest might not be easy. In some cases, people have the urge to lie or avoid answering specific questions with complete accuracy. However, when you are not open and honest with your counselor, the session will likely not be as effective. It can be easier to make true breakthroughs if a counselor knows what is going on. It is perfectly okay if you are not ready to talk about something, but instead of being evasive, it is better to tell the counselor you are not ready now.

It is not part of a therapist’s job to judge you - your counselor talks to people about highly personal matters every day. Your counselor wants to create a safe environment for you to talk about hard things, and it might take time for you to feel comfortable divulging specific concerns, which is okay.

That means your therapist cannot reveal any information about what you’re saying in your sessions to anyone, by law.

The limitations to this vary by state, but in general, they include the following: 

  • If you are a danger to yourself or someone else, your counselor is responsible for getting you appropriate help.
  • Counselors are mandated reporters for child abuse and elder abuse.

Your counselor cannot even tell someone that you are a client unless you sign a consent for the release of information.

Don’t be afraid to ask questions

You don’t need to be afraid to ask your counselor questions. If you have any concerns about the counseling process, telling your therapist is the best way to resolve them. Your counselor would much rather know that you are not connecting or getting better than for you to cancel your next session and never come back. You can talk to your counselor about anything you want and expect professional and objective feedback and suggestions. If you decide that the person you are seeing is not a good fit for you, you can always ask for a referral to someone else or seek another therapist on your own.

If you take the time to engage with your counselor, it increases the chances that your sessions will be successful. Remember depending on the type of therapy, progress can be uncomfortable and slow at times. You may be talking about things you don’t feel safe talking to other people about or maybe something you haven’t told anyone before. It is your counselor’s job to help you make progress, not always to make you feel happy all the time. Growth and positive change often start with some discomfort. Just as you do not build muscle and endurance without challenging workouts, the same is valid for making progress in counseling.

Are you wondering what to expect if you start counseling?

If you are new to therapy, online options might be a good fit

Researchers have concluded that online therapy can be as effective as seeing someone in-person. While online treatment is not appropriate for every mental health condition, it has been found effective for treating depression, anxiety, phobias, post-traumatic stress disorder, panic disorder, and many other conditions.

If you are nervous about talking to a counselor, online therapy might help you feel more comfortable. In addition, with online therapy, it is much easier to seek counseling at times that work best for you. Online therapy platforms allow for connecting with a counselor through chat sessions, text messaging, video calls, and by phone. You can find out more about online therapy options by following this link.


Starting therapy can feel intimidating and overwhelming. However, trained mental health professionals see clients with all types of mental health challenges every day. They work with their clients at a pace that matches the client’s comfort level and needs, and they do so in a non-judgmental way. Talking to a therapist online can make getting started more comfortable.

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