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Starting counselling for the first time can feel like a big step. You may feel nervous, unsure about what to say, worried about being judged, or simply uncertain about what actually happens in a counselling session.

These feelings are completely understandable. Many people arrive at their first appointment not knowing what to expect.

The important thing to remember is that your first counselling session is not a test. You do not need to prepare the perfect explanation, know exactly what is wrong, or have all the answers. The first session is simply an opportunity to meet your counsellor, talk about what has brought you to counselling, and begin deciding what kind of support may help you.

If you are considering counselling for anxiety, depression, stress, trauma, bereavement or another mental health difficulty, knowing what to expect can make taking that first step feel much easier.

What Happens in Your First Counselling Session?

Your first counselling session is usually slightly different from future sessions.

The counsellor will normally spend some time getting to know you and understanding why you have decided to seek support.

You may be asked questions about:

• What has brought you to counselling
• How you have been feeling recently
• How long you have been experiencing difficulties
• Whether anything specific has happened in your life
• Your relationships and support network
• Your physical and mental health
• Any previous counselling or mental health treatment
• What you would like to get from counselling

You do not have to tell your entire life story during the first appointment.

Counselling should move at a pace that feels manageable for you. If something feels too difficult to discuss immediately, you can let your counsellor know.

You Don’t Need to Know What to Say

One of the biggest worries people have before their first counselling session is:

“What am I supposed to talk about?”

The answer is that there is no right or wrong way to begin.

You might start by saying that you have been feeling anxious, low, overwhelmed or stressed. You might explain that something has happened recently that you are struggling to cope with.

You may even simply say:

“I don’t really know where to start.”

That is perfectly okay.

A qualified counsellor is experienced in helping conversations develop naturally. They may ask gentle questions that help you begin exploring what is happening and how you are feeling.

Some people find that once they start talking, things they have been holding inside for a long time begin coming out.

Others need several sessions before they feel comfortable opening up.

Both experiences are normal.

Your Counsellor Will Explain Confidentiality

During your first counselling appointment, your counsellor should explain confidentiality.

Confidentiality is an important part of counselling because it helps create a safe space where you can speak openly.

In most circumstances, what you discuss with your counsellor will remain private.

However, there may be certain situations where confidentiality has limits. For example, if there is a serious concern about your safety or the safety of another person, the counsellor may need to take appropriate action.

Your counsellor should explain these boundaries clearly so you understand how your information will be handled.

If you have any questions about confidentiality, you should feel comfortable asking them.

Talking About Why You Want Counselling

Your counsellor will normally ask what has brought you to counselling.

There may be one clear reason.

Perhaps you are struggling with anxiety, experiencing panic attacks, feeling depressed, coping with bereavement or having difficulties within a relationship.

For other people, it may be harder to explain.

You might simply know that something does not feel right.

You may feel exhausted, disconnected, irritable or overwhelmed without completely understanding why.

Counselling can help you explore these feelings.

You do not need to have a diagnosis before asking for support.

People attend counselling for many reasons, including:

• Anxiety
• Depression
• Low mood
• Stress
• Panic attacks
• Trauma
• PTSD
• Bereavement
• Relationship difficulties
• Low confidence
• Low self-esteem
• Loneliness
• Work pressures
• Family difficulties
• Financial worries
• Major life changes

Sometimes people also seek counselling because several smaller difficulties have built up over time.

You May Be Asked About Your Mental Health History

Your counsellor may ask whether you have experienced mental health difficulties before.

They might ask whether you have previously received counselling, therapy or other mental health treatment.

They may also ask whether you are currently taking medication or receiving support from another service.

This information helps your counsellor understand your circumstances and make sure that counselling is appropriate for your needs.

It is not about judging you or putting a label on you.

The purpose is to build a clearer picture of what support may be most helpful.

You Can Ask Your Counsellor Questions

Counselling is a two-way relationship.

Your first appointment is also an opportunity for you to ask questions.

You may want to ask:

• What type of counselling do you provide?
• How long does each session last?
• How often will sessions take place?
• How many sessions might I need?
• What happens if I need to cancel?
• Is everything I say confidential?
• What qualifications does my counsellor have?

It is important that you feel comfortable with your counsellor.

You do not necessarily need to feel completely relaxed during the first session, particularly if you are already experiencing anxiety. However, you should hopefully begin to feel that your counsellor is listening to you and treating you with respect.

Will I Have to Talk About Difficult Experiences?

You are always in control of what you choose to discuss.

Some people worry that they will immediately be expected to describe painful or traumatic experiences in detail.

This should not be the case.

A counsellor may ask about difficult events because understanding them could be important, but counselling should take place at an appropriate pace.

If you are not ready to discuss something, you can say so.

Building trust can take time.

For some people, the early sessions are mainly about developing a safe relationship with their counsellor before beginning to explore more difficult experiences.

How Long Does a Counselling Session Last?

Counselling sessions commonly last around 50 minutes to one hour, although this can vary depending on the service.

Sessions may take place weekly, fortnightly or according to an agreed schedule.

Counselling may be offered:

• Face-to-face
• Online
• By telephone

Different people prefer different approaches.

Some people value being physically present with their counsellor, while others may find online or telephone counselling more convenient or easier to access.

How Might You Feel After Your First Counselling Session?

People can experience many different emotions after counselling.

You may feel relieved because you have finally spoken about something that has been worrying you.

You may feel hopeful because you have taken a positive step.

You might also feel tired, emotional or unsettled.

Talking about difficult experiences can sometimes bring emotions to the surface.

This does not necessarily mean counselling has gone badly.

It can simply mean that you have begun discussing things you may have avoided or kept inside for a long time.

Giving yourself some quiet time after a session can sometimes be helpful.

What Happens After the First Session?

At the end of your first session, you and your counsellor may discuss what happens next.

You might agree to continue with regular counselling sessions.

Your counsellor may also discuss what you would like to work towards.

Counselling goals can be very different for each person.

For example, you may want to:

• Reduce anxiety
• Understand your emotions
• Improve confidence
• Cope with grief
• Process traumatic experiences
• Improve relationships
• Develop healthier coping strategies
• Feel more in control of your life

These goals can change as counselling progresses.

Sometimes people begin counselling thinking they need help with one issue and later realise that something else is contributing to how they feel.

That process of discovery is an important part of counselling.

How Do I Know If Counselling Is Working?

Counselling is different for everyone.

You may notice improvements relatively quickly, while other changes can take longer.

Signs that counselling may be helping could include:

• Understanding your emotions more clearly
• Feeling less overwhelmed
• Recognising negative thought patterns
• Developing healthier coping strategies
• Becoming more confident
• Communicating more openly
• Setting healthier boundaries
• Feeling more hopeful about the future

Progress is not always a straight line.

You may have good weeks and difficult weeks.

Counselling is about gradually developing greater understanding and finding ways to manage life’s challenges more effectively.

Taking the First Step Into Counselling

For many people, booking the first counselling appointment is the hardest part.

You may have spent months or even years telling yourself that things will improve on their own.

Asking for help does not mean you have failed.

It means you have recognised that something needs to change and you are taking steps towards improving your wellbeing.

At Anxious Minds, we provide accessible counselling and mental health support for people experiencing anxiety, depression, trauma, bereavement, stress and other emotional difficulties.

Our counselling services offer a safe and supportive environment where you can talk openly with a qualified professional and begin understanding what you are experiencing.

You don’t need to know exactly what to say.

You just need to take the first step.

Find out more about counselling and mental health support from Anxious Minds at 0191 262 0305

If you or somebody else is in immediate danger or you believe there is an immediate risk of serious harm, call 999 or go to your nearest Accident & Emergency department.