What to Expect in Your First Counselling Session
Joshua Kruse, PhD
Walking into a first counselling session can bring a mix of emotions—nervousness, hope, uncertainty, or even a sense of relief. Whether it’s your first time seeking therapy or you’ve been before, knowing what to expect can help ease anxiety and set a foundation for meaningful, effective work.
In this post, I want to walk you through what a typical first counselling session looks like in my practice. I’ll also explain how we build a safe space for healing, clarify what my role is, and how we begin to make sense of what’s going on in your life.
Setting the Foundation: Informed Consent and Creating Safety
The very beginning of our time together is about creating a safe, supportive space for you. This starts with a review of informed consent.1 We’ll go over the practical and ethical pieces of counselling—confidentiality, its limits, how sessions work, fees, cancellation policies, and any questions you may have. This is an important step because it ensures that you are fully informed and empowered in your choice to engage in therapy.
But creating safety goes beyond forms and policies.2 I want you to feel emotionally safe, too. That means I approach each session with warmth, curiosity, and without judgment. I understand that stepping into counselling takes courage—it’s not just another appointment on your calendar. It’s a space where we lean into some of the most significant aspects of your life, and I don’t take that lightly.
Understanding What Brings You In
Once we’ve reviewed the logistics, the focus shifts to getting a clear picture of what’s bringing you into counselling.
I often share this metaphor with clients:
“In a first session, I can sit in the driver’s seat or the passenger seat to get a better sense of what’s going on for you and how I can best help.”
If you’re comfortable taking the lead, I’ll sit in the passenger seat, listen carefully, and ask questions along the way to help clarify and deepen the picture. But if it’s hard to know where to start, I’m also completely okay sitting in the driver’s seat—gently guiding us with questions to help understand your experience and what you might need. Either way, you don’t have to prepare anything fancy or polished. Just show up as you are and the picture will come together.
During this part of the session, we may talk about your goals for counselling, what areas of life are feeling hard right now, or what patterns you’ve noticed in yourself or your relationships3. Sometimes people come in with a specific issue like anxiety, grief, depression, trauma, or a relationship breakdown. Other times, it’s more of a sense that “something just isn’t right.” Wherever you’re at, come as you are and we’ll go from there.
A Bit About My Approach
I also spend a few minutes sharing a bit about how I work as a therapist—this can help you get a feel for whether the fit is right for you. My approach is rooted in empathy, collaboration, and tailoring therapy to each person’s unique story and needs. I draw on different types of therapy depending on what’s most helpful, and I always explain things in plain language.
For example, if you’re coming in with anxiety or trauma, I might mention that I integrate thoughts, emotions, sensations, and actions in understanding and working with you (see our blog on Awareness). If it’s relationship issues, we might explore attachment patterns and communication strategies (see our blog on Understanding Attachment Styles). I tend to lean towards talking/processing things through, yet I also keep an eye out for practical tools or resources that might be helpful.
Respecting the Process
I have deep respect for every person who steps into therapy. It’s not easy. It’s often vulnerable and uncomfortable—especially at the beginning. But I also believe that healing and growth happen when we feel seen, supported, and safe enough to be honest.
That’s why I try to match your pace. If you’re not ready to dive into certain topics, we don’t right away. If you’re eager to unpack something right out of the gate, we go there. This is your space, and I work hard to honor that.
Looking Ahead: Mapping the Journey
By the end of our first session, my hope is that we’ve started to connect the dots—both in terms of what’s going on and what you’re hoping to get out of therapy. You might leave with a bit more clarity, or at least a sense that there’s someone walking with you now.
Depending on your goals, I may share a few thoughts on how I typically work with the kind of concerns you’re bringing in. That could include things like pacing, tools we might use, or frameworks I find helpful. But nothing is set in stone—therapy is a dynamic process, and I stay open to adjusting as we go.
Going into future sessions, I typically have a sense of direction for where we could go next. But I always leave room for what comes up in your life between sessions. Maybe something happens between sessions that you need to process, or something we touched on last time stirs up new thoughts or feelings. I want our work to be responsive and relevant—not rigid or overly structured.4
“Therapy isn’t about fixing you. It’s about understanding you, helping you heal, and walking with you as you grow.”
Final Thoughts
It’s normal to feel a bit unsure after your first session. Therapy is a new experience for many people, and like any meaningful relationship, it takes time to build trust and momentum. But even in that first hour, seeds of healing and hope can be planted. My clients often come back to our second session saying that they feel a lot more comfortable coming in.
I often tell my clients: you’re doing something incredibly brave by being here. Whether you’re navigating anxiety, grief, relationship pain, or simply trying to make sense of who you are, you don’t have to do it alone.
Therapy isn’t always comfortable in the moment, but it is a place where you can lay down the burden of carrying everything alone.5
If you’re considering counselling, know that change is possible. Healing is possible. And that first step—showing up—is already a powerful act of courage.
- Informed Consent by Cleveland Clinic ↩︎
- The Heart of Therapy: Creating a Safe Space for Individual Clients by Bethesda Counselling Services ↩︎
- 10 Goals You Can Achieve in Therapy by Mind Flower Group ↩︎
- What to Talk About in Therapy: An Easy Guide on Two Chairs Blog ↩︎
- Sometimes Therapy Is Not About Making You Feel Better on Psychology Today ↩︎