If you’ve been thinking about starting therapy but aren’t quite sure what it actually involves, you’re not alone.
Most people come to their first session with a mix of feelings. Some relief that they’ve finally made the call, some nervousness about what’s going to happen, and often assumptions that turn out to be wide of the mark. That’s completely understandable.
Therapy isn’t something most of us grow up knowing much about, and what little we do know tends to come from films or television, which doesn’t always paint an accurate picture.
Here’s a straightforward account of what working together actually looks like; the first session, what sessions feel like day to day, and what therapy is and isn’t. Hopefully it helps you feel a little more prepared, and maybe a little less anxious about taking that first step.
Before you arrive
It’s normal to feel a bit on edge coming to see someone for the first time, especially to talk about things you may not have shared with anyone before. Even people who’ve had counselling previously can feel a little unsettled meeting a new therapist, that’s just part of being human.
To help with that, everyone who comes to see me receives written information beforehand, so you know what to expect practically, whether we’re meeting in person or online.
One thing people often ask about is confidentiality. This is important to me, and I want you to be clear on where the boundaries are before we start, so that’s all covered in writing too. And if you want to get a sense of who I am and how I work before we meet, the website is there for you to look through in
If you’re still weighing up whether counselling is right for you, see: Do I really need therapy?
The first session
The first session is a little different to the ones that follow. It’s more of a getting-to-know-you conversation, where I’ll ask about your life in a fairly broad way. Work, home, family, social circumstances, and what’s been going on for you in general. I might even ask if you have any pets. Life is life, and understanding the full picture helps me support you better as we go.
It’s also the only session where you’ll see me make written notes. I like to get a clear foundation of the key facts early on, so you don’t have to keep filling me in.
At some point, I’ll ask you an opening question: ‘So, where would you like to start?’ It hands the space over to you. Some people find that a surprisingly powerful moment, perhaps the first time in their lives where the floor is genuinely, fully theirs, without any judgement or expectation attached to it.
You don’t need to come prepared with a neat account of your situation. Just say it as it is. There’s no right way to do it. It’s also completely common to take a few sessions before you really feel comfortable opening up. That’s fine. There’s no pressure here, and no rush.
What sessions are actually like
One thing that surprises a lot of people is that I talk. The image of a therapist sitting in silence, occasionally saying ‘and how does that make you feel?’ isn’t really how I work. I find that long, repeated silences can leave people feeling more uncomfortable, not less. So I’m present and engaged, listening closely, and helping you find and feel the things that need to be said, not just waiting for you to get there on your own.
That said, I do listen carefully. Not just to the words, but to how you’re saying something, and sometimes to what the body is doing while you talk. A lot of emotions don’t come out in words, they sit in the chest, the stomach, the shoulders. I’ll often refer to the physical side of things because our bodies are usually communicating something, even when we’re not quite ready to put it into words.
Each session usually starts with me asking what you’d like to focus on, or checking in on how things have been since we last spoke. You’re always in the lead. Although I do keep an eye out for the things that haven’t come up yet, what some people call the elephants in the room. Not to force anything, but because sometimes the things we’re least comfortable saying are the ones most worth exploring, when you’re ready.
Pace and pressure
You don’t have to talk about the most difficult things straight away. Most people need a bit of time to settle in and build some trust before they feel ready to go to the harder places, and that’s right and proper. I’ll always work at your pace.
I work mainly with men, and I know that for a lot of men, showing emotion, or even admitting to struggling, doesn’t come easily. There’s often shame or embarrassment attached to it. That’s something I understand from personal experience as well as professional training.
If you feel something during a session, you’re allowed to feel it. If you need to cry, then cry. That’s not weakness, it’s often exactly what needs to happen for things to start shifting.
A lot of men worry about this more than anything else. Not whether therapy will help, but whether they’ll be able to talk at all. I’ve written more on that here: What if I don’t feel ready to open up for therapy?
It’s more than just talking
Counselling with me isn’t purely talking therapy, though talking is at the heart of it. Depending on what you need and where you are in the process, I might suggest keeping a feelings journal. I’ll give you guidance on how to do that. I sometimes use simple worksheets between sessions, things like identifying your values, noticing patterns or triggers, or short writing exercises on a particular topic. I’ll often recommend relevant reading too.
None of these things are compulsory. They’re invitations, not homework. If something doesn’t suit you or you don’t get to it, that’s fine, we’ll just think about what might work better instead.
One technique I use is Emotional Freedom Technique, or EFT. It involves tapping certain points on the body in a particular order as a way of helping to process and release emotions. It can feel a little unusual to begin with, but it’s a well-established approach, which has been used to support war veterans and people working through trauma, and many people find it genuinely helpful for shifting things that talking alone hasn’t been able to reach.
What therapy isn’t
Therapy with me isn’t about being psychoanalysed. You won’t be lying on a couch while someone takes notes and says very little. You won’t be given a diagnosis either, that’s not what counsellors are trained to do, and honestly, I don’t think a label is usually what helps people move forward.
What I can do is help you come to your own understanding of what’s going on for you, and if I think there’s someone else who should be involved, I’ll say so.
One client said to me recently: ‘It’s not what I expected — there’s no big words or complicated stuff — it’s just like two guys talking with each other.’ That’s pretty close to how I’d describe it. It’s human, it’s real, and it takes place in a confidential space where what you say stays between us free from judgement..
When things start to shift
I believe starting therapy takes real courage, even if it doesn’t feel that way at the time. Picking up the phone and making that first call is often the hardest part. What comes after it, the first session, the conversations that follow, tends to feel more manageable than people expect.
Deeper change doesn’t usually happen overnight, and I’d never suggest otherwise. But it does happen, often in small moments, a bit of insight here, a shift in how you see something there. Those quiet turning points tend to build on each other, steadily, over time.
Ready to take that first step?
If you’re thinking about starting therapy and want to get a sense of whether working together feels right, I offer a free initial telephone introduction. It’s a relaxed, no-pressure conversation, a chance to ask any questions you have and to get a feel for how I work before committing to anything.
You don’t have to have everything figured out before you get in touch. Most people don’t. Just reach out, and we’ll take it from there.