What to Expect in Your First Counselling Session

Your first counselling session is mostly a conversation. Your counsellor explains how counselling works and what stays confidential, then asks what brought you in, what is happening in your life and what you would like to change. You do not need to prepare a perfect explanation or share anything you are not ready to. By the end, you should have a sense of whether the counsellor is a good fit and what the next steps might be.

Before your first session

• Booking: you can book online through Jane, by phone or through our contact form. You will choose in person at our South Edmonton office or online.
• Intake forms: you may receive a short questionnaire and consent form by email. Completing them beforehand leaves more time to talk.
• Insurance: check what your plan covers and whether we direct bill your insurer. Our guide to counselling coverage in Alberta lists questions to ask.
• For online sessions: find a private space, use headphones, and test your camera and connection. Some people join from a parked car for privacy.

What happens during the first session

1. Consent and confidentiality

Your counsellor explains how sessions work, fees, cancellations and how your information is protected. What you share is confidential, with a few legal exceptions your counsellor will explain, such as:

• A serious risk of harm to yourself or someone else
• Concerns that a child or vulnerable adult is being harmed
• A court order requiring records

You can ask questions about any of this before you start.

2. Understanding what brought you in

You will be asked what is going on and why now. You might talk about anxiety, low mood, relationship conflict, grief, stress at work, a family situation or something you cannot name yet. Share at your own pace.

3. Background and context

To understand the whole picture, your counsellor may ask about:

• Your family, relationships and support system
• Work, school and daily routine
• Sleep, physical health, medications, alcohol or substance use
• Past experiences, including any previous counselling
• Culture, faith, language and immigration, if relevant to you
• Your strengths and what has helped before

4. Safety check

Counsellors routinely ask whether you have thoughts of harming yourself or others. This is a standard question asked of everyone, and an honest answer helps your counsellor support you safely.

5. Goals and next steps

Toward the end, you will talk about what you would like to be different. Examples include sleeping better, arguing less, feeling less anxious at work or making a decision. Your counsellor may suggest an approach, how often to meet and something small to try before next time.

How to get the most from your first session

• Write down a few notes: what you want help with, questions about the process and anything you are worried about.
• Be honest about how counselling feels. Saying “I’m nervous” or “I’m not sure this will help” is useful information.
• Ask about approach and fit: “How do you usually work with people dealing with this?” or “Have you worked with families from my background?”
• Expect some emotion. Tears, relief or tiredness afterward are common. Plan something gentle for later in the day.

Common worries about starting counselling

“My problem isn’t serious enough.” You do not need to be in crisis to deserve support. Many people come in for stress, decisions or relationship patterns.

“What if I don’t click with the counsellor?” Fit matters. Mention it, or ask to see someone else.

“Will I have to talk about my childhood?” Only if it is relevant and you want to. Many approaches, such as CBT, focus mainly on the present.

“What if my family finds out?” Your sessions are confidential within the legal limits above. We do not contact family without your consent. Read more about overcoming stigma about counselling.

Individual, couples and family first sessions

• Individual counselling: one-on-one, focused on your goals.
• Couples counselling: usually a joint first session. Some therapists then meet each partner individually to hear their perspective.
• Family therapy: may start with parents or the whole family, depending on the situation.
• Teen therapy: parents often join part of the first session. Then the teen has private time with the counsellor.

How many sessions will I need?

It depends on your goals. Some people come for a few sessions to work through a specific issue. Others benefit from longer-term support. Many structured approaches show noticeable change within 6 to 12 sessions. You and your counsellor will review progress together.

Frequently asked questions

How long is a first counselling session?

Most sessions are 50 minutes. Some assessments or couples and family intakes may take longer, and we will tell you when booking.

What should I say in my first therapy session?

Start wherever feels easiest, even with “I don’t know where to begin.” Your counsellor will guide the conversation with questions.

Is online counselling as effective as in person?

For many concerns, research shows online counselling can be as effective as in-person sessions. The best choice is the format you will attend consistently and feel comfortable in.

Do I need a referral to see a counsellor?

No referral is needed to book at Disha. Some insurance plans ask for a doctor’s referral to reimburse claims, so check your plan.

What if I need help right away?

Counselling is not an emergency service. If you are in crisis, call or text 9-8-8 any time, or call 911.

Reviewed by Mukesh Mishra, MSW, RCSW, Registered Clinical Social Worker and ACSW-approved RCSW supervisor at Disha Counselling & Wellness Centre. Last updated September 30, 2026. This article is general information and is not a substitute for individual professional advice.