What happens at a counselling appointment?

Counselling is a broad profession with many different evidence-based approaches. Each counsellor brings their own skills, knowledge and personality to counselling sessions and each client is different. This means that each counselling session is unique, but if you have some trepidation about attending counselling, this article will give you an indication of what to expect.

At an initial consultation, you will meet with your counsellor. You may have already spoken on the phone, but this will likely be the first time that you will meet them in person (although it may be virtually).

The “therapeutic relationship” between you and your counsellor is one of the most important aspects of counselling (Fluckiger, et al., 2018). Every counselor has a different approach, but your counsellor will probably take a little time at the beginning of the first session to help you feel at ease and build rapport.

It is important to find a counsellor that is a “good fit” for you. This is one of the reasons I offer a free 15-minute consultation with potential clients prior to booking a counselling session. It provides an opportunity for us to decide if my approaches and skills fit well with the client’s needs and preferences.

Before counselling commences, you will sign a counselling agreement. This is often done during the first session so you can discuss the mutual expectations and obligations of client and counsellor. This includes client privacy and confidentiality and any exceptions to this, such the need to disclose relevant information if there is concern for risk of harm to yourself or others. The contract also covers things such as policies regarding appointments, fees, payments, and cancellations. You may also agree on a number of sessions. This can provide a timeframe for goal setting. The number of sessions can be altered later as needed.

Your counsellor will probably ask you about why you have come to counselling. They will then ask you some questions to help you explore your current situation and what you would like to achieve.

By the end of the session, you will usually have agreed upon a counselling plan that includes the issues you want to address and some broad counselling goals. You and your counsellor may also have agreed upon some methods for monitoring your progress and satisfaction with the counselling experience. As I mentioned above, all counsellors are different. Some are more structured than others so they may not come up with a formal documented counselling plan. Many prefer to discuss goals in a more conversational way to facilitate the flow of the session.

At subsequent sessions, you will have more time to explore your issues and set more specific goals. Your counsellor may check in with how you have been since the last session and any progress or changes that you have made. You can discuss what you would like to focus on for the session and you may review your goals and priorities, which may change over the course of your counselling.

Fluckiger, C., et al. (2018). The Alliance in Adult Psychotherapy: A Meta-Analytic Synthesis. Psychotherapy, 55(4), 616-40. http://dx.doi.org/10.1037/pst0000172