In short: Your first counselling session is mainly about getting to know each other. The counsellor will explain how they work and what confidentiality means, ask what has brought you to counselling, and agree with you how sessions will run. You do not need to prepare anything or know exactly what to say. Choosing a counsellor registered with a professional body such as the BACP or UKCP gives you assurance about their training and standards.

This guide, from the Ready Health team in Standish, explains what usually happens at a first private counselling session for people in Chorley, Wigan, Preston, Bolton and nearby areas.

What happens in a first counselling session?

Most sessions last around 50 minutes. The first one often includes:

Introductions and the agreement (contract): session length, frequency, cost, cancellations and how to get in touch
Confidentiality: what stays private and the limited situations where information may need to be shared
What brings you here: the difficulties you are facing and how they affect your life
Background questions: such as your health, any medicines, previous support and current safety
Goals: what you would like to be different, even if this is only a rough idea at first

It is normal to feel nervous, emotional or unsure what to say. A good counsellor will go at your pace.

What can you talk about in counselling?

Anything that is affecting you. Common reasons people come to counselling include anxiety, low mood, stress, bereavement, relationship difficulties, work pressures, low self-esteem, life changes and past experiences. You decide what you want to share and when.

Will a counsellor give you advice?

Usually not in the sense of telling you what to do. Counselling helps you explore your thoughts and feelings, understand patterns and find your own way forward. Some approaches, such as cognitive behavioural therapy (CBT), are more structured and may include practical exercises between sessions.

Approach	What it focuses on
Person-centred counselling	A supportive, non-judgemental space to explore feelings at your own pace
Cognitive behavioural therapy (CBT)	Links between thoughts, feelings and behaviour, with practical strategies
Psychodynamic therapy	How past experiences and relationships shape current feelings
Integrative counselling	Combines approaches to suit the individual

Is counselling confidential?

Yes, with some limits. Counsellors keep what you say private, but may need to share information without your consent in rare situations, such as a serious risk of harm to you or someone else, a safeguarding concern about a child or vulnerable adult, or where required by law. Your counsellor should explain this at the start, and you can ask questions about it at any time.

How do you choose a qualified counsellor?

In the UK, “counsellor” and “psychotherapist” are not protected titles. To check training and standards, look for membership of a professional body on a register accredited by the Professional Standards Authority, for example:

British Association for Counselling and Psychotherapy (BACP)
UK Council for Psychotherapy (UKCP)
National Counselling and Psychotherapy Society (NCPS)

Practitioner psychologists are regulated by the Health and Care Professions Council (HCPC). You can search each organisation's online register.

How can you prepare for your first session?

Think about what you would like help with, but do not worry about getting it exactly right.
Note any questions about how sessions work, costs or confidentiality.
Arrive a few minutes early, or for online sessions, find a private, quiet space.
Be honest if something does not feel right; the relationship with your counsellor matters.

Are there free NHS counselling options?

Yes. NHS Talking Therapies services in England offer free psychological therapies for anxiety and depression, and you can usually refer yourself online without seeing a GP. Services cover Wigan, Bolton, Chorley, Preston and other areas. Waiting times vary, and private counselling is an alternative for people who prefer more choice of counsellor or appointment times.

What if you need urgent help?

Counselling is not an emergency service. If you are in crisis or thinking about harming yourself, call NHS 111 and select the mental health option, call Samaritans free on 116 123 at any time, or call 999 or go to A&E if your life is at risk.

Frequently asked questions

How many counselling sessions will I need?

It varies. Some people find 6 to 12 sessions helpful, while others prefer longer-term support. You can review this with your counsellor as you go.

Can I have counselling online?

Yes. Many counsellors offer video or phone sessions as well as face-to-face appointments.

Do I need a GP referral for private counselling?

No. You can usually self-refer to private counselling.

What if I do not get on with my counsellor?

That is fine to say. A good working relationship is important, and changing counsellor is reasonable if it does not feel right.

Key takeaways

The first session focuses on getting to know you and agreeing how counselling will work.
You set the pace and choose what to talk about.
Confidentiality has limited exceptions, which should be explained at the start.
Choose a counsellor on an accredited register such as BACP, UKCP or NCPS.
Free NHS Talking Therapies are available by self-referral in England.

Sources and further reading

Last reviewed: October 2026 by Shamir Patel, Independent Prescribing Pharmacist, Ready Health. This article is general information and does not replace advice from your own clinician.

If you are thinking about counselling, find out more about talking therapy at Ready Health in Standish, convenient for Wigan, Chorley, Preston and Bolton, with face-to-face and online options.