By Ben Jefferson MBACP, Counsellor in Cumbria & Men's Counselling Service's Co-Founder

We recently asked men a series of questions about what happens in counselling, and nearly three-quarters (74%) said they felt that most men don’t know what actually takes place in the room. This is a pretty big knowledge gap, and one that we think could be keeping men from benefitting from therapy. Without understanding how something works, it can be hard to appreciate how it could potentially help you. 

This is also mirrored in our conversations with our counsellors. One thing that comes up time and time again is that when men reach out, they often don’t know what to expect from their first session. This isn’t just a case of knowing the practicalities and locations, but also relates to the actual structure and feel of the sessions themselves. 

With that in mind, we have put together a guide to what happens in counselling, with a focus on your first session. We hope you find this useful, and if it inspires you to browse our counselling directory. 

What happens before my first counselling session?

After you’ve initially reached out, counsellors generally offer a free, low-stakes introductory call before anything that feels like a proper session. This is often around 15-30 minutes long, and involves them explaining how they work, and what this could look like together. This is a great opportunity to get a feel for whether you think they would be a good fit before any full session is booked. 

It’s important to remember that this call is not a therapy session, and next to nothing is expected from you during it. You’re not going to have to explain what is going on in your life in great detail, and its purpose isn’t to assess you or overwhelm you with clinical jargon. It’s primarily the therapist telling you how they work, and answering any questions you might have. 

A lot of men presume that they’ll need to arrive with their problem fully articulated or worked out, but that’s not how it goes – this is saved for the room. 

It’s important to also remember that you have full control at this point, and decide whether to commit to doing a session together. 

What happens during my first counselling session? 

As mentioned,some men have a lot of misconceptions about what actually happens in the room, too. Our men’s survey revealed that more than half (54%) said knowing what happened during a first session would make therapy feel like it was more for them. 

Another point that frequently comes up in our conversations with our counsellors is that many men picture therapy as being something that moves very quickly, and will see them immediately forced to explain their whole life and what has led them here. 

You might be thinking, what actually happens in my first therapy session?  During the first session, the emphasis is on building up a comprehensive picture of what is going on and constructing a working relationship rather than immediately reaching for a diagnosis. The quality of the relationship is a good indicator of a successful therapeutic outcome, according to several studies. After your first session, you should hopefully feel like you can trust this person enough to explore thoughts, feelings and behaviours, even if you aren’t used to doing so. 

What you say will also stay in the room. Confidentiality is a massive reservation many men have when it comes to therapy. Any counsellor registered with a professional body like the BACP works to a standard that requires them to protect what you tell them from being shared without your agreement, and to be clear with you from the start about how your information is handled. Very occasionally confidentiality will need to be broken, this typically relates to safeguarding concerns; but again, most practitioners will discuss this with you during your first session.

Ultimately, counselling should move at a speed you’re comfortable with, and is a process you stay in control of. 

What happens after my first counselling session? 

It’s also important to remember that one session does not mean a lifelong commitment. This is a starting point, and it’s totally up to you whether you continue or not. If it feels right to proceed, you and your counsellor agree on how to and when to keep working together. If the fit doesn’t feel good, you’re absolutely free to leave or to try someone else; it’s totally normal to decide that a therapist doesn’t fit what you’re looking for. 

It's worth being honest that a first session can feel uncomfortable, and that on its own isn't always a reason to stop. Talking about things you normally keep to yourself is unfamiliar, and feeling a bit exposed or unsure afterwards can be common rather than a sign it went badly. 

This discomfort sometimes eases as the relationship builds and the initial strangeness wears off. If the first session felt awkward but the counsellor seemed like someone you could work with, it's maybe worth going back for a second before deciding either way.

Next steps

The above has hopefully provided some clarity on what happens counselling, and how your first session might feel. Taking the first step can be difficult – we built Men’s Counselling Service because we had been there ourselves and found the options overwhelming. Our site brings together counsellors and therapists who are passionate about working with men, and would love to hear from you.

If you’re interested in finding a counsellor, or just having a no-stakes browse, you can find our directory here. There are no sign-ups, and no commitments. 

Related Articles:

What Happens in Therapy? A Guide for Men New to Counselling (4 minute read)

Does Mental Health Awareness Week Matter More Than Ever in 2025? (4 minute read)

Gratitude and the Glass-Half-Empty Lens(5 minute read) 

Disclaimer: 

This article is for information only and reflects the thoughts of the writer. It's not medical or mental health advice. Seek professional help for your needs. Men's Counselling Service LTD is not a crisis service. For emergencies, call your local services or the Samaritans at 116 123.

Next Steps: 

To find a men's therapist near you via our directory, click the Find Counselling For Men button below.