You do not have to have all the answers
Starting counselling or therapy can feel daunting. You may wonder what you are supposed to say, whether you will be judged, or what happens if you cannot explain how you feel.
NHS guidance describes counselling as a talking therapy where a counsellor listens and helps you explore your own solutions. NHS Talking Therapies can support people with problems including anxiety, depression, panic, OCD and PTSD.
Common questions you may be asked
Think about what has been happening, whether something triggered things, whether difficulties have built up over time, and why you are seeking help now.
You may want to understand what happened, manage anxiety or anger, process grief or trauma, rebuild confidence, improve relationships, sleep better, make decisions, or simply have somewhere safe to talk.
You might feel angry, frightened, numb, exhausted, ashamed, lonely, overwhelmed or constantly alert. “I don’t know what I’m feeling” is also a valid answer.
Consider sleep, eating, concentration, parenting, work, education, relationships, leaving home, motivation, alcohol or drugs, confidence and enjoyment of normal activities.
You do not need perfect dates. An approximate period, major event or description of how things developed is often enough.
Depending on the reason for therapy, this may include childhood, relationships, bereavement, abuse, neglect, traumatic experiences, caring responsibilities, discrimination or major losses.
You might withdraw, become angry, cry, overthink, stay constantly busy, avoid people, use substances or pretend everything is fine. The purpose is to understand patterns, not shame you.
Think about people, pets, music, exercise, gaming, hobbies, writing, routine, being outdoors, quiet time or anything else that makes things even slightly easier.
This might be friends, family, a partner, GP, charity, community organisation, social worker or another professional. If you feel you have nobody, say so.
You may be asked whether someone is harming or threatening you, or whether you are at risk of harming yourself or another person. These questions help professionals assess safety and support needs.
Questions you can ask the therapist
- What type of therapy do you provide and how does it work?
- What normally happens during a session?
- How long and how frequent are sessions?
- What happens if I become overwhelmed?
- Can I take a break or bring written notes?
- What are the limits of confidentiality?
- Can reasonable adjustments be made for communication, disability or processing needs?
- Can you explain a question differently if I do not understand it?
- What happens if I do not feel this therapy is helping?
Make a simple preparation sheet
What happened?
Write a short timeline if that is easier than explaining everything verbally.
What is happening now?
Describe the biggest difficulties in your life today.
How does it affect me?
Include emotional, practical, physical, family and relationship effects.
What helps?
List coping strategies, people and routines that help.
What would I like to change?
You do not need a perfect goal. Even “I want things to feel more manageable” is useful.
What do I need them to understand?
Include communication needs, fears, previous experiences of services or anything you struggle to say aloud.
Trusted information and support
Urgent help
If you or somebody else is in immediate danger, call 999. If you are experiencing a mental-health crisis or feel unable to keep yourself safe, seek urgent NHS mental-health help. Samaritans can also be contacted free on 116 123, day or night.
Right First Time UK provides general information and signposting. This page is not medical advice, diagnosis, counselling or psychological treatment and does not replace qualified professional care.