What happens during counseling?

Kama Hurley

During your first session the counselor should be getting to know you and learning about the issue you are coming to counseling for. This first session should be about answering any questions you have about the process and helping you feel comfortable with your counselor. Most sessions last about 50 minutes.

James Smith
James Smith on behalf of MDLIVE

During or before your first counseling session begins, you will probably be asked to fill out some forms.  If you have insurance, make sure to bring your insurance card.  You may also be asked to fill out a release of information form if your counselor wants to consult with some of your other professional providers.

After all forms are filled out, your counselor will most likely do an assessment of your current condition.  Your counselor may ask you questions about your past relationships, your family history, give you a depression screen, assertain your and your family's medical history, and administer a substance abuse screening.  These are just a few of the kinds of questions your counselor might ask during the initial assessment. Your counselor needs to complete an assessment in order to develop a treatment plan and to make a diagnosis.  If you have insurance, a diagnosis is needed in order for your counselor to bill your insurance provider.

After all the paper work is finished and the initial assessment is completed, you are ready for a "normal" counseling session.  The paper work and the assessment will probably take up the first session, so you will experience the real work of counseling at your next session.

During that next session, your counselor will listen to you as you express your concerns, experiences, and goals for your future.  Talking freely to a non-judgmental person who is required and genuinely wishes to hold your information confidential will by itself be quite helpful.  Getting thoughts "off your chest" and verbally expressing your emotions will help clear your head, allowing you to find many of your own solutions.

Counselors will also point out discrepancies in your thinking and challenge you at times to confront your own negative self-talk.  Counselors, at times, will suggest actual strategies for you to try during the week that will help you improve your mental health.  Counselors may also give you some "homework" for the purpose of helping you gain insight into the cause of your stressors and possible solutions to your challenges.

Richard Walsh
Social Work
Counseling begins with a thorough evaluation often referred to as a Bio-Psychosocial Assessment. During the assessment questions about problems and symptoms are asked as well as medical conditions, developmental history. Also questions about work, school, social activities, support systems, spirituality, addictions, traumas, and losses will typically be explored. After the assessment you and your counselor will discuss the findings from the assessment and you will decide on the issues you want to work on in you counseling sessions. Over time an issue may be resolved and new issue may come up. Counseling is a dynamic process. It's important that you feel comfortable with your counselor and are able to openly discuss whatever comes up for you. Counselors are trained to be accepting and non-judgmental, having your best interests foremost.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.