Every counsellor approaches things a little differently, but on the whole you should be able to expect a few key things. If these things are not present, ask questions. At your first appointment you should expect to pay your counsellor before the session begins and this will be the trend for each session (unless your counsellor is billing directly to an insurance company). In your first session, you should expect the counsellor to present you with some kind of contract or agreement that outlines the counsellors expectations (i.e. payment, what will happen if you no show or cancel at the last minute, etc.) as well as the rights you have to confidentiality and the limits to confidentiality. Your rights are to have your information kept confidential except when there is a risk (or suspected risk) of harm to a child, when there is a threat of harm to yourself or to someone else (e.g. threatening to commit suicide or homicide, but not restricted to these alone), and where required by law which becomes a factor if you are involved in an active court case (or will be) as counsellor notes are able to be subpoenaed. Besides the confidentiality agreement, many counsellors will also use the first session to discuss any other stakeholders in your care (e.g. physician, psychiatrist, mental health, social worker, etc.) and may discuss with you the possibility of filling out a form that will allow your counsellor to have contact with these other professionals in order to provide the most effective care possible.
Once these formalities are complete, the remainder of the first session is often an information gathering time. The counsellor may take notes while you talk, or may have an intake form with specific questions they require to have answered. These questions may include information regarding past counselling, other stakeholders (it can be helpful to bring a list of names and contact information for these people), medications (it’s a great idea to bring a list of medications you are on and the dosage), family (i.e. kids, spouse, etc.), and questions regarding the presenting concerns that brought you to counselling. If you are receiving counselling through an insurance company or other funding, you will likely have a specific number of sessions being paid for which you will also want to discuss with your counsellor so they can tailor treatment to your timeline. This may also be the time when the counsellor will tell you a bit more about themselves and their approach, and is a great time to ask any other questions you may have.
After the first session, subsequent sessions will typically follow a basic pattern of payment, checking in regarding how things have been going, and then moving into the specific work/goals you have outlined. You can expect that you counsellor will continually check in with you regarding how your goals are being met. You can also expect your counsellor to refer you to other resources/supports as they see fit in order to provide you with optimal care. You can expect that your counsellor will act respectfully but will challenge you to make changes that may not always be comfortable. Above all else, you should expect yourself to assess your own progress and be aware of whether you are making the gains you are wanting to make. If it seems like you are not making progress or have stalled, try discussing this with your counsellor, or consider finding another counsellor.