What Should I Expect in My First Counseling Session?

Starting therapy is a big step, and it's completely normal to feel a little unsure about what to expect. At Aspire Counseling, we work with people facing anxiety, trauma, OCD, and other challenges that often come with a lot of inner pressure. Taking that first step toward help is something to be proud of—even if you’re also feeling nervous.

This post is here to walk you through what the first steps usually look like at Aspire, and what you might experience in your first counseling session.

Do I meet with someone before I start therapy?

Yes! At Aspire Counseling, our Missouri therapists start with a free consultation—a 30-minute meeting that gives you a chance to get a feel for the therapist you’d be working with.

This is your time to ask questions, share what’s bringing you to therapy, and decide if the person across from you feels like a good fit. We know from research that the relationship between you and your therapist—called the "therapeutic alliance"—is one of the most important parts of successful counseling. So we invest more time up front to help build that foundation.

Every practice does this a little differently. Some therapists offer a quick 15-minute phone call, while others may skip this step entirely. When you're looking for a therapist, it’s okay to ask:
“Do you offer a consultation, and what does that look like?”

We believe it’s worth taking the time to feel confident in your choice.

What happens in my first official counseling session?

Your first paid counseling session is what we call an assessment session. It’s the groundwork for everything that comes next.

We sometimes refer to this as the “20 Questions” session—because, honestly, we ask a lot of questions! We want to understand you, your history, your symptoms, your goals, and the key people and events that have shaped your life. This isn’t just small talk—it’s how we begin tailoring your care from the very first session.

Your therapist might use a computer or take notes during this session (even in person), which can feel a bit different. We get it. Talking about personal things with someone new can feel awkward or even exhausting.

And yet—this session is so important. It’s how we get a clear picture of your life so we can offer the right strategies and support. It’s also how we make sure we’re working toward goals that matter to you.

Will all therapy sessions be like this?

Nope. That first assessment session is unique—and future sessions will feel much more like the “real work” of therapy.

After your assessment, your therapist will take some time to reflect on what you’ve shared. They’ll begin developing a treatment plan—essentially, a roadmap to help you move toward your goals.

In the next sessions, you’ll start to dive into the heart of therapy. That may mean exploring patterns, learning new coping skills, or gently working through past trauma. These sessions often feel more interactive and helpful—and many clients say they start to feel a sense of hope, even early on.

So if that first session feels awkward, overwhelming, or even vulnerable, you’re not alone. That’s completely normal. Stick with it. You’re laying the foundation for meaningful change.

How can I prepare for my first therapy session?

You don’t have to do anything fancy to get ready—but here are a few tips that may help:

• Give yourself permission to be honest (even if it feels scary).

• Know that nerves are normal—we’ll meet you where you are.

• Bring any questions you have about therapy, the process, or your therapist’s style.

• Take care of yourself afterward. It’s okay if you feel tired or emotional. That first step takes courage.

Ready to start counseling in Missouri?

If you're feeling anxious, overwhelmed, or just unsure of how to move forward, our therapists are here to help. Whether you're seeking therapy for anxiety, trauma, OCD, or you're simply not feeling like yourself, we’d love to connect with you.

Aspire Counseling has two physical locations—one in Columbia, MO serving the Mid-Missouri area, and another in Lee’s Summit, conveniently located near Blue Springs. We also proudly offer secure online therapy for clients across the entire state of Missouri. So whether you're in St. Louis, Kansas City, or a rural part of the state, support is just a click away.

Our practice is grounded in evidence-based treatment, meaning we use research-supported approaches to help you get real results. As part of our commitment to high-quality care, all clients at Aspire participate in measurement-based care. That means you’ll complete brief symptom questionnaires—like the PHQ-9 for depression or GAD-7 for anxiety—at least monthly. These tools help us track your progress together and ensure you're truly getting better, not just checking boxes.

The first step is simple: email our client care team. They’ll take the time to get to know what you're looking for and thoughtfully match you with the right therapist for a free 30-minute consultation. No pressure, no judgment—just a chance to talk with someone who genuinely wants to help.

Learn more about our approach to therapy or schedule your free consultation today. You deserve support that fits your needs—and a therapist who helps you feel seen, heard, and empowered.

About the Author

Jessica Tappana is a licensed clinical social worker and the founder of Aspire Counseling, a group practice in Missouri that specializes in evidence-based treatment for anxiety, trauma, and OCD. With a passion for empowering both clients and therapists, Jessica brings warmth, clarity, and clinical expertise to everything she does. In addition to her work with clients, she supports other private practice owners through consulting and education on ethical, effective marketing strategies. When she’s not writing or supervising, Jessica is likely homeschooling her two adventurous kids or planning their next travel experience.