Preparing For Your First Addiction Counselling Therapy Session with Tips

Starting addiction counselling with a new therapist is a positive step towards getting control of your life and moving towards recovery. It may be the first time you openly discuss what you are going through with a professional, and a little preparation goes a long way! This Day One recovery series article about preparing for addiction counselling therapy is just what you need to help you take those first steps and book a session.

If you have been trying and failing to overcome a dependency or addiction alone, now is the time to seek help, support and guidance. There comes the point when it is necessary to get professional intervention and support to help you overcome an addiction effectively.

‘Recovery is a journey; take it one step at a time, one day at a time, with the support of others.’

Recovery means different things to each person; for some, it will be about harm reduction, and for others, it will be abstinence-based. Behind every addiction is the story of a person’s life; healing and self-discovery are part of the recovery process. Addiction counselling is also psychoeducation at every stage of recovery, helping you to understand yourself and the condition better.

It is common to procrastinate about getting help for long periods before starting therapy. This adds to a sense of overwhelm, shame and anxiety. Of course, there are many reasons for this! Fear of the unknown, fear of change, anxiety, shame, denial, and an addiction that has become unmanageable. All these factors keep you in a contemplative phase and feeling stuck, the stage just before preparation followed by taking action.  

Stepping out of this contemplative phase and into a preparation phase may feel deeply uncomfortable. It is the difference between just thinking (contemplating) and actively doing something (preparation), like finding a therapist or booking a therapy session. Remember, addiction therapists have dedicated their careers to helping people like you overcome addiction and trauma and all the chaos that comes with dependency so that you can start to believe in recovery.

Knowing what to expect from your first addiction counselling session can help ease the anxious tension and nerves you may be feeling so that you take the first step into therapy. Hopefully, by now, you will have found the right therapist for you who specialises in addiction and recovery via and

Every addiction therapist, including myself, has a routine and format to follow in the first consultation. Generally speaking, the content will remain the same; this is just a guideline to help you prepare.

The criteria will differ if you are attending a therapist for assessment in an addiction rehabilitation centre or meeting with a psychiatrist. They will have different clinical procedures to follow than a psychotherapist.

Unlike general counselling, addiction counselling is direct, motivational and focused on the addiction intervention and recovery process. The first couple of sessions form part of an ongoing assessment and help both client and therapist explore the nature and extent of the problem while learning to talk openly and freely and develop a therapeutic relationship with the therapist.

Recovery means different things to each person; for some, it will be about harm reduction, and for others, it will be abstinence-based.

Here are what you might expect from that first addiction counselling session to help you prepare based on how I work with all my new clients, including some helpful tips to help you prepare mentally. If you are ready to start your addiction recovery journey, let’s get started! Book an online therapy session here.

The Consultation Form

Every new client starts therapy by completing a consultation form with the relevant information a therapist needs to know and keep on file. It may ask for contact information, GP details, diagnosed medical conditions, health concerns, medications and related health information.

General lifestyle questions are often part of the initial consultation – such as diet, exercise, sleep, and profession to give the therapist an idea of general lifestyle and relevant information.

A consultation typically includes a brief screening for alcohol, substances, drugs, smoking, gambling, pornography use, other addictions, or any concerns. It may also enquire about prior rehabilitation treatment, therapy, group therapy, interventions and couples therapy.

For online therapy sessions, I generally work through the whole consultation form verbally with the client. Book an online session here.

Tip: You can prepare for this part of the session by reflecting on each of the above areas and making a few notes and comments to help you prepare for a session.

Understanding Confidentiality

Confidentiality and privacy are at the core of the counselling and psychotherapy process, and that important client-therapist alliance. There are limitations to confidentiality concerning suicidal ideations, harm to others, child welfare concerns, disclosure of child sexual abuse and criminal activity.

The therapist will help you understand confidentiality to feel more reassured in the process. They will invite you to sign a client-therapist confidentiality agreement which often includes additional information about booking, cancellation policies, fees and general information.

Tip: Write a list of questions to ask your therapist in the first session. They will be happy to respond to any questions you may have.

Tell Me About Yourself

I invite new clients to tell me about themselves and their life before we begin discussing the person’s dependency or addiction. This is because you are not your addiction, and as a therapist, I want to get to know the real you, the person behind the condition. 

You may wish to share with the therapist details of family, friends, work, home life, hobbies, interests etc. Then, when you feel ready, we can discuss the problems. 

Tip: Take a page and draw yourself in the middle. Now write down everything you can think of about yourself – personality, profile, interests, hobbies, positive traits, family, friends, hopes, aspirations. Let yourself get in touch with who you are as a person.

Discussing The Problems 

As addiction counsellors, our role is to help you talk in detail about the nature of the problem, sometimes asking difficult but necessary questions. Talking about substances, alcohol abuse, or hidden behaviours like gambling and porn use is the first crucial step to understanding the problem and working through shame and denial. The therapist will help you to go into detail to start assessing the nature of the problem and related factors. This means talking about the what, when, why, where, how, quantities, time, cost etc., of the dependency.

Tip: Get a pen and paper and write out every single problem, challenge and worry you have had over the past six months. Keep adding to the list as you reflect on yourself and bring it to the session. This is called brainstorming, and it is very effective.

The Next Steps…

If you are suitable for one-to-one counselling, the therapist will discuss how often to attend. Towards the end of the first session, the therapist will have a general picture of the nature of the problem and if you are both suitable to work together. A more thorough, detailed assessment may not happen until the second or third session when you feel ready.

An experienced addiction therapist should let you know if they believe you are more suitable for residential or outpatient treatment and can suggest how to be referred onwards. They may make other suggestions like talking with your GP, attending group support and signposting to other supports.

Tip: If you have private health insurance, contact your provider and find out if you have cover for one-to-one counselling, assessments, GP consultations or addiction treatment rehabilitation.

Moving to The Next Phase…. Preparation and Taking Action!

Starting addiction counselling does not mean you will be forced to begin a recovery process immediately. The early sessions are about you and for you, helping you identify or prepare for what recovery means to you. Hopefully, you are ready to move from this contemplative phase to the next phase in the stages of change called the preparation phase and to start counselling with your chosen therapist. As you can see, there will be a lot to discuss in the first few sessions, preparing mentally with these tips will make that feel easier. Recovery is a journey; take it one step at a time, one day at a time, with the support of others.

Orlagh Reid Psychotherapy

Orlagh Reid

Orlagh Reid is an IACP accredited Counsellor & Psychotherapist, Addiction Counsellor, Gottman Couples Therapist and Fertility Counsellor in private practice based in Co. Kildare, Ireland and worldwide online via DOXY. She specialises in addiction, recovery, well-being and clinical sexology. To find out more or to book an online consultation visit

Orlagh Reid Psychotherapy MIACP Therapy Ireland

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