Most people who eventually book counselling spend a long time thinking about it first. Weeks, often months. There’s usually a version of the same internal argument going on: other people have it worse, it’s probably not bad enough to bother anyone with, it’ll pass on its own, and anyway, what would I even say?
If any of that sounds familiar, it might help to know that “not sure it’s bad enough” is one of the most common reasons people give when they finally do sit down in a counselling room. You don’t need a diagnosis, a crisis, or a tidy explanation of what’s wrong to be worth an hour of someone’s time.
This guide covers what counselling actually involves, what happens in a first session, and how our counselling service at Friends Medical Service works.
What Is Counselling?
Counselling is a structured conversation with a trained professional whose only job in that hour is to help you understand what’s going on for you. It isn’t advice-giving. A good counsellor won’t tell you what to do about your job, your marriage or your family, because the point is to help you work out what you think, not to hand you someone else’s answer.
What it offers that friends and family can’t, is neutrality. The people close to you have opinions about your situation, a stake in the outcome, and a limit to how many times they can hear about the same thing. A counsellor has none of those. That changes what you’re able to say out loud.
Our counsellor works in a person-centred style, which means the pace and direction are led by you rather than by a fixed programme. Some people arrive knowing exactly what they want to work on. Others arrive with a vague sense that things aren’t right. Both are workable starting points.
What Can Counselling Help With?
Our service supports individuals aged 16 and over across a wide range of issues, including:
- Stress and anxiety, including the physical symptoms that come with it
- Low mood and depression
- Bereavement and loss, including losses that happened a long time ago
- Trauma and abuse
- Relationship difficulties, whether romantic, family or friendship
- Work-related stress, including burnout and difficult workplace situations
- Life transitions: new parenthood, redundancy, retirement, separation, illness, moving
That list isn’t exhaustive, and plenty of people come in with something that doesn’t fit neatly into any of those categories. If you’re not sure whether what you’re dealing with counts, it probably does.
“I’m Not Sure What’s Wrong” Is a Valid Starting Point
There’s a persistent idea that you need to arrive at counselling with your problem already identified and neatly summarised. In practice, a good portion of the work is often figuring out what the problem actually is.
People frequently arrive describing one thing and discover over a few sessions that something else entirely is underneath it. Someone comes in about work stress and finds it’s really about a bereavement they never properly dealt with. Someone comes in about a relationship and finds it’s about patterns going back years. You don’t need to have done that work in advance. That’s what the sessions are for.
What Happens in a First Session?
Knowing roughly what to expect takes some of the edge off.
The first session is mostly about getting a sense of each other and of what’s brought you there. Your counsellor will explain how they work, cover confidentiality and its limits, and ask what you’re hoping to get from the sessions. You’ll have space to talk about what’s going on, at whatever level of detail you’re comfortable with on day one.
You will not be pushed to disclose more than you want to. You will not be diagnosed. You will not be told what to do. If you spend most of the first session unsure what to say, that’s normal and your counsellor will have seen it many times.
At the end, you’ll usually agree whether to continue and how often to meet. There’s no obligation to commit to a long course of sessions upfront.
How Many Sessions Will I Need?
There’s no fixed answer, and anyone who gives you a firm number before meeting you is guessing.
Some people find a handful of sessions is enough to work through a specific issue: a bereavement, a decision, a period of acute stress. Others benefit from longer-term work, particularly where the issues are longstanding or connected to earlier experiences. We offer both short-term and long-term therapy options, and it’s something you’ll agree together rather than have imposed on you.
Weekly sessions are the usual starting point, since momentum matters early on, and some people move to fortnightly or monthly later.
Confidentiality: What It Means in Practice
This matters to almost everyone, and it deserves a straight answer rather than vague reassurance.
What you discuss in your sessions is confidential. It isn’t shared with your GP, your family or your employer. There are a small number of legal and ethical exceptions, which your counsellor will explain at the outset: where there are serious concerns about your safety or someone else’s, including child protection; if you disclose a serious crime; or where the law requires disclosure.
If any of these situations arise, your counsellor will normally discuss it with you first where possible and keep you informed about who they need to contact. It isn’t something that happens behind your back.
In-Person or Online?
We offer both, at the same price, and neither is a lesser option.
In-person sessions take place at our Lurgan clinic in a private, comfortable space. Some people find that leaving the house and going somewhere specific helps mark the session as separate from the rest of the week. It also removes the risk of being overheard at home.
Online sessions are video-based and fully GDPR compliant. They suit people with demanding schedules, those without easy transport, anyone outside the Lurgan area and people who simply feel more able to open up from their own space. Research over recent years has found online therapy to be comparably effective to in-person work for many common issues.
There’s no wrong answer and you can switch if the first choice doesn’t suit.
Why Does the Counsellor’s Registration Matter?
In the UK, the title “counsellor” isn’t legally protected. Anyone can technically use it. This is why registration with a recognised professional body matters more than most people realise.
Our counsellor is registered and accredited with the British Association for Counselling and Psychotherapy (BACP). That means verified qualifications, adherence to an ethical framework, ongoing supervision of their clinical work, and a complaints process if something goes wrong. You can check any BACP member’s registration on their public register.
If you’re comparing providers, whether privately or through a charity, checking registration with BACP, UKCP or the BABCP is the single most useful thing you can do.
Counselling and Your Wider Health
One advantage of accessing counselling through a medical practice is that mental health doesn’t get treated as a separate compartment.
Physical and psychological health interact constantly. Persistent fatigue, thyroid problems, vitamin deficiencies, chronic pain and sleep disorders can all produce or worsen symptoms that look like low mood or anxiety. Equally, prolonged stress has real physical consequences.
If it would be useful to rule out physical contributors, our blood testing and health check services and GP appointments are available under the same roof. That isn’t about medicalising distress. It’s about not spending a year working on your mood when an untreated thyroid problem is part of the picture.
Myths vs Facts About Counselling
- Myth: Counselling is only for people in crisis.
- Fact: Most people who attend counselling are managing daily life reasonably well and want support with something specific. Waiting until things are severe makes the work harder, not easier.
- Myth: The counsellor will tell you what to do.
- Fact: Person-centred counselling is about helping you reach your own conclusions, not delivering instructions.
- Myth: Talking about difficult things just makes them worse.
- Fact: Difficult subjects can feel heavier in the short term, which your counsellor will pace with you. Avoidance tends to keep things unresolved for longer.
- Myth: You need a GP referral.
- Fact: You can book privately with us directly.
- Myth: Online counselling isn’t as good as in-person.
- Fact: For most common issues, evidence suggests they’re comparably effective. It comes down to what suits you.
What It Costs
Sessions at Friends Medical Service are £80, whether in person at our Lurgan clinic or online by video. There’s no separate assessment fee and no requirement to book a block of sessions in advance.
Appointments are available weekly. To book, call 028 9621 1981 or email [email protected].
If You Need Support Right Now
Counselling is planned, ongoing work rather than emergency support. If you’re in distress and need to speak to someone today, Lifeline, Northern Ireland’s crisis response helpline, is free and available 24 hours a day on 0808 808 8000 (textphone 18001 0808 808 8000). You don’t have to be at immediate risk to call.
Minding Your Head also lists mental health services and helplines across Northern Ireland.
Frequently Asked Questions
Do I need a GP referral for counselling?
No. You can book directly with us.
Is your counsellor qualified?
Yes. Our counsellor is fully qualified and registered with the British Association for Counselling and Psychotherapy (BACP), which requires verified training, adherence to an ethical framework and ongoing clinical supervision.
What if I don’t know what to talk about?
That’s common, and it’s genuinely fine. Your counsellor is trained to help you find a starting point. Turning up without a script is not a problem.
Will my GP or employer be told?
No. Sessions are confidential, subject to the small number of legal and safeguarding exceptions your counsellor will explain in your first session.
How is counselling different from talking to my GP?
A GP appointment is short and focused on assessment and treatment options. Counselling gives you a dedicated hour, repeatedly, to explore something in depth. They complement each other rather than compete.
Can I have counselling if I’m already on medication?
Yes. Many people do both, and the two are often more effective together than either alone.
Is there a minimum age?
Our service supports individuals aged 16 and over.
How long is each session?
Sessions are typically around 50 minutes to an hour, and your counsellor will confirm timing at your first appointment.
Taking the First Step
Booking a first session is the part most people find hardest, and it’s usually far less daunting than the version they’d built up beforehand. You don’t need to have it all worked out first. You just need an hour and a willingness to start talking.
Ready when you are. Book a counselling session, call 028 9621 1981, or find out more about our counselling service.
