Research and clients’ own experience indicate one thing very clearly. First and foremost it is the quality of the relationship you have with your therapist that determines the likelihood of it being helpful to you.

The first session is an informal kind of assessment session where the therapist tries both to get an idea of what is going on for you at the moment and to get a grasp of some of the background. That first session is also your chance to size up the therapist.

To a greater or lesser extent at that first session you will be feeling some anxiety. Everyone does. After all, you are walking into a consulting room you have never been in before, meeting someone you have never met before, starting to talk about issues that are personal to you, and all in all embarking on something quite new.

The first session is a time when you are mostly just trying to acclimatise yourself to the situation. But even at that first session you should be hearing at least a few things that make sense to you, that maybe intrigue you, that give you some encouragement and sense of optimism that you can make some changes to your life.

You need to feel the therapist is flexible and receptive to you and able to adjust to what you are saying and feeling. The therapist’s responses should make it evident to you that they are understanding, or genuinely trying to understand, at least some of what is going on for you. Some of those responses should ‘click’ with you so that you have a gut feeling that the therapist is ‘with you’, that even at that first session they have some understanding of you, not just at an intellectual level but at an emotional level too.

Bear in mind your expectations need to be reasonable ones, not only reasonable expectations of the therapist but of yourself. Depending on your background it can take time to build up trust, given that trust can be a big word for many people seeking therapy. The therapist also needs time to try to grasp the important issues for you. You have lived with yourself all your life while the therapist has only just met you.

Finally, competent therapists should have confronted and struggled through a good many of their own painful issues. This is important to enable them to empathise with your own struggles and, from personal experience, to know what it is to be a client in therapy. After all, if you are embarking on a difficult journey isn’t it more valuable to have as a guide someone who has had the experience of their own journey and confronting their own issues?