@galen84basc -- It usually depends on the counselor and the couple.
For instance, while many people used to get pre-marital counseling from their religious leader, now it is just as common to get it from a secular or non-affiliated counselor.
Some counselling sessions include skill-building, like improving communication skills, learning how to fight appropriately and non-abusively, etc.
Others are more discussion based, and may ask the couple to do an "inventory" of themselves to share with the other person.
This usually includes stuff like their expectations from the marriage, things that they feel they can and cannot compromise on, etc.
But like I said, every program varies, and a lot of it can be shaped by the counselor or couple -- there's no "one size fits all".