What to Expect in Your First Therapy Session in Cary, NC
Starting therapy often brings up a mix of curiosity, hope, and nerves. Even women who are confident and capable in most areas of their lives can feel unsure walking into their first session, especially if therapy is new.
One of the biggest barriers to getting started is simply not knowing what to expect. This post is meant to walk you through what a first therapy session typically looks like, so it feels more familiar and less intimidating.
If you’re still in the process of finding a therapist, my step-by-step guide to finding the right therapist in Cary offers a broader overview of how to approach that search. This post zooms in on what happens once you’ve scheduled that first appointment.
Before You Arrive
Most therapists will send intake paperwork before your first session. This usually includes questions about what’s been going on for you, a bit of background information, and practice policies.
Taking time to complete this paperwork thoughtfully can be surprisingly helpful. It allows your therapist to come into the first session with a clearer picture of what you’re navigating and helps the conversation feel more focused from the start. It can also be helpful for you because it gives you a chance to reflect on the information you are sharing and get clarity on what you want to accomplish in therapy.
You’ll also want to:
Confirm where the office is located (or how to access your virtual session)
Make note of parking or login details
Reach out ahead of time if anything feels unclear
Many women find that simply knowing these logistics ahead of time lowers their anxiety and helps them arrive feeling more confident and able to participate in a way that feels meaningful.
The First 10 Minutes
The beginning of a first session is usually more grounding than people expect. Therapists often review any remaining questions about paperwork or policies and discuss what brought you in. If you connected through an initial consultation, this will feel like a continuation of that conversation and will allow the therapist to learn more about your life outside their walls.
This part of the session helps establish a shared understanding of the reason for therapy and sets the tone for the work ahead. Rather than jumping straight into “fixing” anything, the focus is on creating clarity and understanding, so the session feels collaborative rather than overwhelming.
The Heart of the First Session
The main part of the first session is about getting to know you and your story.
Therapists typically ask about:
What’s been weighing on you recently
How long these concerns have been present
Relevant personal or family history
What you are hoping might shift or feel different through therapy
Many women are surprised by how quickly the conversation becomes meaningful and how easy it is to talk about themselves. Even when you’re unsure what to say going in, the structure of the session tends to guide things naturally.
An important part of this conversation is understanding what you hope to get out of therapy. Naming this early on helps shape the work in a way that feels intentional and aligned, rather than open-ended or vague.
Ending the Session
As the session comes to a close, your therapist will help wrap things up and outline the next steps. Depending on how your therapist handles their calendar, this may include discussing how often sessions typically occur and what scheduling looks like moving forward. In my practice, clients have a weekly standing session time because that fits well with my clientele and their desire for ease of scheduling and consistency. You will want to understand your therapist's scheduling policies to find a therapy cadence that aligns with your availability and goals.
A common concern before the first session is not knowing what to talk about—or worrying that the time will drag. More often, I find my clients are surprised by how quickly the session goes and how much they were able to share without feeling pressured. The anticipation of talking can feel like a barrier, but once you are in the session, I hear from clients that it’s a relief to finally share with someone what is going on and feel like they are taking a step toward creating change.
Common Feelings After Session One
There’s no single “right” way to feel after your first therapy session.
Some women feel relieved. Others feel tired, thoughtful, uncertain, or quietly hopeful. Many experience a mix of emotions all at once.
These reactions are a normal part of beginning something new. Especially something that asks you to slow down and reflect in ways you may not often have space for.
You’ve Got This!
The first therapy session isn’t about having everything figured out. It’s about beginning a conversation in a space designed to support reflection, understanding, and change. If you have done the work of finding a therapist, scheduling the initial session, and showing up, it is the therapist’s job to run the session in a way that feels grounding, clarifying, and hopeful. If you’ve been hesitating because the first step feels too big or unclear, knowing what to expect can make it feel more approachable.
Author Bio
Megan Giroux is a Licensed Clinical Social Worker providing in-person therapy in Cary, NC, for high-achieving women struggling with anxiety, overfunctioning, and emotional burnout. She helps women slow down, understand long-standing patterns, and create meaningful change. Learn more about her approach and what it’s like to work with her here.