Resources · Starting therapy

Starting Therapy: A Guide to Finding Care

Thinking about therapy can bring up a lot of questions. This guide walks through what usually happens, how to find someone who fits, what it can cost and where to turn locally, at whatever pace feels right to you.

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Is therapy right for me?

People come to therapy for many reasons, and you do not need a crisis or a diagnosis to be one of them. Some of the most common:

  • Anxiety, worry or constant tension
  • Stress, burnout or feeling stretched too thin
  • Low mood, depression or feeling flat
  • Grief and loss
  • Relationship difficulties, family conflict or a breakup
  • Identity questions, including gender, sexuality, faith and culture
  • Major life changes such as a move, a new job, parenthood or retirement
  • Trauma, or things that happened a long time ago that still weigh on you
  • Feeling stuck, or wanting to understand yourself better

If you are wondering whether it is “bad enough” to reach out, that question is usually reason enough to try a conversation. Therapy is a good fit when you want support, space to think and someone in your corner who is trained to help. It does not have to be permanent, and you are always free to pause or stop.

Not sure about timing? Our clinicians wrote about it in Is it a good time to start therapy?

What happens in therapy?

Every practice is a little different, but the path usually looks like this.

  1. A first conversation

    Many practices, including Origins, offer a short phone or video consultation. It is a chance to ask questions and see whether the person sounds like someone you could talk to. Nothing is expected of you afterward.

  2. Paperwork

    Before or right after you book, you will usually complete intake forms about your contact details, health history and consent. Take your time with them.

  3. The first appointment

    You and your therapist talk about what brought you in, what you hope will change and how therapy works. See the next section for more detail.

  4. Setting goals

    Together you decide what to focus on. Goals can be specific, such as sleeping better or handling a conflict, or open-ended, such as understanding yourself.

  5. Ongoing sessions

    Sessions are commonly weekly or every other week. Your therapist may teach skills, help you explore patterns or simply give you room to talk things through.

  6. Checking in on progress

    A good therapist will ask whether therapy is helping and adjust if it is not. You are welcome to raise that question yourself at any time.

What happens during the first therapy session?

The first session is mostly a conversation, and it goes at your pace. You do not have to tell your whole life story. Start with whatever feels most pressing.

What a therapist may ask

  • What brought you in now?
  • What have you already tried, and what has helped?
  • How are sleep, energy, work, school and relationships going?
  • Who supports you?
  • What would you like to be different?

What you may want to bring or say

  • Anything you are nervous about, including being nervous itself
  • Your pronouns, name and any preferences for how you want to be addressed
  • Access needs, such as sensory needs, communication preferences or breaks
  • Questions about how the therapist works

Confidentiality

What you share is private. There are a few general limits: a serious risk of harm to yourself or someone else, suspected abuse or neglect of a child or vulnerable adult, or a legal order. A therapist should explain these clearly in your first session so nothing comes as a surprise.

Deciding whether it feels like a fit

It is normal to leave a first session unsure. Notice whether you felt listened to and respected. If it did not feel right, that is useful information, and it is fine to try someone else. Our post on finding a therapist goes deeper on this.

How do I choose a therapist?

There is no single right answer, but these questions help. You can ask them during a consultation.

  • Do you regularly work with what I am going through?
  • What approaches do you use, and what does a typical session look like?
  • Do I feel heard and respected when I talk with you?
  • Do I want to meet online or in person, or a mix?
  • How often would we meet, and for how long?
  • What will therapy cost, and how does billing work?
  • How will we know whether therapy is helping?
  • Are you affirming of my identity, culture and values?

Origins lets you browse clinicians by specialty, insurance, location and availability on our Find a therapist page, so you can compare a few before you reach out.

Understanding therapist credentials in North Carolina

The letters after a name tell you what training and license someone holds. Here is what the common ones mean. You can check any license for free with the state board.

  • LCMHC

    Licensed Clinical Mental Health Counselor. A master’s-level counselor who can diagnose and treat mental health conditions.

  • LCMHCA

    Licensed Clinical Mental Health Counselor Associate. Has a master’s degree and is working toward full licensure under supervision.

  • LCSW

    Licensed Clinical Social Worker. A master’s-level social worker trained in therapy and diagnosis, often with a focus on the whole person in their environment.

  • LCSWA

    Licensed Clinical Social Worker Associate. Completing supervised experience toward the LCSW.

  • LMFT

    Licensed Marriage and Family Therapist. Trained to work with individuals, couples and families, with a focus on relationships.

  • Licensed psychologist

    Doctoral-level. Provides therapy and can also do psychological testing and assessment.

  • Licensed psychological associate

    A master’s-level psychology license in North Carolina. Practices under supervision.

  • Psychiatrist

    A medical doctor who specializes in mental health. Can prescribe and manage medication, and often works alongside a therapist.

Verify a license

Paying for therapy

Cost is one of the most common reasons people put off getting help, so it helps to know the basics.

  • Private pay. You pay the therapist’s fee directly. Some clinicians offer a sliding scale.
  • Insurance. If your therapist is in your plan’s network, you typically pay a copay or part of the fee after your deductible is met.
  • Deductible. The amount you pay each year before your plan starts sharing costs.
  • Copay and coinsurance. A set amount or a percentage you pay per visit.
  • Out-of-network benefits. Some plans reimburse part of the cost when you see a provider outside their network. A superbill, an itemized receipt from your therapist, is often what you submit.
  • HSA and FSA. Health savings and flexible spending accounts can often be used for therapy. Check the rules for your account.

Plans vary a lot, so the most reliable way to know what applies to you is to call the number on your insurance card.

Origins lists the plans our clinicians are in network with on our insurance page, and our post A beginner’s guide to using insurance for counseling explains the process step by step.

Preparing for your first session

You do not need to prepare much. If it helps you feel steadier, here is a short list.

  • Think about what brought you here, even in a sentence or two.
  • Jot down questions you want to ask.
  • Have your insurance card and payment details handy if you need them.
  • Think about what would make therapy feel useful to you.
  • If you are meeting online, check your connection and find a private spot.
  • Leave a little time before and after so you are not rushing in or out.

Finding mental health care in Greenville and Eastern North Carolina

Origins is one option among several. These organizations can help you find care, cover costs or get support while you decide. Everything here was checked against the organization’s own site or an official state or county page.

  • REAL Crisis Center (opens in a new tab)

    Greenville

    A Greenville-based crisis center where trained counselors answer calls, texts and chats around the clock. It also works with the 988 Lifeline in North Carolina.

    Phone
    252-758-435724/7

    Verified September 2026

  • ECU Health Behavioral Health (opens in a new tab)

    Greenville

    Outpatient psychiatry and therapy in Greenville, including diagnostic evaluations, medication management and psychotherapy. Call to ask about establishing care.

    Phone
    252-744-1406Outpatient clinic
    Address
    905 Johns Hopkins Drive, Greenville, NC 27834

    Verified September 2026

  • ECU Family Therapy Clinic (opens in a new tab)

    Greenville

    Individual, couple and family therapy for the Pitt County community, provided by graduate students in ECU's Marriage and Family Therapy program under faculty supervision. Reduced fees are available, so ask about current rates.

    Phone
    252-737-1415Request an appointment by phone
    Address
    612 East Tenth Street, Greenville, NC

    Verified September 2026

  • Pitt County Mental Health & Crisis Resources (opens in a new tab)

    Pitt County

    Pitt County's own list of crisis lines, mobile crisis and community mental health resources.

    Verified September 2026

  • NAMI Pitt County (opens in a new tab)

    Pitt County

    Free peer and family support groups, education and referrals run by volunteers, serving Pitt and Beaufort counties. The information line is not a crisis line.

    Phone
    252-717-9600Information line: 252-600-3815 (not a crisis line)
    Address
    101 W 14th St, Greenville, NC 27834

    Verified September 2026

  • Trillium Health Resources (opens in a new tab)

    Eastern NC

    The public behavioral health plan for many eastern North Carolina counties, including Pitt. Call to talk through what you need and how to get connected to mental health, substance use or developmental disability services. Trillium also runs a Medicaid Tailored Plan.

    Phone
    1-877-685-2415Access to Care line, 24/7

    Verified September 2026

  • NC 211 (opens in a new tab)

    North Carolina

    A free, confidential way to find local help of many kinds: counseling, food, housing, transportation, utilities and more. A community resource specialist listens and connects you with options near you.

    Phone
    211Or 888-892-1162. 24/7, most languages.

    Verified September 2026

  • SAMHSA National Helpline (opens in a new tab)

    National

    A free, confidential referral service in English and Spanish for mental health and substance use, with an online treatment locator at FindTreatment.gov.

    Phone
    1-800-662-43571-800-662-HELP, 24/7

    Verified September 2026

From the Journal

Read more about starting therapy

Words you may hear

New to therapy language? These plain-language definitions can help.

Browse the full glossary

When you are ready

Take the next step at your own pace

Browse clinicians, read about the people you might work with, or book a free 15-minute phone consultation with no obligation.

Find a therapistBook a consult (opens in a new tab)

Keep exploring

  • Anxiety

    Understand anxiety, panic and worry, explore coping strategies and learn when more support may help.

  • Mental Health Glossary

    Plain-language explanations of mental health, therapy and North Carolina behavioral-health terms.

Sources & additional reading

This page is general information, not medical or clinical advice, and it does not replace care from a qualified professional. Last reviewed September 26, 2026.