What Therapists Wish You Knew Before Starting Therapy
- Elemental Wellness
- 4 days ago
- 4 min read
Part 2: A Therapist's Perspective:
Insurance, EAPs, Telehealth & Fit
Once you’ve decided to look for a therapist, the next layer can feel even more confusing—especially when it comes to insurance, employee benefits, and online platforms.
Here are some things therapists often wish clients knew upfront.
Know What You’re Looking For
Before reaching out, spend a little time getting honest with yourself.
Ask:
Do I need support and validation—or someone more direct?
Am I looking for skills-based therapy (CBT, DBT)?
Do I want body-based or somatic work?
Does identity, spirituality, or lived experience matter to me?
There’s no wrong answer—only what feels right for you. Stay open, but trust your instincts.
Questions Worth Asking a Therapist
You’re allowed to ask questions before committing. Helpful ones include:
How do you structure sessions?
How long are sessions and how often would we meet?
Are you available during the times I need?
Do you offer in-person sessions if that’s important to me?
Do you have experience with the concerns I’m seeking help for?
Are you aligned with what feels important to me in terms of values or identity?
Feeling safe matters. While therapists work hard to remain neutral, subtle cues—environment, language, energy—can influence your comfort level.
Please know that therapists cannot read your mind. Being able to share your expectations of what you think will happen in therapy is important to reduce miscommunication and distrust. Asking someone before you start is valuable and time-saving information.
Understanding Insurance (This Matters)
Many smaller practices don’t have the capacity to do a deep dive into your benefits before your first session, so knowing your coverage is important.
Things to check:
Do you have a copay or a deductible?
Are your mental health benefits managed by a third party (check the back of your card)?
Is your therapist in-network for that benefit specifically?
Just because your card lists one insurance company doesn’t always mean your mental health benefits are handled there. Some insurance companies use third party groups for their mental health benefits. For example, PEBFT (PA state employees) often have Aetna as their primary and their MH benefits are through Optum.
If you have an HSA or FSA, those funds often apply to therapy.
EAPs: Helpful, With Limits
Employee Assistance Programs (EAPs) generally often offer 3–6 free sessions and can help you get in quickly. They’re designed to be short-term and solution-focused.
They are offered through an employer (yours or your partners) and are confidential. HR can give you more information if your company offers this service.
EAPs are a great way to:
Start therapy at no cost
Assess fit between client and therapist
They’re are solution focused care and not intended for specialized or long-term trauma work, and therapists are reimbursed at much lower rates—but they can open the door.
Often when you finish your EAP sessions you can roll over to use your insurance benefits and continue treatment with the same therapist or walk away, hopefully with some skills to help you cope. It is a great way to see if the therapist is a good fit for you.
IMPORTANT NOTE: Do find out if the EAP has the therapist using a separate medical record system. We have come across companies that are needing us to use a separate system for record keeping and also mandating that telehealth sessions are recorded. We will not participate in that!
Telehealth, AI, and Transparency
It’s okay to ask:
Do you use AI in your practice and how?
Does your telehealth platform record sessions or use data to train AI?
Any use of AI for documentation or recording should be clearly stated in informed consent and must be HIPAA-compliant. If something concerns you, ask questions. Transparency matters.
If You Decide to Move On
If a therapist doesn’t feel like the right fit, you’re allowed to leave. If you’re able, a brief email explaining that it doesn’t feel right is appreciated and helps maintain professionalism.
You’re not obligated to stay because you’ve invested time—or even years. People grow, and therapy needs change.
As a therapist, I do care about those I see and when you "disappear" I do worry. On the other side, I may have also ghosted a therapist in the past and still feel guilty for it!
Final Thoughts
This isn’t an exhaustive guide, but it’s meant to help you navigate the process with more clarity and confidence.
You deserve a therapist who supports you through both the hard moments and the growth that follows. It may take time—but it’s worth the effort. From personal experience, when you find the right therapist it is amazing what can happen.
Written by: Jamie Hogan, MA, LPC, NCC
Jamie Hogan is a guide, space-holder, and founder of Elemental Wellness. With nearly 20 years in the healing world—and lived experience on the client side of therapy—she trusts in the wisdom that emerges when safety, curiosity, and compassion are present. Her writing offers a gentle pause and a reminder that healing does not have to be done alone.
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