Our lives have shifted online more and more over the past decade, affecting how we socialize, how we buy and sell goods, how we work, and now most recently, how we access healthcare. Telehealth has arrived in a big way, and your options for accessing healthcare online are only growing.
Maybe no area of healthcare is better positioned for this new frontier than therapy. For many people, online counseling sessions with a trusted therapist prove just as helpful as in-person sessions. Companies have developed intuitive app and website experiences that make access easy, and you can’t beat the convenience or privacy of therapy from the comfort of home or wherever you happen to be.
But as your options expand, the question becomes: which online therapy program is best for you? Innerbody Research has thoroughly tested the companies and services they provide. In this guide we’ll share the pros, cons and all details you will need in order to decide which one is best for you.
For those of you in a hurry, here’s a quick summary before we dive into the details.
Summary of our top recommended online therapy services
- Why you should trust us
- What to expect in online therapy
- Main factors when comparing online therapy services
- Individual online therapy services
- Group therapy online
- Online couples counseling
- Online teen counseling
- LGBTQIA counseling
- Online psychiatric service
- What criteria do we use to evaluate home health products and services?
Innerbody Research recently celebrated its 20-year anniversary online. Over the past two decades, we have helped tens of millions of readers make more informed decisions involving staying healthy and living healthier lifestyles.
This review, like all medical-related content on this website, was thoroughly vetted by one or more members of our Medical Review Board for medical accuracy. Additionally we extensively test, experience and order from each medical service we review. We try our best to give you unbiased, marketing-jargon-free descriptions of all the at-home health services evaluated based on the latest scientific evidence and medical standards.
Thanks to intuitive interfaces on their websites and apps, along with advances that make messaging in all formats easy – text, phone and video – you should expect online therapy to be a rich and valuable experience. As long as you aren’t bewildered by your devices or by the video chatting experience, you should be just fine accessing the therapy services with any of our top choices in this guide.
Though the specifics vary slightly from company to company, generally the process for getting started with online therapy follows a basic pattern:
Fill out a questionnaire up front with details of your medical history, what you are looking for in a counselor, etc.
Create your account, which requires email and a password.
Get matched to a counselor.
Choose a pricing plan and get started.
These companies make the process very straightforward. Where they differ is in the details within these steps, such as:
- Pricing structure and membership options
- Whether a human or an algorithm informs the matching decision
- Whether you have to use your real name at all or instead can use a pseudonym if you prefer (for added privacy)
Once you are a member, the best companies give you the opportunity to:
- Message your counselor as often as you’d like, with pretty fast turnaround times
- Schedule a live session, if you wish
- Switch counselors easily if you aren’t satisfied
- Message however you choose – text, voice message, or video
While we share all of the pertinent details from our testing of these online therapy services, there are important considerations for you to make in order to identify the best therapy for you. This choice ultimately is a personal one, and here are the main factors to consider:
Do you need your therapist to prescribe medication?
If you are on a tight budget and can afford one therapist but you need that person to fill your prescription, this is a consideration that definitely affects the landscape of online therapy options. You still may find a perfect fit, depending on other factors, and online therapy will expand to make telehealth psychiatric options more competitive and varied, with more prescribing options.
For now, your options are limited but it’s possible to access this type of care in a convenient way today. See our section on online psychiatric services, deeper in this guide.
Your preferred mode of communication
For some people, nothing compares to face-to-face communication. Other people, however, are accustomed to text and email and find as much value from these modes of communication. If voice and face-time are your preferred mode and you find yourself often scratching your head or frustrated about written messages, then this is very important when comparing online therapy services. It plays to an extent into budgeting and which service is likeliest to satisfy you or frustrate you unnecessarily.
Preferred devices and app vs. website
For our top service, BetterHelp, this doesn’t really matter (which is actually the main reason why BetterHelp is our top service). But if you were considering Talkspace, for example, you would be better suited there if you’re more comfortable with apps as opposed to wanting to interface with your therapist via a desktop or laptop device exclusively.
The good news is that online therapy can often save you money compared to traditional therapy services. But everything does cost money, and a misunderstanding about the price structure or billing schedule of an online service can cause headaches. Budget is a very important consideration, whether you intend to access online therapy for just a few weeks or as an ongoing member for possibly a year or longer, if you establish a great relationship with your counselor.
Do you prefer group or individual therapy?
This is a matter of personal preference. Some patients feel they gain the most from a guided group therapy session and the camaraderie, support and unexpected learning and growth that can occur. Others find the process uncomfortable and counterproductive and would never enjoy opening up in the ways that they only can in a private session with a therapist. Both therapeutic modes exist because people have different preferences. What is yours?
For most people who seek therapy from a counselor, the goal is to establish a trusting and useful relationship with a counselor who can provide therapy in a private, individual setting. A multitude of possible challenges and goals motivate us to seek this therapy.
In the growing telehealth industry, few medical services are as well suited to virtual care as therapy. With vast networks of highly qualified counselors spanning the spectrum of specialties, our top picks give you great power to find that ideal therapist and benefit from the ongoing, convenient therapy they can provide.
Our recommendation: BetterHelp
Both BetterHelp and Talkspace are solid choices for most people, but right now we are slightly more impressed by BetterHelp. You almost can’t go wrong with either BetterHelp or Talkspace, but we believe BetterHelp edges them out.
Both BetterHelp and Talkspace provide excellent counseling and pricing is very similar. So what are the differences, you wonder? For us, it boils down to a few things:
- Flexibility in how you use the service, once you’re a member. BetterHelp gives you a bit more flexibility to choose how you want to communicate with your counselor.
- Counselor selection. Telehealth isn’t magic… No matter which service you choose, you might still decide you want to switch counselors. (In our testing, this was the case.) Both Talkspace and BetterHelp let you do this with ease. But the selection process at the outset is different between these two companies. BetterHelp’s counselor-matching benefits from an algorithmic component, taking some of the decision-making out of human hands. If the algorithm is well designed (and we believe it is), this can remove potential for bias and/or flawed human judgment calls. There’s no potential for someone to be judging you unfairly in any way (even unknowingly) for your answers to the questionnaire or any information you provide up-front. It’s a safe, impartial space.
- Pricing. If you find that you love BetterHelp and commit to a longer term of counseling, you will save money compared to Talkspace.
- Free trial. For those of us who have never tried online therapy, a weeklong free trial can really help us decide whether it works well or not for us. BetterHelp offers this.
To be clear, we were very pleased by Talkspace’s counseling as well during testing, but BetterHelp edges them out right now.
What we love about BetterHelp:
- Excellent flexibility in how you interact with your counselor.
- Highly skilled and experienced counselors only.
- You can opt for a different counselor if you want, at any time.
- You aren’t forced to use the app for video.
One gripe: they could make their free 7-day trial easier to access, because it’s a fantastic feature that really helps us. But they do offer it. Check out our full BetterHelp review for more details.
Your plan comes with one live session per week, regardless of how long you commit to the service.
Talkspace is a very close second to BetterHelp for best overall online therapy, in our book. We slightly preferred their sign-up process and also their app. In fact, for people who know they will exclusively use the app and will never want to video chat via PC or laptop, Talkspace might provide just as good of an experience for you. But you won’t get to try it for free.
And video chat via smartphone isn’t everybody. Many of us would prefer the flexibility to video chat via our laptops, which we consider a better experience.
Talkspace’s counselors are just as high quality as BetterHelp’s, and the pricing is comparable unless you subscribe for three months or a year up-front via BetterHelp (which we honestly don’t recommend until you try a week for free or pay for a first month, alternately). If you are somebody who lives in apps and seldom strays to a desktop or laptop device, then Talkspace would likely serve you very well.
You can learn more about the company, its services and price structure with our full Talkspace review.
Hims and Hers?
Stay tuned for exciting developments from Hims and Hers in individual online therapy. The two websites have gained a solid reputation in the telehealth industry, with virtual healthcare in sexual health, hair loss, skin care, and most recently in primary care (in 29 states so far).
At this time (May 2020), their fledgling mental health offerings are not yet comparable or competitive because they don’t offer individual therapy at all – that’s still a coming attraction. But if their other high-quality telehealth offerings are any indication, soon we believe they will present another very solid alternative to the major players in online individual therapy. A year from now, our recommendations may be different – it isn’t wise to bet against Hims/Hers.
Some people discover that group therapy is actually the pinnacle of therapeutic treatment. Often this is thanks to the profound realities that we humans tend to thrive with peer support and an awareness that we aren’t isolated in our struggles.
Our recommendation: Hims/Hers
In their group therapy sessions, you can talk in a structured and professionally guided atmosphere about issues that confront you, along with people who have similar experience.
- It’s totally free to try.
- You can be as anonymous as you’d like, turning off your camera and using an alias to protect your identity completely.
- Learn from peers as well as the mental health professional guiding the session.
While we wait for their individual therapy and also psychiatry telehealth offerings, right now you can explore Hims and Hers group therapy sessions for free. The therapy session subjects and scheduling are the same for both Hims and Hers. Stay tuned for more as their offerings develop.
The same benefits and conveniences in individual online therapy exist for couples counseling. As a society, we’ve not done the best job of making couples feel comfortable seeking counseling in order to find good ways to improve the health of their relationship. The good news is that, until we totally destigmatize counseling and mental health services in our culture, couples counseling online offers a totally private alternative to traditional formats.
You and your partner can enjoy a rich and beneficial counseling experience online, without leaving your home.
Our recommendation: Regain
ReGain is our top choice right now for online couples counseling.
Some of what we love about ReGain:
- Quality: ReGain’s counselors are all licensed and certified.
- Price: $40-$70 per week for unlimited correspondence with your counselor. A single session in traditional settings is, on average, double this amount. And price doesn’t change, whether both people are in the “room” or just one of you.
- Consult the way you want: Video, phone, text, email messaging – the choice is yours.
- Device flexibility: use any device you want in order to send messages in any of those formats.
- Try it before you buy it: ReGain offers a free 7-day trial period.
- Anonymity: You can use any nickname you’d like, in your account. ReGain doesn’t ask for your full name or contact information at all when you sign up.
This is a great deal for solid advice and counseling. However, it doesn’t replace traditional therapy in every way:
- Counselors can’t officially diagnose you.
- Counselors can’t prescribe medication. You’ll need a psychiatrist for that.
- You can’t satisfy court orders via ReGain counseling.
- The packages are for unlimited messaging, not live sessions.
Our testers found that the ability to message in a private “room” with couples counselors at their own pace, in the amount that suited them, was very valuable. Counselors were responsive and their messages substantive and helpful. If you find it’s not a great fit with your counselor, talk with ReGain and get a switch.
You might find that frequent, brief messages back and forth with your counselor is the natural mode for you, or alternately you might find that just a few longer correspondences per week is what works best. Or something in between – the great thing is that you have the ability to utilize the unlimited messaging however it suits you best.
Close runner-up: Talkspace
Talkspace offers excellent relationship counseling as well. At $99 per week, the price is higher than ReGain’s services, but still more affordable than many traditional therapy options.
We wish that Talkspace would provide a free trial week, like ReGain, because this makes the service much more approachable for those of us who are brand new to online therapy and unsure whether we’ll like the format.
However, if you are certain that your counseling will require live sessions in addition to messaging, then you might be happier with Talkspace; you can purchase live sessions as part of your plan. These sessions could be video sessions also, as long as you are fine with using a smartphone for video.
If you’re age 13-19, would you like to have a counselor available for messaging 24/7 – a professional you could message whenever you need to share thoughts or concerns and get advice? If you’re a parent, would you like your teen to access this kind of service from home or from school or wherever you teen may be? Sometimes the structure of traditional therapy sessions is very valuable, but other times it can feel, well, too structured. Not to mention very expensive.
Online therapy offers an affordable and convenient alternative to consider.
Our recommendation: TeenCounseling.com
We recommend Teen Counseling as our top pick in 2020 for its online therapy for teens.
Teen Counseling, as its name suggests, focuses exclusively on providing online counseling to the teen community, helping teens thrive among the host of concerns they face, including:
- Anxiety and depression
- Eating disorders
- Relationship challenges
- Anger management
If you’re a parent, you can create an account and then invite your teen to join. Teens can sign up themselves, too, but will ultimately need a parental guardian to give the OK in order for the service to begin.
From there, here’s what we love about Teen Counseling:
- Affordability: $40-$70/week, depending on how long you commit to service. Single sessions of teen counseling in person can cost double that price or more.
- Communicate how you want: Text, phone, video messaging on whatever device suits you. Live chat via phone call or video from any device also.
- A dedicated counselor: A teen works with one licensed and highly experienced counselor who specializes in teen counseling. Changing counselors is super easy, if the fit isn’t perfect.
For many people, it can be difficult to find a safe space to reflect on our sexuality and all of the complex issues and feelings that surround and intersect with it. Thankfully, online counseling provides a new path for people to access counseling with this focus with remarkable convenience and privacy, from the comfort of home.
Our recommendation: Pride Counseling
You can find highly qualified and specialized therapists to suit your needs among the wide array of therapists at BetterHelp or Talkspace, both of which are overall strong choices. But for this particular goal, based on our testing, we believe you’ll have the best experience at Pride Counseling, which focuses exclusively on providing care for LGBTQIA clientele.
Some of what we love about Pride Counseling:
- Competitive price: Pride Counseling is $40-$70 per week, making it the same rate as BetterHelp.
- Exclusive focus: Pride Counseling is focused entirely on LGBTQIA counseling. All of its counselors specialize in serving the LGBTQIA community.
- As much anonymity as you like: You don’t even have to use your name.
- Flexibility in how you communicate: Message your counselor in a private space via text, video or phone. Live chat is an option as well.
Psychiatric services are more expensive than counseling, whether you access this care online or in traditional venues. The psychiatrist is able to prescribe medication, should you need a prescription treatment.
Options are more limited for online psychiatry right now, which for the customer ultimately means the benefits aren’t quite as dramatic yet. But this space is evolving rapidly and will be much more competitive soon, so stay tuned.
Our recommendation: Talkspace
Right now, based on our testing, the best choice for online psychiatric therapy is Talkspace. In fact, you may find that Talkspace is a good price compared to the psychiatric services you traditionally access, on top of being more convenient than traveling to someone’s office for a session.
Talkspace offers psychiatric services for $125 per session, with an initial evaluation fee of $199. As you consider these prices, keep in mind that the average price of traditional psychiatric sessions is $100-$200. If your traditional psychiatric sessions cost you closer to $200 per session, then you would begin saving money with Talkspace psychiatry by your third session with an online psychiatrist. If you are able to access traditional psychiatric services for $100, then it will take you much longer to reach parity with traditional cost via the telehealth route.
(Note: these psychiatric sessions must be conducted via video chat. As with Talkspace’s counseling video sessions, these sessions must occur via their app either on a smartphone or tablet. The fact that Talkspace is too inflexible to allow you to use a laptop or desktop device in order to initiate video sessions is one reason why we prefer BetterHelp for online therapy.)
The remaining benefit of psychiatric telehealth is convenience; many of us don’t have the time to travel to a doctor’s office, sit in the waiting room, and then have a session. Online psychiatry via Talkspace will save you this time and hassle, which could be well worth the extra $25 per session.
Stay tuned, because there’s about to be much more competition in this space… Hims and Hers are preparing to offer online psychiatric services as well. As competition increases, online patients will benefit from better pricing and a greater variety of service plans.
At Innerbody Research, we customize our evaluation criteria depending on the type and nature of the health-related service. For most online healthcare services (also known as telemedicine or telehealth services), we have five areas that we use for our evaluations, including:
Quality: Are the doctors on the service licensed to practice in the US? Are the physicians board-certified in the relevant practice areas? Do they have a high quality medical review board with oversight? Are their treatment options FDA-approved?
Value: Are you getting your money’s worth? Are there any hidden costs or charges? Does the test provider offer discounts or free services to our readers?
Customer support: How well does the healthcare provider help you choose the best treatment? How clearly are the options presented? How well does the healthcare company help you understand options and get treatment if necessary?
Privacy: Are all treatments sent in discreet packaging? Will your data be stored securely? Could your data ever be shared without your permission?
Speed: How fast will you receive your treatment from the moment you click “buy?” Are doctors and medical professionals responsive to your questions and needs when you are messaging them? Are the waiting times stated by the company accurate and consistent?