How We Tested and Reviewed Online Therapy Services
We evaluated 80 online therapy companies and therapist directories in order to compile this list.
Firsthand Experience
As part of our research, we signed up for talk therapy at all 55 online therapy companies we reviewed. We tested each company’s therapy services, and if the company offered other services (such as couples therapy and kid or teen therapy) we tested those too. Our testers are located all across the United States and abroad, meaning we have extensive information about each company’s services in a variety of areas.
User and Brand Surveys
In addition, we surveyed more than 10,000 therapy users: 105 at each of the 55 online therapy companies and 180 at each of the 25 therapist directories. We collected over 100 different data points in which we asked users to evaluate each company’s services, from their therapist’s qualifications to whether they found a therapist who met all their needs to how they’d rate the company overall. We also sent questionnaires to each company we considered, asking for their perspectives on the services they provide, and we interviewed former patients and therapists at the companies where possible.
Research
In addition to the extensive research we performed on each of the 55 online therapy companies we reviewed, we also researched dozens of therapy directories. We tested each by searching for appropriate therapists for 37 hypothetical scenarios that might lead someone to search for a mental health provider across 18 zip codes. We then rated the results by how well the therapists we found in each directory could address each scenario, looking into whether it had competent, licensed therapists that were qualified to treat these issues.
Expert Recommendations
Once we completed this testing and these surveys, we evaluated our findings with the help of three licensed therapists—Amy Marschall, PsyD; Nic Hardy, PhD, LCSW; and Hannah Owens, LMSW—in order to make our recommendations. These therapists provided extensive insight into the ethics and efficacy of online therapy as well as information about relevant therapeutic modalities and approaches.
Frequently Asked Questions
How Do I Choose an Online Therapy Service?
How Much Does Online Therapy Cost?
The cost of online therapy varies depending on the service and level of support you choose. The average cost of therapy in America is between $60 and $200 per session and the 80 services we reviewed fall squarely within that range, as well as to either side. Some online therapy companies offer pay-per-session rates, while others have subscription or membership models where you pay a set amount, ranging from $280 to more than $400 per month, for a specific number of sessions.
How Is Online Therapy Billed?
At all the online therapy companies we evaluated, you pay for online therapy with a credit or debit card. Some also accept flexible spending account (FSA) or health savings account (HSA) cards. If you have health insurance and the company or therapist accepts your insurance, you may pay a copay at the time of your session or receive a bill in the mail after your health plan is billed.
Does Insurance Cover Online Therapy?
Since the Affordable Care Act (ACA) was passed, mental health services are covered by most insurance plans. However, insurance generally only covers talk therapy and/or psychiatric services where you receive a diagnosis. Services like couples therapy are generally not covered. Plus, some therapists and therapy companies do not work with insurance providers, meaning you pay for out-of-pocket or seek reimbursement from your insurance provider.
Do Medicare and Medicaid Cover Online Therapy?
Does What I Tell My Therapist Stay Between Us?
Online therapy companies, like all online services, gather personal data and information about anyone that visits their sites and uses their services. In addition, since online therapy companies are telehealth services, they also gather and store health information about their patients. In order to know how an online therapy company utilizes your personal data, we recommend reading the company’s terms of service and terms of use to better understand its particular policies.
As for what you discuss in session, your online therapist generally will follow the same rules as an in-person therapist: They will not share what you discuss with them unless you are a threat to yourself or others, or there is evidence of abuse or neglect to a child, elderly person, or person with disabilities.
