How we tested and reviewed online therapy services
We evaluated 80 online therapy companies and therapist directories to compile this list.
First hand experience
As part of our research, we targeted talk therapy at the 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 child or adolescent therapy), we also tested them. Our testers are located all over the United States and abroad, which means we have extensive information about each company’s services in different areas.
User and brand surveys
In addition, we surveyed more than 10,000 therapy users: 105 in each of 55 online therapy companies and 180 in each of 25 therapist directories. We collected over 100 different data points where we asked users to rate each company’s services, from their therapist’s ratings to whether they found a therapist that met all their needs and how they would rate the company Generally. We also sent questionnaires to each company we considered, asking for their perspectives on the services they offer, and interviewed former patients and therapists from the companies when possible.
research
In addition to the extensive research we conducted 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 seek a mental health provider across 18 zip codes. We then rated the results based on how well the therapists we found in each directory could address each scenario, looking at whether it had competent, licensed therapists who were qualified to treat those issues.
Expert recommendations
After we completed these tests and 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
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How do I choose an online therapy service?
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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 the United States is between $60 and $200 per session, and the 80 services we reviewed fall directly within that range, as well as on both sides. Some online therapy companies offer pay-per-session rates, while others have subscription or membership models where you pay a fixed amount, ranging from $280 to over $400 per month, for a specific number of sessions
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How is online therapy billed?
At all of the online therapy companies we’ve reviewed, you pay for your 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 co-pay at the time of the session or receive a bill in the mail after your health plan is billed.
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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 when you receive a diagnosis. Services such as couples therapy are generally not covered. Also, some therapists and therapy companies do not work with insurance providers, meaning you pay out of pocket or seek reimbursement from your insurance provider.
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Do Medicare and Medicaid cover online therapy?
Since the COVID-19 pandemic, Medicare and Medicaid sometimes cover online therapy. But, as you normally do with any insurance, you’ll want to check that the online therapy service or doctor you choose is covered.
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Does what I tell my therapist stay between us?
Online therapy companies, like all online services, collect personal data and information about anyone who visits their sites and uses their services. Also, because online therapy companies are telehealth services, they also collect and store health information about their patients. To learn how an online therapy company uses your personal data, we encourage you to read the company’s terms of service and terms of use to improve it. understand their particular policies.
In terms of what you discuss in session, your online therapist will generally follow the same rules as an in-person therapist: you will not share what you discuss with them unless it is a threat to yourself or others, or there is evidence of abuse or neglect of a child, an elderly person or a person with a disability.
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