Key Takeaways Why Trust Us

Betterhelp stands out as our best online therapy platform overall. We chose Betterhelp because users can select one of their 35,000 licensed therapists, schedule appointments within 48 hours, and choose a therapy format that works for them, with text, video, or phone options available. Receive 20% off your first month with code NCOA.

Taking care of your mental and emotional wellness is vital, but there may be barriers to accessing mental health care that make it difficult to prioritize your well-being. Online therapy platforms can help eliminate some of those barriers, like cost, transportation issues, limited mental health professionals in your area, mobility issues, and scheduling challenges due to work or caregiving. Online therapy provides a safe space for you to talk through life challenges and receive quick, affordable care for mental health conditions.

Our Reviews Team looked at which platforms offer the best care, features, and functionality. We signed up for their services, explored their websites, and interacted with customer service to investigate the ins and outs of their platforms.

We highlighted key features that make these platforms the best picks that suit different needs and budgets so you can find the right online therapy provider for you.

It’s important to know that online therapy is not right for certain mental health conditions. For conditions like schizophrenia, eating disorders, suicidal thoughts, or if you’ve been hospitalized for a mental health condition in the last six months, you should seek in-person care.

A quick look at the best online therapy platforms in 2024

• BetterHelp: Our Top Pick:
• Brightside: Best for Insurance Coverage
• Talkspace: Best for Choosing Your Provider
• Online-Therapy.com: Most Affordable
• Talkiatry: Best for Medication
• Calmerry: Best for Text Therapy
• ReGain: Best for Couples Therapy

Table 1, Comparison of the best online therapy platforms of November 2024

Best online therapy platforms of 2024

 Our expert opinion on BetterHelp

We chose BetterHelp as our top pick because we were impressed by the bonus features that many other platforms don’t offer. On top of weekly online therapy sessions, BetterHelp allows you to keep a journal, set goals with your therapist, fill out worksheets, and attend classes and group sessions to supplement your experience.

Out of all the bonus features, we were most impressed with the group sessions. During group sessions, a small group of people (five to 18 members) of similar backgrounds and experiences can offer and receive support. The group is more similar to a support group than therapy. Although a licensed professional leads the session, they are only there to moderate the discussion. Our tester hesitated to sign up because a 90-minute session is a significant time commitment. However, our tester found it was worth attending. They left the session feeling seen, heard, and understood.

There is a vast selection of group sessions, so you will likely find a group for you. On one day alone, there were 22 sessions available, including “Recovering from Grief and Loss,” “Veteran to Veteran: Overcoming Adversity Together,” “Alcohol and Drug Addiction and Recovery,” and “BIPOC Mental Wellness Women’s Support Group.”

Overall, the platform is easy to use and navigate. Scheduling an appointment is simple and straightforward. BetterHelp also has provider availability on the evenings and weekends. Appointment times are as early as 7:30 a.m. and as late as 10 p.m., which can accommodate people who are busy during the day.

Customer reviews

BetterHelp is a BBB-accredited business. It has the highest rating of any other platform in our review. Based on more than 584 reviews, the average rating is 4.03 out of 5 stars. They also have an average rating of 4.5 out of 5 stars based on 7,684 reviews on Trustpilot.

Many reviews echo that the app is user-friendly and offers flexibility for scheduling and switching therapists. They also say they have had positive experiences with their therapists, stating that they have been paired with helpful, flexible, and quality therapists.

“At 60 years old, I was facing some very traumatic life events. I felt isolated and confused. I had my first online meeting through BetterHelp, and my therapist was so professional and engaging. She validated my feelings and offered me realistic activities for self-help. If you are on the fence about online therapy, give BetterHelp a try. Sometimes, when you’re just hanging on, it can be a push over the edge or pull to safety—BetterHelp pulled me to safety. Looking forward to better days ahead.”

Read more in our BetterHelp Review.

Our expert opinion on Brightside

When you’re looking for mental health services, it can be frustrating trying to figure out how you can afford the help you need. Not only does Brightside offer a low-cost option, but they also offer flexible insurance coverage, including coverage under some Medicare Advantage plans and original Medicare in select states—a feature few online therapy platforms offer.

Brightside accepts many major insurance plans, including:

• Cigna
• Aetna
• UnitedHealthcare
• UnitedHealthcare Medicare Advantage
• Original Medicare Part B (in select states)
• Anthem Blue Cross Blue Shield California
• Allegiance
• Some BlueCross BlueShield plans
• PEHP Health & Benefits

If you want to know more about your specific insurance coverage, you can fill out a form through their website to see if your insurance plan covers Brightside. You can also receive an estimate of how much care would cost you after insurance. Brightside accepts Visa, Mastercard, and HSA/FSA cards.

Customer reviews

The customer reviews on Brightside are mixed. On BBB, it has a rating of A- and 1.26 out of 5 stars based on 42 customer reviews. On Trustpilot, Brightside has 1.3 out of 5 stars based on 125 reviews.

Some reviews state that Brightside has been beneficial for their mental health and is easy to use. One review on Trustpilot said, “My family member had been seeing a therapist…when the decision was made to try medication, we could not get in to see any providers in our area for months. My husband found the Brightside app, and we were able to schedule a Zoom appointment within 36 hours. The gentleman my family member spoke to was calm, kind, and non-judgemental…within three hours we had the medication in hand.”

However, other reviews reported delayed response times from their psychiatric provider. Brightside states that messages to a psychiatric provider will receive a response within 72 hours. This can be a long time to wait, especially if someone is experiencing side effects due to their medication or having difficulty receiving their medication, a common complaint in many of the reviews.

Our expert opinion on Talkspace

Out of all of the platforms we tested, Talkspace was the most convenient when it came to choosing a provider and scheduling an appointment. During the sign-up process, you will choose a plan, answer questions about your medical history, and pick a therapist from nine providers matched to you. Each of the online therapists had a graph of their availability, making it super easy to pick a provider that fits within your schedule. If you don’t find a suitable therapist in that selection, you can request more choices through customer service.

They also accept a wide range of health insurance plans, such as Aetna, Cigna, Optum, Carelon Behavioral Health, and Regence. Talkspace also accepts Medicare. Their website tells you what is covered under these plans and the average copay that members of your insurance plan pay for Talkspace. A full list of accepted insurance plans is available on their website.

Customer reviews

On BBB, Talkspace has a rating of B and 1.1 out of 5 stars based on 103 customer reviews. On Trustpilot, they have a rating of 4 out of 5 stars based on 469 reviews. Reviewers report positive experiences with their therapist. They were matched with someone who was encouraging, thoughtful, and helpful.

“I spent months trying to find an in-person therapist in my city, and was never able to find one who had open availability. I tried Talkspace, and I was instantly matched with a therapist. Luckily enough, she was a great fit right away.”

Reviewers also report issues with verifying health insurance coverage, technical difficulties, and a lack of providers. Although you are only presented with nine provider choices, you can always reach out to customer service for more choices.

Our expert opinion on Online-Therapy.com

Out of all of the platforms on our list, Online-Therapy.com is the most affordable, and their financial aid is straightforward and very easy to sign up for.

Here are the prices for the individual therapy plans:

• Basic (unlimited messaging and therapy program): $200 per month
• Standard (one weekly live session, unlimited messaging, and therapy program): $320 per month
• Premium (two weekly live sessions, unlimited messaging, and therapy program): $440 per month

They also offer couples therapy for $440 per month. In our selection, no other platforms offer a monthly subscription plan with eight live sessions. This is a great offering, especially for people who need more frequent appointments. If you split up the monthly cost by session, each session on the Premium plan would cost $55. Some other platforms offer the option to purchase additional sessions, but it may not be easy to spend additional money unexpectedly.

Applying for financial aid when you sign up for your account is easy. You fill out information like your employment status, whether or not you are a veteran, monthly income, and if you have any children. Approval is immediate, and you will receive an instant discount that is automatically applied. When our Reviews Team applied for financial aid, we were able to receive a 30% discount for the first two months with the option to apply for an extension after that.

Customer reviews

There are very limited online reviews of Online-Therapy.com. On Trustpilot, they have a rating of 3.8 out of 5 stars, based on 15 reviews. They do not have a profile on BBB.

Our expert opinion on Talkiatry

Talkiatry is an online psychiatry platform that accepts major insurance providers, including Aetna, Cigna, Humana, BlueCross BlueShield, United Healthcare, and Medicare Part B. Since Talkiatry is an in-network service, the cost varies based on your insurance provider. The best way to get an estimated cost is by contacting your insurance company. You may have to pay a small copay (around $30), or you might have to reach a deductible before your insurance can start covering some of the cost. We recommend Talkiatry for psychiatry because it only offers psychiatry services covered by insurance. This makes it one of the most affordable options for online psychiatry, as long as you have an accepted insurance plan. We also like that the initial evaluations with your Talkiatry provider are typically 60 minutes, longer than some other platforms.

Biweekly or monthly payment plans are available. One of the benefits of Talkiatry is that if you have a balance over $250, you can pay it off over time. You must pay a minimum of $50 and pay off the balance within six months.

Talkiatry is the only platform on our list without a subscription plan. You do not pay a monthly fee; you only pay for your appointments. If you need to take a break from treatment, you can do so without canceling a subscription. You just have to inform your provider.

Customer reviews

Talkiatry has a rating of 1.4 out of 5 stars on Trustpilot based on 229 reviews and a rating of 1.02 out of 5 stars on BBB based on 63 reviews. It is not a BBB-accredited business. Reviewers report positive experiences with their providers and that it is easy to use the app, access appointments, and get their prescriptions. Other reviewers report issues with billing and difficulty scheduling appointments within their availability.

One reviewer from Trustpilot said, “I have tried many online mental health services, and Talkiatry has been the best so far, hands down. I have been continuously impressed with my psychiatrist, his willingness to communicate, and the ease of getting my prescriptions.”

Our expert opinion on Calmerry

Calmerry is a platform that provides excellent, quality therapists and responsive customer service. During our testing, we found that our therapist was supportive and resourceful. They often went above and beyond to offer support.

“My therapist’s practice of sharing useful resources and actively seeking feedback demonstrates a commitment to my well-being and a willingness to foster a collaborative therapeutic relationship.”

Calmerry will match you with a therapist based on your needs, so you don’t get to choose your therapist. When you’re matched with a therapist, you will receive information about them that includes a short bio (and sometimes a video introduction), a list of specialties, treatment approaches, qualifications, and communities they are a part of. If you want to switch therapists at any time, you can reach out to customer service.

Having live chat support 24/7 is a major plus of Calmerry. Many online therapy platforms don’t offer immediate access to customer support, and customers often have to wait a few hours or days to hear back. With Calmerry, you can talk to customer support through your account whenever you need to. When we reached out to customer support through the chat, we received a thorough reply within two minutes.

Customer reviews

Calmerry is rated 4.3 out of 5 stars on Trustpilot based on 55 reviews, and they do not have a profile with the BBB. On the Apple App Store, Calmerry has 3.9 out of 5 stars based on 59 ratings. On the Google Play Store, it is rated 2.1 out of 5 stars based on 61 reviews.

Reviews mention positive experiences with therapists through live chat and video therapy and attentive customer service. Other reviews cite dissatisfaction with the frequency of their therapist’s responses and a poor experience on Calmerry’s app.

Our expert opinion on ReGain

If you are experiencing challenges in a relationship, you may consider couples therapy. ReGain is an online therapy platform and branch of BetterHelp that provides a quality environment for couples to meet with professional counselors to work through issues and learn how to communicate better. ReGain can be an affordable option for couples because it offers financial aid.

Once you’ve created an account, you can fill out an application for financial aid. The application is easy and takes less than five minutes to complete. After completion, it instantly tells you whether you are eligible. Financial aid applies to the next three months of your subscription with the option to apply for an extension.

The cost of a ReGain subscription varies from $65 to $90 per week, depending on location, preferences, and therapist availability. When our Reviews Team signed up for ReGain, we were quoted $360 per month. The subscription includes four live sessions a month and unlimited messaging with your provider.

Customer reviews

On Trustpilot, ReGain has a rating of 3.3 out of 5 stars based on 234 reviews. On BBB, ReGain has an F rating and 3.93 out of 5 stars based on 15 customer reviews. ReGain is not a BBB-accredited business.

Reviewers appreciate how convenient and accessible the platform is, and they report having positive experiences with their therapists. Other reviews mention that therapists lack availability, and users were charged a renewal fee even after canceling their subscriptions.

“I have been in therapy on and off for 15 years. In one session with Regain, I had a very different experience. The insight I have gained from ReGain is really changing my life. It just felt like my boat was stuck in the ice, but the ReGain ship came steaming through and yelled, ‘Well this is the way. Are you coming?”

How we test online therapy

According to the Health Resources & Service Administration, only 31.64% of the United States has enough mental health practitioners to meet the needs of the population in their designated geographic region. This means that over two-thirds of the United States is living in an area where they do not have access to adequate mental health care. We feel online therapy, which allows you to find healthcare providers offering remote mental health services with flexible scheduling, could help to fill the gap in care. Knowing this, we have dedicated ourselves to researching and reviewing the best online therapy platforms.

During testing, we sign up for services to get first-hand experience with each platform. Guided by standardized testing forms, we carefully document our experience across a number of categories, including:

• Affordability: We compare the cost of each platform we test with other online therapy services as a well as the average cost of in-person counseling.
• Customer service: During testing, we reach out to customer service with questions and concerns and document the responsiveness of each company.
• Brand reliability: To determine each brand’s trustworthiness, we research any lawsuits or concerning press involving each platform.
• Features: Our tester uses each feature offered by the therapy provider, taking note of which platforms offer resources like workshops, homework, messaging, and support groups.
• User experience: In order to determine if our first-hand experience matches up with the more general experience of users, we read reviews left on third-party websites and survey users about their experience with each online therapy platform.

What is online therapy?

Online therapy is a form of telehealth, which is why it is sometimes called teletherapy. Telehealth lets you connect with a health care provider online rather than in person. ^[1]Telehealth.HHS.gov. What is telehealth? Found on the internet at https://telehealth.hhs.gov/patients/why-use-telehealth These virtual visits primarily take place over the internet with a computer, tablet, or smartphone. NCOA and other organizations continue to press for expanded telehealth access for older adults and address common barriers such as lack of internet access.

Although there are arguments for and against online therapy, it provides increased access to psychotherapy, whether at home, at work, or while traveling. Depending on the provider and the platform, it may even be covered by private insurance, Medicare, or Medicaid.

How does online therapy work?

While every online therapy platform is different, the types of therapy each company offers are very similar. Typically, you will log into the platform online and use the company’s software to complete a therapy session through video, phone, or chat. During these sessions, you will talk to your provider about why you’re seeking therapy, your challenges, and anything else you want to discuss. Additionally, many platforms offer the option to chat with your therapist between sessions. If something comes up between sessions, you can send them a message to talk it through.

Is online counseling effective?

Online counseling is generally just as effective as in-person therapy. Video and audio therapy are effective forms of therapy that can help increase access to care. Research has found that teletherapy can be helpful for the treatment of depression, anxiety, adjustment disorder, substance use, and eating disorders.

How much does online therapy cost?

The online therapy subscriptions in this article range in cost from $95–$436 per month, while online psychiatry ranges from $95–$1,260. This seems to be the average cost based on our research. The cost of online therapy can depend on various factors, including session format. For instance, a chat-only subscription is cheaper than one that includes live sessions, and psychiatry is typically more expensive than counseling. In comparison, the self-pay cost of face-to-face therapy may be anywhere from $100–$250 per session.

Does insurance cover online therapy sessions?

Some insurance plans cover the cost of online therapy, but it will depend on your specific plan and whether or not the platform accepts your insurance. If the platform does not accept your insurance, you may be able to submit your bill to your insurance company for reimbursement.

What online mental health services does my insurance cover?

It can be difficult to understand what mental health care your insurance plan covers, so we compiled a list of the various mental health services some major insurance companies offer.

Aetna

• MinuteClinic Virtual Care: A telehealth platform where you can schedule an appointment (often on the same day) with a therapist of your choice. Appointments are available seven days a week from 7 a.m. to 7:30 p.m. This service is only available in the following states: Arizona, California, Connecticut, Florida, Georgia, Illinois, Maryland, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Texas, and Virginia.
• CVS Virtual Care (limited to certain Aetna plans): Telehealth appointments with a therapist or psychiatrist. Same-day appointments may be available.
• Teladoc Health: Telehealth counseling appointments with a therapist.

Aetna also has a helpful PDF that further breaks down its offerings by mental health conditions, ages treated, provider, contact information, and the states where the services are available.

UnitedHealthcare

If you have UnitedHealthcare mental health benefits, you have access to virtual therapy. You can meet 1:1 with a therapist or psychiatrist through video therapy. This service is offered to children, teens, and adults. Talkiatry also accepts UnitedHealthcare insurance plans.

UnitedHealthcare also offers self-care tools through AbleTo. This platform provides self-care techniques and tools, including meditation, coping skills, daily mood tracking, and curated content.

Medicare

Medicare Part B will help you pay for outpatient mental health services provided by psychiatrists, psychologists, clinical social workers, clinical nurse specialists, nurse practitioners, and physician assistants. Deductibles and coinsurance may apply. Starting Jan. 1, 2024, Medicare also covers licensed marriage and family therapists. ^[2]Medicare.gov. Medicare & your mental health benefits. Found on the internet at https://www.medicare.gov/Pubs/pdf/10184-Medicare-and-Your-Mental-Health-Benefits.pdf

Can I use HSA for online therapy?

You can use HSA funds for telehealth appointments, including services such as online therapy, regardless of whether or not you use insurance. ^[3]IRS. Publication 969 (2022), Health savings accounts and other tax-favored health plans. Found on the internet at https://www.irs.gov/publications/p969 BetterHelp and Brightside are some online therapy platforms that accept HSA funds as payment.

Does Medicare or Medicaid cover online therapy?

According to Medicare.gov, original Medicare covers therapy and online counseling services. ^[4]Medicare.gov. Telehealth. Found on the internet at https://www.medicare.gov/coverage/telehealth When you sign up for an online therapy platform, check with customer service to determine if the platform bills Medicare and if the therapist you are seeing is eligible to bill Medicare. Brightside and Talkiatry are two platforms that accept Medicare.

As for Medicaid, your state determines whether Medicaid covers certain telehealth services like online therapy. ^[5]Medicaid.gov. Telehealth. Found on the internet at https://www.medicaid.gov/medicaid/benefits/telemedicine/index.html But since the start of COVID-19, many states have expanded their coverage for telehealth services. Check your Medicaid benefits carefully and talk with your Medicaid care manager to determine what is covered in your state.

How to save money on online counseling

While telehealth can still be a significant monthly expense, there are ways to make it more affordable.

1. Maximize your in-network benefits: Seeing a doctor or therapist in contract with your insurance to provide therapy at a certain rate will be cheaper than seeing someone out-of-network.
2. See if a platform offers financial aid or sliding scale payments: Some companies offer financial assistance or will use your financial status to determine how much you will pay per month or session.
3. See if your provider accepts Medicare or Medicaid: If you have coverage under either of these programs, be sure to ask if the provider accepts them. Medicare covers certain types of online therapy, but not all, and certain states’ Medicaid programs do, too. ^[6]American Psychological Association. How well is telepsychology working? Found on the internet at https://www.apa.org/monitor/2020/07/cover-telepsychology

Pros and cons

While there are benefits to online therapy, it may not be right for everyone.

Pros of virtual therapy

The benefits of online therapy may include:

• Ability to expand your therapist search to mental health professionals around your state
• Eliminating commute times to and from a therapist’s office
• Reducing potential exposure to illness because you can attend appointments from home
• Availability of appointments that are outside traditional business hours or on weekends
• Scheduling therapy appointments with your preferred communication style, such as audio, video, or chat sessions
• Eliminating transportation and mobility barriers
• Taking sessions from the comfort and familiarity of home

Cons of virtual therapy

The drawbacks of online therapy may include:

• Absence of an in-person connection
• Not the right fit for those in crisis or who have complex or severe mental health symptoms
• Can be challenging for those uncomfortable using new technologies
• Technical difficulties and interruptions may occur and disrupt the therapeutic process

Neelima Kunam, MD, a board-certified psychiatrist who practices in the Midwest and California, also noted that “those with difficulties with attention span may need in-person focused attention to absorb and listen to what the therapist is offering.”

Who should be using online therapy?

Online therapy can be used to treat many of the same mental health conditions treated through traditional in-person therapy. These conditions include depression, panic disorder, social anxiety disorder, generalized anxiety disorder, and stress and anxiety. People who can’t pursue in-person therapy because they live in rural areas, have scheduling issues or have privacy concerns may find online therapy much more accessible.

Who should not use online therapy?

Online therapy isn’t right for everyone. It isn’t recommended for people who have severe mental conditions and serious addictions or for those experiencing thoughts of self-harm or suicide. People with these conditions should seek the more intensive treatments offered through in-person therapy.

What to look for in an online therapy platform

Based on our Reviews Team’s experience with virtual therapy, we recommend you consider the following factors when looking for an online therapy platform:

1. If it fits in your budget: Many online therapy platforms advertise their services with weekly prices while charging you monthly. Be sure to look at the monthly price and determine whether it fits in with your ongoing expenses.
2. If it’s the type of therapy that works best for you: Decide what areas or issues you’d like to focus on and whether you’d feel more comfortable with video, audio, or chat therapy.
3. If it makes sense to use insurance: Some insurance plans, including Medicare or Medicaid, cover online therapy, but if your deductible or copay is unaffordable, a pay-as-you-go service or a discounted subscription may be a good option.
4. If the appointment times fit your schedule: Many negative online therapy reviews mention trouble finding appointment times that work with their schedule. Look for providers and platforms that offer useful appointment times.
5. If it has responsive customer service: A good customer support line can quickly and easily resolve any problems you encounter.
6. If the platform will provide you with a receipt for services: If your chosen online therapy platform doesn’t accept insurance, you can still submit a receipt to your insurance for potential reimbursement. The exact reimbursement amount will be based on your insurance plan.
7. If it’s easy to change or cancel appointments: Make sure you can adjust or cancel appointment times if you need to, and confirm whether you’re charged a fee when that happens.
8. If the technology is easy to use: You can sign up for most online therapy services without paying to get a free preview of what you’ll be using. The technology should feel easy to navigate and use or have tutorials explaining how to use the platform and connect with your therapist.
9. If you can choose your therapist: Certain online therapy platforms allow you to search for and request a specific therapist based on gender, religious affiliation, ethnicity, or if they offer specialized treatments. Finding a therapist you are comfortable working with is key to the success of any therapy. Look for platforms that provide the biographical information, education, and professional credentials of the therapists on the site before you meet them. Some platforms do not guarantee that you will be assigned to a requested therapist, so make sure you know how to switch to a different therapist or provider if you are not comfortable working with the one you are assigned.

Different types of therapy

Cognitive behavioral therapy (CBT)

CBT is a common form of talk therapy that providers use to help someone change their thinking and behavioral patterns. The treatment plan is often a collaboration between the provider and the patient; they work together to develop solutions, tactics, and coping skills. CBT focuses on what is happening in the present rather than what has happened in the past. ^[7]American Psychological Association. What is cognitive behavioral therapy? Found on the internet at https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral

Interpersonal psychotherapy (IPT)

Interpersonal therapy focuses on how the relationships in your life impact you and your mental health. IPT can help you improve and understand aspects of your relationships. This type of therapy can be offered in an individual setting and in couples therapy. ^[8]Rajhans P, et al. Interpersonal Psychotherapy for Patients With Mental Disorders. Indian Journal of Psychiatry. January 2020. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001362/

Dialectical behavior therapy (DBT)

DBT is similar to CBT: they both involve changes in behavior. DBT is best for people who find it difficult to manage their emotions. The goal of DBT is to accept yourself, your emotions, and your behaviors to understand how you can benefit from changing behaviors that are not benefiting you. ^[9]Cleveland Clinic. Dialectical behavior therapy (DBT). Found on the internet at https://my.clevelandclinic.org/health/treatments/22838-dialectical-behavior-therapy-dbt

Couples and family therapy

Therapy can be offered in an individual and a group setting. If you are in a relationship and experiencing challenges, you and your partner may decide to seek couples counseling. ^[10]American Psychological Association. Couples therapy. Found on the internet at https://dictionary.apa.org/couples-therapy There is also family therapy that can benefit a family unit that is encountering issues or concerns. ^[11]American Psychological Association. Family therapy. Found on the internet at https://dictionary.apa.org/family-therapy There are many different subtypes of couples and family therapy.

How to prepare for your first online therapy session

To ensure you get the most out of your first online therapy session, make a point of planning ahead. Prepare a private space where you’ll feel comfortable speaking openly without the concern of being overheard. Come prepared with notes of topics you want to discuss, and have a pen and paper handy to jot down any homework your therapist suggests before your next sessions. This might include journaling or specific exercises.

It’s also important to be open and honest with your therapist from the beginning. Honesty helps you develop rapport, and it’s also the best way to determine whether you’ve been matched appropriately with a therapist who can help you.

​​Is online therapy safe and private?

Privacy concerns are understandable for people who are considering online therapy. Online therapy platforms must comply with federal guidelines to ensure your information stays safe and private, and many use high-grade encryption to do so. Before starting online therapy, check that a particular platform is compliant with the Health Insurance Portability and Accountability Act (HIPAA). Inquire about the platform’s practices relating to record-keeping and what will be done to protect your privacy. Remember to follow best practices for security as a patient, such as using a strong password and changing it often.

Online therapy regulation

Since online therapy is still relatively new, regulation of therapy platforms and mobile apps is somewhat lacking. Most medical apps, though not all, are regulated by the U.S. Food and Drug Administration (FDA) and the Federal Trade Commission (FTC). State agencies are also increasingly regulating psychologists, counselors, and other mental health professionals on online platforms. According to the American Counseling Association, counselors who offer telehealth services must follow state licensing requirements, and most online therapy platforms use licensed professionals only.

One potential issue with online therapy relates to the regulation of a therapist and a patient who are in different states. Typically, therapists are only allowed to practice in the states in which they’re licensed. For online platforms with virtual appointments, this can pose an issue if a therapist doesn’t reside in the same state as a patient. Since therapists must follow the rules and regulations of their licensing board, interstate cases can create problems. Many platforms take steps to match patients with therapists in their state to avoid problems.

How we chose the best online therapy platforms

Our Reviews Team consulted with mental health experts to determine what online therapy platforms are best for NCOA readers’ needs. We determined the following factors to be important when looking for online therapy:

• Cost
• Insurance coverage
• Financial aid and other discounts
• Reliability of customer service
• Therapist availability
• Ability to switch or choose therapists

In case of emergency

Trying to find help during a crisis can be exhausting. In an emergency or crisis situation, it isn’t safe to wait for a therapy appointment. If there is an emergency, including plans to harm yourself or others, call 911. If you are having suicidal thoughts or experiencing a crisis, you should seek in-person care immediately. You can also call or text the 988 Suicide & Crisis Lifeline.

You may be experiencing a mental health crisis if you are: ^[12]Wisconsin Department of Health Services. Crisis Services: Identifying a crisis. Found on the internet at https://www.dhs.wisconsin.gov/crisis/signs.htm

• Feeling sad or depressed most of the time
• Acting violently (punching a hole in the wall, fighting with other people)
• Feeling anxious or agitated
• Feeling hopeless or like there’s no reason to live
• Not taking care of yourself (not brushing your teeth or hair, eating, drinking)
• Not sleeping
• Having mood swings
• Writing a will or getting your affairs in order

Bottom line

When you are looking for the best online therapy, make sure you know what features are most important to you. BetterHelp impressed us with their bonus features, including the support group sessions, which we found to be a valuable addition to our experience. You may want to find a platform that accepts your insurance plan, like Brightside or Talkspace.

Online therapy is effective, convenient, and can be more affordable than in-person therapy. If you are unsure about online therapy, talk to your health care provider about options for mental health support.

Frequently asked questions

Is there free online therapy?

No credible platforms offer free online therapy, but there are several affordable online therapy options. You may try applying for financial aid, asking providers about sliding scale payments, or using your insurance for a lower cost.

How effective is online therapy?

Online therapy is just as effective as traditional therapy and has been proven to help with conditions like anxiety, depression, and eating disorders.

Are any online therapy platforms designed specifically for older adults?

There are currently no online therapy platforms designed specifically for older adults, but the online therapy platforms featured in this review offer help for issues that can affect older adults, including depression, anxiety, grief, sleep disturbances, family or relationship concerns, and substance use disorders.

What is the best option for online therapy?

The best online therapy is one that fits your mental health needs and is at a sustainable price for your budget. Our Reviews Team’s pick for the best online therapy overall is BetterHelp because the platform includes weekly therapy and support groups and is one of the few to offer financial aid.

Does insurance cover online therapy?

Many insurance plans now cover online therapy, but you’ll need to check with your provider to determine your plan’s coverage. The online therapy platforms we recommend that take insurance include Talkspace, Brightside, and Talkiatry.

Who should not use online therapy?

Online therapy is not recommended for certain mental health conditions. For example, those with bipolar disorder, schizophrenia, eating disorders, suicidal thoughts, and anyone who has been hospitalized for a mental health condition in the last six months should seek in-person care.

Is online therapy secure?

Online platforms use secure encryption to protect your data, but it’s still important to use best practices to protect yourself. Inquire about a platform’s data-sharing practices, including storage and user control, to determine whether you feel comfortable with their standards.

How much does online therapy cost?

Pricing varies from one platform to another. Subscriptions for online therapy in this article range between $95–$436 per month, and online psychiatry is between $95–$1,260. Session format and therapy type both tend to influence pricing. Chat-only subscriptions are generally cheaper than those that include live sessions, and psychiatry is typically more expensive than counseling. In comparison, traditional in-person therapy can cost between $100–$250 per session.

Have questions about this review? Email us at reviewsteam@ncoa.org.

Sources

1. Telehealth.HHS.gov. What is telehealth? Found on the internet at https://telehealth.hhs.gov/patients/why-use-telehealth
2. Medicare.gov. Medicare & your mental health benefits. Found on the internet at https://www.medicare.gov/Pubs/pdf/10184-Medicare-and-Your-Mental-Health-Benefits.pdf
3. IRS. Publication 969 (2022), Health savings accounts and other tax-favored health plans. Found on the internet at https://www.irs.gov/publications/p969
4. Medicare.gov. Telehealth. Found on the internet at https://www.medicare.gov/coverage/telehealth
5. Medicaid.gov. Telehealth. Found on the internet at https://www.medicaid.gov/medicaid/benefits/telemedicine/index.html
6. American Psychological Association. How well is telepsychology working? Found on the internet at https://www.apa.org/monitor/2020/07/cover-telepsychology
7. American Psychological Association. What is cognitive behavioral therapy? Found on the internet at https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
8. Rajhans P, et al. Interpersonal Psychotherapy for Patients With Mental Disorders. Indian Journal of Psychiatry. January 2020. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001362/
9. Cleveland Clinic. Dialectical behavior therapy (DBT). Found on the internet at https://my.clevelandclinic.org/health/treatments/22838-dialectical-behavior-therapy-dbt
10. American Psychological Association. Couples therapy. Found on the internet at https://dictionary.apa.org/couples-therapy
11. American Psychological Association. Family therapy. Found on the internet at https://dictionary.apa.org/family-therapy
12. Wisconsin Department of Health Services. Crisis Services: Identifying a crisis. Found on the internet at https://www.dhs.wisconsin.gov/crisis/signs.htm