Online Therapy Review Methodology

How we tested and rated each online therapy provider

Part of our mission at Verywell is to provide you with thorough and unbiased reviews of products and services that can improve your health and well-being. To accomplish this task, we researched and reviewed online therapy websites and apps. We scored them on 15 key features that are likely to impact your experience as a therapy consumer.

In the process of assigning final star ratings, we scored each feature on a scale of 1 to 5. These individual category scores are then weighted based on the overall importance of each category to generate the star ratings you see on our reviews. We have broken down the features into general categories below to explain our online therapy review methodology.

Talkspace
Talkspace

Topic Areas Covered

Users don’t always know what issues they need to cover in therapy. After all, a traumatic past may seem unrelated until they begin talking about a problem in therapy. Or, someone may learn that their depression really stems from a substance issue they didn’t recognize. So it’s important that online therapy sites treat or address a variety of issues (anxiety, PTSD, LGBTQ issues, etc). The highest scores were given to sites that were equipped to handle a variety of major mental illnesses, as well as lifestyle issues, like divorce and stress, and specific problems, like trauma. Lower ranks were given to sites that specialized in few areas or those that didn't mention which areas they cover.

Types of Treatment Offered

Online therapy can be a little more limiting than in-person therapy in terms of the types of treatment offered. Group therapy, for example, is less common online than it is in person. But, some sites do offer a variety of treatments (educational groups, cognitive behavioral therapy, dialectical behavioral therapy, psychodynamic therapy, etc). Those that provided the most treatment types received the highest scores. The lowest scores were given to sites that offered individual therapy only, or those that did not make it clear if family, couples, or other therapy treatments were available.

Sign-Up Process

The therapy sign-up process gives users a first impression of the website, the technology, and the therapy process. A lengthy or confusing sign-up process is likely to turn people away. But, an overly simplified sign-up may also be a cause for concern—after all, users want to know what to expect from services before they pay.

Top marks were given to websites that provided a live chat service for users to ask questions in real-time and offered clear information about pricing and confidentiality as users were matched to a therapist who could meet their needs.

The poorest marks were given to websites that requested names and payment information upfront before offering information about services, pricing plans, and confidentiality.

Types of Therapists Available

It’s essential that users can trust that their therapists are licensed mental health professionals. Sites that offered access to psychiatrists, psychologists, licensed marriage and family therapists (LMFTs), licensed clinical social workers (LCSWs), and licensed clinical professional counselors (LCPCs) received the highest ranks. Those that offered fewer types of therapists received lower ranks.

Betterhelp
Betterhelp

Therapist Experience

Users want to know that their therapists are experienced. So sites that ensured their therapists have at least 3,000 clinical hours of experience plus additional training in how to provide online therapy received the best scores. Those that had fewer requirements or those that did not offer much information about their therapists' experience received lower scores.

Speed of Therapist Match

One of the major advantages of online therapy is often the speed of the service. While it can take several weeks to schedule an appointment with an in-person therapist, online therapy can happen much faster. Therefore, the speed at which a user is matched to a therapist and the speed at which the therapist responds are critical to the outcome.

Since it’s an online service, most users expect to be connected with a therapist as fast as possible. And while few services offer immediate access to a mental health professional, some of them match users with a therapist within a couple of hours.

Services that matched a user with a therapist within a few hours received the highest ranks. Those that took more than 48 hours received the lowest star ratings.

Therapist Response Time on Average

Whether they’re sending emails or making video messages, users expect speedy replies from their therapists. So telehealth sites that offered responses within one day received the highest marks—especially if they had guaranteed response times. Any site that took more than 48 hours received the lowest ratings.

Available Means of Communication

There are many different ways to attend online therapy—live chat, live videos, phone calls, e-mails, audio and video messages, and direct messages. And while some users may only want to connect on their smartphones, others may prefer using a full-sized laptop to communicate. Those with slow internet connections may also prefer phone support rather than video messaging. Therefore, sites that offered the biggest range of services and made services available on desktop and mobile devices, received the highest grades.

Regain
Regain

Switching Therapists

The fit between a user and a therapist is essential. Therefore, it’s important for users to know they can switch to a new treatment provider if they don’t feel like their current therapist is a good match. Highest scores were given to sites that made it clear how to switch therapists and made the process simple—like a few clicks of a button as opposed to an email asking customer service for help. The lowest ranks were given to sites that didn’t allow users to change therapists at all.

Availability of Service

Many U.S.-based telemedicine sites want to reach a global audience. And for people who live outside the United States or those who don’t speak English, this is refreshing news. Sites that offered services in most countries and had therapists available in most languages received the highest ranks. Those with the least availability and those that only offered English-speaking therapists received the lowest ranks.

BetterHelp
BetterHelp

Customer Service

From technological problems that interfere with therapy to subscription fee questions, individuals who are interested in online therapy want to know how they’ll get answers to their questions. Questions may include things like “How do I access my live appointment?” or “What should I do if I want to change therapists?” In those cases, you may need access to someone to talk to aside from your therapist.

Sites that offered a live agent via phone or chat received the highest ranks. High ranks were also given for sites that sent automated emails inquiring about service satisfaction and providing information on how to switch therapists or discontinue services. The poorest ranks were given to sites that only offered email support and whose customer support information was difficult to locate.

Privacy

Privacy is a major concern for online therapy users. They want to know that their information is being transferred safely and stored in a secure manner. Sites that provided a clear privacy policy earned the highest ranks. Sites with vague policies received lower ranks, and the ones that didn't reference privacy until the first meeting with a therapist received even lower ranks. Sites without a privacy policy received the lowest score.

Talkspace
Talkspace

Price

The price of online therapy is often very appealing to individuals looking for treatment since it’s usually significantly lower than the cost of in-person therapy. But, unlike face-to-face treatment, online therapy often involves a subscription service. For some individuals, signing up for a week, month, or year at a time (without a chance to test the service) can seem like a poor decision. Therefore, we took into account whether or not websites offered free trials and we evaluated them based on a variety of different subscription terms.

Available Pricing Plans

Before signing up for online therapy, users want to know how much it’s going to cost and what type of subscription (if any) they are buying into. So the highest scores were given to sites that made their pricing plans readily available.

Sites that offered multiple pricing plans, a free trial, and the ability to cancel at any time also received the best scores. Sites that only offered one option (such as live appointments only that must be purchased one at a time) received the lowest score.

Weekly Price

Not all services allow you to sign up for a week at a time. Instead, some of them have monthly minimums. But we wanted to know: what would one week of online therapy cost you across the different sites? Sites that provided treatment for $50 or less a week were given the highest ranks. Poorer grades were given to sites that charged $125 a week and the poorest rank was given to sites that didn't offer weekly subscription services.

Monthly Price

We calculated how much services would cost if you signed up for them for one month at a time. While some websites specifically offer monthly contracts, others do not. The best ratings were given to those with the lowest monthly fees. Any site that cost $300 or less per month received the best score while those that didn’t offer any type of monthly plan received the lowest marks.

Talkspace
Talkspace

Annual Price

Some users are certain they want access to a therapist on an ongoing basis, and an annual subscription may be a good option. So we gave the best rank to sites that offered annual plans for $2,000 or less. The lowest ranks were given to sites that do not allow for annual plans.

Insurance Acceptance

Users who have mental health insurance coverage usually want to use it for online therapy. Most sites, however, don’t accept insurance. We gave the highest rank to sites that accepted most major insurances. Lower scores were given to sites that provided users with billing information so users can submit their information to insurance companies on their own. The lowest scores were given to sites that didn't accept insurance and that didn't give users the information they’d need to get reimbursed from their insurance companies.

Cancellation Policy

Sites that allowed users to cancel services immediately with a refund were given the highest scores. Those that made it difficult to cancel (requiring multiple emails or lengthy explanations about why services were being discontinued) received lower scores. The sites that didn't allow subscriptions to be discontinued until the end of the plan were given the lowest ranks.

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