Online Therapy Review Methodology

How we evaluated 33 online therapy companies to determine which ones were best

Every year, we help 150 million people who come to Verywell Mind seeking answers to their health questions. As part of that mission, we aim to provide you with thorough and unbiased reviews of products and services that can improve your health and well-being.

To accomplish this task when it comes to online therapy companies, we researched and reviewed 33 companies currently in operation in order to determine which ones are the best at providing quality care to their users.  We fairly and thoroughly reviewed each company against its competitors by taking a data-centered approach, collecting key information about each one before expertly assessing their capabilities. Our team of experts included writer and psychotherapist Mary K Tatum and the Editor-in-Chief of Verywell Mind, Amy Morin.

Data Collection

We began our process of evaluating each company by surveying 100 users from each of the 33 businesses in order to gain insight into their experiences using the platforms. We asked them 26 questions about their experience with each company, including inquiries about the platform’s ease of use, therapist qualifications, the quality of the service rendered, cost, and value for the money. We also asked them if they planned to continue services with the company or recommend it to others. 

Then, we sent a questionnaire directly to each company, asking them to give us more detailed information about its services, therapist hiring processes, privacy measures, and what they felt set the company apart from the competition. 

These surveys and the questionnaire responses (though not all the companies responded) allowed us to directly compare different aspects of the businesses and the quality of services provided. 

Scoring Features

We scored each company on seven key areas using our collected data and the expert analysis of our writer, who is a licensed, mental health counselor and psychotherapist. Then, in order to generate the star ratings you see in our reviews, we weighted those scores based on the overall importance of each category to the experience of online therapy consumers. 

Below are the general categories we looked into while reviewing each company and how we analyzed each one.

First Impressions and Customer Service

Like it or not, businesses are often judged based on first impressions. So, if a company has an out-of-date or poorly designed website, a potential client might have misgivings about signing up. If a company had a website that loaded slowly, had older resources, didn’t answer key questions about price or what its services entailed, or generally was difficult to navigate, it tended to score poorly in this category.

We also judged the ease of the signup process was in general, scoring companies that had easy signup processes more highly than ones that were confusing or misleading. Companies that withheld prices until the very end were also generally penalized in this category. 

We also evaluated the strength of customer service, looking to see if companies had customer service helplines or chat functions for clients who had questions or problems with the signup process. 

Companies that prominently displayed therapist bios and qualifications on their website were rated higher as this helped clients feel more comfortable signing up for the service. Similarly, companies that allowed clients to choose their therapist during signup or easily switch therapists were also rated higher in this category. 

We also rewarded companies that took the matching process seriously between client and therapist. Those companies that had personalized matching services or detailed intake questionnaires generally scored higher.

Once sign-up was completed, we also evaluated whether the process remained intuitive, scoring companies with dedicated customer service lines or easy functionality more highly. For example, companies that made it easy to add, change, or cancel services were ranked higher.

Types of Therapy Offered

Not everyone benefits from the same type of therapy, which is why companies that offer a range of different types of modalities increase the chances that you’ll find something that works for you. Traditionally, online therapy has been a little more limited in terms of the types of treatments it offers; group therapy, family therapy, or certain psychotherapy techniques are often less common. 

However, as online therapy companies grow and strive to improve, many have dramatically expanded their services in order to be a one-stop-shop for all your needs, whether that’s individual therapy, couples therapy, teen counseling, psychiatry, medication management, or group therapy. Others, meanwhile, focus on being the best at providing one type of therapy. 

As a result, we scored companies highly if they offer a wide range of different services, as long as we could verify that all of those services were high quality and beneficial to mental health.

This meant rewarding companies that prioritize quality talk therapy, ensuring that session lengths are long enough to do real therapeutic work and that the video call platform is high quality. If a company offered subscriptions with unlimited messaging, they only scored highly if clients were guaranteed timely responses from their therapists. If medication management or psychiatry was offered, it meant evaluating whether diagnoses could be made, which conditions are treated, and what medications could be safely prescribed. 

To avoid unfairly penalizing companies because they chose to specialize in one or two types of treatment, we rewarded companies that outperformed their competition when they focused on one type of service, whether that was couples therapy, teen therapy, or psychiatry, and received higher user satisfaction ratings than those companies that took a more generalized approach. 

Communication Options

There are many different ways to participate in online therapy:

  • Live chat
  • Live videos
  • Phone calls
  • Email
  • Audio messages
  • Messaging

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. As a result, we tended to score companies that have a wide range of communication methods better than those that had fewer. 

That said, companies didn’t just score well in this category if they had a lot of options—those communication methods had to be high quality. As a result, we asked our surveyed users to rate the quality of each method, such as how reliable the video calls were or how quickly and thoughtfully their therapist responded to messages, and took this into account when determining final scores. Similarly, companies that offer longer video or phone sessions also tended to score higher because this allows for more in-depth therapeutic work. 

Quality of Care

Of the users we surveyed, 83 percent said that therapist qualifications were one of the most important factors across the board in choosing an online therapy company.

As a result, we carefully evaluated the qualifications of the staff employed by each company. Companies that ensured that all their therapists were licensed and had at least a Master’s degree were rewarded, as were those that had diverse staffs with a range of specialized training. Meanwhile, companies that had staffs made up mostly of trained listeners, life coaches, or counselors were scored lower.  

We also scored companies that prioritize diversity in their staff so that they can more effectively serve diverse audiences. 

In addition, companies scored higher if they responded to our questionnaire and gave us detailed information about how they vetted therapists or board-certified doctors before hiring them. We also considered staff turnover and attrition rates because quality treatment requires that clients have continuity of care. 

We also carefully considered how our surveyed users evaluated their experience with their therapists. We scored companies higher if they did a good job matching their therapists to clients and if users wanted to stay with their therapist instead of repeatedly switch.

As part of this category, we looked at how well a company knows its audience and serves its needs. So, for example, if a company was set up to serve marginalized communities or first responders, we evaluated how well they actually did this to ensure it wasn't just a marketing approach.

Privacy and Security

When you’re signing up for an online service, particularly one where medical data will be collected about you, privacy and security are very important considerations. In other words, can a company keep your private information and data safe and secure?

Unfortunately, lots of the companies we evaluated were vague about how they protect their clients’ private information. 

As a result, companies that were transparent on their websites and in their apps about how they keep private information safe generally scored higher in our ratings, as long as their measures seemed adequate. We also rewarded companies that were HIPPAA compliant or that required privacy training for their staff. 

Price

Most online therapy companies strive to make mental health services more affordable than traditional, in-person therapy—and by and large, almost all 33 companies we reviewed achieved this goal.

Still, there was a pretty substantial range of prices across companies, ranging from $60 to over $600 a month if a client were to see a therapist weekly. 

In general, the companies we examined kept prices low by structuring their businesses based on two different payment models:

  • Subscription Model: This monthly subscription plan comes with a certain number of live therapy sessions and messaging with your therapist.
  • Pay-per-Session Model: A price-per-session lets you book as many or as few sessions with your therapist as you like.

The subscription model is, by and large, substantially more affordable than traditional therapy. However, because it’s a subscription, you are locked into a monthly commitment that requires you to decide upfront how many live sessions you want with your therapist in a month or if you prefer to communicate with your therapist entirely in messaging form. 

To evaluate subscription-based companies, we considered whether a company offers more than one subscription option, what the monthly price tag is, and whether those subscriptions offer good value for money by providing clients with enough therapy time to actually make a difference for their mental health. We also rewarded companies in our scoring if they offer clients free trials or discounted first months so that you can feel confident in your subscription purchase. 

The pay-per-session online therapy model is closer to the way traditional therapy is set up. The advantage is that it allows you more flexibility in the amount you want to spend in a given month because you can book sessions as often as you want. However, if you want weekly sessions with a therapist, the price per month is almost always higher than with a subscription. Thus, if a company had this model, we gave higher marks to them if they offer variable pricing, which allows a client to pay more or less depending on how much experience or training their therapist has. We also rewarded companies in our scoring if they offer financial assistance to those who need it. 

As part of our price scoring, we also took into account whether a company accepts health insurance because if a company is in-network on your health plan, you can save substantially on out-of-pocket costs. 

Finally, if a company offers access to a psychiatrist or medication management, we took into consideration whether the costs associated with these services were part of your monthly price or you had to pay extra, as well as if they involve copays and shipping costs.

Overall User Satisfaction

Many online therapy companies, particularly the bigger ones, have very effective advertising and marketing campaigns to attract customers, but this doesn’t necessarily translate into happy customers.

So, in order to effectively gauge each service’s effectiveness, we examined three key data points in our surveys:

How Did Users Rate the Services Overall? 

Our survey asked users to rate whether the services were excellent, very good, good, fair, or poor. If more people than average scored a company as excellent, very good, or good, we reflected this in our final star rating scores. 

If more than the average number of users said the company was poor, we reflected this in their final star rating score. 

How Likely Users Were to Recommend the Company to Others Like Them? 

There’s no greater compliment than recommending a company to others, so we asked users to tell us whether they were very likely, likely, neutral, unlikely, or very unlikely to recommend the company to someone like them who was looking for therapy. 

If more people than average said they were very likely or likely to recommend the company to others, we reflected this in our final star rating scores. 

If more than the average number of users said they were unlikely or very unlikely to recommend the company, we took away points in their star rating score. 

If the User Had Tried Another Online Therapy Company in the Past, How Did This Company Compare?

We asked users to tell us if the company was much better, a little better, about the same, a little worse, or much worse than the services they’d tried in the past.

If a company had more than average users saying it was much better, we scored them higher.

Who Were the Users We Surveyed?

We tried to survey a wide range of users who had tried each of these companies so that we could fairly evaluate the companies against each other. However, it’s important to note that these users represent only a small fraction of each company’s users as a whole. 

In addition, there were some trends that emerged in terms of the demographic that signs up for online therapy and responds to surveys: The average age of users who spoke to us was 36 years old. In addition, 71 percent of respondents were male and 90 percent were white. Note that we did not speak to users from all 50 states.

However, we were careful to balance the survey data we collected with the questionnaire answers provided by the companies themselves and the expert analysis of our writer who is a licensed psychotherapist with over 15 years of experience in the field.

Our Team

Mary K. Tatum, MS, LMHC
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Personal Detail

Mary is a licensed mental health counselor and psychotherapist with 15 years of experience working in the psychology field. She earned a Bachelor of Science in psychology from Bluefield College and a Master of Science in Psychology from Palm Beach Atlantic University. 

She began in social work and then moved to drug rehab settings, working as a therapist, group facilitator, and clinical director. She specializes in family dynamic systems, trauma recovery, improving resilience, addiction recovery, and the psychology of successful business management.

 

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Simone Scully
Health Associate Editorial Director, Performance Marketing
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Simone is the health associate editorial director for performance marketing at Verywell. She has over a decade of experience as a professional journalist covering mental health, chronic conditions, medicine, and science. She's written extensively about medical and mental health care, medical research, relationship conflicts, pregnancy and postpartum care, neonatal loss, and parenting.

Simone has a master's degree in journalism from Columbia University, where she was awarded the John Horgan Award for critical science and health journalism at graduation. She also has an MFA from Columbia University and a bachelor of science with honors from the London School of Economics.


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Amy Morin, LCSW
Editor-in-Chief, Verywell Mind
Amy Morin
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Amy Morin, LCSW, is the Editor-in-Chief of Verywell Mind. She's also a licensed clinical social worker, psychotherapist, and international bestselling author. Her books, including "13 Things Mentally Strong People Don't Do," have been translated into more than 40 languages. Her TEDx talk,  "The Secret of Becoming Mentally Strong," is one of the most viewed talks of all time.

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Chris Tolan
Research Director
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Chris is a senior director at Dotdash where he oversees audience research related to health. He is responsible for designing and executing research and analysis and identifying opportunities and strategies for exploration.

Prior to joining Dotdash in 2019, Chris was a senior analyst at FleishmanHillard where he specialized in executing primary research projects and strategic consultation. Before relocating to New York, Chris lived in his hometown of Los Angeles, CA.

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Ray Finch
Copy Editor, Writer
Ray Finch
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Ray is a copy editor, fact-checker, mental health writer, and editorial producer with over five years of experience. They have offered editorial support to a variety of digital publications over the last five years, including Upworthy, GOOD Magazine, The Bold Italic, Elemental, Everyday Feminism, and Let’s Queer Things Up! 

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