The need for therapy services continues to grow, but it’s not always easy for people to get the help they need. The high cost of therapy and the shortage of qualified therapists, among other reasons, can prevent people from finding help. There can also be a stigma associated with seeking mental health care, with some people seeing it as a sign of weakness or a personal failing. In a 2022 Kaiser Family Foundation survey of 2,400 adults in the United States, 60 percent cited shame and stigma around seeking care as one of the main reasons for not getting therapy.
“Historically, the stigma of mental health has probably been one of the biggest barriers. However, I think there has been more understanding about the importance of mental health lately,” says Toni Teixeira, a licensed clinical social worker at Strong at the Core Counseling in Freehold, NJ.
We want you to know that you’re not alone in this journey. Online therapy allows you to receive mental health care from the comfort of your home, which can make it more convenient to reach out for help when you need it. BetterHelp is our HelpGuide Handbook Team’s overall pick for the best online therapy platform. Learn about its benefits and drawbacks in our review.
Why HelpGuide cares about access to timely, affordable mental health care
Your mental health influences how you think, feel, and act in daily life. It also impacts your physical health as well as your ability to overcome challenges and setbacks, cope with stress, and build relationships.
You don’t have to be dealing with a diagnosed mental health problem, such as depression or anxiety, to benefit from mental health care. If you’re going through a difficult time in your life, such as a bereavement, unemployment, or relationship problems, support from a mental health professional can help. Even if you’re facing everyday concerns like overwhelming stress, low self-esteem, or trouble sleeping, the right care can help you make positive changes in your life. In many situations, online therapy or telepsychiatry can be an effective, convenient solution.
Current evidence suggests that for many people online therapy can be just as effective as in-person therapy. Talking from the security of your own home may even make it easier for you to open up about your problems. Online therapy also enables you to communicate with a qualified specialist remotely, while avoiding the expense, travel time, and inconvenience of having to meet in-person.
Ultimately, how well online therapy works often depends on the same factors that determine the success of any type of therapy: the level of connection you make with your therapist, how much you’re able to open up, and the work you’re willing to put into the process.
Finding the right therapist online can take some time and effort, so don’t be afraid to ask questions, read reviews, and take advantage of any introductory sessions. An online therapist will become your partner in healing, recovery, and growth so it’s important to choose someone who makes you feel understood, supported, and cared about. You need to trust this person enough to talk comfortably about intimate and often difficult subjects, and to be honest about what you’re thinking and feeling.
Of course, there can be some drawbacks to online therapy as well. While connecting via text or messaging app, for example, may be a comfortable way of communicating, the lack of face-to-face interaction robs the therapist of gauging your all-important body language and tone of voice. It can also make it harder to build trust and a supportive rapport between you and the therapist, which can be crucial to the success of therapy. That can usually only be achieved in-person or via a live video link.
With online therapy, you’re also reliant on the speed of your internet connection and the reliability of your electronic devices. Online therapy isn’t the right choice in a crisis situation or mental health emergency, either.
In a mental health emergency:
Online therapists may not be the most appropriate resource to help in a mental health crisis. If you or someone you know is a danger to themselves or others around them, it is an emergency, and cannot wait for an online therapist’s response.
- Visiting urgent care
- Calling or texting 988 for the Suicide & Crisis Lifeline
- Chatting online at 988lifeline.org
- Calling the Substance Abuse and Mental Health Services Administration (SAMHSA)’s Helpline at 1-800-662-4357 or text your zip code to 435748
All the above options will connect you with trained professionals who can provide crisis support. You can find even more resources, including international options, on our helpline directory page.
Handbook’s research into online therapy platforms
There are many different options out there when it comes to online therapy services. Not every site offers therapist-matching services. Some simply serve as directories, where it’s up to you to search through the listings and connect with professionals. Other online therapy platforms allow you to apply search filters for factors like location, gender, faith, and age. Others have you complete an assessment, then pair you with a suitable therapist.
Collectively, the Handbook Team has put in more than 7,500 hours of research, testing, and evaluation to review different online therapy platforms, down to the fine print. We wrote this review to guide you in finding a provider who can best fit your mental health care needs.
HelpGuide Handbook for BetterHelp online therapy
If you learn just five things about BetterHelp, here’s what you need to know:
Quickly match with a therapist based on your preferences.
Switch providers with ease.
Weekly therapy sessions via video, phone, or live chat.
Optional support groups led by a therapist.
In-app messaging with your provider.
Our testing experience
The Handbook Team researched more than 70 online therapy platforms, directories, and networks. Based on that research, we narrowed our list down to actually sign up for and thoroughly test 14 of the most popular platforms. Here’s what we did with each online therapy platform:
Fill out the intake assessment.
Subscribe as a new user.
Get matched with a therapist.
Schedule and attend sessions on the platform for one month.
Go through the steps to switch therapists.
Contact customer support with questions.
Explore platform features such as journals, worksheets, and group sessions.
Cancel subscription.
Our testers explored the platforms and attended online therapy sessions for at least four weeks. Testers were instructed to navigate the platforms through the lens of a real user, paying attention to how easy or difficult it was to find a therapist they could talk to. Testers logged their experience in a diary and came together to share their findings once testing concluded.
On BetterHelp, our tester onboarded and filled out a preferences questionnaire to match with a therapist. Once matched, she could see therapist reviews from other clients and read through their biographies. These bios included their professional experience, how many years they’ve been in practice, areas of specialty (like stress, anxiety, grief, etc.), services offered (video, phone, live chat, messaging), and license information.
A key indicator of success in therapy is the quality of the relationship between the therapist and client, according to research from the American Psychological Association (APA). Therefore, finding someone who you feel comfortable talking to is an important first step when researching providers. You should also ensure your therapist has the appropriate academic and professional background to meet your needs, according to Aura De Los Santos, a clinical psychologist at EHProject in the Dominican Republic.
“There are many different types of mental health professionals, so people should ask if the training [the provider] has can help them with their problem,” she says.
Switching providers on BetterHelp is straightforward if the first therapist you match with isn’t a good fit. BetterHelp customer service quickly responded to our tester’s request to switch and helped her navigate a list of available providers.
If you would like to save the messages you exchanged with your therapist for future reference, our recommendation is to copy and paste the text into a separate document or take screenshots of your conversations before you change therapists.
Outside of the traditional therapy appointments, our tester enjoyed the bonus features BetterHelp offers, like journaling, goal sharing, and group sessions.
From our tester
“I’m really impressed by the bonus features on BetterHelp. It’s cool that you can keep a journal and choose whether or not to share it with your therapist. You can also set goals with your therapist. And there are so many classes to choose from to supplement your experience.”
As with most online therapy platforms, BetterHelp providers do not diagnose or confirm diagnoses. While many of the therapists and providers on the platform are licensed to diagnose mental health conditions, BetterHelp does not allow them to provide virtual diagnoses through the platform. While a diagnosis can be empowering, it isn’t always necessary for therapy to be effective. Without a formal diagnosis, a BetterHelp therapist can still help you deal with emotional, relationship, and life issues, as well as any symptoms you are experiencing. Typically, a diagnosis is only required if the therapy is billed through insurance or if you need a prescription medication as part of your treatment. If you have a mental health diagnosis from another professional, you can always discuss it with your BetterHelp therapist.
Pros and cons of BetterHelp online therapy
What we liked about BetterHelp
Offers a variety of therapeutic approaches
Providers on BetterHelp practice a variety of therapeutic approaches, including cognitive behavioral therapy (CBT), family therapy, and mindfulness training, to help clients with a range of mental health issues. Beyond traditional one-on-one appointments, BetterHelp also offers weekly therapist-led group sessions.
Large number of providers
One thing we noticed right away on BetterHelp was the large number of available therapists. The platform has over 34,000 psychologists, clinical social workers, marriage and family therapists, and board-licensed professional counselors in the United States and the United Kingdom. With such a large number of therapists available, people on BetterHelp may have a better chance of finding a provider who is a good fit for them based on their needs, preferences, and location.
Direct messaging with therapists
BetterHelp users can contact their therapist through the messaging feature in the app. Providers may not be able to respond to your messages immediately, but you can at least record your thoughts or questions the moment you have them.
What we didn’t like about BetterHelp
Therapists may not reflect your background
Although BetterHelp has thousands of available therapists, you are not guaranteed a provider who reflects your background or community. You can note your provider preferences when you sign up, but be aware that the platform may not be able to meet your request.
From our tester
“I asked to be matched with a therapist who specializes in LGBTQ+ issues, but they were unable to guarantee a match with a therapist who is part of the LGBTQ+ community.”
No psychiatric services
BetterHelp’s providers are therapists, not online psychiatrists, so they cannot prescribe medication. Providers can refer you to a psychiatrist outside of BetterHelp. The providers on BetterHelp also do not diagnose mental health conditions or confirm diagnoses. Many of the therapists are licensed to diagnose conditions, but BetterHelp does not allow them to offer diagnoses virtually through the platform.
Does not accept insurance
BetterHelp does not accept insurance and users must pay out-of-pocket for therapy sessions. Paying $65–$95 per appointment may be too expensive for some people.
Data privacy on mental health platforms
Communications between you and your therapist can be very personal and sensitive. In our October 2023 survey of online therapy users, 77 percent of respondents said the digital privacy of an online therapy platform was extremely or very important to them. Online therapy platforms have a responsibility to safeguard user data in the following ways:
- Health care providers are responsible for protecting your personal health information (PHI) under HIPAA.
- Platforms aren’t allowed to sell or use your PHI for marketing purposes without your permission under the Health Information Technology for Economic and Clinical Health (HITECH) Act.
What’s covered by HIPAA?
The HIPAA Privacy Rule protects your PHI from being disclosed to other parties to ensure your privacy. Your PHI can include your name, Zip code, birth date, and contact information, collected from your medical record and used to make your health care decisions.
Although the information shared between you and your online therapy provider may be considered PHI, data collected by the online therapy platform may not be. In contrast to PHI, personally identifiable information (PII) can still be the same information—your name, date of birth, zip code, etc.—but it’s not covered under HIPAA. PII can also be data collected through questionnaires (i.e., onboarding questionnaires for online therapy platforms), which may be disclosed to third parties with your consent.
How your data is collected and used can be outlined in a Terms and Conditions agreement, Privacy Policy page, or a website disclosure. Many sites have Terms and Conditions that assume your consent to data collection simply by using their website, but some online therapy sites we visited had a popup asking you to acknowledge their data-sharing policy.
Your PII is protected under the Privacy Act of 1974 from being disclosed without your consent. Unlike the HITECH Act, there currently aren’t any laws regulating the collection and sale of PII by private companies like online therapy sites. The Federal Trade Commission (FTC) is a federal agency that enforces laws to protect consumers’ privacy.
The FTC voiced data privacy concerns about BetterHelp for disclosing users’ personal data to advertisers without users’ consent. In July 2023, BetterHelp settled with the FTC and agreed to pay $7.8 million to affected users, among other remedial steps to protect user data. When we reached out to BetterHelp, the company clarified that it is not regulated by HIPAA because it is not a covered entity—a health plan, health care clearinghouse, or a health care provider. BetterHelp states its platform is now certified by the Health Information Trust Alliance (HITRUST), a health industry data security program, and that all messages between you and your therapist are encrypted using 256-bit encryption.
Data privacy concerns aren’t limited to online therapy platforms. We recommend reading through the privacy policies of any online app or platform to understand what data will be collected, how it will be collected, and what the platform does with your data. Read more about the privacy policies of the BetterHelp platform.
What kind of online counseling does BetterHelp offer?
Therapists on BetterHelp are trained and accredited psychologists, licensed marriage and family therapists, licensed clinical social workers, or licensed professional counselors. These providers have specialized training in specific types of therapy, including:
- Family therapy
- Cognitive behavioral therapy (CBT)
- Trauma-focused therapy
- Emotionally focused therapy (EFT)
- Acceptance and commitment therapy (ACT)
BetterHelp therapists can help you with a wide range of mental health concerns, including:
- Anger management
- Stress
- Anxiety
- Depression
- Grief
- Relationship concerns
- Sleep problems
- Trauma
- Family conflict
BetterHelp providers do not diagnose conditions, but you do not need a diagnosis to seek therapy. A BetterHelp therapist can help you deal with symptoms and cope with emotional and life issues without a diagnosis. They can also treat you if another mental health professional has previously diagnosed you.
How does BetterHelp online therapy work?
BetterHelp connects people with licensed therapists for teletherapy sessions. A BetterHelp subscription includes in-app messaging and one live therapy appointment per week via chat, phone, or video.
In-app messaging
BetterHelp offers in-app messaging with your provider at all hours of the day, but you should not expect an immediate response. According to our January 2023 survey of online therapy users, only 50 percent of BetterHelp subscribers received a response from their therapist within a day. Of the rest, 17 percent received responses within a few days, 25 percent received responses within a week, and eight percent said it regularly took more than a week for their therapist to respond. We recommend you ask your therapist during your initial session when and how often they will reply to your messages.
You will receive an email when your therapist sends you a message. Messaging can be convenient between sessions when you have a quick question or need to check in with your therapist. It also creates an ongoing conversation you can reference at any time. BetterHelp allows you to “shred” messages you send to your therapist if you choose. Once shredded, these messages will no longer be visible in your account.
Live chat messaging
BetterHelp’s live chat sessions are similar to messaging, except your therapist will reply immediately during the duration of your appointment. Live chat can be a good option for people who prefer texting over talking. Plus, you can always review your conversations later because the chat sessions will remain in your counseling “room” unless you cancel your subscription.
Phone calls
Schedule a phone session with your therapist the same way you schedule a chat or video appointment in the app. To speak with your therapist over the phone, log in to your therapy room at the scheduled time, and the system will request your phone number. Once you answer the call, it will connect you with your therapist to start the phone session.
Video sessions
Live video sessions are the closest thing you’ll get to in-person therapy. You will meet via video chat through your counseling room online or through the app. According to our Handbook Team’s January 2023 survey of 200 BetterHelp users, 66 percent of BetterHelp members used its video therapy option.
Group sessions
The platform offers 90-minute therapist-led group sessions with your subscription. Group sessions have five to 18 participants and are popular among subscribers. According to the same January 2023 survey of BetterHelp users, 79 percent also attended a group session at least every other week, and 47.5 percent attended weekly.
Topics include:
- Tired of Helping? The Compassion Fatigue Support Group.
- Living With Chronic Pain Support.
- Adjusting to Change/Life Transitions.
- Divorce/Separation Support Group for Adults.
- Boundary Identification, Setting, and Enforcement.
- Women’s Support: Healing From Domestic Violence & Trauma.
- Queer Women.
- Mood and Affective Disorders Support Group.
- Recovering From Dysfunctional Family Systems.
- Surviving Imprisonment: My Loved One is Incarcerated.
From our tester
“I attended a group session and genuinely loved it. If I were to choose BetterHelp over another platform for any reason, it would be for the experience I had in the support group. I felt truly seen, heard, and understood in a way I hadn’t before by people who shared similar life experiences. It was really special.”
How much does BetterHelp cost?
BetterHelp therapy ranges from $65–$90 per week, based on your location, preferences, and therapist availability. BetterHelp bills every four weeks, and you can cancel your subscription anytime. The platform accepts Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) for payment. You can also pay by credit card or PayPal.
While signing up for BetterHelp and answering the questionnaire, our tester received a promotional discount for listing the podcast name where she first heard about the platform. BetterHelp automatically deducted $9 per week, saving our tester $36 in the first month.
Handbook Tip
When you invite your friends and family using a referral link, they get two free weeks of therapy when they join, and you get $150 credit for every referral. Your credits will automatically be applied to your next membership payment.
Does BetterHelp take insurance?
BetterHelp does not accept health insurance at this time. However, some reviewers think paying upfront makes the platform more convenient than dealing with insurance.
Huge improvement over traditional, insurance-strangled therapy structures. The pricing turns out to be better, too. There is a monthly fee, but you can see your therapist a lot more often than I was ever able to see my in-person therapist, and you can do it from the privacy of your own home office/computer screen.
Anne C. (VERIFIED BBB CUSTOMER REVIEW)
Is BetterHelp covered by Medicare or Medicaid?
BetterHelp does not accept Medicare or Medicaid.
Does BetterHelp offer financial aid?
The platform offers financial aid up to 40 percent off for those who are eligible, and you can find discount codes to make online therapy more affordable. However, some customers found BetterHelp doesn’t consistently deliver on the discounts offered on its website.
How to use the BetterHelp app
You can download the app from the Google Play Store or the Apple App Store. Using the app was a breeze and very intuitive. As you sign up, BetterHelp walks you through a detailed questionnaire that asks questions about your current mental health status, age, gender, sexual identity, and other personal identifiers. It also asks why you are considering therapy to better match you with a provider.
Once sign-up is complete and you match with a therapist, you can click through additional BetterHelp offerings such as group therapy sessions, journaling, and messaging.
In between appointments with her therapist, our tester used the journal prompts to explore issues she was experiencing. You can share your journal entries with your therapist or keep them private.
In a mental health emergency:
Online therapists may not be the most appropriate resource to help in a mental health crisis. If you or someone you know is a danger to themselves or others around them, it is an emergency, and it cannot wait for an online therapist’s response.
- Calling or texting 988 for the Suicide & Crisis Lifeline.
- Chatting online at 988lifeline.org.
- American Sign Language users can use 988 Videophone.
- Veterans with hearing loss can text a Veterans Crisis Line responder at 838255.
- Calling the Substance Abuse and Mental Health Services Administration (SAMHSA)’s Helpline at 1-800-662-4357 or text your zip code to 435748.
All the above options will connect you with trained professionals who can provide crisis support. You can find even more resources, including international options, on our helpline directory page.
Our final verdict
BetterHelp provides a variety of ways to connect with a therapist so you can access mental health care in the comfort and privacy of your home. While the platform does not accept insurance, it does offer financial aid to those who qualify, and discounts are available.
Our tester particularly enjoyed the group therapy sessions included with the subscription and thought this offering made the platform stand out from some of its competitors. Although BetterHelp therapists cannot diagnose mental health conditions or prescribe medications, they can make referrals to mental health professionals, like psychiatrists, who can.
Frequently asked questions
BetterHelp is a legitimate online platform that connects subscribers to licensed therapists and various features to support your mental health.
BetterHelp only provides therapy, not psychiatry. Its therapists cannot diagnose you with mental health conditions or prescribe medications. As with all online platforms, customer data privacy can be at risk.
BetterHelp does not accept insurance, but does provide financial aid and promotional discounts to those who qualify. BetterHelp therapy ranges from $65–$90 per week, based on your location, preferences, and therapist availability. BetterHelp bills every four weeks.
- Lopes, L., Kirzinger, A., Sparks, G., Stokes, M., & Brodie, M. KFF/CNN Mental Health in America Survey. (2022, October 5). Kaiser Family Foundation. Link
- Hilty, D. M., Ferrer, D. C., Parish, M. B., Johnston, B., Callahan, E. J., & Yellowlees, P. M. (2013). The Effectiveness of Telemental Health: A 2013 review. Telemedicine Journal and E-health, 19(6), 444–454. Link
- Flückiger, C., Del Re, A.C., Wampold, B.E., & Horvath A.O. The alliance in adult psychotherapy: A meta-analytic synthesis. (2018). Psychotherapy, 55(4):316-340. Link
- HITECH Act Enforcement Interim Final Rule. (2017, June 16). U.S. Department of Health and Human Services. Link
- The HIPAA Privacy Rule. (2022, March 31). U.S. Department of Health and Human Services. Link
- The Privacy Act. (2022, August 31). U.S. Department of Health and Human Services. Link
- Protecting Personal Privacy. U.S. Government Accountability Office. Link
- Privacy and Security Enforcement. Federal Trade Commission. Link
- BetterHelp, Inc., In the Matter Of. (2023, July 14). Federal Trade Commission. Link
- Covered Entities and Business Associates. (2017, June 16). U.S. Health and Human Services. Link
- BetterHelp Survey. 200 respondents. Conducted Using Pollfish. Launched January 9, 2023.