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5 Best Online Therapy Services for 2022

5 Best Online Therapy Services for 2022

The destigmatization of mental health has come leaps and bounds over the years, but access to traditional resources hasn't followed suit. As per a study, up to 70% of the people who need mental health care don't have access to it. Enter online therapy. It helps bridge the gap and offers resources to those who otherwise can't get help, whether because of location, finances or scheduling conflicts. 

There are plenty of reasons traditional therapy may not be the best option for you. The convenience and flexibility of online therapy are quickly making it one of the most popular ways to connect with mental health professionals. If you're considering giving online therapy a try or just interested in learning more, here are our top six choices for the best online therapy. 

But not all online therapy platforms are created equal. Below, a primer on five popular HIPAA-compliant therapy services that only employ licensed and trained mental health professionals. 

Read more: Best Mental Health Apps  

BetterHelp

BetterHelp is one of the largest, reputable online therapy platforms that gives you access to over 12,000 experienced mental health professionals. You can feel confident about the therapist you work with through BetterHelp therapists, thanks to experience requirements and a thorough vetting process. Every therapist has a minimum of three years and 1,000 hours of hands-on experience. 

After you sign up and complete the questionnaire, you'll be matched with a therapist, generally within a day. BetterHelp therapists specialize in various areas, including anxiety, depression, substance abuse and eating disorders. You can message your therapist from anywhere, anytime. However, that doesn't mean you will always get an immediate response. Given they are real people, they aren't available 24/7. 

The cost of online therapy with BetterHelp ranges from $60 to $90/week. You are billed monthly. According to the website, pricing is based on your location, preferences and therapist availability. Some users did note frustrations with customer service and technical issues with the BetterHelp app. 

BetterHelp best features:

• You can participate in video calls, instant messages, text and live therapy sessions with your counselor. 
• On the website, you have access to blog articles and educational content.

Things to consider:

• BetterHelp doesn't accept insurance, so what you see is what you'll pay. Financial assistance may be available through BetterHelp for qualified individuals. The initial questionnaire determines the eligibility for financial assistance, as it asks about employment and financial troubles. 
• You get talk therapy with BetterHelp; counselors do not diagnose or prescribe medication. 

Talkspace

Talkspace is one of the most versatile online therapy platforms with several communication methods, therapy options and price points. With Talkspace, you get message-based therapy that's a great option for those who feel comfortable sharing through video or have a changing schedule that cannot commit to weekly sessions. 

Starting Talkspace is simple. Once you sign up, you complete an assessment that includes the payment plan options. Talkspace has three therapy subscription options. Messaging therapy which includes text, video and audio messaging with a therapist, starts at $69/week. Live therapy starts at $99/week and includes four 45-minute live therapy sessions each month. The last subscription option combines the two. Starting at $129/week, it includes four live sessions and text, video and audio messaging. Talkspace notes that pricing is based on where you live and the network of available therapists. 

After you select which plan you want, a consultation therapist selects a list of matched therapists that you can choose from. 

Talkspace best features:

• Those with an employee assistance program through their employer may have coverage. 
• A psychiatrist through Talkspace Psychiatry has the ability to prescribe medication and help you manage it. These services cost $249 for the initial consultation and $120 for your follow-up sessions. 
• TalkSpace has a network of over 3,000 mental health professionals. 

Things to consider:

• While still more affordable than traditional therapy, Talkspace doesn't offer sliding scale payments. However, Talkspace does offer the occasional discount. 
• Your therapist may not reply immediately to messages; it typically takes a day. 
• Recent user reviews note that customer service and insurance claims with TalkSpace can be frustrating. 

Cerebral

Cerebral takes the spot for the best online therapy platform for medication management, thanks to its all-in-one approach to mental health. You have access to talk therapy and medication with a licensed psychiatrist. Those who manage their prescriptions through Cerebral will be shipped directly to your home. 

There are three membership plans. Medication and care counseling includes evaluation, diagnosis and prescription from a psychiatrist, medication delivery and weekly video/phone sessions. This plan is $85/month. Mediation and therapy costs $325/month and includes everything the first plan does, though you can chat with your therapist anytime. The final is therapy, which does not include any medication though weekly meetings with your therapist. It costs $259/month. 

Cerebral subscriptions are about average compared to competitors for out-of-network providers. However, if you have an insurance plan that Cerebral accepts, the price can be as low as $30/month, plus a copay.

Cerebral best features: 

• Membership plans are FSA/HSA eligible. 
• Cerebral is a one-stop shop that offers therapy, psychiatry and medication management. 
• All therapists and psychiatrists are board-certified and licensed. 

Things to consider:

• Cerebral is not available in all states. Treatment for disorders also varies by state. 
• When signing up, you have to add a payment method before an appointment. This may result in your card being charged if you do not match with a therapist within the time period provided. However, since Cerebral recently started issuing refunds for this. 
• User reviews are typically positive at 4.3 on Google Play and 4.6 on the App Store. 

Amwell

Most online therapy platforms don't accept insurance, making counseling unattainable for many. Amwell is the best online therapy platform that takes insurance because of its large network of accepted health plans. 

After signing up with Amwell, you will choose a licensed therapist and schedule your first session. You can choose your therapist based on what they specialize in, allowing you to find the best fit for your needs. Each therapist has a bio on their profile. 

Amwell offers fewer communication options than competitors because it is not a subscription-based therapy. You only have access to virtual video sessions that you schedule. This tends to be the best for people who only have sessions with a therapist and have a schedule that requires flexibility. Most users comment that while the app may not be the most modern, it is typically easy to use. 

The cost of your sessions is based on the therapist or psychiatrist and their experience level. Typically, sessions cost between $109 to $129. Your health insurance plan will determine how much you pay out of pocket.

Amwell's best features:

• You can schedule a session with a psychiatrist for medication.
• Amwell accepts many types of insurance providers. 
• Amwell also offers a variety of services competitors don't have, like breastfeeding support or stress management. 

Things to consider:

• Amwell doesn't do subscription plans; you are charged by session. 
• Since it doesn't have messaging or phone call options, Amwell is not a good choice for crisis situations. 

Pride Counseling

The LGBTQIA+ community struggles with mental health issues at a disproportionately high rate. And traditional counseling options aren't always helpful. A survey of LBGTQ+ people found that 50% had experienced harsh language, scapegoating problems on their sexual orientation or outright denial of care. 

Pride Counseling, a subsidiary of BetterHelp, offers inclusive and accessible virtual counseling specialized for the LGBTQIA+ community to address struggles like gender identity, stigma, eating disorders and stress. Every therapist you encounter when using Pride Counseling has extensive experience working with the LGBTQIA+ community. 

At the start, you are asked several questions, including your pronouns, how you identify and your sexual orientation, to ensure you at matched with the best therapist. Pride Counseling also has taken steps to ensure security and anonymity are valued -- you can pick a "nickname" instead of your full name. 

You have unlimited messaging to contact your therapist at any time. Unlike other options, your counselor cannot diagnose conditions or prescribe medication. Costs range from $60 to $90/week with a billing cycle of every four weeks.  

Pride Counseling's best features:

• All therapists have experience working with the LGBTQIA+ community. Requirements are at least three years and 1,000 hours of experience to become a Pride Counseling therapist.
• Price Counseling has positive reviews from users, with a 4.5 on Google Play and 4.6 on the App Store. 

Things to consider:

• Unfortunately, Pride Counseling does not accept insurance. 
• Pride Counseling is only for adults. 
• The website, while straightforward, doesn't offer any additional resources like blog articles for those seeking an answer to a specific question. 

ReGain

ReGain, a sister site to BetterHelp, is a virtual therapy platform with experts specializing in relationships, intimacy and family issues. That's why it's our choice for the best online therapy for couples counseling. All therapists through ReGain are licensed and hold titles like licensed marriage and family therapists or clinical social workers.  

The sign-up process is similar to the other options on the list -- you fill out a questionnaire and are matched with a therapist. You can have both couples sessions and individual sessions with your therapist. You have access to 24/7 chat messaging, phone and video sessions. Unique to ReGain, there is a one-week free trial when you sign up.  

Another benefit that ReGain offers that alternatives do not is the wealth of educational information available on the website. ReGain offers dozens of articles and advice on relationships, regardless if you are signed up. This is not a standard feature in the virtual therapy space. 

ReGain online therapy costs between $60 to $90/week; you'll be billed every four weeks.  

ReGain's best features:

• You don't have to pay double for having both partners in the session. 
• All therapists through ReGain specialize in relationships and family issues.
• ReGain has a 4.5 rating on Google Play and 4.8 on the App Store. User reviews are generally positive.  

Things to consider:

• ReGain doesn't support three-way video conferencing; you and your partner have to be in the same room for your video sessions. 
• Typically it is not covered by insurance. 

How we chose the best online therapy platforms

Many criteria were considered when choosing the best online therapy platforms. The most important being the therapist's qualifications and credibility, pricing, ease of use, customer reviews, accessibility and insurance coverage. 

All of the selections on the list have positive user reviews, are easy to use and more affordable than traditional therapy. 

What is online therapy?

Online therapy brings the expertise of mental health professionals to the comfort of your home through phone calls, messages and video conferencing. Each online mental health service will vary in what they offer. For example, some services won't be able to diagnose or prescribe medication as a traditional therapy option could. 

Online therapy isn't for everyone. But it's a good option for people who have inconsistent schedules, tight budgets or aren't comfortable meeting with a therapist face to face. Research has shown that virtual therapy can be as effective as in-office meetings for some. 

Online therapy benefits: 

• Virtual therapy is more affordable and accessible than traditional therapy options. However, not all platforms accept insurance. 
• It's convenient. You can schedule your sessions around work, childcare or other life events that may get in the way.
• Being at your home when you're working in sessions can be more comfortable than going into an office. 

Read more: Tips to Find the Right Therapist For You

Is online therapy secure?

Privacy is one of the most important concerns when seeking online therapy. The American Psychological Association provides specific guidelines that therapists should follow for virtual sessions. One of the most important guidelines states that all online therapy platforms must comply with the Health Insurance Portability and Accountability Act (HIPAA). Whether through video or chat or text, all communication is covered under HIPAA. 

Some virtual counseling platforms take extra levels of precaution and allow you to delete messages after reading. It's important to read the privacy policies of each platform before signing up. This information is often found in the frequently asked questions section of the website. 

How to choose the best online therapy

Finding your ideal match can be difficult with so many options available to you. All platforms will vary in strengths and weaknesses, so it's important to know what your most important needs are. When you're looking for the best online therapy, you'll want to keep a few things in mind:

• Your goal: The first thing you want to check is that the platform includes the issue you want help with. Some platforms are specialized, like in the case of ReGain and couples counseling. 
• The therapists' credentials: You should be able to find the credentials and experience requirements for the platform's therapist. This is often located in the FAQ section of the website. You typically also want a service that allows you to change therapists. 
• User reviews: User reviews can serve as a gauge of the satisfaction of the platform. Did people find the website or app easy to use? What were their favorite features? Were there any pain points you need to watch for?
• Your budget and insurance: The unfortunate truth is that money is one of the main reasons people do not get the help they need. The subscription options and cost should be clearly stated on the website. You also should be able to find insurance coverage. 

Read more: How Cognitive Behavioral Therapy Can Reshape the Way You Think

More support for your mental health

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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What has the pandemic changed people have changed since the pandemic how the pandemic has impacted healthcare how the pandemic has impacted healthcare the pandemic changed health care how has the pandemic changed healthcare how has healthcare changed since the pandemic the pandemic the pandemic institute

The pandemic changed health care, and there's no going back

The pandemic changed health care, and there's no going back

This story is part of The Year Ahead, CNET's look at how the world will continue to evolve starting in 2022 and beyond.

If the pandemic has taught us one thing, it's how to take our health into our own hands. 

We've become our own triage nurse, analyzing a sore throat with such urgency that, in another time, would've been considered a little obsessive. We've been asked to monitor our temperatures and even become citizen public health surveyors with the help of at-home COVID-19 tests. But one day (hopefully soon), the consequences of leaving the house with a sore throat won't mean we're risking someone's life. Soon, our physical health will remain a core piece of our well being, but we'll shake the neurosis of a pandemic mindset – hopefully, keeping our newfound sensitivity to public health and a desire to not harm others in the process.

But will our health care system?

"The pandemic accelerated a lot of changes that were kind of percolating in the background," says Matthew Eisenberg, associate professor of health policy and management at Johns Hopkins Bloomberg School of Public Health. Eisenberg studies how neoclassical economics ("supply and demand") applies to health care. While COVID-19 "catalyzed" many of the changes -- and inequities -- already budding in health care, he said, it will be up to policy makers as well as the supply-and-demand cycle of health care to decide what sticks and what doesn't.

Telemedicine: a thing of the past, or the future?

Video-calls-as-doctor's-visit wasn't a tool created because of COVID-19, but the pandemic has transformed it from an obscure practice to the new way to do health care. Importantly, policy changes made during the pandemic helped knock down some barriers for telemedicine access, and helped providers get paid for it.

Private insurance companies as well as public payers (i.e. Medicare) relaxed their policies on telemedicine reimbursement for health care providers because of COVID-19. As more health care providers get paid for telemedicine (which gives them incentive to provide it), the more supply there is for patients, Eisenberg says. 

"Prior to the pandemic, the only way a Medicare provider could be reimbursed for telemedicine would be if a patient was in a rural area where they could not physically travel to a provider," he says. "Even then, they had to go to a specialized facility and do the telemedicine at some out-patient facility's computer." 

Even through a computer screen, there are roadblocks to accessing health care. Before COVID-19, some patients, depending on where they live and what medical condition they have, would need to drive across state lines to access a specialist (which requires an amount of time and money many patients don't have). The loosening of interstate licensure laws during the pandemic has allowed people to connect with a doctor miles away, and even fill a prescription across state lines. 

Dr. Megan Mahoney is a family medicine doctor and the chief of staff at Stanford Health Care. Stanford Health Care, along with many other providers and organizations, have advocated to keep those restrictions loose once COVID-19 is no longer a public emergency, and the emergency rules no longer apply.

"We have noticed that there are states that don't have a single pediatric endocrinologist," says Mahoney. These specialists treat children with diabetes, for example. "We have a whole team of pediatric endocrinologists."

But in order to participate in telemedicine, you need an internet connection. Mahoney called the bipartisan infrastructure bill, which has a $65 billion budget for expanding internet access to rural communities and helping families pay their internet bill, a "tremendous" help in health care access. In the new virtual health landscape, access to broadband is a "social determinant of health," she says. Some policies and benefits put into place during the pandemic to help families access the internet, like the Emergency Broadband Benefit, were temporary. As broadband continues to mold in its form as a public good, its relationship to health care access will only strengthen.

FS Productions/Getty Images

Sliding into your doctor's DMs

In addition to telemedicine, the pandemic also gave us nearly unlimited access to our doctors' inbox through the patient portal. According to a report published in JAMA, which looked at instant messaging data between patients and their providers from March 2020 through June 2021, the number of patient messages increased, despite fewer patients seeking care in some specialties.

"The sheer demand that we're seeing is very much a testament to the patients' desire for this new channel of care," Mahoney says.  

Even older patients, whose relationship with technology sometimes gets a bad rap, are sending their doctors messages and embracing telemedicine, she says. 

"That was what propelled and accelerated the transformation," Mahoney says. When elderly people, who were originally reluctant to use telemedicine, were forced to use it in order to get care during the lockdown, "that helped them get over that hurdle." 

"What I've noticed is the digital divide, while we do need to be aware of it, it can be overcome and sufficiently addressed through additional education," she says. 

Some of that education for patients requires medical assistants to take on tech support roles. In addition to taking blood pressure and temperature when patients come into the room, they also need to make sure patients are comfortable signing into their patient account and feel comfortable with the technology, according to Mahoney. 

That shift in the patient-provider dynamic, and more direct access to care, is necessary to maintain a system Mahoney says can help people get early intervention and, hopefully, prevent visits to the emergency room.

Many of the messages Mahoney receives from patients involve correcting misinformation patients have heard about COVID-19 -- the type of preventative, education-based work that the current health care structure "does not support," she says. For example, sustaining a more thorough patient-doctor messaging system would require providers be paid for their time consulting with patients off-hours. It also requires online communication to be in the patient's language – a barrier for many people in the US who don't speak English or speak it as a second language. 

"I hope that health care can keep up with this cataclysmic shift that's happening," Mahoney said. "It will have to."

There are arguments against telemedicine as the end-all-be-all. Dr. Thomas Nash, an internist in New York City, told The New Yorker in a June 2020 report that though telemedicine is "doable...I worry that it's going to delay a good exam, and get in the way of deeper interactions between people and their doctors." The informal setting of telehealth may also be less likely to pick up on big issues which routine in-person exams would normally detect, such as high blood pressure, California Healthline reported. And it's more difficult to build an open relationship with your doctor through a screen than it is when you're sitting in their office.

But that also assumes people had a relationship to lose in the first place. As of Feb. 2019, one year before the pandemic began, about one fourth of all adults and half of all adults under 30 didn't have an ongoing relationship with a doctor, according to a report from the Kaiser Family Foundation. This is also a group that shows a strong preference for telehealth, and is the target audience for pre-pandemic care-on-demand services, including Nurx, which allows people to get birth control prescriptions and other medications online, sister sites Hims and Hers, Curology and more.

Sarah Tew/CNET

The great vaccine race 

Scientists impressed the world by moving quickly to develop highly effective COVID-19 vaccines in record time – doses of Pfizer and BioNTech's vaccine, with Moderna's authorized right behind it, were available to the first round of eligible adults in the US less than a year after the the country went into lockdown. According to Nature, the fastest anyone developed a vaccine was for mumps in 1960, and that took four years from development to approval (Pfizer's vaccine for people age 16 and up has full approval by the US Food and Drug Administration, while Moderna and Johnson & Johnson have emergency use authorization). While there's much left to be desired about how the vaccines are distributed and accessed by populations in countries outside the US (only 8.9% of people in low-income countries have had a coronavirus shot), an estimate from the Yale School of Public Health reports the vaccines have saved about 279,000 lives and prevented 1.25 million hospitalizations a s of early July 2021. 

Part of the reason the vaccines were developed so quickly was because research on the technology they use was already underway (the mRNA vaccines were developed using information from HIV research). While the global society has shown we can be very efficient at producing effective and safe vaccines, don't get your hopes up too high that it'll happen that fast again, says Michael Urban, an occupational therapist and program director at the University of New Haven.

"The thing people have to remember is that the federal government pumped tons and tons of money into this development," says Urban. "Globally, not just the United States." 

One reason for that is because COVID-19 had such a prominent impact on our economy. "The fact that this [vaccine] came out is because this is disrupting the fabric of life," Urban says. "How we make money, how we engage with people – how we enjoy our lives."

While it's tempting to hope that because scientists banded together to create a vaccine for COVID-19 and the US government helped fund much of that work it will usher in more resources to find preventative measures and treatments for other diseases, it's unlikely. The incentive for the government to subsidize research and development of treatments for other things that are more individualized, such as cancer or HIV, Urban says, might not be as strong, which leaves it up to the drug companies themselves. And without a public health emergency as transmissible and widespread as COVID-19, it's unlikely drug companies will pour quite as much time and effort into finding treatments.

And when addressing a drug company that profits "billions off of cancer treatments," for example, is it really in the best interest of the company to find an effective preventative measure? 

"If they can do one shot and get rid of cancer, is it really in their best interest?" Urban says. "I hate to say that," says Urban.

Two steps forward, two steps back

In addition to propelling us into trends that've been helpful in health care, the pandemic has magnified our shortcomings and has disproportionately affected the same people who have been mistreated by the medical system for years. Black and Hispanic Americans have been hospitalized with COVID-19, and died from the disease, in much greater numbers compared to white Americans.

Dr. Shantanu Nundy, a primary care physician and author of the book Care After Covid: What the Pandemic Revealed Is Broken in Healthcare and How to Reinvent It, told NPR in a May 2021 report that the pandemic scramble to find a testing site, get a vaccine appointment or access preventative care exposed those who might not have ever experienced it to the perils of health care. 

"The pandemic magnified long-standing cracks in the foundation of the US healthcare system and exposed those cracks to populations that had never witnessed them before," said Nundy in the NPR interview.

Another weak spot exposed because of COVID-19 was the US public health response, and its subsequent communication to the public about what to do when you're sick. When the pandemic struck, public health agencies were relying on "old methodologies" in terms of quarantine requirements and testing rules for COVID-19, Urban says. Compared to other countries, we have issues with containment and quarantine restrictions that don't always prevent people from spreading the virus, he says. The CDC's latest isolation guidance for people who test positive for COVID-19, for example, has been criticized by some for being too relaxed and not requiring a negative test.

In the US, there's a one-and-done mentality. "You do a one-time test, you're cleared," Urban says. "Have a nice day." 

When the next pandemic happens, he says the US is likely still not set up with the structure and tools needed to respond appropriately to a public health emergency. "We didn't learn from the Spanish flu," Urban says. 

An early December report from the Global Health Security Index, an assessment of health security across the globe developed by the Johns Hopkins Center for Health Security and the Economist Impact, backs that up. According to the report, 195 countries across the globe are "dangerously underprepared for future epidemic and pandemic threats, including threats potentially more devastating than COVID-19." 

But importantly, the blame isn't solely on public health agencies, Urban says. The CDC, for example, is "under pressure" to get people back to work and everyday life, Urban says. To do so, the agency has to work within US federal law and the vastly different state and local laws which govern what we can and can't expect people to do.

Looking forward

As we move away from the immediate threat of COVID-19, our appreciation for mental health care is likely to stay. Eisenberg says that we may see specialized mental health services, including some practices that are virtual-only, and some that are a hybrid of in-office and virtual visits. There may also be a shift away from medication treatments for mental health conditions and more provider-focused psychotherapy, Eisenberg finds. 

"It's a small shift, but that could have big implications down the road," he says.

While there are structural and policy changes needed to ensure everyone has autonomy over their health, the pandemic has shifted the way care providers approach health care. Now more than ever, there's an emphasis on public health. 

In an interview with the American Medical Association, Nundy explained the framework he believes is necessary to progress health care after the pandemic. Through the course of the pandemic, Nundy said, doctors "built a muscle" for operating with public health in mind. 

"Let's take that muscle and let's start applying it to diabetes, let's start applying it to mental health," Nundy said. "So much more is possible." 

Correction, Jan. 14: The original version of this story misspelled Shantanu Nundy's last name. 

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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