We Put the Top Online Therapy Platforms to the Test: Here Are the Results

This content is researched and written based on extensive testing by an external reviews team and does not reflect the views or opinions of Everyday Health’s editorial team. Everyday Health may earn a commission from purchases of products featured in this article.

As mental health professionals work to keep up with the increased demand for mental health care, online therapy has provided a new way for people to access the care they need, according to the American Psychological Association (APA) Practitioner Impact Survey. Considering the number of online therapy services available, though, it’s important to choose the right one for your needs.

To provide clarity for those looking for online therapy, our reviews team went behind the paywalls and put some of the most popular platforms to the test. We conducted online therapy testing and became users of these platforms for more than two months, in addition to surveying more than 1,600 online therapy users and conducting two focus groups. We then scored each platform based on the data we compiled about cost, user experience, customer service, and any special features they offered. In this article, we detail the results of our research, our experiences as users of the platforms, and what users should know about the top online therapy platforms.

The demand for treatment for anxiety, depression, substance use disorders, and trauma-related disorders increased between 2020 and 2022, according to the APA Practitioner Impact Survey. 65 percent of psychologists surveyed reported an increase in the severity of symptoms among their patients in 2022. Yet, 28 percent of U.S. adults with a mental illness are not able to receive the treatment they need, according to Mental Health America (PDF), with affordability, provider availability, and insurance coverage the major barriers. According to Vaile Wright, PhD, senior director of the Office of Health Care Innovation at the APA in Washington, D.C., online therapy provides opportunities to reduce those barriers. In fact, the APA survey found that 97 percent of psychologists surveyed agreed that telehealth had proven its worth as a therapeutic tool during the pandemic, and that 96 percent intended to continue offering telehealth visits as an option for patients moving forward.

Caleb Birkhoff, licensed marriage and family therapist in San Francisco, says that online therapy makes it easier for individuals to find a licensed therapist in their state who is a good fit for them or has expertise in a particular therapeutic area, instead of being limited to the practices within an area they can reasonably drive.

Knowing that many clinicians intend to continue providing teletherapy options, and that telehealth has the potential to expand access for those looking for therapy, we tested online therapy ourselves to gather reliable data on some of the most popular teletherapy platforms. We tested and researched to find out what real users may encounter on these platforms and detailed all the pros, cons, and special features included to help users find out if online therapy is right for them.

We tested eight of the most popular platforms that offer online therapy, including platforms with unique services like psychiatry and relationship therapy.

We designed our testing criteria to better understand a user’s experience on each online therapy platform. We gathered data from real customer experiences and became users ourselves.

We surveyed 1,600 online therapy users to find out more about their experiences with the platforms. We asked questions about the customer service, cost, how they communicated with their therapists, and which features they used and found useful.

We then conducted in-depth focus group interviews with 16 individuals who have used or were considering using online therapy platforms. We took a deep dive into their experiences with the platforms in comparison to in-person therapy and the impact that online therapy had on their lives.

We also explored the platforms extensively before becoming real users. We signed up for each of the platforms, got paired with therapists, and tested out all the features available to users over the course of more than two months. Because therapy itself is a highly individualized experience, we focused our testing on how the platforms worked and if they helped individuals access mental health care, rather than rating each therapist we engaged with. Our testers took note of the availability of therapists on the platform, special features or extra resources they found, their customer service experience, and any technology issues they encountered.

We developed a scorecard that compared each of the platforms across four major categories: cost; customer service; user experience; and special features. We assigned scores and weights to each category based on published research and our own research from interviews, surveys, and tester insights. Each category is composed of subcategories. For example, the cost score evaluated the monthly cost of therapy on the platform and considered discounts, financial assistance programs, total membership costs, and whether the platform accepted insurance.

Comparing the Brands We Tested

The average overall score among the brands we tested was 3.62 out of 5 stars. Brightside Health (Brightside) earned the highest overall score of 4.13 out of 5 stars, and Sesame Care (Sesame) received the lowest overall score of 2.7 out of 5 stars.

Affordability was one of the largest factors in our testing, as cost is one of the most significant barriers to receiving mental health care, as reported by a study published in September 2021 in the journal SSM - Population Health. Platforms that offered different ways of making online therapy more financially accessible scored higher in the cost category. For example, Brightside accepts insurance, and BetterHelp offers a financial assistance program that may help lower the overall costs an individual can expect to pay for online therapy.

Since the costs of online therapy on Sesame and Zocdoc can vary widely based on the provider, those platforms scored lower compared with platforms that may have fixed costs for sessions with their providers. The average cost of a live therapy session among the platforms we tested was $82.29, based on monthly subscription plans with one live therapy session per week.

Special features like online worksheets, reflection tools, and workshops earned platforms such as Online-Therapy.com and ReGain extra points. Limited provider availability and in-app bugs that disrupted therapy sessions decreased points for Sesame and Calmerry, respectively.

BetterHelp

BetterHelp earned an overall score of 4.01 out of 5 stars, which was above average. Despite not accepting insurance, it offered a financial assistance program to help make it more affordable. We found the platform was easy to navigate, and it included extra features like group sessions and an online journal. Users could connect with their therapists through live video, phone, or chat sessions through the platform. They can also send an unlimited number of messages to their therapist between sessions, and their therapist will respond when available. BetterHelp offers one plan option, which is a monthly subscription that provides users with four live therapy sessions.

BetterHelp Features

• Four monthly live therapy sessions
• Unlimited messaging with your therapist
• Online worksheets
• One group session per week
• An online journal

BetterHelp offers group sessions along with its monthly subscription for online therapy. These weekly sessions are facilitated by licensed therapists over Zoom and last 90 minutes. Each session can have up to 18 participants. According to BetterHelp, group sessions are meant to be spaces for group support where individuals can connect with others experiencing similar mental health challenges.

Read our full review of BetterHelp for more information about what’s included in the platform.

What Users Say

According to our research, the ability to choose the right therapist was a top priority for users engaging in online therapy. Those who responded to our reviews team's April 2022 survey of 1,000 online therapy users, as well as those surveyed in our January 2023 survey of 200 BetterHelp users, indicated that choosing their therapist was the second-most important feature in an online therapy platform.

BetterHelp has more than 31,000 therapists across all 50 states on the platform. Our reviews team tester was pleased with their therapist match, but some of our BetterHelp focus group participants indicated that they had to try a few therapists to find the right match. One participant shared that they spent the first month essentially testing out therapists. Although BetterHelp makes it easy to switch therapists, you have to complete a new questionnaire each time and schedule appointments with the new therapist. "So you've essentially not had any good therapy progress, and all you've done is had conversations vetting therapists," the focus group participant said.

Despite this, the BetterHelp users we interviewed found it was an easy process to switch therapists. In our January 2023 survey of 200 BetterHelp users, 77 percent of respondents switched therapists on the platform, and 67 percent of them found it was easy and convenient.

Brightside Health

Brightside had the highest overall score across our testing categories. It earned an overall score of 4.13 out of 5 stars, compared with an average of 3.62 out of 5 stars across all platforms. Its live therapy session plans had a lower-than-average cost-per-session, and the platform accepts insurance. Brightside included extra features such as an anxiety and depression progress tracker, and online learning modules called lessons.

Brightside Features

• Options for psychiatry, therapy, or both
• Therapy plans include four live sessions per month
• Unlimited messaging with your therapist
• Mental health learning modules
• Anxiety and depression progress tracker

While Brightside earned high scores for “Cost” and “Customer Service,” the platform’s user experience fell short compared with the other online therapy platforms we scored. Instead of choosing your own therapist from a list of matches, the platform matches you to a therapist. When switching therapists, users must contact customer service to get matched with another provider.

Brightside has an iOS mobile app, but it doesn’t have an Android mobile app. The live sessions with therapists are held through Zoom. Although Brightside is accessible using an internet browser on a computer, tablet, or smartphone, users still need to install Zoom if they want to attend a live session.

Brightside was one of the few platforms we tested that accepted insurance. Users can use its insurance checker tool during the sign-up process to check the eligibility of their insurance plan.

Brightside offers plans with psychiatry (for medication management), therapy, or both. It was one of our top picks for the best online psychiatry providers. You can read more about the platform’s plans, pricing, and features in our full review of Brightside.

What Users Say

Despite not being able to choose your own therapist, our tester and the Brightside users we surveyed reported positive experiences with their matches and the therapist-switching process. In our January 2023 survey of 200 Brightside users, 78 percent of users switched therapists while using the platform, and 74 percent of those who switched therapists found it to be an easy and convenient experience. Our tester agreed: Even though they needed to contact customer service to request a new provider, they were rematched with a new provider within 24 to 48 hours.

A unique feature of Brightside is the ability to track your anxiety and depression symptoms in your account dashboard. In our survey of 200 Brightside users, 75 percent of respondents indicated that they liked the feature and found it useful.

Through testing, we found that the platform offers a series of self-guided lessons that take about 10 minutes to complete. These lessons help individuals learn more about their mental health. For example, a lesson called “Breaking the Cycle” asks individuals to think about any habits they may have created to cope with uncomfortable emotions. Therapists may review the lessons' activities and question prompts with users during therapy sessions. In our survey of Brightside users, 65 percent of respondents liked the lessons and used them often.

Calmerry

Calmerry earned an overall score of 3.48 out of 5 stars. The cost per live therapy session was higher than average, and the platform doesn’t accept insurance. Its reflection and journaling chatbot is an easy-to-use special feature. The platform’s customer service can be reached by live chat, phone, or email, 24/7. Its customer service scored above average with a full 5 out of 5 stars, and the platform was one of our best online text therapy platforms.

Calmerry Features

• Three plans, two with live therapy sessions
• Unlimited messaging with your therapist
• Reflection chatbot
• Mood tracker calendar
• Online journal
• Anxiety and depression symptom tracker

The Calmerry platform has a few special features to supplement its online therapy. The reflection chatbot, named Coa, checks in with users daily and asks them questions about their mood, physical symptoms, and any activities they have planned for the day. Mood entries are tracked in a mood calendar. Users can add journal entries in the reflection tool and choose whether to share them with their therapist.

Its messaging therapy plan was one of the more affordable therapy options from those that offered monthly subscriptions. But Calmerry plans with live sessions cost more than similar plans from the other platforms we researched. For example, a plan with four monthly live therapy sessions is $360 per month on Calmerry, making it the second most expensive after Talkspace, which costs $396 per month.

Read more about the platform’s plans and pricing in our full Calmerry review.

What Users Say

Our tester and one of our focus group participants encountered technical difficulties when using the Calmerry platform. If therapists start the session late, they may get logged out of the room 30 minutes after the scheduled appointment time, which interrupts the ongoing 30-minute session for the user. On a positive note, Calmerry adds an extra 15 minutes to your visit for free if your session doesn’t start on time. There was an instance when our tester's appointment didn’t appear on the therapist’s calendar, almost causing them to miss a session.

Interacting with the platform through a web browser may require some patience. For example, when our tester clicked to check in for their appointment, nothing happened. They needed to reload the page to try a few more times to continue with the session. Our tester reported that the Calmerry mobile app was more responsive.

Like Brightside, Calmerry matches you with a therapist. Users who want to switch therapists must contact customer service to get rematched with another provider.

Despite this, our tester found that customer service was always prompt and polite when it came to addressing their issues. Important requests, for example, switching therapists and canceling the subscription, were addressed quickly with no issues.

Online-Therapy.com

Online-Therapy.com earned an overall score of 3.96 out of 5 stars. All of its therapists are trained in cognitive behavioral therapy (CBT), a type of psychotherapy that helps individuals change unhelpful thinking and behavioral patterns, according to the APA. The platform includes specialized digital resources to support the online delivery of CBT, including lessons, yoga and meditation videos, CBT worksheets, and a journal. Online-Therapy.com was our best overall pick in our review of the best online CBT platforms.

Online-Therapy.com Features

• Three plan options, two with live therapy sessions
• Unlimited messaging with your therapist
• Eight learning modules with digital worksheets
• An activity log
• A digital journal
• Yoga and meditation videos

Online-Therapy.com matches users with their therapist. As with our Brightside and Calmerry testers, our Online-Therapy.com tester needed to switch from the therapist they were first paired with. The first therapist our tester matched with was not able to take on new clients, so it was apparent that the platform didn't consider therapist availability when matching. The need to switch therapists creates an extra step for users, which isn't ideal if they want to get started with a therapist as soon as possible.

The process to switch therapists was easy, and Online-Therapy.com provides a list of therapists to choose from.

The platform included extra resources beyond self-guided work. Therapists review your completed worksheets and reply with comments or points to follow up on during your next live session. This feedback can be helpful if you prefer more professional guidance when reflecting, learning new skills, and putting them into practice.

Among the platforms we researched, the average monthly subscription cost was $329.17 for plans with four live sessions per month. The Online-Therapy.com plan with four live sessions costs slightly less at $320, and Online-Therapy.com helps users get the sessions that they pay for. We found that customer service can help you carry over live therapy sessions to the next month if you didn’t schedule or use them.

We detail all of the plans and features of the platform in our review of Online-Therapy.com.

What Users Say

You can find details and pricing on Online-Therapy.com plans without having to sign up for an account. But if you had any questions, the only way to reach customer service was through email. When our Online-Therapy.com tester reached out for account help, they received a prompt answer to their question. In our survey of 1,000 online therapy users, 82 percent of Online-Therapy.com users responded that they had a positive or mostly positive experience with the platform’s customer service.

ReGain

ReGain earned an overall score of 3.7 out of 5 stars. This online relationship therapy platform has licensed therapists who can support couples and offer marriage counseling. Like BetterHelp, its parent company, there is one subscription option that gives you and your partner access to the platform. ReGain does not accept insurance, but has a financial assistance program for couples who meet its eligibility requirements. Extra features include an online journal, online worksheets, and group webinars called Groupinars for couples to attend.

ReGain Features

• Four monthly live couples therapy sessions
• Unlimited messaging with your therapist
• Online worksheets
• Group webinars
• An online journal

The platform offers an online journal for each partner, who can decide whether to share their entries or keep them private. All shared entries are visible to both the therapist and the other partner. Groupinars are group webinars that couples can attend to get further support along with their therapy sessions. They cover topics including anxiety, depression, skill building, relationships, and more.

Read more about the platform’s relationship counseling in our review of ReGain.

What Users Say

In our survey of 1,000 online therapy users, ReGain users indicated that the top five most important features they looked for were:

1. Appointment times outside of work hours or on weekends
2. A cost that was within their budget
3. The ability to choose their therapist
4. The ability to switch therapists
5. A provider was specially trained in the area they needed help

ReGain fell short on its user experience score when we put these survey insights to the test. Similar to BetterHelp, ReGain users are first matched with their therapists, then they have the option to choose a new therapist if they want to switch. Our testers found it difficult to find a therapist who fit their needs, even after contacting customer service for help. As a result, our testers were unable to attend four live sessions with a therapist within the two-month timeframe of our testing. The therapists they were matched with either didn’t specialize in the area they requested help in or didn’t have appointment availability that fit their schedules.

The APA states that therapists are required to be licensed in the state their clients reside in, even when providing teletherapy. Relationship therapy on ReGain is conducted by licensed therapists, but our testers weren’t always matched to therapists who were licensed in their state, even when customer service stepped in to help.

Finally, our testers encountered technical difficulties with the ReGain platform. A live video session was interrupted and cut short when the session was disconnected.

Sesame Care

Sesame scored 2.7 out of 5 stars overall, the lowest score among the platforms we tested. Online therapy on this platform is straightforward without any frills. It doesn’t offer unlimited messaging or extra resources like worksheets or learning modules for mental health. Sesame offers psychiatry and couples therapy in addition to individual therapy sessions on the platform. The cost of sessions varies by provider, and it doesn’t accept insurance.

Sesame shows the appointment availability of providers licensed in your state. Our tester was able to find and book a same-day appointment on the platform. Attending online visits, canceling appointments, and switching therapists on Sesame was uncomplicated.

We found that the availability of providers on Sesame varies based on the user’s location. For example, one of our testers was unable to find any online therapy providers licensed in their state and, as a result, could not continue testing the platform.

Users can see the cost of a session with a provider even before creating an account. For example, a video therapy session for a user in New York state can cost between $80 to $170. Sesame Plus is the platform’s yearly membership that costs $10.99 per month or $99 per year. This subscription provides a discount for the cost of each online therapy session by $20.

Read more about the platform and Sesame Plus in our full review of Sesame.

What Users Say

Users on Sesame can book and pay for one or more appointments at a time. Providers may request a follow-up if users indicate they’d like to receive ongoing care. Our tester was able to receive mental health care in an as-needed capacity without the pressure to book again. This can be helpful for individuals who are looking to try out a therapist or online therapy without the commitment of a monthly subscription.

Although users can contact Sesame customer service through live chat on the website, we were unable to connect with a live agent on multiple attempts and had to submit our questions by contact form instead. We received a reply through email within a business day. Sesame also has a customer service phone number users can call.

Talkspace

Talkspace earned an overall score of 3.58 out of 5 stars, slightly below the average overall score of 3.62 out of 5 stars. The platform accepts insurance, but its monthly plans cost more than the average of all the platforms we tested. Similar to BetterHelp, Talkspace has extra features like group workshops and unlimited messaging. Unlike BetterHelp, users can sign up for couples therapy and psychiatry in addition to individual therapy on Talkspace.

Talkspace Features

• Plans with four monthly live therapy sessions
• A plan that includes access to group workshops
• The ability to add psychiatry sessions for an added cost
• Unlimited messaging with your therapist
• A symptom and goal tracker

Talkspace offers a variety of plan options that we detailed in our full Talkspace review. One of its plans includes access to live group workshops. Subscribers of this plan can attend group workshops that cover a variety of topics, including relationship guidance and parenting.

The symptom and goal tracker on Talkspace is a feature the therapist activates and manages. After a few sessions, therapists can work with users to create goals or set symptoms to track over time. The symptoms, short-term goals, and long-term goals can be helpful touchpoints to keep track of progress.

What Users Say

Talkspace advertises that its providers are in-network with most insurance plans, yet we found that coverage may vary. Talkspace lists quite a few insurance plans in its intake form, but it doesn’t mean that the platform is in-network with the insurance plans listed.

In our reviews team’s January 2023 survey of 200 Talkspace users, respondents indicated that the most important feature of an online therapy platform was the ability to choose their therapist. Unlike BetterHelp, ReGain, and Online-Therapy.com, which match you with your first therapist, Talkspace allows you to choose your therapist from the start from a list of your top matches. Our Talkspace tester found a good fit with the first therapist they chose.

Switching therapists was an easy process, but choices may be limited. Talkspace allows you to choose a new provider from a selection of matched therapists that specialize in the area that you need help with. Our tester was only able to go through nine matches before Talkspace suggested they contact customer service to help with their therapist search. When we surveyed Talkspace users, 65 percent of respondents switched therapists, and 70 percent of respondents who switched found it an easy and convenient process.

Talkspace has a response guarantee for its unlimited messaging, where therapists are guaranteed to respond during the five days a week they are working on the platform. Our tester confirmed that they received responses from their therapist at least once daily when their therapist was available. When we surveyed Talkspace users, 83 percent of respondents indicated they were satisfied or somewhat satisfied with their therapist’s responsiveness.

The only way to contact Talkspace customer service is through email or by filling out a contact form on the website. In our survey of Talkspace users, 70 percent of respondents received a resolution from customer service within a business day or sooner. When our testers had questions about the platform, they typically received a response within a few business days.

Zocdoc

Zocdoc earned an overall score of 3.44 out of 5 stars. Like Sesame, the cost of Zocdoc online therapy sessions varies by provider. Users on Zocdoc are able to filter for providers who are in-network with their insurance plans. Some therapy providers offer sliding scale rates. The platform has many different types of providers, including providers for individual online therapy, psychiatry, couples therapy, and group therapy. Users on Zocdoc can choose a therapist who specializes in the specific area they’re looking for help in. Same-day appointments are available on the platform and vary by provider.

Since providers are responsible for maintaining their own Zocdoc profiles, the accuracy of appointment availability, pricing, and in-network insurance may vary depending on the provider. The provider sends a confirmation of your appointment through Zocdoc to let you know if your appointment has been booked successfully. This means it's more like requesting appointments than booking them directly.

Sessions with Zocdoc providers can be conducted on the platform using a web browser or mobile app. Zocdoc providers may also conduct their sessions through external platforms like Doxy.me or Zoom. The provider will indicate their chosen platform on their provider profile.

Zocdoc works with provider networks such as Grow Therapy. For these providers, this means that users can request an appointment through Zocdoc, but payment and appointment details are provided by the provider network. We reviewed online therapy on Zocdoc to explain the booking process in-depth.

What Users Say

Our reviews team tester reported that finding and switching therapists were easy on Zocdoc. Because they booked with a Grow Therapy provider, Zocdoc customer service could not help with modifying their appointment, though. We learned that once the appointment is confirmed, users should be communicating with the provider or provider network directly for further information or assistance with billing, insurance, and cancellations.

*All scores are out of five.

Our testing revealed strengths and weaknesses of the online therapy platforms we reviewed. We found Brightside, BetterHelp, Online-Therapy.com, and ReGain performed above average, whereas Talkspace, Calmerry, Zocdoc, and Sesame performed below average in our testing.

Brightside, BetterHelp, Online-Therapy.com, and Talkspace are all platforms dedicated to providing online mental health care that earned balanced scores between all the testing domains.

Calmerry and ReGain fell short on user experience after we factored in our testing insights.

Platforms with a la carte therapy appointments, Zocdoc and Sesame, lacked the special features available with subscription-based online therapy platforms and had variable costs for their sessions.

Research on online therapy is still in progress, but the literature published in the last five years lends some support to online therapy and its potential for delivering mental health care.

Shauna Pollard, PhD, a licensed clinical psychologist in Atlanta, says efficacy can depend on the type of therapy delivered online. Dr. Pollard says that CBT, for example, lends itself well to the online platform. A systematic review published in the journal Cognitive Behavioral Therapy found that online therapy, specifically online CBT, was just as effective as in-person therapy. In addition, a systematic review published in June 2020 in the journal eClinicalMedicine found that online CBT was more effective than in-person therapy for depression.

A review published in September 2020 in The American Journal of Psychiatry says that, with the exception of online CBT, much of the research in support of teletherapy has been for live audio (phone) sessions. The evidence base for live video sessions is still developing.

Dr. Wright of the APA says that although there have been published studies on the efficacy of live, or synchronous therapy sessions, research for asynchronous text therapy is lacking. This can be important when considering messaging therapy plans from some of the online therapy platforms we tested. Wright says that clients and therapists using text therapy may lose out on clarity, timeliness, rapport-building, and non-verbal cues that come with synchronous sessions.

As a result, she suggests that text therapy may be better suited for individuals with less severe mental health concerns, who don’t need a high level of interaction (as with live or in-person sessions) and can benefit from the occasional reminders to engage in healthy coping skills. A small study published in the journal Telemedicine and e-Health found that messaging therapy for 15 weeks had a clinical benefit for individuals with a variety of mental health disorders.

“Whether clients are getting care online or in-person, the quality of care provided by a therapist should be the same,” says Carrie Ditzel, PhD, director of geropsychology and neuropsychology at Baker Street Behavioral Health in Franklin Lakes, New Jersey. Dr. Ditzel says that therapists should use the same tools, quality of communication, and coordination of care online as they would in person in order to ensure that a patient receives high-quality, individualized care.

If you are in crisis, waiting for an online therapy appointment is not safe. In case of an emergency, call 911. This includes plans to harm yourself or others. If you’re having suicidal thoughts, you can call the 988 Suicide and Crisis Lifeline by dialing 988. Help is available 24/7.

You can also reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-HELP (4357). The SAMHSA helpline is a free, confidential, 24/7, 365-days-a-year treatment referral and information service for individuals facing mental or substance use disorders.