Best Online Therapy for Teens in 2023

A growing number of Americans are struggling with mental health issues — and that includes kids. More than 2.5 million children in America live with severe depression, and multiracial youth are at greatest risk, according to a 2022 report by Mental Health America. The report also found that more than 15 percent of youth in the United States experienced a major depressive episode in the past year, up from approximately 13 percent the year before.

Unfortunately, many kids with mental health issues don’t get the treatment they need. Indeed: More than 2 in 3 American youth with severe depression don’t receive consistent mental health care, according to the Mental Health America report.

The good news: A growing number of programs offer online therapy for minors. Online therapy helps adolescents acquire the skills and resources they need to feel better and has the potential to relieve the burden of mental health needs in children and adolescents, according to an article published in the journal Child Adolescent Psychiatric Clinics of North America. Here, we’ve rounded up the best online therapy for teens.

• Best online therapy with unlimited messaging for teens: Talkspace
• Best online therapy specifically geared toward teens: Teen Counseling
• Best online therapy for teens that offers medication management: Sesame

We independently investigate and recommend products and services we believe will enrich the lives of our readers and meet their specific needs. We’ve spent many hours carrying out in-depth research on the online therapy market. You can trust our review because we did the legwork for you in these specific ways:

• Engaged in ongoing independent research
• Spent over 245 hours testing eight brands, deployed surveys that included over 200 participants each, and interviewed focus groups
• Went behind the paywall for two months with eight brands to mystery shop our best online therapy choices
• Contacted the brands’ customer service teams to ask questions and gauge responsiveness
• Consulted six leading psychologists and psychiatrists
• Became customers of online therapy providers ourselves
• Reviewed academic research about the efficacy of online therapy versus in-person therapy

Read hundreds of verified customer reviews from trusted third parties such as the Better Business Bureau (BBB) and Trustpilot

Pros

• Ability to send an unlimited number of messages
• Accepts insurance
• Switch therapists at no extra cost; cancel anytime

Cons

• Doesn’t offer psychiatry services for teens
• Negative reviews online mention poor customer service, questionable billing practices, and unprofessional therapists

• Session Types Text-based, audio, or video messaging; no live sessions
• Cost and Payment Options Subscriptions start at $69 per week, billed monthly at $276 per month for messaging therapy plan; prices vary depending on insurance, where you live, and the network availability of therapists in your area
• Accepts Insurance Yes; not covered by Medicaid
• Prescribes Medication No; prescriptions are for adults only

Talkspace, one of the most well-known online therapy programs, offers a special service for teens ages 13 to 17. Through Talkspace, teens can communicate with their counselor asynchronously via text-based, audio, or video messaging — and they can send as many messages as they like. We reached out to Talkspace to confirm how often therapists respond and were told that providers typically respond twice a day and are guaranteed to respond five days a week. The remaining two days are the provider’s days off, and they choose those days at their discretion.

Adolescents who have grown up with technology may find the ability to interact with their therapist via messaging more attractive than interacting in person. The ability to build a relationship with their therapist in a way that is natural and comfortable for them is important because the therapeutic relationship is one of the most important success factors in counseling, according to the National Council for Mental Wellbeing. When we surveyed 200 Talkspace users in January 2023, 62 percent said they liked the non-live unlimited messaging feature and used it often.

The registration process starts with a brief assessment on the Talkspace app or online. Then you can choose from a list of therapists according to gender, days of the week they’re available, and background. Talkspace promises that its therapists return messages five days a week, but the company isn’t transparent about how frequently therapists respond or how often they respond per day. When we surveyed 200 Talkspace users, 61 percent said they were satisfied with their therapist’s responsiveness and 22 percent said they were somewhat satisfied.

It’s worth noting that the platform receives 1.3 out of 5 stars on Trustpilot and 1.09 out of 5 stars with a B rating by the BBB. Negative reviews refer to poor customer service, questionable billing practices, unprofessional therapists, and poor customer service. When we surveyed Talkspace users about their experiences with customer service, 30 percent of those who needed to reach out said they received responses within a few minutes, 37 percent got a response within a few hours, and 26 percent heard back within a day or so. Less than 1 percent waited a week or longer.

Pros

• Network of more than 12,000 licensed counselors
• Financial aid for those who qualify
• Less expensive per month than Talkspace

Cons

• Doesn’t take insurance or prescribe medication
• Some negative customer reviews online cite poor customer service and unprofessional therapists
• Not transparent about qualifications of its therapists

• Session Types Text-based messaging, and live chat, audio, or video
• Cost and Payment Options Prices range from $60 to $90 per week and vary depending on where you live, the network availability of therapists in your area, and financial aid eligibility
• Accepts Insurance No
• Prescribes Medication No

BetterHelp, a popular online counseling service for adults, launched Teen Counseling to provide online counseling specifically for teens. Teen Counseling includes a network of more than 12,000 licensed, experienced counselors who can help teens with issues including anxiety, stress, self-esteem, depression, bullying, eating disorders, relationships, anger, and more. Although a participating therapist’s licensing may allow work with members of all ages, their strengths are in working with adolescents. The company isn’t fully transparent about its therapists’ qualifications; it simply states that individual therapists may list additional training or experience working with adolescents on their Teen Counseling profile to help you and your teen choose a practitioner they feel comfortable with.

Teens are able to communicate with counselors in four ways: asynchronously via text-based messages, or synchronously by chatting live, speaking over the phone, or videoconferencing.

For synchronous sessions between your teen and their therapist, you can schedule one live chat, phone call, or video session per week. For asynchronous sessions, you and your child will each have your own dedicated messaging “room,” which is your private and secure place for communicating with the therapist. You and your teen can each send unlimited messages anytime to the therapist. You’ll be notified by email when the therapist has responded.

Teen Counseling receives 3.4 out of 5 stars on Trustpilot; 6 out of 12 reviews mention poor customer service and unprofessional therapists. The platform isn’t rated by the BBB.

Pros

• Options for video psychiatry consultation, meaning some providers are able to prescribe medication
• Same-day appointments available, depending on location

Cons

• Limited therapist options in some states
• Not specifically geared toward teens
• Doesn’t accept insurance

• Session Types Live video only
• Cost and Payment Options Ranges from $60 to $300 per session, depending on therapist, type of session, where you live, and the network availability of therapists in your area
• Accepts Insurance No
• Prescribes Medication Yes, if seen by a psychiatrist

Sesame is a telehealth platform that connects users with healthcare providers specializing in a variety of issues spanning both mental health and physical health, such as for urinary tract infections, sore throats, rashes, back pain, and cold and flu symptoms. On the mental health front, Sesame offers virtual counseling and therapy services with mental health professionals across the country, including those who can prescribe medication.

To find a mental health professional who provides online therapy for teens in your state, simply enter your location and choose “Video mental health consult” if you’re interested in therapy, or choose “Video psychiatry consult (new patient)” if you’re looking for treatment that includes medication. Next, you’ll see a row of telehealth providers with same-day availability as well as their prices. You’ll also be able to view each provider’s profile to see whether they specialize in teen therapy before you choose.

The video psychiatry consultation includes a psychiatric evaluation and treatment plan, which may include medication. If it does, Sesame may be an affordable option because most pill-based medications start at $5 for 30 pills. Sesame does not list the medications you can get for $5, requiring you to visit the Sesame website and search for the “$5 MEDS” tag to find a provider who can prescribe $5 medication. Prescriptions include free home delivery.

One plus for Sesame is the ability to schedule a one-off appointment to try the platform. When our in-house tester signed up for Sesame, she quickly connected with a therapist for a same-day appointment with no technical issues. She found it was easy to find therapists open to meeting “just to talk” as well as those who were available for long-term mental health needs.

You can also easily cancel an appointment on Sesame should life get in the way, according to our tester's firsthand experience. She liked that she got an email immediately afterward letting her know her card had been refunded for the cost of the appointment. Sesame will provide a full refund when you cancel at least three hours in advance of your appointment.

When it came to customer service, our tester was unable to connect with a real person via live chat and found the irrelevant pop-up FAQs frustrating. But she did get the answers she needed over the phone within five minutes and via email within the same day.

There are several signs that your teen may need mental health support in general, whether online or in person, according to Stephanie Clarke, PhD, a child and adolescent psychologist and the speciality clinic director of the Mood Disorder Clinic at Children's Hospital Colorado in Aurora. Signs include:

• Major changes in behavior, such as withdrawing from family and friends
• Struggling to complete daily tasks that they previously could complete relatively easily, like going to school or practicing proper hygiene
• Big changes in mood or emotions

Additional signs that your teen could benefit from a mental health evaluation, per the National Institute of Mental Health (NIMH), include:

• Desire to spend more time alone than usual
• Low energy or decreased interest in things they used to like
• Dieting, working out excessively, or fear of gaining weight
• Self-harm behaviors, like cutting or burning
• Smoking, drinking alcohol, or using drugs
• Exhibiting risky or destructive behavior while alone or with friends
• Going through periods where they are highly energetic, active, and need a lot less sleep than normal
• Believing someone is trying to control their mind or saying they hear things other people cannot hear

As for whether your teen specifically needs online youth counseling, Dr. Clarke suggests asking a mental health provider whether the mental health issue your teen is experiencing can be managed with virtual care.

Clarke also recommends asking your teen how they’re doing, what they’re feeling, and if they’re struggling with anything. “Offering a nonjudgmental, curious stance in response to this question can help teens confide in parents or caregivers,” she explains.

If your teen is acting in ways that are concerning or saying concerning things (such as having suicidal thoughts), seek mental health help for them immediately, advises Clarke. For emergency scenarios, call the National Suicide Prevention Lifeline toll-free at 800-273-TALK (8255). You also can text the Crisis Text Line (HELLO to 741741) or use the Lifeline Chat on the National Suicide Prevention Lifeline website.

Your teen may benefit from online therapy if they meet any of the bulleted criteria described above. According to the NIMH, research shows online therapy can benefit people suffering from a number of mental health issues, including, but not limited to:

• Attention deficit hyperactivity disorder (ADHD)
• Post-traumatic stress disorder (PTSD)
• Depression
• Anxiety

Teens who don’t have a reliable internet connection, device, or private space at home where they can participate in sessions may not be great candidates for online therapy. Additionally, a systematic review published in the Journal of Medical Internet Research indicated that young people who require intensive treatment for severe mental health problems would benefit better from in-person treatment than online therapy.

Whether online therapy is right for your teen depends on a number of factors, including your teen’s personality and the specific mental health issue they’re experiencing. A mental health provider can tell you whether online therapy is a viable option for your teen’s specific situation.

Online therapy platforms for teens can prescribe medication if the provider your teen sees is a psychiatrist who deems medication management necessary.

Research published in June 2020 in the Journal of Psychotherapy Integration showed that online therapy can benefit people suffering from a number of mental health issues, including teens. A review published in June 2016 in the World Journal of Psychiatry found that telepsychiatry outcomes were equivalent to in-person care. But that doesn’t mean all online therapy is effective for every teen. It’s important to find the right therapist and the right form of therapy to address your teen’s specific concerns.

For some teens, online therapy can help improve mental health issues. But it’s not a one-size-fits-all solution. Understanding the pros and cons of online therapy, as highlighted by NIMH, can help you determine if it’s a good option for you or your teen.

Pros

• Convenience Your teen can participate in online therapy sessions without leaving your home, making it a convenient option that can save time and fit more easily into their schedule.
• Cost Some online therapy sessions can be more affordable than in-person therapy services.
• Broad Reach Online therapy can help more teens access mental health help, particularly teens in rural areas; 1 in 5 children live in a county without a child psychiatrist, according to the American Academy of Pediatrics.
• Fewer Hurdles For some people, mental health is a stigmatized topic, and seeking help online can be easier than seeking traditional in-person services.

Cons

• Requires Reliable Technology Online therapy platforms require a reliable internet connection and either a smartphone, tablet, or laptop. This can limit who is able to participate in online therapy.
• Presents Privacy Concerns Online therapy can be more difficult for teens without a private space at home, as they may feel less inclined to speak freely during sessions if they think others are able to hear them. Moreover, cameras at home and the security of virtual online platforms can raise privacy concerns.
• Not Always Covered by Insurance The pandemic ushered in changes to insurance policies that increased access to online therapy, but it’s unclear how long these changes will last, according to the NIMH. Moreover, some insurance carriers are vague about what mental health services they cover.

There are a lot of factors to weigh when deciding which online therapy option (if any) is right for your teen. Things to consider include:

• Price The cost of online therapy for teens varies from program to program, so take your budget into consideration before committing.
• Therapist Credentials Make sure the therapy your teen will be receiving is provided by a licensed therapist, says Leslie Miller, MD, an associate professor of psychiatry and behavioral sciences and the director of the Mood Disorders in Adolescents and Young Adults Program at Johns Hopkins University School of Medicine in Baltimore. “I think it’s important to see the criteria of the person who you (or your teen) are going to be seeking treatment with to make sure that they have the training to teach the therapy and the skills,” Dr. Miller explains. Ask any potential therapist what their training has been, what their experience is, and what their areas of expertise are, adds Clarke. Their answers can help you determine if they’re a good fit for your teen.
• Type of Therapy Make sure the therapy you’re considering is evidence-based and that it teaches your teen skills for coping with their mental health issue, says Miller. Examples include cognitive behavioral therapy, dialectical behavioral therapy, and interpersonal psychotherapy, among others, according to the Society of Clinical Child and Adolescent Psychology. The therapy should also include ongoing assessments that track your teen’s treatment progress, as this can help you understand whether the type of therapy is working, whether medication could be helpful, and whether your teen would benefit from switching to a new therapist or form of therapy, Miller explains.
• Home Space It’s important to have a private space in your home where your teen can participate in their therapy session without worrying about other people listening in or distracting them. Before you commit to online therapy, think through your living situation and make sure you have the right physical space.
• Reliable Technology Ensure you have both a reliable internet connection and a functioning electronic device so your teen can participate in sessions without technical difficulties or interruptions.
• Parent or Caregiver Involvement Understand how much involvement you will have in your teen’s therapy program. Instead of opting for online therapy for minors without parental consent, both Miller and Clarke recommend some level of parent or caregiver involvement. You don’t need to know everything that your teen tells their therapist, but being looped in on some level can help you support your teen in learning new mental health coping skills and also help you stay aware of their progress (or lack of progress) over time.

It’s also important to note that each U.S. state has certain requirements regarding whether teens need parental consent to start therapy. Some providers may request your consent before consulting with your teen. Additionally, some states prohibit mental health providers from sharing information discussed during teen counseling sessions without a signed consent form. If you want to be involved in your teen’s therapy, be aware that your provider may not be legally allowed to share private information discussed during sessions with your teen.

Make sure your teen has a quiet, private, and distraction-free environment where they can participate in the appointment, says Clarke. It’s also a good idea for the parent or caregiver to be available during the virtual session, either via phone or on-site (for instance, at home).

Our reviews team extensively scrutinizes online therapy platforms to make sure we only recommend those we believe will make a difference to our readers. Together, we’ve researched prominent brands by mystery shopping apps and platforms, understanding the experiences of real customers, and consulting with independent experts to better understand why people seek out online therapy for teens. Our method includes going past the paywall to test therapy platforms for ourselves, conducting in-depth interviews with focus groups, and deploying surveys to gain real customer insights.

We used our collected data to develop a scorecard to evaluate the platforms we tested ourselves. Read more about how we researched and tested online therapy platforms in our online therapy review methodology.

A growing number of programs offer online therapy for teens, and they’re not one-size-fits-all. When determining the best online therapy services for your teen — whether you’re considering teenage anxiety therapy, teenage depression therapy, or other forms of treatment — it’s important to consider a variety of factors, including the mental health issue your teen is struggling with as well as your budget, home situation, and access to technology.

If you’re looking for adolescent therapy online that prescribes medication, you may want to consider Sesame. And if you want the best online therapy for sending messages to a therapist as issues arise throughout the day, we suggest checking out Talkspace. Another option is Teen Counseling, which offers a network of counselors who have additional experience working with teens.

If your teen is in crisis, waiting for an online therapy appointment may not be safe. In case of an emergency, call 911. That includes plans to harm themselves or others. If your teen is having suicidal thoughts, you can call the 988 Suicide and Crisis Lifeline by dialing 988. Help is available 24/7. You can also send a text message to the Crisis Text Line at 741741. A crisis counselor will respond via text to help your teen stay calm and make sure they’re safe.

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