BetterHelp Review: We Tried the App with 7 People—Is It Reliable?

As one of the largest online therapy companies, chances are you’ve heard of BetterHelp. With over 27,000 therapists in its network, the company says it has helped over three million people access virtual therapy across the U.S. and in over 200 countries. And there is no question, given its reach, that the company has changed the landscape of this business in its attempts to make affordable, convenient therapy available to more people.

But just because the company is the biggest doesn’t mean it’s the best—and there have been quite a few competing online therapy companies that have shown up in the past few years. So we decided to test BetterHelp ourselves: we asked seven people to test the service in order to get a sense of how well the company served people in different locations, with different budgets, and with different therapy needs. 

We tested BetterHelp’s services in Missouri, Massachusetts, California, New York, Kansas, and even the UK. From stay-at-home moms to mental health professionals, we represented all walks of life and were each looking for different kinds of help, turning to BetterHelp for support with everything from parenting to ADHD.

In addition to our own testing, we also surveyed 100 current and past BetterHelp users, sent the company a questionnaire, and interviewed three therapists employed at the company. We also worked with three subject matter experts—Dr. Amy Marschall, PsyD, Dr. Nic Hardy, PhD and LCSW, and Hannah Owens, LMSW—to assess the company’s strengths and weaknesses. The best thing about BetterHelp is its availability across the US and 200 countries (which we highlighted in our 2023 Online Therapy + Wellness Awards), but other than that, we didn’t think there was much to write home about. Here’s how BetterHelp fared in our review.

Key Facts

Price: $280 to $400+ per month
Is Insurance Accepted? No
Type Of Therapy: Individual Therapy
Communication Options: Messaging, Phone, Video Chat
Is There an App? Yes

What Is BetterHelp?

BetterHelp is an online therapy company established in 2013, specializing in counseling for individuals across the United States and over 200 countries. It does not offer psychiatry services or group or family therapy, but if you’re looking for couples therapy or therapy for teens, you can sign up for its sister sites ReGain (for couples) and Teen Counseling (for teens).

The company says it can provide therapy for a number of mental health conditions, including:

• Stress
• Anxiety
• Relationship issues
• Family conflicts
• Aging and geriatric issues
• Grief
• Depression
• Trauma and abuse
• Intimacy-related issues
• Parenting issues
• Anger management
• Self-esteem
• Coping with life changes
• Compassion fatigue
• ADHD

How Much Does BetterHelp Cost?

BetterHelp only offers one subscription plan (unlike many of its competitors like Talkspace and Brightside) which costs $70-$100 per week, though you’re billed monthly. 

The reason the price is listed as a range—despite there only being one plan—is because the company told us it partakes in surge pricing. This means the cost of services changes based on where you are and how much demand there is for mental health care at any given time. When we signed up, we were indeed quoted different prices: for example, in New York, we were quoted $90 per week, whereas testers in less urban areas (such as Missouri and the UK) were offered the same services for $80 and $70, respectively. 

We found this practice of surge pricing troubling. “Raising costs of mental health care based on demand makes affordable and accessible care even more difficult for therapy seekers, many of whom are already faced with barriers to care because of cost,” explains Hannah Owens, LMSW and Mental Health Editor for Verywell Mind. “It’s akin to a hospital charging more for cancer treatment because there are more cancer patients seeking treatment at that time.”

Health insurance can increase people’s access to mental health care by lowering the cost. In the U.S., the average cost of therapy ranges from $60 to $200 per session. If you do use insurance for therapy, a session could have a copay as low as $20 to $40, which is more affordable than BetterHelp’s subscription plans. 

However, BetterHelp does offer financial aid for students, veterans, and low-income therapy seekers. If you are hesitant about trying BetterHelp, it usually offers promo codes for new users on their first month's subscription. In fact, Verywell Mind readers can get their own discount. 

Of the 100 BetterHelp users we surveyed, 74% found the service to be affordable or very affordable, and 93% rated BetterHelp’s value for the money as good, very good, or excellent.

Signing Up for Therapy at BetterHelp

We thought that BetterHelp’s website was easy to use. When we landed on the homepage, we were greeted with the words “You deserve to be happy;” below that, we were asked what type of therapy we were looking for (individual, couples, or teen, the latter two of which redirected us to ReGain and Teen Counseling respectively). BetterHelp's intuitive dashboard allowed us to manage sessions and track our progress conveniently. And most of our surveyed users agreed, with 95% saying they found it easy or very easy to navigate the site.

The sign-up process for BetterHelp is actually pretty long: It took us about 20 to 30 minutes to complete, so make sure you set aside time to finish it. If you stop mid-sign-up and exit your browser, it will not save your answers and you’ll have to start all over again (something we discovered first-hand). 

To get started, we were asked a series of questions about our gender identity, age, sexual orientation, and relationship status. It is worth noting that the company provides a variety of choices for describing gender identity and sexual orientation. For instance, under “gender identity,” we could choose from “woman,” “man,” “non-binary,” “transfeminine,” “transmasculine,” “agender,” “I don’t know,” “Prefer not to say,” and “Other.” In detailing our sexual orientation, we were given the options of “straight,” “gay,” “lesbian,” “bi/pan,” “Prefer not to say,” “Questioning,” “queer,” “asexual,” “I don’t know,” and “Other.” We very much appreciated how inclusive this section of the intake process was, and it gave us confidence that we would be matched with a therapist who understood our identities.

We were also asked if we were religious and, if yes, which religion we identified with. If we answered that our religion was Christianity, we were then asked, “Would you like to be matched with a Christian-based therapist?” 

However, if you answer that you identify with a different religion other than Christianity, you won’t get asked if you want to match with a therapist of that faith. We tried answering this question a few different times, each time saying we were from a different religion, and never got that same follow-up. That being said, the only options for “Which religion do you identify with?” are Christianity, Judaism, Islam, and Other.

After the questions about our identity and religious affiliation, we were asked to complete questions about our mental health history, such as whether we had ever been in therapy before and what led us to therapy today. Options for what led us to therapy included “I’ve been feeling depressed,” “My mood is interfering with my job/school performance,” “I am grieving,” and 10 other choices. Then, we were asked what our expectations were from our therapist, such as a therapist who listens, explores our past, teaches us new skills, assigns us homework, and more.

The platform also asked us to rate our current physical health and eating habits as good, fair, or poor. (This holistic attention to different aspects of our health did not go unnoticed.)

Then, we were asked if we were experiencing overwhelming sadness or depression. Following this, there were a few questions from the Patient Health Questionnaire, or the PHQ-9, an assessment used to screen for depression. In addition to depression, it asked if we were experiencing anxiety, panic attacks, or chronic pain. Other demographic questions include how we would rate our current financial status on the same good, fair, or poor scale. We were asked if we were currently employed, reported how often we drink alcohol, and rated our sleeping habits. Other screening questions towards the end included if we had any problems with intimacy and when the last time we thought about suicide was—if ever. Though we appreciated the thoroughness of the intake questionnaire, we felt like it was a little random and disorganized.

At the end of the questionnaire, we specified how we preferred to communicate with our therapist, whether through mostly messaging or mostly phone/video sessions. We could also indicate specific preferences for our therapist, such as their gender, whether they are Christian or non-religious, and whether they are a member of the LGBTQIA+ community or a person of color, as well as whether they are older than 45. This further increased our confidence in BetterHelp’s ability to match us with an appropriate provider.

Once this intake questionnaire was complete, we were asked a series of questions about our financial circumstances, including if we were a student, identified as disabled, were unemployed, had a low income, or were a veteran. These questions assessed whether we were eligible for financial aid. There was no requirement to provide documentation to prove whether we were a part of these demographics.

The one thing we really didn’t like about BetterHelp’s sign-up process, however, was the fact that we were required to pay for our monthly subscription before we received our therapist match. 

It’s important to note that this is the stage where you will be quoted your exact subscription price. Up until this point, you do not know how much therapy will cost you or if you’re eligible for a discount. 

The amount of time it took us to get matched with our therapist varied between testers and locations. The company states it will take about 48 hours to receive a match. In our experience, sometimes we had to wait the full 48 hours, while in one case we were matched within 2 hours.

We did not get to choose our therapist match at sign-up, which is different from some of the other companies we reviewed and may be a drawback for some users, especially since the success of therapy is so dependent on the client-therapist relationship. 

Still, 97% of users rated BetterHelp as excellent, very good, or good overall, and the same number of users felt similarly about the qualifications of BetterHelp’s providers. Ninety-four percent of users reported that they found a therapist who met all or most of their needs. 

How Do Therapy Sessions Work at BetterHelp?

Once we’d signed up, we could access sessions and message our therapist via the BetterHelp app or online portal. This portal is where we were able to contact our therapist in the chat room, schedule sessions, attend those sessions, complete daily journal prompts in this portal, and attend webinars. 

All BetterHelp sessions are typically 30 to 45 minutes long, depending on what you and your therapist agree to. You can also message your therapist at any time through the messaging room in the app or web portal. However, the company does not promise therapists will respond within a specific time frame.

Messaging Our Therapist

In our portal, we had access to a platform to message our therapist on BetterHelp anytime, with responses typically provided five days a week. We could send them a written message, an audio message (up to five minutes in length), and even a video message—and they responded to us asynchronously once they were available to do so.

Our experiences with this messaging service varied greatly. In a few cases, our therapists messaged back within a few hours during the day, and even responded to multiple messages; one of our therapists in particular was especially responsive, clearly taking the time and care to respond thoughtfully to us. However, other times, we only received one message back per day (or night), most of which felt canned and impersonal.

“As I continued messaging my therapists, I noticed a pattern,” one of our testers noted. “Their responses were short and vague—often directing me to wait until the next live session.” For instance, one of the responses we received after sending a long message about our desire for therapy said, “We can process through how to get to that goal. Look forward to speaking with you soon.” And if we sent a message over the weekend or at night, it took longer to respond—though at one point we did receive a therapist response at 2 a.m. on a Saturday.

This is why we do not think that texting with a therapist, however frequently, is really an appropriate alternative to talk therapy and why we would only recommend using BetterHelp’s messaging service in conjunction with and as a complement to the phone and video sessions it offers, not alone. “There are important elements of a therapy session that are impossible over text,” explains Hannah Owens, LMSW and subject matter expert. “Your therapist cannot read your body language, interpret your tone of voice, or even see your facial expressions. This makes it much more difficult for your therapist to fully understand the issues you bring up and how you are truly feeling about what you’re talking about.”

However, one unique feature of this messaging app that stood out to us is that you’re able to mark messages as “Urgent” by clicking a checkbox prior to sending. That being said, BetterHelp has a statement in the footer of its website that reads “If you are in a crisis or any other person may be in danger—don't use this site” as well as links to crisis resources. It does not specify what you should use the “Urgent” messages for.

Live Sessions

A monthly subscription plan got us four live sessions with BetterHelp. We could not buy additional sessions. 

There were three options available for live sessions with our therapists: via live chat, phone call, or video call. These sessions were either 30 or 45 minutes, depending on our therapist’s availability as well as the main issues we indicated in the initial questionnaire. We could schedule our first live session directly on the portal. Then, much like in-person therapy, our therapists would ask when we would like to schedule next week’s appointment at the end of each session. The therapists filled this information out for us on their end and the next appointment automatically appeared in our schedule on our portal.

BetterHelp does not charge for missed sessions, but you can’t schedule an extra session if you miss one.

Our Live Video Sessions

When it was time for our scheduled video session, we logged into our portal on the website or the app. Our therapists initiated the video calls within the portal, but we still needed to accept the call.

Much like our experiences with messaging, the quality of our video calls varied widely. Sometimes, we had absolutely no technological issues, while other times we experienced lags and volume problems with the video. In addition, sometimes our sessions were 45 minutes long, whereas other times they only lasted 30 minutes (and we greatly preferred the longer sessions).

The same variation was true for the quality of our therapy sessions themselves. Most of the time, we felt like our therapists were well-qualified, relatable, and competent—they were attentive to our problems and listened to what we had to say, offered useful advice and support, and even assigned us worksheets to do in between sessions that they felt would benefit us. For the most part, we felt like we received appropriate and helpful care, which was surprising—we were afraid that at such a big company, the chances of receiving quality therapy were slim. In one case, we specifically noted that “The therapist was warm, calm, and made a real effort to delve into my concerns.” In fact, “One of the critical aspects that this therapist got right was taking the time to holistically understand our family life, and therefore she didn’t suggest things that simply wouldn’t work for us.”

That being said, our sessions were not without their issues. We found that, while some of our therapists conducted a standard “intake” session, where they asked us questions about our mental health history and confirmed that we were not in crisis, most of our therapists did not do this, which was concerning. In addition, during one of our video calls, our therapist often looked off-screen. We assumed they were taking notes, but it added an impersonal element to the session. And, even worse, we had a bad experience with a therapist who was ableist and assumed that we were seeking therapy because of our physical disability when that was not the case.

Our Live Audio Sessions

Similar to video sessions, audio sessions took place within our portal, and we found their quality unreliable as well. In one case, we “felt strange during the audio call because it did not feel like a true therapy session. It mostly felt like a phone call to someone.” 

In addition, we felt like it was more difficult to develop a rapport with our therapist over the phone because they were unable to see our body language and nonverbal communication cues. We also found that, without the accountability of seeing our therapist face-to-face, we were tempted to disengage from the session. After a few audio calls, we completely understood why our therapists preferred video sessions.

Our Live Chat Sessions

Live chat sessions are held inside the portal and are similar to asynchronous messaging, but are held in real-time, which can make it more akin to traditional therapy (rather than sending a random text and waiting hours for a reply). Our therapists initiated the live chat and a timer appeared on the screen, indicating the length of our session.

Much like our audio sessions, we were not impressed with our live chat therapy appointments. It felt too much like texting a friend, and we did not feel like we received the same level of care that we did with video—though for the most part that was not the fault of our therapists. It is difficult for conversation to flow easily when you have to wait for the other person to send their reply. However, in one case, “the therapist used only text messaging during the live chat, creating a good pace of conversation,” as opposed to clunkier options like voice or video messaging. During that conversation, we felt like our therapist did the best they possibly could under the circumstances.

A unique feature for BetterHelp, too, is that we could choose to see “Live Typing.” This means that we were able to see what our therapist was typing as they typed it—and vice versa. The messages appeared in a different color once they were complete and sent.

We discovered that it was important that we did not leave the app or close out of the portal during our live chats. Doing so ended the session early and the therapist was unable to restart it.

Journaling

BetterHelp also offers a journal feature through the patient portal. We could respond to daily prompts or just quickly jot down our feelings. If we wanted our therapist to read our entries, we could share them with them through the portal, but we could also keep our entries to ourselves. 

Webinars

BetterHelp offers webinars, which it calls “groupinars,” through its patient portal. These groupinars are about various mental health topics—for example, we tried out one about ADHD and found it affirming and supportive.

Switching Therapists at BetterHelp

If you’re unhappy with your therapist at BetterHelp, you can always switch—and we were pleased to find that the process of doing so was clear and easy. 

All we had to do was to click our name in the top left corner in the portal, which opened a dropdown menu. The third option on the dropdown was “Change therapist.” We were then asked a few questions, such as whether we had any preferences for who we’d like our new therapist to be and what our experience was like with our previous therapist.

We were then given 10 to 20 available therapists to choose from, which is different than the sign-up process where we were matched with someone. This time, we could read through their bios and specialties to make our own decisions about who we wanted to work with. 

After we chose a new provider, we were immediately connected with them in the portal and could schedule a live session within 48 to 72 hours, depending on the therapist’s availability.

Canceling Our BetterHelp Subscription

We could cancel our subscription to BetterHelp at any time. We simply clicked our username in the top right corner and went to "Account Settings." Once on this page, we scrolled down to the Payment Settings header and clicked “Change membership / cancel membership.”

Once we clicked, we were given the choice between changing our subscription plan or canceling it altogether. 

Although when we signed up we were only offered one subscription plan, when we went to cancel, we could downgrade our subscription to two previously unavailable options: 

• A weekly option, which involves paying for one session weekly instead of monthly.
• A maintenance plan, which includes unlimited messaging and one live session a month for $160 per month. It does let you know that your therapist's responses to messages may be less frequent as well. 

When we did decide to cancel, the site asked us a few questions, including whether we had discussed canceling with our therapist and what our reasons were for canceling. 

Once we’d canceled, we could continue with our unused session(s) for the month, and our subscription plan would stop renewing. BetterHelp does not offer a refund for any unused sessions at the end of the billing period.

Pros and Cons

Any online therapy service is going to have its ups and downs, and BetterHelp was no exception:

Pros & Cons

Final Verdict

BetterHelp is a reliable alternative for those whose schedules don’t allow them to go to in-person therapy. The company prioritizes accessibility with its convenient, user-friendly website and app as well as its available financial aid. To this point,  82% of users rated BetterHelp’s customer service as very good or excellent, and 96% said they were likely or very likely to recommend BetterHelp to a friend. 

Still, the concerns surrounding BetterHelp—including its surge pricing and the inconsistent quality of its services—are worth considering before using the company for online therapy.

Methodology

To fairly and accurately review the best online therapy programs, we sent questionnaires to 55 companies and surveyed 100 current users of each. This allowed us to directly compare services offered by gathering qualitative and quantitative data about each company and its users’ experiences.

Specifically, we evaluated each company on the following factors: website usability, the sign-up and therapist matching processes, therapist qualifications, types of therapy offered, the service's quality of care, client-therapist communication options, session length, subscription offerings, client data management, average cost and value for money, whether it accepts insurance, how easy it is to change therapists, overall user satisfaction, and the likelihood that clients would recommend them.

We also signed up for the companies in order to get a sense of how this process worked, how easy to use the platform is, and how therapy takes place at the company. Then, we interviewed three of therapists we found who either currently work or worked for this company in the past and worked with three subject matter experts to get their expert analysis on how suited this company is to provide quality care to therapy seekers.