How to Choose an Online Therapy Service

With more options than ever, choosing an online therapy service can feel overwhelming, especially if you are trying therapy for the first time. The good news is that the abundance of options means there is a good chance you can find one best suited for you.

Ultimately, choosing the right online therapy service—or therapist—for your needs is very personal.  What might work for you might not work for someone else—and that’s OK. However, when you’re searching for care, there are a few things we recommend you consider to help you make the right choice.

What Type of Therapy Does It Offer?

Most therapy companies and directories will connect you with therapists that can provide individual talk therapy, but some offer other types of therapy that might be a better fit, such as couples therapy, family therapy, or group therapy (where you’ll join a group that meets regularly with peers who are dealing with similar mental health challenges). Others specialize in peer counseling or support groups, which do not require attendance of the same group members every week like group therapy does. Some other initial questions you might want to ask yourself about a service include the following:

• Is psychiatry available? Not everyone who could benefit from therapy needs medication, but some services allow you to meet with a psychiatrist or medical doctor to get a diagnosis and, if you’re a candidate, they can prescribe medication to help relieve your symptoms.
• Do the therapists have the specialization you’re looking for? Therapists have different areas of expertise based on their qualifications and experience treating patients. If you know why you’re seeking therapy (say, you think you might have ADHD or OCD), you’ll want to look for a therapist that specializes in treating these conditions.
• Does it cater to a specific community or age group? While most companies serve adults, some services cater to specific age groups (i.e. kids or teens), cultural or racial backgrounds, or specific communities, such as the LGBTQ+ community.

Sign-Up Process and User Experience

Online therapy comes with a number of logistical questions you may want to think about while choosing a service, especially if you are concerned about user experience, flexibility, and other similar issues like the following:

• Does it match you with your therapist? Some companies invite you to fill in an intake questionnaire, which helps them match you (with the help of an algorithm) to a therapist—or a few therapist options—that might be a fit for you. Others meet with you for an intake session where you can have a conversation with a person who will then match you with a therapist. But therapist matching isn’t for everyone, so if you want to choose your therapist yourself, look for a company that allows you to do this (like most telehealth providers) or a therapist directory.
• Do the therapists have flexible session availability? Online therapy may be more flexible than its in-person counterpart, but you’ll still need to coordinate your schedule with your therapist’s. Think 9-5, and don’t forget to consider time zones. There are some companies that offer early morning and late evening sessions, which aren’t easy to come by (especially with in-person providers).
• How do you communicate with your therapist? Online therapy usually takes place via live video call, but some companies offer additional communication options as well, such as live chat, phone calls, asynchronous texting or messaging, or journaling. Other companies offer hybrid or in-person options if you need them.

Paying for Online Therapy

While online therapy can be flexible, convenient, and more affordable than in-person options, it still represents a considerable expense for a lot of people. Financial questions like these are likely top of mind as you're getting started with your search:

• How expensive is the service out-of-pocket? This may sound obvious, but make sure that you can afford the cost of care at the company you choose. Prices vary widely across companies, with some services offering discounted prices if you commit to a subscription and others offering sliding scale rates if you are in need of financial assistance to afford your care.
• How often do you pay? Some online therapy companies are subscription based, which means you sign up for a monthly plan that bills once every four weeks. These plans usually lock you into a set number of therapy sessions. However, other companies and directories allow you to pay per therapy session, allowing you to have more flexibility over how often you get therapy.
• Is health insurance accepted? Health insurance benefits can reduce how much you pay out-of-pocket, but not all companies, directories, therapists, or psychiatrists work with insurance plans. If you want to use your insurance benefits, make sure you check ahead of time that your plan is accepted (and keep in mind that some types of therapy, like couples therapy, are not usually covered by any insurance plan).

Key Considerations for Online Therapy

Who Is Online Therapy For?

Online therapy is a good option if you’re living with mild to moderate symptoms of mental health conditions such as depression, anxiety, OCD, trauma, PTSD, grief and loss, and postpartum anxiety.

It can also be especially useful if you live in a therapy desert, which is a place where access to mental health care is limited or nonexistent because there aren’t enough providers near you. So if you live in a rural area, cannot travel to a therapist’s office because of your work schedule or childcare needs, or cannot find an in-person therapist near you, online therapy is a great alternative. 

However, online therapy is not for people with more serious conditions. For example, says Amy Marschall, PsyD, a licensed clinical psychologist, “if someone is in a major crisis and requires inpatient care, online therapy is not adequate to address that.” It is also not for you if you experience dissociative or psychotic symptoms that are interfering with your ability to distinguish reality. 

In those cases, you’d be better served by in-person therapy, which allows your therapist to fully understand what you’re dealing with by being able to read your body language as well as listen to what you are saying (because often, more serious mental health conditions make it difficult to communicate if you are symptomatic). 

What Kind of Online Therapist Should I Choose?

The key to knowing which type of therapist is right for you is having a good grip on what your goal is for therapy. Similar to in-person practices, the type of providers available depends on the online platform. Some offer only therapists, some only psychiatrists, and some a combination of providers, including counselors and social workers. Each type of provider is appropriate for a variety of therapeutic goals, needs, and treatments.

For example, psychiatrists are medical doctors who can prescribe medication to treat mental health conditions, but therapists have a master’s or doctorate degree in counseling or psychotherapy and provide talk therapy only.

There are different types of therapist credentials: psychologists, licensed social workers, licensed marriage and family therapists, licensed professional counselors or mental health counselors. Some, such as psychologists and licensed clinical social workers, can diagnose you with a mental health condition, even if they cannot prescribe you medication. Others, like marriage and family therapists, have specialized training that focuses more on treating couples and families.

If you’re not sure what kind of therapist is best for you, look for an online therapy company that offers a matching session with a professional who can help you find the right provider or that has you fill out a comprehensive intake form so it can better match you with the right kind of therapist.

Is Online Therapy Effective?

Yes, online therapy can be just as effective as in-person therapy for certain conditions. For example, a 2018 study found that cognitive behavioral therapy, which is a therapeutic technique that many of the companies we included above use regularly, was highly effective at treating anxiety disorders and depression when used in an online format, while another 2019 study found online therapy to be effective for adult depression.

Online therapy for children and adolescents has also been proven effective, and the virtual interventions for kids who need mental health care continue to grow and improve.

Are There Free Online Therapy Resources Available?

Yes, there are online resources available that you can use for free, such as:

• The CRISIS Text Line is a confidential text line available to you 24/7 available when you text “HOME” to 741741.
• The Samaritans is a 24-hour, completely confidential hotline available if you’re in crisis if you call 212-673-3000. It doesn’t use caller ID or call tracing so you can remain anonymous. 
• NYC Well is a free, anonymous local service for NYC users available 24/7 via phone, text, or chat. You can access it if you text “WELL” to 65173, call 1-888-NYC-WELL (1-888-692-9355), or access an online chat service.There is also a relay service available for the hearing impaired (dial 711) and interpreters for over 200 languages.
• 7 Cups is a 24/7 online chat room service where you can enter a chat room and be connected to a trained “active listener” within seconds of setting up your username. 
• The Therapy Fund at the Loveland Foundation is a foundation that provides the Black community with vouchers to cover 12 therapy sessions. The Therapy Fund sign-up form opens quarterly. To sign up, visit its website.

However, you should know that free services do not provide the same level of personalized care as regular therapy appointments with a therapist you see consistently.

Should I Be Concerned About My Privacy When Using Online Therapy Services?

Online therapy companies, like all online services, collect personal data and information about anyone that visits their sites and uses their services. In addition, since online therapy companies are telehealth services, they also collect and store private health information about their patients.

In order to know how an online therapy company uses, stores, or shares your private data, we recommend reading the company’s terms and conditions and privacy policy. Look for any mention of which third parties it shares information with (i.e., does it share with advertisers?) and see if the company states that it is HIPAA-compliant (which means that it follows the federal law protecting personal health information). 

As for what you discuss in session, your online therapist will follow the same client-to-therapist confidentiality rules as an in-person therapist: They will not share what you discuss with them unless you are a threat to yourself or others, or there is evidence of abuse or neglect to a child, elderly person, or person with disabilities.