I’m a Psychologist With ADHD Living in a Therapy Desert, So I Tried Thriveworks

Over the past three years, Verywell Mind has repeatedly tested Thriveworks, a therapy company that offers both online and in-person mental health services in 49 states and DC. In this review, Dr. Amy Marschall, PsyD, explains her experience testing Thriveworks in 2023. Then, we discuss our findings from our most recent test of this company's online therapy services from 2024.

Amy's 2023 Testing

In 2023, we asked Amy to test Thriveworks' online therapy services for a month to learn about the quality of care the company could provide. These are her personal insights.

Why I Chose Thriveworks

As a psychologist living with ADHD, I have spent the last two years researching online therapy platforms and evaluating their services, looking for those that have ethical practices, offer accessibility, and prioritize client satisfaction. But I’ve also been particularly interested in companies that provide affirming services to neurodivergent people like me. After seeing Thriveworks come up again and again in my research, I’ve been consistently impressed with its therapy services and its high client satisfaction. But for a long time, it didn’t offer services in my state—which honestly didn’t surprise me that much. South Dakota could be considered a “therapy desert” because it’s a place where there are not enough mental health providers to meet demand, which means that even if you find a therapist near you, you might be on a waitlist to see them for a long time. 

So when I learned that Thriveworks did launch an online therapy office in South Dakota (and we actually got one before some other therapy desert states, like Vermont), I jumped at the chance to try it out. And I’m pleased to say that over the month I used it, I received quality care from my therapist and appreciated the additional resources provided on the website, though the platform was pricier than others I have tried. Here’s my experience with Thriveworks.

How I Signed Up for Thriveworks

When I first navigated to the Thriveworks website, I was instructed to input my location and to call a phone number for my region in order to schedule a session with a customer service representative. I admit I was a bit disappointed that I didn’t have the option to schedule an initial appointment online—which other online therapy companies offer. 

My call with customer service didn’t go smoothly. We had some difficulty scheduling because my state has two time zones, and the therapist assigned to me is not in the same time zone as I am. The customer service person I spoke with had some trouble figuring out the time difference and had to make, cancel, and reschedule my appointment a few times to get it right. However, we eventually got it sorted out. 

The therapist in my state was an LCSW who, according to her profile, specializes in “depression, anxiety, trauma, substance use, mood disorders, major life transitions, postpartum depression, and relationship issues.” 

This was OK, but when I first called, I requested a provider with knowledge of neurodivergence and neurodiversity-affirming care because I wanted a provider who understands that while neurodivergence (like having ADHD) can come with challenges, it is not inherently pathological or wrong. This is an approach I use in my own therapy practice, and I look for it in other therapy services too.

Still, I appreciated that my therapist had evening and weekend availability, as that is what works best for my schedule. I also appreciated that Thriveworks sent me multiple email and text reminders about my appointment time.

How Much Thriveworks Costs

The truth is, Thriveworks rates can be expensive out-of-pocket, though its price varies based on region, and session costs are not listed on the website. However, it accepts many insurance plans, including Humana, Aetna, BlueCross, TriCare, Cigna, UnitedHealthcare, Tufts, and Medicare, which could lower your out-of-pocket prices if your plan is accepted. 

Unfortunately, though, I have health insurance through a local hospital, and the plan is primarily in-network with employees of that hospital system. As a result, I did not have the option of using my insurance to help cover the cost of my Thriveworks sessions. 

In addition, although I did not have to pay a cancellation fee, I was told that there would be a $135 charge if I canceled within 48 hours or did not show up for my appointment.

How My Therapy Sessions Went

At my intake, my therapist followed a structured interview format to gather extensive history information. This is typically the purpose of a first appointment: getting a thorough history to inform treatment going forward. She asked about my family, education, employment, substance use, mental health history, current symptoms, and other topics. 

We discussed treatment goals and her approach to therapy as well. Therapists follow different theoretical orientations and approach work with clients differently, which is wonderful because every client has different needs and deserves a therapist they click with. While my therapist did not have extensive training in ADHD or neurodiversity-affirming care, I still felt affirmed by her approach. She set me up with a recurring weekly time.

I found our subsequent sessions helpful, with my therapist bringing up things I had mentioned in previous sessions but also making room for me to bring anything new to the session.

I felt that she remembered things I told her and was invested in my care. 

Her approach was a bit less structured than other therapists I have seen in the past, and we did more processing versus giving me specific skills to try in between appointments. This means we talked through things without necessarily intending to solve or fix. I appreciated this and felt like there was space for me to dig into my own history and mental health instead of just responding to symptoms. This helped me understand my feelings and thought process, and it brought my attention to patterns in my life and how they are informed by my past.

While I have used other platforms that invited me to privately provide feedback regarding my care, this was the first platform that attempted to solicit a public review. The American Psychological Association, American Counselors Association, and National Association of Social Workers ethics codes all prohibit therapists from requesting testimonials and public reviews from current clients. While these requests did not come directly from my therapist, they still made me uncomfortable. Having the platform request a testimonial instead of the actual therapist seems like a difference of semantics, and I did not feel the request was appropriate.

Additional Resources

Thriveworks offers a wealth of free educational resources on its website, including several ebooks that I could download for free:

• How to Resolve Relationship Issues
• Media and Your Mental Health
• Getting Started With Self-Improvement
• Understanding Causes and Types of Depression
• Grappling With Grief
• Drugs and Other Addictions

While I was already familiar with much of the information presented, if I were not a mental health professional, I probably would have learned a lot from the books and blogs. Topics covered include coping with grief, depression, trust, and culturally competent mental health. Overall, I felt like the educational resources on the website were highly beneficial, as I could learn more about my mental health and appropriate coping skills in between sessions if I wanted to.

Our Most Recent Testing

In the summer of 2024, we had a tester in New York try Thriveworks' online therapy services for a month. This was her first-hand experience.

Why I Chose Thriveworks

I have been doing Zoom meetings with my therapist since 2020. Most of the issues were resolved; however, there's one issue that I am not comfortable talking about, so my health coach recommended EMDR (Eye Movement Desensitization and Processing), a gold-standard approach to trauma work, in order to process that particular traumatic experience.

Thriveworks advertises that it offers EMDR therapy, so I decided to try the company in order to help me work through that trauma.

Signing Up for Thriveworks

The sign-up process was not straightforward at all. When I specified the type of therapy I was interested in (EMDR), I was shown therapists in North Carolina only. When I tried to filter by therapists in NYC, where I live, I was offered none.

However, since I tested Thriveworks in the summer of 2024, the company has since updated its system so that a warning alert pops up letting you know that you are making a cross-state booking and giving you information about that state's licensure regulations. This should mitigate the confusion and frustration I experienced.

I ended up scheduling a session with one of my very few options. It took me about two weeks to get to my appointment.

I also had to provide my insurance info and my credit card info. A questionnaire was sent to me a few hours before the appointment, but when I tried to click on it, it would not open.

My Therapy Session

The therapist was late for the appointment. When she finally logged in, she immediately gave me a speech saying that she is too busy and doesn't really have spots for new patients, and explained that I was only able to book a session with her because she had a last-minute cancellation.

To me, this seemed problematic for a therapist who treats trauma and/or PTSD patients, because we cannot control when something triggers us and when we will need support. 

She also started asking me to immediately sign a financial waiver, saying she will not proceed with the session until that's done. When I mentioned that the link to the waiver was not working, she resent the doc to me in Spanish, then made me call the help desk to resolve the online signature issues. All in all, that took 20 minutes out of the 45-minute appointment. 

She then asked me why I scheduled the appointment.

She suggested that my trauma is somehow my fault, and that I need to get to the bottom of why I even got to the traumatic event. This felt too pushy and like she was blaming me for my own trauma.

Finally, after 30 minutes, I mentioned that I am in NYC. And she said: "Oh, girl, bye, I'm not licensed to even talk to you since you're not in NC."

How I Felt About Thriveworks

Not worth it at all. Horrible. Unprofessional. Luckily, the fee was waived for that horrendous session.

My therapist was incredibly rude from start to finish. I also felt as though the company itself made false claims about the services it offers. Even though EMDR is specifically mentioned on the website as a modality its therapists offer, I could not find a single provider in my area who offered this approach.

We heard from a Thriveworks representative about this particular issue. Because there is only one clinic located in New York, providers there are scarce to begin with. She also explained the limits of finding a therapist who provides EMDR. "On the services bar at the top of our website, we are very clear on the main services offered and common specialties. EMDR is not listed among these but as one of the Explore More options. While there was not a provider available in the tester's area (New York only having one clinic) EMDR is a service hundreds of our clinicians offer nationwide, something I can validate." 

Our Other Testers' Experiences with Thriveworks

We also tested Thriveworks’ individual, couples, and children/teen therapy six other times across the country, in Massachusetts, Missouri, Kentucky, Kansas, Florida, and Ohio, and our experiences, for the most part, differed greatly from our 2024 testing results. It was clear to us that Thriveworks provides quality mental health care. We especially appreciated the thorough intake process that our providers took us through—this made us feel as though our therapists were professional and engaged in making sure they had all the necessary information in order to treat us properly. In fact, one of our 50-minute intake sessions actually lasted an hour and fifteen minutes because our provider was invested in getting all the background she’d need in order to collaborate with us the best she could.

Our therapists worked with us on particular issues (such as balancing chores and tasks in our relationships) and led us through focused and guided sessions, offering advice and action items we could set in place immediately.

They made a point of sharing their own family experiences (with children about the same age as ours), which made us feel like they truly understood our family dynamics. We were happy to keep scheduling sessions with our therapists, even when we were paying for their services out-of-pocket—that’s how much we liked them.

We also had great experiences when we sought Thriveworks’ services for our children and teens. Our teenage daughter really liked how conversational her therapist was, compared to previous therapists who had made her feel like they weren’t really listening to her; so she especially appreciated the fact that her provider would often call back to previous conversations they’d had and make recommendations based on issues they’d already discussed. Our daughter quickly found that she and her therapist had things in common (like an interest in sports and travel) and she was able to develop a rapport with her rapidly. In addition, they worked together to help our daughter recognize triggers that set off her stress and anxiety, and the therapist provided useful tips for calming down in those situations, such as breathwork and grounding exercises.

Our 11-year-old daughter’s initial experience with her therapist wasn’t quite so positive. The provider’s quick transition between starting the session off by asking for our payment information and then diving into more personal subjects like why she was seeking therapy and whether she was feeling suicidal set our kid a little off-kilter—but by the second session it was clear that she was the right therapist for our daughter. She seemed to understand the issues that had brought our daughter to therapy, and immediately set about making her feel more comfortable.

For our first session, we had prepared well in advance, including making sure both our work schedules were open and even hiring a babysitter to look after the kids so that we wouldn’t be interrupted. However, an hour before the session was supposed to start, we got a call from the therapist saying that she wasn’t actually available for that session and that it had been a scheduling mistake on the platform’s part. Needless to say, we switched therapists, but the next provider wasn’t great for us either. Most of our first session was just small talk (presumably to get to know us), but when we did finally dig into what had actually brought us to therapy, he often jumped to conclusions without listening to our answers to his questions. In addition, he seemed to misunderstand us, and often offered platitudes like “stay calm” and “be nice” that left us feeling like he’d glossed over the somewhat more complicated situation we were dealing with.

Canceling Therapy at Thriveworks

Following the end of my trial of Thriveworks, I cancelled future appointments by logging onto the website and canceling in the client portal. 

A couple of days later, though, I got an alert that I was put back on my therapist’s schedule even though I had not requested another appointment. My therapist also emailed me to check in, which I appreciated, but I did not like that Thriveworks made another appointment for me that I had not requested.

Pros and Cons

I had a good experience with my Thriveworks therapist and feel that she provided me with competent, helpful care. At the same time, were I not being reimbursed for my sessions, I would not have been able to afford the cost out-of-pocket. There are some great, free resources on Thriveworks’s website for anyone who wants to learn more about mental health. All things considered, these are my pros and cons.

Final Thoughts

Although there was not a therapist with neurodiversity-affirming specialization available in my state, my therapist had knowledge of my presenting concerns. It would have been nice to have more therapist options, but since Thriveworks just launched in South Dakota, it is understandable that it does not have a large therapist network yet—and I have hope that the company will continue expanding its network in the coming months or years, because currently, other therapy desert states like Nebraska and Wyoming have only one in-person location and no therapists available online.

I appreciated the free educational resources on the website as well, and the free ebooks are a great source for anyone who wants to better understand their mental health.

However, Thriveworks is quite expensive if you are not able to use insurance, which can be a barrier, but quality mental health care is often pricey. I also have ethical concerns about Thriveworks soliciting reviews from current clients, but I did not see the same privacy concerns I have seen on other platforms regarding the selling of personal health information to third parties like advertisers.

Overall, my experience with Thriveworks was positive, and I would use it again if needed and if I can fit the expense into my budget.