We Tried BetterHelp's Online Therapy Services: Is It Worth It?

BetterHelp provides basic mental healthcare for people struggling with managing everyday challenges. Its combination of weekly talk therapy, messaging, and a homework-based approach allows it to effectively help a vast clientele. However, potential users may struggle to find an appropriate therapist if they are part of a marginalized group or have a more complicated mental health condition. 

Pros & Cons

Pros

• Messaging available
• Easy to switch therapists
• Goal-oriented treatment
• Available nationwide and internationally
• All therapists are licensed 
• Financial aid available 
• Website and app are easy to navigate
• Match with a therapist within days

Cons

• Cannot provide diagnosis
• Does not accept insurance
• Only one payment plan available
• Cannot choose your own therapist
• Engages in surge pricing
• Therapists may not be culturally competent 
• No medication management available 

Given that over 50% of adults in the United States with mental illness do not receive treatment and another tenth don’t have health insurance, a company with BetterHelp’s mission—“Making professional therapy accessible, affordable, and convenient”—is sorely needed. This ideology is evident from its uncomplicated treatment system and its tech-based approach to care.

In addition, BetterHelp’s active marketing strategy has made it one of the most popular online therapy companies, so we decided to see whether it truly helps users. To do so, we surveyed over a hundred of its users, tested its services, and asked the company to complete a questionnaire. We also compared it to 54 other online therapy companies and 25 online therapist directories. Here’s how it fared. 

What Is BetterHelp?

According to the company's website, venture capitalist, Alon Matas founded BetterHelp at the end of 2012. He was soon joined by Daniel Bragonier, a former product manager and marking analyst. In less than a year, the company expanded to provide services in all 50 states. BetterHelp’s customer base grew from 10,000 total users to 1,000,000 users between the end of 2014 and June 2020. Additionally, it launched specialized services, under different company names, for couples (ReGain), teens (Teen Counseling), Christians (Faithful Counseling), and the LGBTQIA+ community (Pride Counseling).

BetterHelp’s then-innovative approach to therapy partially explains its rapid growth. For a monthly fee, it provides weekly video or audio therapy sessions with a licensed therapist in addition to unlimited messaging with the therapist. This model set the company up for success when the COVID-19 pandemic hit and the world converted to online healthcare. 

Despite its ideal positioning, BetterHelp has experienced a few reputation-related difficulties. There are ongoing concerns about users’ privacy. The Mozilla Foundation labeled BetterHelp “Warning: *privacy not included with this product” due to the fact that it not only records information exchanged between therapists and clients but shares the metadata with Facebook. Furthermore, some of BetterHelp’s marketing techniques have been insensitive, especially when partnering with YouTubers. 

What Services Does BetterHelp Offer?

BetterHelp offers individual and group counseling to adults. (If you want couples or teen counseling, the site will redirect you to ReGain and Teen Counseling, respectively.) 

As noted above, you interact with your therapist via weekly live chat, video, or audio sessions. Additionally, you can send unlimited messages to your therapist, who will likely respond within 24 hours. The company also provides users with access to daily group workshops and an online journal. BetterHelp does not offer medication management, nor does it take insurance. 

Who Is BetterHelp For?

BetterHelp markets itself as individual therapy for almost all adults. It says it has therapists who specialize in the following issues:

• Stress
• Anxiety
• Relationships
• Parenting
• Depression
• Addiction
• Eating
• Sleeping
• Trauma
• Anger
• Family conflicts
• LGBT matters
• Grief
• Religion
• Self-esteem issues

When we asked the company what therapy techniques it uses, it listed 28 modalities ranging from the usual cognitive behavioral therapy (CBT), which is used to treat a range of conditions including anxiety and depression, to more uncommon methods such as the Adlerian theory, which is used to address self-esteem challenges. 

So who is BetterHelp best for? Well, because its therapists can’t diagnose you or provide medication management, its broad scope is most applicable to those facing mild to moderate mental health concerns that don’t require highly specialized treatment. 

The site makes it clear that its providers do not treat minors, people in crisis, nor those mandated to receive therapy by a court of law. 

How Much Does BetterHelp Cost?

Unlike some of its biggest competitors (think: Talkspace), BetterHelp doesn’t offer multiple different therapy plans. It has one single plan that includes four weekly sessions and access to weekly group sessions on various topics and this plan ranges in price (as of November 2022) from $60 to $90 a week (or $240 to $360 per month). BetterHelp users are offered one live video (or audio, or chat) session per week with their therapist. Sessions run between 30 minutes and 45 minutes, and you don’t know how long the session is going to be before it starts. 

The exact price you’ll pay will vary based on where you live and the demand for therapy in your area; I live in the greater Boston area and was charged $80 per week. This practice is referred to as surge pricing. While surge pricing makes sense when applied to unnecessary services with limited supply, such as when airplane tickets cost more around the holidays, it seems unethical to apply it to any kind of healthcare. (Imagine if the cost of flu medication increased every winter.) 

While this monthly subscription might be about average compared to other companies that offer subscription plans, these rates may be unaffordable for many who need therapy. Only around half of the BetterHelp users we surveyed rated the service as “affordable” or “very affordable.” This is especially alarming since a survey conducted by the American Psychological Association in 2018 revealed that 39% of Americans believed they needed mental health treatment but didn’t receive it because of cost as their main reason.

Does BetterHelp Take Insurance?

No, nor does it allow you to submit reimbursement claims. However, it does accept FSA/HSA payments. 

Not accepting insurance makes BetterHelp inaccessible to many people. Of the users we surveyed who stopped using BetterHelp but continued therapy, 20% did so because they couldn’t afford BetterHelp’s services and another 10% switched to a therapist who accepts their insurance. Although BetterHelp claims that its pricing is “typically comparable with the co-pays of most insurance plans,” this isn’t true. Insurance copays generally vary from $10 to $50 per week, which is much less than $68 per week. 

Does BetterHelp Offer Discounts?

BetterHelp does try to make therapy more affordable via discounts for certain groups, including students. However, I could not find a comprehensive list of these discounts. I received a 10% discount for being disabled and/or a student for the first month. (I’m not sure if I received a 5% discount per identity or if I would have received a 10% discount with either one of them.) 

BetterHelp also offers need-based financial aid. You can apply while signing up, and it does not require any documentation—all you need to do is enter the amount you and your spouse (if you have one) make per month and whether you have any dependents. 

Navigating the BetterHelp Website

BetterHelp’s website is well-designed. The first thing you see on the homepage are three buttons allowing you to specify if you want individual, teen, or couples therapy. 

If you click on the “teen” or “couples” options, you will be redirected to BetterHelp’s specialized platforms. 

All you need to do is scroll down to get more information on BetterHelp’s services. There, the website outlines how the service works, provides answers to common questions, and compares BetterHelp to traditional therapy. You can also give BetterHelp as a gift via the last panel on the homepage. 

Along the top of the homepage, you will see links to several pages. The first enables businesses to offer BetterHelp to their employees. The second is an “about” page that provides information about BetterHelp’s mission and its therapists. There are also links to an in-depth FAQ, a contact page, and a page for therapists seeking employment. 

There’s also an “advice” tab that links to BetterHelp's mental health blog. The regularly updated blog features articles about a variety of mental health topics, all written by licensed therapists. You can also sign up for a free newsletter with information about mental health, but when I did, I did waited over a week did not receive a newsletter. 

Does BetterHelp Have An App?

BetterHelp does have an app that you can download via Google Play or the Apple App Store. The app allows you to message and video chat with your therapist as well as create journal entries. 

How Do You Sign Up for Therapy at BetterHelp?

Signing up for BetterHelp is an uncomplicated, but somewhat lengthy process. 

After you click the “get started” button on the top right-hand of the page, or “individual therapy,” you begin a questionnaire consisting of over 30 questions about your demographic information and current mental health. 

Most of these questions seemed standard to me, but a few had confusing wording. For example, I didn’t know how to answer the question, “How often do you think about suicide?” As a mental health writer, I think about suicide more than your average person, but I’m not suicidal. 

One question asked if I identify as LGBTQ+ (I do) and then if I would prefer a therapist who also identified as LGBTQ. However, I wasn’t asked about my race or whether I was disabled. I wish I had been because having a therapist who is competent regarding and/or shares the client’s racial or ability identity can be crucial to effective treatment (more on this later).  

Once you answer the questions, you’re then prompted to enter your email and create a password. Once you’ve verified your email, you enter either your first name or a pseudonym. You can then choose from a plethora of options regarding what you want your therapist to specialize in. You’ll also be asked to answer an open-ended question about why you want therapy. 

Before you pay, the questionnaire asks you if you meet a separate list of demographic information (such as whether you’re a student), which the company seems to use to determine whether you qualify for a discount. You can also take this opportunity to apply for financial aid. Finally, the company provides you with a clear outline of the service so that you know what you’re paying for. 

After entering your payment information, you are brought to a personal portal that shows your answers to the questionnaire in the chat and tells you that the company is trying to match you with a therapist. In the meantime, you can use the platform’s journal to record your feelings and/or respond to prompts. 

Matching With a Therapist at BetterHelp

BetterHelp matches you with a therapist within a few days. I was matched after two days and had my first appointment four days later. 

While you have no say in what therapist you are assigned, the matching process seems effective: 65% of our surveyed users never switched therapists at the company. The therapists I was matched with were not familiar with my disability, but outside of that seemed like they would have been a good fit. Furthermore, the therapists are qualified. They are all licensed counselors, clinical social workers, or doctorate-level psychologists.

How Do Therapy Sessions Work at BetterHelp?

Once the platform matched me with a therapist, it emailed me an alert saying as much. When I checked my portal, I found that my therapist had sent a brief message telling me how to find more information about her and encouraging me to book a session for the following week. I used the built-in calendar to schedule an appointment. At this point, I could have messaged her at any time. 

Messaging Your Therapist

BetterHelp broadly advertises its messaging feature to potential users. A fifth of our users said that having multiple ways to contact their therapist was important to them, and 11% specified that they wanted to be able to text their therapist. 

On BetterHelp, you can message your therapist at any time via either your desktop or the app, and you can mark a message as “urgent” if you need a faster response. Therapists are likely to respond within 24 hours. My therapist responded within a few hours even when I sent her a mundane question in the middle of the night. 

Video Sessions

My half-hour session started with my therapist asking me a series of intake questions. Some of the questions were worded as if they were written for the therapist and not the client. 

For example, instead of asking me why I wanted therapy, she asked me what my “presenting problem” was. If I didn’t have a psychology degree, I don’t know if I would’ve known what she was asking. She also asked if I had ever been diagnosed with a mental health condition before. When I said I have ADHD, she didn’t ask a single follow-up question about it, which seemed odd. 

After we’d finished the preliminary intake, we discussed why I was in therapy and what my goals were. Then, she asked me about my physical disability and invasive questions about how I acquired it. Once I revealed some fairly personal medical information, she said that we would continue the conversation at our next session. 

I felt this initial interaction was problematic on multiple levels. While understanding a client’s personal history is important to provide effective care, details about their medical history are rarely relevant. Also, the therapy goals I outlined had nothing to do with my physical disability. I felt like she made the ableist assumption that I must have negative feelings about my disability (which I don’t). 

This is indicative of the fact that BetterHelp isn’t designed for members of marginalized groups. For example, there’s no way to guarantee that your therapist will share any specific identity with you. While you can say that you prefer a therapist of color or one who is broadly LGBTQ+, this isn’t sufficient. A cisgender lesbian is going to have a wildly different experience than an asexual non-binary person. People of different racial backgrounds also experience racism differently. So, matching based on broad categories doesn’t always lead to positive outcomes.

Group Therapy Sessions

You can attend group therapy sessions regarding specific mental health issues at BetterHelp. You sign up via your portal by clicking the “schedule” tab. Underneath that, you choose “group” and are presented with a list of topics with the time and date of the session. Once you’ve signed up, you meet by clicking on a Zoom link that appears when it's time to join the session. 

I attended a 90-minute-long group for people with ADHD where people could share their struggles and get advice from the moderator, who was a therapist who specializes in ADHD. I enjoyed the session. The dozen or so attendees were from all over the English-speaking world and ranged in age, race, and career background. Everyone was welcome to speak and share their experiences and give advice to others. It felt supportive and affirming. 

What Happens If I Miss a Session at BetterHelp?

Missing a session at BetterHelp comes with little to no consequence. You won’t be charged a fee. You will simply lose the opportunity to meet with your therapist that week. 

Switching Therapists at BetterHelp

BetterHelp compensates for the fact that you don’t choose your therapist by allowing you to easily switch therapists at any time. You can do so either by contacting customer service or clicking on “change therapist” in the menu beneath your name. 

Once you do this, you answer two questions: if you want a therapist with a specific identity (such as being over 45 or being of color) or if you want them to specialize in a certain area (like parenting issues or bipolar disorder). BetterHelp says it matches you with a new therapist within 48 hours, but 24% of our users said it took a week and another 12% said it took a few weeks. 

Pausing or Canceling Therapy at BetterHelp

Ending therapy is also very easy and can be done via your account settings. Once you say you want to cancel, a popup appears offering you a 10% discount or an alternative payment plan wherein you play weekly instead of monthly.

If you continue to cancel, you will fill out a survey about why you want to leave, if you've discussed leaving with your therapist, and whether you would recommend your therapist to someone else. If you say you haven't told your therapist, the company recommends you do and brings up a pop-up window asking you to write to your therapist, but you can cancel regardless. There's also a pop-up with an optional survey asking more questions about your therapist. You can continue to use the service until the end of the billing period. 

Quality of Care and User Satisfaction

Our user survey indicates that, overall, most people are satisfied with the care they receive from BetterHelp. Eighty-six percent of users rated it as being “good,” “very good, or “excellent.” This is slightly above average when compared to other companies users tried. Additionally, 73% of users rated the value they got for the cost as “good,” “very good, or “excellent.”  

One key measure of care quality is therapist turnover, which BetterHelp wouldn’t comment on. The therapists there, however, seem well-qualified based on our survey respondents. Forty-one percent of users rated their therapist’s qualifications as “excellent.” 

My experience with BetterHelp was mostly negative due to my therapist’s lack of disability awareness. However, I’ve had similar issues with in-person therapists in the past, so my experience may not be a good indicator of how someone else may find BetterHelp. 

In fact, up until that point in the conversation, the therapist did a very good job of empathizing with my concerns and giving me constructive homework. It was only her second BetterHelp session ever, and she didn’t quite understand how the platform worked, but she was attentive to my needs and forthright about her therapeutic approach.  

So, although the care at BetterHelp may not be suitable for marginalized communities or those with more complex mental health issues, it will likely serve most people well. 

Privacy Policies at BetterHelp

BetterHelp’s privacy practices are dubious at best. Some of its practices are standard—like tracking your movements and not sharing identifying information with third parties—but others are questionable for a company providing mental healthcare, especially since the site doesn’t mention anything about being HIPAA compliant. 

An NPR article cited a report from Jezebel revealing that BetterHelp sells information about its users' activity to Facebook. Although it doesn’t share the content of messages, this is still concerning. You should be able to destroy the contents of your messages at any time. 

BetterHelp vs. Its Competitors

BetterHelp is one of the leading providers for a reason—84% of our surveyed users said that BetterHelp was better than online therapy services they had used in the past.

BetterHelp’s leading competitor seems to be Talkspace. Talkspace provides a similar service to BetterHelp in that it allows users to message their therapist and have weekly sessions. There are crucial differences, however. Talkspace offers multiple membership options, including a message-only plan. Furthermore, not only does it accept insurance, but its weekly rates are cheaper than most BetterHelp pricing. For a large additional cost, it also offers medication management. 

Users rated Talkspace 4% better than BetterHelp in terms of both the overall quality of the service as well as the value they received for the money they paid. While BetterHelp has the additional benefit of group therapy, Talkspace may be the better option, especially if you have insurance. 

Final Verdict

BetterHelp is widely known for providing convenient mental healthcare for a large number of people around the world. Seventy-seven percent of the BetterHelp users we surveyed said they would recommend it to a family or friend. Its emphasis on live individual talk therapy in addition to messaging and group therapy means that you will receive therapy on par with most in-person services. If you don’t have insurance and/or have an HSA/FSA fund to draw from, BetterHelp’s consistent monthly fee may be preferable to other plans. 

To be clear, BetterHelp isn’t for some people. Its providers can’t address more severe mental health concerns or prescribe medication. While our opinions haven’t changed much since last year’s review, we do have a better understanding of how BetterHelp struggles to serve marginalized communities. 

Despite its flaws, BetterHelp is one of the best options for online therapy for those who, in the company’s own words, just “need someone else to talk to.” 

Methodology

To fairly and accurately review the best online therapy programs, we sent questionnaires to 55 companies and surveyed 105 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 privacy protections, 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 it.

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 worked with three subject matter experts to get their expert analysis on how suited this company is to provide quality care to therapy seekers.