We Tested E-Therapy Café's Online Therapy Services: Is It Worth It?

E-Therapy Café offers accessible one-to-one boutique online therapy with licensed mental health professionals and life coaches. It is a good alternative to in-person therapy with most of the same benefits, though live sessions are only 30 minutes long. Still, its lower prices and written communication options could make the therapy more accessible to people with tight schedules or budgets.

Pros & Cons

Pros

• Tiered payment options
• Shorter sessions
• One-on-one video sessions
• E-journal (written) sessions option
• Discounted first session
• You can choose your therapist
• Text chat available with therapist
• Switching therapists is easy
• Sessions run by licensed mental health professionals or certified coaches
• Emotional support animal services
• Wedding and bridal coaching

Cons

• Clunky website
• No app
• Limited diversity among therapists
• No psychologists or psychiatrists on staff
• No medication management
• Insurance not accepted

Therapy can be expensive—and even when you can afford it, it can be hard to find a therapist that’s accepting new clients. A recent study by the National Council for Mental Wellbeing found 42% of Americans cited cost and lack of insurance coverage as the reason they couldn’t see a therapist. And a recent analysis by ABC News found that 75% of rural counties in the United States have either no access to mental healthcare providers, or there are fewer than 50 providers for every 100,000 people.

E-Therapy Café aims to address that disparity by offering online therapy that is convenient and affordable and can be accessed “anytime, anywhere,” as it states on its website. Its founder and president, Jude Black, says that the company aims to make “being heard” simple and that a big goal is to help people “get unstuck” on personal issues so they can move through challenges, build resilience and learn to thrive.

I reviewed survey data from 105 user respondents, researched the company, and spoke with subject matter experts about E-Therapy Cafe’s offerings. I also signed up for the service myself to see how it stood up to its mission statement and fared against 54 other online therapy companies we reviewed. Here’s what I found out. 

What Is E-Therapy Café?

Jude Black is a former military spouse who first used video chat to stay in touch with her husband when he was deployed overseas. She was so moved by its ability to keep them connected that in 2003, she used her experience to start a company called Cope Today that offered virtual chats and video sessions to military members and veterans across the country. As her clients’ mental health and lives improved, she was inspired to start E-Therapy Café for civilians in 2016.

The boutique therapy service provides individual therapy in 30-minute increments. For users who want longer sessions, the 30-minute sessions can be stacked together, with the permission of the therapist, to make hour-long sessions. According to clinical psychologist Amy Marschall, PsyD, “Thirty minutes can be effective depending on the issue—sometimes young kids can't hold attention for a forty-five-minute session—but typically this is considered too short,” she explains. “The stacking sessions option feels odd to me.”

The company also offers an e-journal option, in which the client can write up to 700 words, submit it to their therapist or coach, and receive an in-depth reply within 48 hours. While the e-journal could be good for introductions or for clients who struggle to express themselves verbally, it does not replace live talk therapy. 

That said,  there appear to be some state exceptions to E-Therapy’s accessibility mission in its terms of use. According to national licensure requirements, E-Therapy Café practitioners are allowed to provide psychotherapy services in all states except Arkansas, California, Florida, Nebraska, and Ohio, where practitioners have to be licensed by that state. If a user is from one of the excluded states, it explains, “you understand and acknowledge that you will not be receiving state-licensed treatment but a confidential consultation.” While I’m not sure of the difference in treatment based on the semantic differences, as a California resident, what I experienced felt like therapy.

What Services Does E-Therapy Offer?

E-Therapy Café advertises a menu of specific counseling services, including relationship counseling, online journaling, marriage counseling, couples counseling, college counseling, LGBTQ+ counseling, and military counseling. In addition, E-Therapy Café has two unusual support options not typically found at other online therapy sites: wedding coaching and emotional support animal resources (ESAs).

Wedding coaching is designed to help people through the stress of planning a wedding, and more specifically create “actionable strategies that allow brides to reduce stress, establish clear boundaries and gain peace, clarity, and focus.” The service is aimed at helping to minimize feeling overwhelmed, diminish drama, and smooth out communication issues.

Marschall says that she can see the benefit of a niche service like that but had never seen it advertised that way. “Generally any therapist who works with stress management would be appropriate for that service, so I wouldn't say it's necessary,” she continues.

Subject matter expert Hannah Owens, LMSW, suggests that “it must be in demand if the company is advertising those services.”

Though E-Therapy Café states that it teaches techniques to integrate a pet into therapy and teaches techniques to self-soothe and reduce anxiety with one’s pet, as well as potentially providing a letter recommending your pet be an officially registered ESA under certain criteria, Marschall is dubious. “ESAs can be legitimate, but unfortunately many online companies have just started giving out the letters without actually assessing people, which has devalued the process. I would need to vet their process for deciding who gets a letter before saying for sure.”

However, Owens adds “The fact that it offers ESA certification makes me think that its process is more than just writing bogus letters for anyone who asks—though I don't know for sure.”

Who Is E-Therapy Café  For?

On the one hand, E-Therapy Café suggests that it offers therapy for “anyone, anywhere,” and it does offer a wide range of types of counseling services, as outlined below. However, it also appears to offer specific services to couples at various stages in their relationships, college students, the LGBTQ+ community, and military members.  

E-Therapy doesn’t state which specific mental health conditions it treats, but it refers in the various descriptions of types of counseling to such conditions as anxiety, depression, and eating disorders, to name a few.

Also, its terms of use explicitly state that clients must declare if they have any history of major psychiatric episodes, hospitalizations, or drug/alcohol dependence, or have received a diagnosis of borderline personality disorder, major depressive disorder, bipolar disorder type 1, mentally ill/chemically addicted (MICA) and/or schizophrenia, as the therapist/coach may opt to refer you to another agency that can better serve these needs.

How Much Does E-Therapy Café Cost?

E-Therapy Café works on a tiered system. You can pay-as-you-go for 30-minute sessions for $55, but it urges you toward a subscription plan. Those are:

• 4 e-sessions or e-journals: $196, or $49 per 30-minute session
• 8 e-sessions or e-journals: $360, or $45 per 30-minute session

You can mix and match your e-sessions and e-journals if you choose to partake, and you can stack two 30-minute sessions to build an hour if your therapist agrees. 

At these rates, a 60-minute stacked session of two 30-minute sessions would cost between $90 and $110.

Additionally, you can pay $55 to obtain an assessment for an ESA prescription for your pet. There is no guarantee that your pet will qualify, however, 

On the surface, $55 for 30 minutes seems more affordable, when you contrast it with the average rate of therapy in the United States, which runs between $60 and $200 for an hour-long, individual session. However, if you choose the stacking option, an hour-long session ends up being average in cost.

Interestingly, in our user survey, of all the factors that were most important in users’ search for therapy, only 2% of E-Therapy Café users said cost was one of those factors. 

Does E-Therapy Café Take Insurance?

E-Therapy Café does not take insurance, which is disappointing as health insurance helps make mental health care more affordable for many people. Many of E-Therapy Cafe’s competitors do accept insurance, which puts it at a disadvantage.

However, upon request, it will provide a detailed monthly superbill or bill of services that a client can submit to their insurance provider for reimbursement. It does note that you must be working with a licensed therapist in order for insurance reimbursement, and state laws and exclusions may apply.

While it is a disadvantage that this company doesn't take insurance, its superbill service may result in some users receiving money back from their insurance.

Does E-Therapy Café Offer Discounts?

E-Therapy Café offers several discounts, including:

• Trial session: New users can receive $5 off a trial session, which is not a significant discount in contrast to other sites which offer a month or week free. 
• Military discount: With its founder’s background as a military spouse, it’s no surprise that the company offers a 10% discount to all military members, dependents, and veterans for subscription only.
• First responder discount: All first responders and their families receive 10% off subscription-only plans.
• Student discount: College students who are actively enrolled in school also receive a 10% discount on subscriptions only.

Navigating the E-Therapy Café Website

E-Therapy Café’s home page is aesthetically busy, with a lot of rotating images in the background of the home page and lots of words in different size fonts, with such catchphrases as “It starts with a conversation,” “Expert online therapists you can trust” and “Life is messy—we can help.”

In addition, its sterile beige and gray colors are not visually appealing. There are two buttons amidst all this that do take you to relevant info: “Find a Therapist Online” and “Meet Our Team.” But overall, it’s overwhelming to the eye. 

Fortunately, the site does have a navigation bar at the top of the screen with easy-to-find, pertinent information.  The company uses a private online portal through Simple Practice and does not have an app.

Surprisingly, users were not bothered by the website’s busyness. Only 2% of survey respondents described navigating the website as “difficult.” 34% said it was “very easy” and 37% said it was “easy.”

How Do You Sign Up for Therapy at E-Therapy Café?

Signing up was relatively straightforward. I clicked “Take the First Step Now” and was taken to a registration page that asked whether I wanted individual, couple, or bridal counseling.

I was then asked to fill in my name, address, phone number, gender, relationship status, and employment status. The questionnaire also asked me how I was feeling that day, and some general questions about stress levels, anxiety, energy, and whether I was currently suicidal. (If a person is suicidal, it recommends they call emergency services, that E-Therapy Café’s services will probably not suffice for a crisis).

Then it asks which coaches you want to work with and lists them by name. Lastly, it asks two open-ended questions, “What would you like to achieve through therapy?” and “Is there anything else you want us to know?”

After you answer these initial questions, the site lists the therapists by name that you can choose from (about 6 options). I looked up each of their bios to see who felt like the right fit for me.

Choosing a Therapist at E-Therapy Café

At sign-up, you have the option to choose from a pre-populated list of therapists. I looked at the qualifications and most of the therapists have LCSW, LGSW, and MFT licenses, as well as some certified life coaches. There are no psychologists or psychiatrists on staff. I also noticed that most of the therapists are women and that there is not a wide range of diversity among staff.

If you don’t know how to choose, E-Therapy Café will pick a therapist for you—depending on how thoroughly you fill out your intake questions, this may or may not be a great strategy.  

How Do Therapy Sessions Work at E-Therapy Café?

After I submitted my replies during sign-up, I received an email stating that my submission had been successfully and that I would receive a secured link to the email I provided that would allow me to complete the setup of my online portal and schedule my first appointment. 

It warned me to check my spam, and to know that once I chose my therapist I would receive an email from my “clinician.”

E-Therapy Café uses Simple Practice as its private online portal. Every time I wanted to log in, whether to request an appointment, use the chat function with my therapist, or write a journal entry, I would go to my login page and it would send me a direct, private link, within seconds, that would take me directly to my portal. I never had any trouble accessing the portal.

Messaging Your Therapist

Once I received the welcome email and my portal link, which came within 24 hours, I requested an appointment for a few days later with the therapist of my choice through an online calendar system within the online portal. She contacted me that same day to let me know I could reach out with any questions, and once she approved my appointment request I was then able to reach out to her via chat in the online portal. 

The chat function is designed for quick questions, not therapy, but I asked a few different questions through it, and each time my provider responded very quickly. I also had to sign a bunch of forms, including terms of use, informed consent, telehealth instructions, and payment policy.

Video Sessions

My first 30-minute session was the trial video session, which gave me a $5 discount. 

A login link was sent to my email 15 minutes before the session began, which took me into Simple Practice, into a virtual room much like Zoom or Google Meet. I arrived before my therapist, who was a couple of minutes late to my first session, which I did find a bit annoying given the short session time. However, she did extend the time to give me a full session. She had read my intake form so she had a good idea of what I was there to discuss and what I wanted to work on. 

I felt she did a good job of reflecting this and showing me that she wanted to help me with my specific goals. She even asked me a couple of tough questions that had me looking more deeply at myself. I felt it was a strong first session. 

 E-Journal Sessions

Next, I tested an e-journal session. Journal entries are like asynchronous therapy: The client posts written thoughts of up to 750 words, and the therapist responds in writing within 48 hours. For people who struggle to express themselves verbally, or may feel shy about opening up in a first session, this could be a great option.

I thought this would be a good way to work on the homework my therapist assigned me, which included a journaling prompt. Once you register for the journal, you’re given access to a digital space that is private between you and your therapist. I journaled my answers there, then clicked submit. Here is where I experienced the only technical difficulty. My therapist replied to my journal within 24 hours, but for some reason, I couldn’t access her reply within the portal. So we wound up having to involve customer service (she reached out on my behalf). 

My therapist offered to send her reply as a PDF, but she was worried about confidentiality with digital information. So I opted to wait until customer service could work it out. It took about three days for them to correct the glitch so I could access her reply. 

While ultimately the journal process wasn’t better for me than talk therapy, I could see it being very effective for people who prefer communicating in writing or have other difficulties verbally expressing themselves. However, Marschall has some reservations about this service. “I am wary of asynchronous therapy because the therapist and client aren't processing emotions in real time as they come up. I don't know definitively that it would not work and would need to see research on it, but my initial reaction is I'm not sure it would be equally effective.”

I did feel that the cost for the e-journal, which is the same as the one-to-one therapy session, should be slightly less, as there is no live interaction. 

I scheduled a second video session with the same therapist about a week later, and felt that she was less attentive and focused in that session. She seemed tired and talked more than she listened. 

Couples Counseling

I did not try E-Therapy Café’s couples counseling option, but here’s how it works: Relationship, couples, and marriage counseling all aim to help people improve communication and connection, with marriage counseling offering even more specifics, ranging from building empathy and respect to minimizing ineffective or threatening patterns, reducing power struggles, renewing commitment to the relationship, and making decisions about separation and divorce.

What Happens If I Miss a Session at E-Therapy Café?

All of your sessions are pre-paid 24 hours in advance of your sessions, no matter what kind, with a credit card or debit card on file. 

E-Therapy Café has a 24-hour cancellation policy for all sessions, including e-journals. If you cancel or reschedule within less than 24 hours of your appointment, you will be charged the full amount. If you’ve paid for a subscription, it will use one of your credits for any cancellation not within this window, and there will be no refunds. 

Pausing or Canceling Therapy at E-Therapy Café

If you have a session and your payment method does not go through, you will not be allowed to schedule any future sessions until your balance due is paid.

However, you can change your subscription at any time by emailing hello@E-TherapyCafe.com 24 hours prior to your renewal date. 

Switching Therapists at E-Therapy Café

I found it interesting that in its terms of use, E-Therapy Café urges you to think twice before switching therapists, and it encourages people to first try to work out any problems or difficulties with one therapist before requesting another one. 

Because of this, I anticipated meeting with resistance when I was ready to switch therapists. I sent an email to the requested customer service email stating that, having a lot of experience with therapy in my life, it was best for me to try out several therapists to find a good fit before committing. I received a reply in a couple of days that they understood and asked who I would like to see next. I picked a different therapist and was able to schedule with her quickly. So though E-Therapy Café makes a bit of a fuss about switching providers in writing, in practice, it was ultimately easy.

There was almost no difference in the logistics for communicating with my second therapist, whom I liked better than the first one. She gathered more background information on me and also gave me some strategies. I did not do an e-journal session with her. In the portal, when I was assigned a new therapist, I could no longer access the chat function I had with the first therapist.

Quality of Care and User Satisfaction

Even though I only saw two therapists, for a total of three video sessions and one written e-journal, both therapists had similar strategies of trying to offer advice and information that would help me take action, versus just listening to me talk or vent, which made the shorter sessions more productive than I expected. If I were to pursue therapy online in earnest, I would consider continuing with this company.

Despite some questions about the necessity and validity of some of their counseling areas, namely wedding counseling and emotional support animal resources, the proof of E-Therapy Café’s quality is in how users feel about it. E-Therapy Café scored in our top three of the 55 therapy companies reviewed. And even though some of our experts expressed concern about the short length of sessions, I found all of my live sessions to be quite helpful and could see 30 minutes being plenty of time for the kind of therapy I need.

Personally, I’d say this style of therapy might lend itself more to active change for people with problems they already know about and want to change, rather than therapy where more deep-seated issues require more emotional investigation.

Forty-eight percent of users felt that all of their needs were met while using the service and 34% felt that most of their needs were met, which adds up to a significant 82% of users who felt that some or all of their needs were met. 

E-Therapy Café users are also among the more committed to their therapy among all our survey users. A cumulative 58% said they are “very likely” or “likely” to still be seeing a therapist in six months, and a cumulative 51% said they’d be “very likely” or “likely” to still be seeing a therapist in 12 months. Finally, 39% of users said they were “very likely” to recommend the service to a friend, and 43% said they were likely to do so. Only 7% said they were not likely to do so.

Marschall feels that the $55/session price is a potential red flag that the company may be underpaying its therapists. However, I could not find any evidence that this is true—there are no negative reviews about the company or its therapists online that I could find. 

The closest thing to a negative review comes from an employee review on Glassdoor. It first states, “I really enjoyed my time here. I am a licensed therapist and joined E-Therapy Café to complement my in-person practice. I believe in the value that distance counseling adds to our field, and I feel that E-Therapy Café is the leader in online counseling.” The reviewer goes on to add, “The only downside would be adapting to the learning curve involved with working with clients online (but this is something that would happen with any distance counseling platform, not just E-Therapy Café). And honestly, it didn't take that long to adjust to online therapy versus traditional therapy.”

Privacy Policies at E-Therapy Café

E-Therapy Café clearly states that it makes privacy a priority and is a HIPAA-compliant platform. It uses encryption, firewall, virus, and password protection on stored files and communications, and commits to destroy all records after a given period, though it doesn’t say what that period is. It encourages users to take further steps to ensure confidentiality by changing their passwords and deleting their web browser's cookies regularly. E-Therapy Café does not use cookies for collecting user information from the site and states that it won’t collect any information that isn’t required for system administration of the Web server.

While discussions are private and confidential, it makes clear that the law requires mental health professionals to disclose information and possibly take action in the event of  “(a) reported or suspected abuse of a child or vulnerable adult; (b) serious suicidal potential; (c) threatened harm to another person; (d) court-ordered presentation of treatment.”

E-Therapy Café reserves the right to update its privacy statement at its sole discretion and encourages users to review it again periodically.

E-Therapy Café vs. Its Competitors

E-Therapy Café may not have the medication management and psychiatry services of bigger platforms like Talkspace and BetterHelp, but for therapeutic satisfaction among users, it outscores both of them. Talkspace is a therapy company that allows users to text chat with a therapist. Its mission isn’t too far from E-Therapy Café’s: ”to make therapy and psychiatry more available and affordable,” as well as to reduce the stigma around mental health treatment. 

Through Talkspace, users can obtain therapy through audio, video, or chat sessions, the latter either live or asynchronously. Talkspace ranks almost as high as E-Therapy Café in our user survey, scoring a collective 90% of users who felt the service overall was either good, very good, or excellent. Still, E-Therapy Cafe outscored Talkspace, with 94% of users feeling that it was good, very good, or excellent.

Talkspace users did feel pretty satisfied with their experience. 34% said most of their needs were met, and 45% said all of their needs were met, for a cumulative 79%. Yet, here, too, E-Therapy Café won out with a collective 82% of users saying that either all or most of their needs were met.

BetterHelp is one of the largest online therapy platforms in the world and offers virtual therapy with licensed and certified therapists through chat, phone calls, and video sessions.

BetterHelp scored a cumulative 76% of users who felt that its therapists satisfied all or most of their needs, which can’t compete with E-Therapy Café’s 94%. For a small company, E-Therapy Café seems to be doing a lot right.

However, when compared to companies used in the past, 89% of E-Therapy users said it was better compared to a whopping 97% of Talkspace users. BetterHelp, again, ranked behind with 84% of users saying it was better.

Final Verdict

Despite a less-than-appealing website and some unusual offerings that could use some closer vetting, the actual therapy experience here was a good one, one that I would continue with if I was seeking online therapy. The short sessions might not work for people at the beginning of their therapy journey, but for those with therapy experience and active goals, they could be just right. 

While the company is still relatively small and could expand its therapist diversity, what it’s doing is working, and users are satisfied with their therapeutic results. The company is responsive in its emails, accommodating to making a therapist switch and working out glitches or problems within a couple of days. The therapists I worked with were both effective in different ways, and I definitely felt I could build a rapport with either of them. When users were asked whether they would return to Café if they had to start their therapy search over again, 77% said yes.

E-Therapy Café has a strong foothold among its competitors and seems to be making its users happy.

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

Key Specs

• Price: $55 per 30 minute session to $360 for a subscription of 8 sessions
• Is Insurance Accepted? No
• Types of Therapy Offered: Individual, couples, relationship, family, LGBTQ, wedding, college, military, emotional support animal services
• Communication Options: Video, text chat, phone, and e-journal
• HIPAA Compliant? Yes
• Is There an App? No
• Accepts HSA or FSA? Not sure
• Prescriptions Available? No
• Billing Cadence: Pay-per-session or buy a subscription package of sessions