I Have Tried Online Therapy at Three Companies. Here's What I Learned

For years, I used to see a therapist regularly in person—but that was also when I was a student. I could afford to do this (despite living on a student’s meager income) because it didn’t cost me all that much out-of-pocket since it was covered by my university-provided benefits. But then I left school and therapy quickly became a luxury that I struggled to afford, especially while working my first few jobs out of school. So I gave it up, even if that meant neglecting my own emotional health.

But then I had a baby and the birth was somewhat traumatic for me. My maternity leave was difficult and stressful. I was frustrated that my recovery from the caesarean section took longer than I wanted and the sleep deprivation that comes with having a newborn at home started to impact my mental health. By the time I was nearing the end of my maternity leave, I knew I had to go back into therapy or I wouldn’t be effective at my job. But with a five-month-old, a full-time job, and a four-hour roundtrip commute, I also knew I didn’t have the time to fit in a therapist visit in person. So, I turned to online therapy. 

Since then, I’ve tried three different types of online therapy and the experience has been, well, interesting. But in the end, I think online therapy is truly worth it; here’s why. 

I Tried Text Therapy at Talkspace First

I’d originally intended to choose a plan at Talkspace that included both live video sessions and unlimited asynchronous messaging, but after glancing at the therapy subscription plans’ pricing, I decided to keep it simple and went with the cheapest option. After all, I wasn’t even sure if I’d stick with online therapy, so why not start off simple?

The plan only included unlimited messaging with my therapist and guaranteed responses five days a week, and while I was aware this wasn’t really the same as therapy, it actually worked for me at the time—at least at first.

With a nursing baby, long train commutes to and from the office, and the combo of depression and anxiety I was battling daily, the idea of talking to someone over a video call felt a little more than I could handle right then. Texting my therapist (which is done in a secure portal in the app), meanwhile, felt doable, especially since I had plenty of time to send messages: I would make time for it on the train, while I was pumping in the lactation room at work, during nighttime feedings, or whenever my anxiety kept me wide awake for hours worrying about… well… everything. 

I was also really lucky to get assigned to a therapist I actually liked. She didn’t make the asynchronous messaging feel weird. Her messages were always thoughtful, long, and detailed—much like the ones I used to get in session back in grad school.

She took the time to read all my long messages (and sometimes I would send multiple before she’d have the time to respond) and her responses were specific and inquisitive. Sometimes she’d send me exercises or worksheets too.

But then, my therapist abruptly left Talkspace about four months after I started working with her.

I didn’t get a lot of heads up about this either—barely a week. My therapist offered to keep chatting with me until her last day, or I could be rematched with someone new right away. I opted for the latter and she directed me to the matching form.

I didn’t like the new therapist, though. She would only respond once a day (if that) and her answers always felt rushed. They were generally short and she typically only acknowledged the first or the last thing I’d typed in my most recent message, giving me the impression she was skimming my messages, at best. 

And sometimes her messages—which would come right at the end of the day—would not say anything at all. Instead, they were simply messages letting me know she “hadn’t forgotten about me” but that she’d need a little longer to respond—which sometimes meant I had to wait until the next day to hear from her.

These kinds of messages felt forced (and they probably were, since Talkspace guarantees you an answer once a day, five days a week).

So I decided to switch therapists again.

This was admittedly easy to do at the click of a button in the app. However, none of the three therapists I was shown seemed all that great.

Reluctantly, I chose someone that seemed OK and this new therapist did respond more regularly, but her messages were short too. I didn’t find them nearly as empathetic or engaging as my first therapist's, either, so therapy started to feel like a chore.

I started putting off messaging her back—which was also easier to do now because the pandemic meant I was working from home and no longer had long train rides or lactation room time to message. 

To her credit, my therapist would check in if I hadn’t messaged in a while, but after the third check-in message, it was clear she was using a form check-in message that wasn’t personalized at all. The messages all read the same, with whole paragraphs copy-pasted from check-in to check-in. This made me avoid messaging even more.

So I paused my subscription for three weeks, then another three. Then I got a message from my therapist saying she was leaving the company. That was my cue; I canceled the subscription. 

Next, I Tried Online Couples Therapy at ReGain

My marriage had changed after our son was born and the pandemic had only made things worse. We both had lost our jobs in large-scale layoffs (though not at the same time, thankfully), our daycare shut down, and we were stuck at home around each other every single day. Bickering was the norm and full-blown arguments were weekly occurrences. So rather than look for a new place to do individual therapy, I signed us up for couples therapy at ReGain. 

The plan included one weekly 30- to 45-minute session with our therapist and unlimited messaging in a joint portal. I didn’t love the idea of sharing a messaging platform with my husband and it made me reluctant to message at all before we joined our first video session.

I’d hoped our therapist would give us some guidance for how to use the chat portal in session. Instead, she made it clear that she actually wasn’t a fan of the asynchronous messaging feature being used as a place to really share things like we would in session. Instead, she encouraged us to use it more as a way to communicate scheduling questions or concerns with her. So that’s what it became: a way for us to let her know if one of us was running late, we needed to move our session, or we wanted to schedule another one. 

Our couples sessions took place over live video call.

And at first, these live sessions were a breath of fresh air to me, especially after months of only messaging a therapist.

They took place through the ReGain app and I found myself looking forward to them. My husband and I would join together from one device because we were both home and we rarely had any technical difficulties. We could join from our phone app or a desktop, but it was awkward holding a phone for a joint video call so we only did that once. Desktop joint sessions were definitely way easier (and she could see us both—and sometimes our dog too—on the screen better that way too.) 

ReGain has since added a feature allowing partners to join from separate devices or locations as a three-way calling feature. But when my husband and I were signed up, this wasn’t available yet and it was kind of annoying. There were times he’d be running late from work so I’d start alone and he’d join when he arrived. I can definitely see where it would have been more convenient for him to call in from his phone.  

On difficult weeks, we’d schedule two sessions (an extra session cost us an extra $25), but our therapist didn’t always have availability for two sessions and you couldn’t book more than one session at a time even when adding a second one for a fee. This meant that sometimes we wanted two sessions but couldn’t get them.

Forty-five minute sessions also meant that sometimes, we’d leave a session in a not-so-great place. After discussing difficult, painful, or tense things with our therapist, sometimes we were so on edge that we’d end up in an argument later that day when our mediator was no longer there.

And once these arguments after sessions started becoming more frequent, I started dreading sessions and finding myself less willing to open up in session because I didn’t want the fight later if we ran out of time. My husband started doing the same. Soon, neither of us was willing to get into the hard stuff in session unless we knew we could get a second weekly session. Things got expensive booking extra sessions. But it was also expensive to be paying for weekly therapy sessions when neither of us were really doing the hard work.

So we ended up canceling around six months after we started. 

Then I Went Back to Individual Online Therapy

By the time my husband and I ended our subscription to ReGain, I knew I wanted individual therapy with live video sessions—and I also knew I wanted to use my health insurance to help lower the out-of-pocket cost. I paid pretty high monthly premiums for those benefits, so I might as well take advantage of them. 

I found my therapist on Headway, which is a online therapist directory.

All I had to do to get started at Headway was search for a therapist I wanted to work with (by reading through bios), create an account, schedule my first session with my therapist, and provide my insurance benefits and payment information. From then on, billing was handled for me. (And all I had to pay is my co-pay, which is way cheaper than any therapy plan I had at either Talkspace or ReGain.)

A common complaint with directories is that you have to find a therapist yourself, much like you would if you’d just been given a list of names (though a list that displays photos, specialties, and detailed bios). For some people, this can lead to them having to do hours of research and lots of trial and error; I was lucky—I’m still with the same therapist today. 

What I like most about Headway is that I can schedule additional sessions in a week if necessary, or skip a week or two when I am out of town or busy with work. I’m billed per session, so I only pay for what I schedule. My therapist and I also schedule a whole month of appointments in advance each month, which is very handy and allows me to plan ahead. 

The sessions take place over Zoom; my therapist emailed me the session link once when we started therapy and now I just use that same link each time I join a session. The few times I’ve been traveling or unable to get to a computer, she’s also called me.

And since Headway allows me to work directly with their practice, I also don’t have to worry about my therapist leaving for another company.

So Is Online Therapy Worth It?

In the end, yes, I believe it is, even though I have tried three different platforms. 

Skipping the commute to an in-person office is a pretty great benefit. Plus, I personally like not having to be face-to-face in a strange office. At all three places, I actually opened up faster because I was behind a screen, rather than awkwardly sitting in a chair across from a stranger. I can do therapy from wherever I am (even curled up under a blanket with a cat in my lap). 

The different communication options are also handy, though I do think that text therapy has its limitations, as I discovered when I tried Talkspace. It can work, but only if your therapist likes doing this type of therapy. If they see asynchronous messaging as a burden or a chore on their to-do list, enforced by their employer, you’re not going to get quality care.

I also realize now that there is something that gets lost in asynchronous messaging. I couldn’t see my therapist’s expression when I told her something and this meant that sometimes, I’d feel silly re-reading my messages back, waiting for her response. Talkspace didn’t let me edit my messages, but it did let me delete them, so sometimes, I’d do just that and hide them. This made me feel awkward and embarrassed—and likely didn’t serve either me or my therapist. 

In live sessions, my therapist can respond to me in real time so I don’t have the opportunity to second-guess what I’ve shared. This has allowed us to cover more ground more quickly in our sessions.  

I live in a rural area, which means that there aren’t a ton of therapists near me. It would take a lot of time to research them, then call them up to make sure they’re taking on new clients. My GP gave me a list of therapists in the area when I asked for one before signing up for Talkspace, but even he warned that there might be waiting lists; I didn’t have to deal with waiting lists at any of the three online services.

That said, since it’s Mental Health Awareness Month, I’d be remiss if I didn’t mention a few guardrails to keep in mind when considering online therapy.

First, your experience likely varies quite a bit depending on what therapist you work with. I had a great experience at Talkspace at first, but then it took a turn for the worse. Maybe I’d still be using Talkspace had my first therapist not left. I might have even upgraded my plan to include live sessions—Talkspace allows you to upgrade or downgrade your membership at any time.

Second, session length is a big deal. Thirty to 45 minutes is fine for individual sessions, but it’s short when you’re doing couples therapy. So make sure you know what kind of time you need to open up before you make your choice.

Third, if cost is important to you, look for a company that accepts your benefits or look for a platform with sliding scale rates. But the good news is: it’s way easier to look for platforms that offer affordable rates online. 

And finally, don’t expect that the convenience offered by therapy will save you from some trial and error. It took me a few years to finally find a way to do online therapy that worked for me. You might need to do some testing too to find what works for you. But don’t give up—it is worth it.