Best Online Trauma Counseling

In a 2022 survey our editors conducted, nearly half of 2,938 American respondents said they were concerned about affording counseling. BetterHelp addresses that concern by offering low rates compared to other online therapy services. 

In addition, beyond its relative affordability, BetterHelp has built a roster of licensed counselors that serve clients in all 50 U.S. states (and in 200 other countries). Among the more than 27,000 therapists under the BetterHelp umbrella, you can find trauma specialists who work with several different trauma-informed modalities, ensuring that you can find a therapist and style of therapy that work for you.

BetterHelp treats individuals. It does not serve families, couples, children, or teens. There are also no group therapy options or medication management providers at BetterHelp. When you go to the BetterHelp homepage, you’ll see options for individual, couples, and teen counseling, but the latter two links take you to BetterHelp’s sister sites, ReGain and Teen Counseling. 

The sign-up process at BetterHelp is fairly straightforward. After answering several questions, including many about trauma and post-traumatic stress disorder, you’re matched, within hours or days, with a therapist licensed to practice in your state or country. 

Before you are connected to your chosen therapist, you’re required to pay for a monthly subscription plan (see pricing information below). Once you are connected with a therapist, you can have your sessions via video, phone, or live chat.

A potential downside of BetterHelp’s less-expensive sessions is that they are usually 30 minutes and shorter than the traditional 50- or 60-minute therapy appointment. 

According to Hannah Owens, LMSW, mental health editor for Verywell Mind, 30-minute sessions are, in general, not ideal. “That doesn’t leave much time to build rapport or really delve into issues, and the end of the session might be jarring and potentially leave the user in a heightened emotional state that they would otherwise be able to wind down from with a longer session,” she says. This is something to consider as you research the types of therapy that may, or may not, work for you.

BetterHelp does not offer a free consultation and standard rates range from $60 to $90 a week, depending on therapist availability and local pricing. You can also inquire about financial aid. 

Sessions are 30 minutes, but you can ask for another 15 minutes for an additional fee. Rates include access to a private, 24-hour virtual therapy room, where you can leave messages and questions for your therapist. Message response times will vary based on your therapist’s availability. 

BetterHelp bills on a monthly subscription basis and you can cancel at any time.

While generally being more affordable than in-person counseling and other online therapy sites, BetterHelp unfortunately practices surge pricing. The cost of sessions can change based on demand in your area, but will not exceed $90 a week, according to BetterHelp pricing information.

Owens describes this practice as “despicable.” “Raising costs of mental health care based on demand makes affordable and accessible care even more difficult for the therapy seeker, many of whom are already faced with barriers to care because of cost,” she explains. 

While BetterHelp does not take insurance, it does accept payments from health savings accounts (HSAs) and flexible spending accounts (FSAs).

For the most part, BetterHelp users are satisfied customers. Of the 105 BetterHelp clients we surveyed, 86% said they would rate the service excellent, very good, or good. Thirteen percent said they sought out help specifically because of a traumatic event, and 21% saw therapists who practiced trauma-focused therapy or trauma systems therapy. Eighty-seven percent of survey respondents said they would rate the quality of their assigned therapist as excellent, very good, or good.

Little Otter is our choice for childhood trauma because it emphasizes a holistic approach to therapy and psychiatry that includes treatment for your child, you, and your family. The practitioners at Little Otter use trauma-informed approaches and modalities to address major life changes, the death or loss of a parent, abuse, and other traumatic events. 

Founder Helen Egger, MD, is a veteran child psychiatrist who has developed proprietary assessments for common emotions and behaviors in early childhood related to family stress.

Little Otter’s inclusive approach considers the role of parents, co-parents, couples, siblings, grandparents, guardians, and more in the health of children and families. In support of its mission to help families receive the mental health care, support, and guidance they need, Little Otter offers parent coaching, couples and family counseling, and psychiatric care in addition to virtual therapy sessions for children.

Beyond trauma therapy, Little Otter specializes in anxiety, depression, and focus—which can be symptoms of unprocessed trauma.

The sign-up process at Little Otter starts with a free online assessment, then a paid 30-minute intake session. Once the website determines that there are Little Otter practitioners in your state, you are asked to create a Little Otter account and fill out personal information about your child. Next, you'll complete an assessment related to the behavioral or emotional challenges your child, you, and your family may have.

You are then paired with a licensed mental health practitioner who is employed full-time by Little Otter (many other platforms hire practitioners as contractors, instead of full-time staff members). You have access to a private portal for scheduling appointments and sending your therapist messages.

Little Otter doesn’t offer subscription plans, but it does have session bundles that can help you save money. The payment options are:

• $540 for a 90-minute psychiatric assessment plus one standard therapy session
• $2,040 for a 12-session therapy bundle (sessions are 45 minutes at $170 each)
  

The mandatory initial 30-minute welcome session costs $90. The Little Otter website does not mention discounts or financial aid. 

Little Otter is an in-network provider for Kaiser Permanente, but that's the only insurance plan it takes. Otherwise, the company can provide you with a superbill for reimbursement from your insurance company. It also accepts HSA and FSA payments.

Little Otter customers are generally satisfied, with 75% of the 105 clients we surveyed saying their overall experience was excellent, very good, or good. Fifty-eight percent of survey respondents said they would recommend Little Otter to a friend, while 81% said Little Otter was much better, better, or a little better than similar services they’d used in the past.

Talkspace rises above other large online therapy platforms in the resource department for clients with PTSD. Dozens of blog posts cover the definition of trauma, plus specific considerations for veterans, racial injustice, intergenerational trauma, abandonment trauma, mass shootings, sexual assault, and more. 

Additionally, Talkspace offers a post-traumatic stress disorder (PTSD) test that assesses how likely it is that you have PTSD based on your responses about several symptoms, including having disturbing dreams of a traumatic event and feeling agitated and on high alert.

At Talkspace, you can sign up for individual therapy and psychiatry sessions or couples counseling with licensed therapists. The process starts with a quick assessment before you are matched with a therapist and subscribe to a pricing plan (see options below). You schedule with your therapist online. 

Talkspace reports that 59% of its users experience significant change within three months.

Talkspace offers three therapy subscription plans:

• $69 a week for messaging therapy
• $99 a week for messaging therapy plus weekly video sessions
• $109 a week for messaging therapy plus weekly video sessions and workshops 

Sessions are 30 minutes long and you have the option to buy additional sessions for $65 each.

You’ll be billed monthly, quarterly, or biannually, cashing in on a 10% to 20% discount if you pay quarterly or biannually. You can cancel at any time. 

Couples therapy starts at $396 a month for weekly sessions, while psychiatry sessions are charged per session, at $249 for an initial assessment and $125 for follow-up sessions. 

Talkspace does take several insurance plans, as well as HSA and FSA payments.

Talkspace consistently ranks among the top performing online therapy sites in our user surveys. Of the 105 Talkspace clients interviewed, 90% said they thought Talkspace was excellent, very good, or good overall. Twenty-two percent of survey respondents reported starting therapy at Talkspace to work through the trauma of abuse, while 17% said they were seeking help with fallout of traumatic events in general and 32% said they received trauma-specific treatment.

The Inclusive Therapists Directory supports accessible mental healthcare for the QTBIPOC  community—the intersection between the 2SLGBTQ+ and BIPOC communities. Through Inclusive Therapists, you can find a provider who can help you work through any trauma you’ve experienced because of your gender or sexual identity, often with therapists who have been through similar challenges and traumatic events themselves.

Founded in 2019 by psychotherapist Melody Li, LMFT, the Inclusive Therapists Directory aims to be a mental health justice movement. As Li writes on the Directory website: “As a queer migrant of Color and diasporic settler on Turtle Island, despite my many privileges, I had my fair share of struggles in finding a therapist that gets me. I was tired of educating my therapist on what it's like to navigate systemic injustices impacting my communities. I've been gaslighted by therapists that upheld colonial practices,” she says, explaining that “entering into a therapeutic relationship shouldn't feel like a gamble. My heart is to help connect social justice and liberation-oriented therapists with melanated, marginalized, neglected, and displaced Peoples.”

The directory includes listings for therapy for individuals, couples, families, children and teens, and group therapy, as well as psychiatric care, medication management, and coaching. 

On the Inclusive Therapists Directory website you can search for a therapist by state, therapeutic approach, insurance provider, sliding scale rate options, and category (including transgender trauma. abuse, loss, human trafficking trauma, PTSD, racial trauma, and religious trauma), among other options.

Because the Inclusive Therapists Directory is a mix of therapists across the United States and Canada who have their own practices, rates vary. About 71% of the Inclusive Therapist Directory providers we surveyed offer sliding scale services and 42% don’t take insurance.

Of the 180 directory users we surveyed, 89% said the platform was very good or good. Sixty-seven percent of those surveyed said they were able to find a therapist who met all of their needs.

Hurdle Health started in 2018 as Henry Health—a mental healthcare and technology company serving Black men. Then in 2020, it rebranded as Hurdle Health and now serves diverse communities across genders.

Hurdle Health therapists are required to complete a training on addressing issues of race, ethnicity, class, and culture. Hurdle also coaches therapists in cultural humility, which has been shown to improve therapy outcomes for people belonging to marginalized communities.

Serving individuals, relationships, and children ages 12 to 17, Hurdle Health therapists primarily use a trauma-informed cognitive behavioral therapy approach to help you examine, process, and transcend trauma. The platform does not offer psychiatry, medication management, or group therapy.

Hurdle Health therapists offer specialization in PTSD, grief, loss, domestic violence, and racism, among other areas. 

Once you register on the Hurdle Health website, voicing your therapist preferences, you’ll be matched with a practitioner. 

Once paired with a therapist, you can schedule teletherapy appointments and send your therapist messages via a secure client portal.

Hurdle Health has three payment options:

• $129 per 45-minute session
• Two-sessions-a-month subscription ($97.50 per session)
• Four-sessions-a-month subscription ($87.25 per session)

You can take an additional 10% off if you agree to be billed every three months. You can cancel at any time. 

Hurdle Health is an in-network provider with many insurance plans, including Aetna, Blue Cross Blue Shield, and Medicare. Customer service can help you figure out if your treatment is covered. The site does not say whether Hurdle Health accepts HSA and FSA payments.

While Verywell Mind hasn’t surveyed Hurdle Health users and therapists, the company seems to be doing well, securing $5 million of venture capital in 2020. Its streamlined focus on the experiences and trauma of those in BIPOC communities makes this company a useful tool for those seeking therapy that is guaranteed to be culturally informed.

It is hard to beat the affordability and flexibility of ReGain, an online therapy and couples counseling company that, on top of trauma services, also has therapists who can treat grief, stress, anxiety, parenting, depression, addiction, anger, family conflicts, LGBT concerns, religious issues, and self-esteem problems. Plus, it offers helpful resources on developmental, childhood, and acute trauma that may be affecting your relationships. The company’s online resources also offer advice on whether you should seek trauma therapy.

ReGain accommodates individuals, couples, and other forms of relationships. 

The sign-up process starts with a questionnaire about the type of therapy relationship you’re looking for (individual or couples), information about yourself and your relationship status, your experience with therapy, what you want out of counseling, what you're looking for in a counselor (therapeutic approach, gender, sexual orientation, religious leanings, etc.), what you can afford, where you’re located, and your preferred language. You then set up an account and ReGain matches you with a licensed therapist.

From a secure portal, you can schedule video or phone sessions.

Therapy at ReGain is billed monthly at $60 to $90 a week, depending on the therapist you work with. You can cancel at any time and not be billed for the next month. There is no free trial period or free consultation option. ReGain does not take insurance, but you can pay with an FSA or HSA card. Financial aid may also be available.

Of the 105 ReGain users we surveyed, 80% said ReGain met all or most of their therapeutic needs, and 72% said they would recommend ReGain to friends and family. In addition, 84% of survey respondents reported that ReGain is better than other online therapy services they’d used in the past, and 82% reported that the process of looking for a therapist on ReGain is very easy or easy.

Listing “PTSD” as one of its main specialties on its homepage, Talkiatry layers psychiatric care with cultural diversity to deliver trauma treatment, prioritizing hiring and serving people from diverse backgrounds and with diverse identities. Plus, it takes most major insurance policies and makes sure you’re covered before you begin.

Talkiatry primarily offers psychiatric evaluations and care and medication management to adults and children older than five. If you are a Talkiatry psychiatric patient, you can also schedule supplemental therapy sessions if your psychiatrist deems it necessary. This gives you options in terms of treating trauma with multiple different modalities—medication management as well as talk therapy.

Once you fill out your personal information, answer several questions about your symptoms and why you are seeking therapy, and supply your insurance information, the Talkiatry website will let you know if your insurance is accepted, then pair you with a practitioner. Like on many of the other sites listed here, you can schedule your first appointment almost immediately.

Talkiatry can’t help with crisis situations or disability benefits, or if you are looking for only talk therapy (without psychiatry). 

There are no self-pay options at Talkiatry; you have to use insurance. It also accepts FSA and HSA payments.

Eighty-nine percent of survey respondents reported that the psychiatry and medication management services at Talkiatry were excellent, very good, or good, and 70% said Talkiatry met their needs. Twenty-two percent of the 105 Talkiatry clients we surveyed said they had sought treatment for trauma or abuse.

Thriveworks has flexible hours, both online and in-person, that can make it easier for busy families to find time for therapy. The ease of scheduling can reduce stress in an already often stressful situation. Thriveworks prioritizes family counseling and accessibility, and even explains the efficacy of online therapy for treatment of PTSD on its website.

Thriveworks serves individuals, couples, children, and teens in addition to families. It also offers psychiatric care.

The registration and scheduling process is different from most other platforms in that you choose your practitioner instead of getting matched. You can search a directory of Thriveworks counselors and psychiatrists by location, specialty, or insurance coverage, and can indicate through its search filters if you would like help treating trauma and/or PTSD. There are no assessments; you simply create an account and then schedule with the licensed or pre-licensed therapist you choose.

Self-pay rates start at $99 per 50- to 60-minute session and vary from location to location. 

Thriveworks does take several insurance plans, including Cigna and Humana, as well as FSA and HSA payments.

Of the 105 Thriveworks clients we surveyed, 90% said they thought this service was excellent, very good, or good. Twenty-three percent of them had gone to therapy because of family issues and 46% were in therapy because of abuse, grief, loss, or a traumatic event. Seventy-eight percent said their provider at Thriveworks met all or most of their needs.

The Reclamation Collective is a unique directory of diverse resources created to help people who have experienced religious trauma. It was started by two women in the Midwest who both left their childhood faith communities for various reasons and in the process had to work through grief, shame, and isolation.

In addition to a directory of counselors who specialize in religious trauma, the Reclamation Collective also offers online classes and support groups, in-person events and retreats, and other resources. One such resource is known as an “Integration Circle,” which is a group experience specifically for the purpose of integrating into a community after experiencing trauma with a religious community.

While the directory doesn’t have the best user interface, it still allows you to search nearly 80 registered and licensed or pre-licensed therapists by location, specialty, and insurance coverage. Specialties include purity culture, fundamentalist Christianity, Mormonism, Orthodox Judaism, childhood abuse and neglect, LGBTQIA+ concerns, and sexual trauma.

As it is a directory, prices and insurance coverage vary from therapist to therapist.

Although we did not survey users of this company, we are confident recommending the Reclamation Collective directory because of its specific focus on religious trauma and its wide array of additional resources that can give much-needed support to anyone who has had a traumatic experience at the hands of a religious organization, community, or individual.

Circles offers accessible, relatively affordable online group therapy for many topics and populations that are related to or familiar with trauma. 

Persistent complex bereavement disorder is the diagnosis for long-term (for more than a month) intense distress associated with grief and loss. It can often lead to adverse effects on emotional, social, physical, and even spiritual well-being. This suffering is also called complicated grief, which many of us experienced during the COVID-19 pandemic when we couldn’t grieve the loss of loved ones or felt isolated from our communities.

Circles offers 12-week core groups centered around grief/loss and divorce/separation. These are led by professionally trained and licensed social workers, psychologists, and therapists. Circles also offers free, ongoing support groups led by trained peer support providers around more than a dozen topics, including abortion, cancer, chronic illness, and LGBTQIA+ and veterans’ issues. These groups run for 60 minutes each week. They are for adults only.

Circles offers a simple and straightforward subscription service. Twelve-week core group sessions are $237, billed monthly at $79. Your first week, or group, is free. In addition to weekly live video groups, you also get access to 24-hour messaging with mental health professionals. 

Circles doesn’t accept insurance, but may offer financial assistance.

Seventy-seven percent of the 105 Circles users we surveyed said that the groups met all or most of their needs, and 83% said that group facilitators were excellent, very good, or good. Seven percent of users sought Circles’ services after a traumatic event, 15% said they sought treatment after abuse, and 10% were dealing with grief and loss.

The Choosing Therapy website features dozens of additional articles about mental health issues and types of therapy and the robust directory is easy to search by specialty (including trauma and PTSD), location, therapist identity (BIPOC or LGBTQIA+), and insurance coverage.

The volume of therapists in the directory combined with the amount of helpful articles about everything from EMDR therapy and grief counseling to how to prepare for your first ever therapy session make Choosing Therapy a one-stop shop for psychoeducation and easy scheduling.

The providers listed in the Choosing Therapy directory cover nearly everything, including child mental health, trauma therapy, gender identity and transgender health, and race and cultural identity. While it doesn’t include listings for psychiatrists or groups, it is easy to search for appropriate therapists using the “PTSD” or “Trauma” specialty filters when narrowing down your choices.

Rates and insurance coverage depend on the location and therapist.

Ninety-eight percent of the 180 Choosing Therapy directory users we surveyed said that the therapist they found on the site met all or most of their needs. Forty-two percent had success with the first therapist they tried, which is slightly better than the success rates on the first try with the other directories we evaluated. Eighty percent reported that the diversity of therapists was very good or good, and 81% said they would be very likely or likely to recommend Choosing Therapy to a friend.