BetterHelp Online Therapy Review

As one of the largest online therapy companies, chances are, you’ve heard of BetterHelp. With over 27,000 therapists in its network, the company says it has helped over three million people access virtual therapy across the U.S. and in over 200 countries. And there is no question, given its reach, that the company has changed the landscape of this business in its attempts to make affordable, convenient therapy available to more people—and that is why, last year, we considered it our top pick for online therapy. 

However, it is impossible for us to ignore that the company has also been at the center of numerous scandals and ethics controversies, facing accusations of data mining and failing to comply with HIPAA laws to protect user privacy. 

There have also been a number of newcomers to the online therapy business, which is why we were curious to find out how BetterHelp stacked up to its competition. To find out, we surveyed 105 users, sent the company a questionnaire, and interviewed three therapists employed at the company. I also signed up for a monthly subscription in order to test the service. Read on to find out how effective BetterHelp’s mental health care services are and how it stacks up against its competitors.

What Is BetterHelp?

BetterHelp is an online therapy company that was founded in 2013, just one year after its largest competitor Talkspace. Its founder, Alon Matas, had found the process of finding a good therapist to be expensive and intimidating when he looked for himself, so he launched the company with his friend Daniel Bragonier, a product manager and marketing analyst, as a way to make therapy more accessible, convenient, and affordable for everyone. 

In the years since, the company has grown to become one of the biggest therapy companies in the world due to its convenience, relative affordability, and large reach across all 50 states and internationally. It also owns and operates four other therapy sites—ReGain, Faithful Counseling, Teen Counseling, and Pride Counseling—and in 2015, it was acquired by Teladoc, one of the largest telemedicine companies.

What Services Does BetterHelp Offer?

Unlike some of its competitors, BetterHelp’s app and homepage focus exclusively on individual talk therapy, though this isn’t entirely clear when you land on the homepage as you will see three buttons for individual, couples, and teen therapy. However, if you click on the Couples or Teen buttons, you will be redirected to ReGain and Teen Counseling, respectively. 

BetterHelp does not offer group or family therapy, nor does it provide any medication management or psychiatry services as some of its competitors do. 

All live talk therapy sessions are 30 to 45 minutes long, depending on what you and your therapist agree to. You can also message your therapist at any time through the messaging room in the app or web portal. However, the company does not promise therapists will respond within a specific time frame.

Who Is BetterHelp For?

BetterHelp serves users looking for individual therapy, but if you are looking for teen or couples therapy, the company will send you to its partner companies. The majority of BetterHelp users we surveyed looked to the company for services related to anxiety (63%) and depression (62%). About another third each said they came to BetterHelp seeking therapy for stress and family issues.

Although treatment techniques depend on the therapist, some common methods that BetterHelp therapists use include:

• Attachment-based therapy
• Cognitive behavioral therapy (CBT)
• Dialectical behavior therapy (DBT)
• Mindfulness therapy
• Motivational interviewing
• Narrative therapy
• Solution-focused therapy

Common conditions BetterHelp’s therapists treat are:

• Stress
• Anxiety
• Relationship issues
• Family conflicts
• Aging and geriatric issues
• Grief
• Depression
• Trauma and abuse
• Intimacy-related issues
• Parenting issues
• Anger management
• Self-esteem
• Coping with life changes
• Compassion fatigue
• ADHD

How Much Does BetterHelp Cost?

BetterHelp only offers one subscription plan, which BetterHelp told us (in their company questionnaire) costs an average of $68 per week (though users are billed monthly. If you go to their website, you will see a much higher range. 

However, BetterHelp also told us that it partakes in surge pricing, meaning the cost of services changes based on where you are and how much demand there is for mental health care at any given time. 

Our editors were able to confirm this discrepancy in pricing first-hand both times we reviewed BetterHelp. In New York, the website displayed the weekly cost as $60 to $90, but when our Seattle-based editor checked, they were quoted at $90 to $150. This could result, on the high end, in a monthly difference in price of $240, which could be prohibitive for some low-income therapy seekers, especially in cities like Seattle where the cost of living is already quite high. 

This is likely why, of the users we surveyed, only 58% said they found BetterHelp to be affordable or very affordable.

Does BetterHelp Accept Insurance?

The company does not accept any insurance plans, which is a significant drawback. Health insurance can increase individuals' access to mental health care by lowering the cost. In the U.S., the average cost of therapy ranges from $60 to $200 per session. If one does use insurance for therapy, a session could have a copay as low as $20 to $40, which is more affordable than BetterHelp’s subscription plans.

Of the users we surveyed, 88% said they had health insurance—and of those that told us they are no longer seeing the therapist they found on BetterHelp, 10% said they left because they found a therapist that accepted their insurance. This is much higher than the average number of users at other companies that said the same. 

Does BetterHelp Offer Discounts?

Your costs of using BetterHelp depend on whether you are receiving financial aid for being a student, a veteran, or low-income. If you indicate you are a student, veteran, or low-income, you can receive the financial aid without providing a bunch of documentation, though it is difficult to determine how BetterHelp decides who it helps.

If you are hesitant about trying BetterHelp, it usually offers promo codes for new users on their first month's subscription. In fact, Verywell Mind readers can get their own discount. 

Navigating the BetterHelp Website

When you land on BetterHelp’s website, you’ll be greeted with the words “You deserve to be happy” across a green image of two people holding hands. Below that, you’ll be asked what type of therapy you’re looking for, though as noted above, two of those buttons will redirect you to other companies that focus on those types of therapy. 

At the time of our survey, 73% of users said that the website was easy to navigate. But the website has been redesigned since we last reviewed the site last year, and the new design is a marked improvement: It is clean, easy to navigate, and modern, utilizing far less aggressive colors than in its previous iteration. 

On the top navigation bar, you will find links to their About page, blog, FAQs, reviews, and contact page. There are also links if you are a company seeking to provide BetterHelp services to your employees or if you are a therapist seeking a job through BetterHelp.

Scrolling down the page, you’ll find a section dedicated to the company’s statistics: how many sessions it has had, how many therapists are within its network, and how many people it has helped to date. For example, one image displays screenshots of what BetterHelp’s chat and live video sessions look like. Other images involve potential users looking at their computer screens as well as friendly photos of therapists.

Further down, you’ll find information about who the company’s therapists are along with a button inviting you to get matched (i.e. sign up), as well as an interactive explanation of how BetterHelp’s services work. 

Next, you’ll find a comparison of what the company offers compared to traditional in-office therapy, testimonials (as well as a button to read more “success stories”), and a section with nine Frequently Asked Questions. You can click from there to its more in-depth Frequently Asked Questions page too. 

At the very bottom of the page, you’ll find a place to buy a gift membership for someone else, as well as a link to resources for people in crisis who are not good candidates for BetterHelp’s services. 

There is also a footer navigation, which links to info about its business, a “About” page, FAQs, Reviews, Careers, Find a Therapist, Online Therapy, Contact, and For Therapists pages. You can also find links to its social media pages here. 

BetterHelp has one million Facebook followers, 360,000 Instagram followers, and 374,000 TikTok followers and frequently features its therapists in its posts. As a whole, its social media posts are encouraging, informative, and sharable, providing helpful information about mental health topics and coping tools.

The company also has a blog, which is aptly titled “Advice” and can be accessed in the top navigation menu. Here, users will find informational content about the therapeutic process itself as well as various diagnoses, tips and tricks for coping with specific diagnoses, and other outside resources. Its authors are a mix of freelance writers and BetterHelp’s editorial team, which posts about twice a week. It is worth mentioning that its blog posts aren’t medically reviewed or frequently written by licensed therapists.

Fifty-three percent of users we surveyed rated its additional resources, such as their blog, as very good or excellent.

How Do You Sign Up for Therapy at BetterHelp?

The sign-up process for BetterHelp is actually pretty long: It took me about 20 to 30 minutes to complete, so make sure you set aside time to complete it. If you stop mid-sign-up and exit your browser, it will not save your answers and you’ll have to start all over again. But despite this issue, 76% of the users we surveyed said the sign-up process was easy.

You can sign up by clicking any of the green buttons on the homepage, which will ask you to confirm what type of therapy you’re interested in, though as we said before if you click anything besides talk therapy, you’ll be redirected to one of BetterHelp’s other sites. 

From there, you’ll be asked a series of questions in an intake questionnaire about your gender identity, age, sexual orientation, and relationship status. It is worth noting that the company provides a variety of choices for describing your gender identity and sexual orientation. For instance, you can choose from woman, man, non-binary, transfeminine, transmasculine, agender, “I don’t know,” “Prefer not to say,” and “Other” for describing your gender identity. Comparatively, BetterHelp gives users more options to describe their gender than Talkspace does. In detailing your sexual orientation, you are given the options of straight, gay, lesbian, bi/pan, “Prefer not to say,” “Questioning,” queer, asexual, “I don’t know,” and “Other.”

You’ll also be asked if you are religious and if yes, which religion you identify with. 

Interestingly enough, users will find below this question in the form a highlighted fact: "Therapists on the BetterHelp platform have diverse backgrounds. You'll be able to request a Christian therapist if needed." So, during the intake questionnaire, if you answer that your religion is Christian, you will be asked “Would you like to be matched with a Christian-based therapist?” 

After the questions about your identity and religious affiliation, you will be asked to complete questions about your mental health history, such as whether you have ever been in therapy before and what led you to therapy today. Options for what led you to therapy include “I’ve been feeling depressed,” “My mood is interfering with my job/school performance,” “I am grieving,” and 10 other choices. Then, you will be asked what your expectations are from your therapist, such as a therapist who listens, explores your past, teaches your new skills, assigns you homework, and more.

The platform will ask you to rate your current physical health and eating habits from good, fair, and poor.

Then, it will ask you if you are experiencing overwhelming sadness or depression. Following this, there will be a few questions from the Patient Health Questionnaire, or the PHQ-9, an assessment used to screen for depression. 

You will be asked if you are currently employed as well as how often you drink alcohol. Other screening questions towards the end include if you have any problems with intimacy and when the last time you thought about suicide was—if ever.

In addition to depression, it asks you if you are experiencing anxiety or panic attacks, or chronic pain. Other demographic questions include how you would rate your current financial status on the same good, fair, or poor scale.

I found the questions to be a bit random as I went through the questionnaire. Next, BetterHelp will ask you to rate your sleeping habits and answer if you are comfortable with your identity. 

At the end of the questionnaire, you can specify how you prefer to communicate with your therapist, whether through mostly messaging or mostly phone/video sessions. You can also indicate specific preferences for your therapist, such as their gender, whether they are Christian or non-religious, whether they are a member of the LGBTQIA+ community or a person of color, as well as whether they are older than 45.

Once this intake questionnaire is complete, you will be asked a series of questions about your financial circumstances. The company will ask you if you’re a student, identify as disabled, whether you’ve been impacted by a COVID-19 outbreak, are unemployed, have a low income, or are a veteran. These questions will assess whether you are eligible for financial aid. There is no requirement to provide documentation to prove whether you are a part of these demographics.

Then you will create an account by entering your email and creating a password; next, you are prompted to pay for the monthly subscription. 

You have to provide your payment information before you get to see your therapist match too. 

Then, once you’ve paid, a private portal becomes accessible to you (more on that below) but you won’t be able to really do much in the portal until you receive your therapist match. 

It does take a little while for you to get your therapist after you’ve signed up; you’ll get an email from BetterHelp when your therapist is matched to you. The company states it will take about 24 hours to receive a match. In my case, it took less than 12 hours to be matched. 

This process is likely very quick because BetterHelp has over 27,000 mental health providers in its network. Still, Cheryl Reeley MS, LCSW, PMH-C, who worked for BetterHelp for over a year, stated she “only accepted about 10% of the members that were matched with [her] or requested to work with [her].” 

“It is important to me to screen potential members thoroughly before agreeing to work with them because I want to make sure that they are getting the best care possible for their specific needs and that I am utilizing my education and experience fully,” she explains. 

You do not get to choose your therapist match at sign-up, which is different from some of the other companies we reviewed and may be a drawback for some users, especially since the success of therapy is so dependent on the client-therapist relationship. 

However, of the users we surveyed, 77% said they were satisfied or very satisfied by the therapist options provided by BetterHelp. Sixty-five percent of users tried only one therapist, which is a higher percentage than its competitors.

How Do Therapy Sessions Work at BetterHelp?

As noted above, once you’ve signed up, you’ll have access to a private portal both online and in the app. This portal is where you’ll be able to message your therapist in the chat room, schedule sessions, and attend those sessions. 

You can also complete daily journal prompts in this portal, as well as attend "groupinars," which are webinars about various mental health topics.

Messaging Your Therapist

In your private portal, you’ll have access to a secure messaging platform for talking with your therapist. You can leave them a text, audio, and even video message—and they’ll respond to you asynchronously once they are available to do so. 

In my experience, though, therapists messaged back within a few hours during the day. If I sent a message over the weekend or at night, it took longer to respond—though I did receive a therapist response at 2 a.m. on a Saturday.

The first response I received from my therapist through the messaging app appeared to be a generic administrative message, but the last few sentences were personalized to my information and concerns. As I continued messaging my therapists, I noticed a pattern. Their responses were short and vague—often directing me to wait until the next live session. For instance, the response I received after sending a long message about my desire for therapy said, “We can process through how to get to that goal. Look forward to speaking with you soon.”

Live Sessions

You have three options available to you for live sessions with your therapist: via live chat, phone call, or video call. These sessions are either 30 or 45 minutes, depending on your therapist’s availability as well as the presenting problem you indicated in the initial questionnaire. My sessions were automatically 45 minutes, although my two therapists often ended them early when the conversation lulled.

Users can schedule their first live session directly on the private portal. Then, much like in-person therapy, therapists ask when you would like to schedule next week’s appointment at the end of each session. The therapist will fill this information out for you on their end and the appointment will automatically appear in your schedule on your portal.

Your monthly subscription plan gets you four sessions with BetterHelp. You cannot buy additional sessions. On the company’s Ask A Therapist page, a BetterHelp therapist states users can do biweekly sessions but does not clarify how payment would work.

What Happens If I Miss a Session?

If you miss a session or cancel within 24 hours of its scheduled time, you will be charged an additional $15 fee on top of paying for the missed session as part of your subscription plan.

Live Video Sessions

When it is time for your scheduled video session, you will log into your private portal on the website or the app. Your therapist will initiate the video call within the portal, but you will still need to accept the call.

During the video sessions I attended, both the audio and video quality were seamless with few issues. I didn’t have any crackling or lagging, as I did when I tested Talkspace, one of BetterHelp’s biggest competitors. 

That being said, during video calls my therapist often looked off-screen. I assume they were taking notes, but it added an impersonal element to the session.

Live Audio Sessions

Similar to video sessions, audio sessions take place within your private portal. Your therapist initiates the audio session, and you will begin after you accept the call. I felt strange during the audio call because it did not feel like a true therapy session. It mostly felt like a phone call to someone.

Live Chat Sessions

Live chat sessions are held inside the private portal and are similar to asynchronous messaging, but held in real time, which can make it more akin to traditional therapy. The therapist will initiate the live chat and a timer will appear on the screen, indicating the length of your session.

In my case, the therapist used only text messaging during the live chat, creating a good pace of conversation. A unique feature for BetterHelp, too, is that you can choose to see “Live Typing.” This means that you will be able to see what the therapist types as they type it—and vice versa. The messages will appear in a different color once they are complete and sent.

It is important that you do not leave the app or close out of the private portal during your live chat. Doing so ends the session early and the therapist is unable to restart it.

Switching Therapists

If you’re unhappy with your therapist at BetterHelp, you can always switch—and the process of doing so is clear and easy to do. 

All you have to do once you click your name in the top left corner, which will open a dropdown menu. The third option on the dropdown is “Change therapist.”

Once you click, you’ll be asked a few questions, such as whether you have any preferences for who you’d like your new therapist to be and what your experience was like with your previous therapist.

You’ll then be given 10 to 20 available therapists to choose from, which is different than the sign-up process where you were matched with someone. This time, you can read through their bios and specialties to make your own decision about who you want to work with. 

After you choose, you are immediately connected with them in the portal and can schedule a live session within 48 to 72 hours, depending on the therapist’s availability.

Pausing or Canceling BetterHelp

Various websites state you can pause your BetterHelp subscription for up to three weeks, but I could not find that choice in my portal. That said, I assume that I could call customer service and request this pause.

You can cancel your subscription to BetterHelp at any time, though. Simply click your username in the top right corner and go to "Account Settings." Once on this page, you then will need to scroll down to the Payment Settings header and click “Change membership / cancel membership.”

Once you click, you will be given the choice between changing your subscription plan or canceling altogether. 

Although when you sign up, you only get one subscription plan offering, when you go to cancel, you can downgrade your subscription to two previously unavailable options: 

• A weekly option, which involves paying for one session weekly instead of monthly.
• A maintenance plan, which includes unlimited messaging and one live session a month for $160 per month. It does let you know that your therapist's responses to messages may be less frequent as well. 

If you decide to cancel instead, it will first ask you a few questions, including whether you have discussed canceling with your therapist and what your reasons for canceling are. 

Once you’ve canceled, you can continue with your unused session for the month, and your subscription plan will stop renewing. You do not receive a refund for any unused sessions at the end of your billing period.

Quality of Care and User Satisfaction

BetterHelp’s widespread reach is a large benefit in using its services. The company is available to users worldwide, and it quickly matches users with a therapist. This is important considering there can be long wait times with private practices. It also is helpful for those who live in therapy deserts, where there are few therapists in the area.

Of the users we surveyed, 65% rated BetterHelp as very good or excellent overall. 72% of users rated their therapist’s qualifications on BetterHelp as very good or excellent. And 84% of users said BetterHelp was superior to other therapy services they'd used in the past.

When I spoke with therapists who worked for the company as independent contractors, most spoke positively of their experience.“I was able to build rapport, set realistic goals, and make progress [with clients] through conversation, skills, and psychoeducation which is more of my style,” Toni Rose Mieses, a licensed mental health counselor who has worked for BetterHelp for one year, says. She also told me that she was confident that the quality of teletherapy offered by BetterHelp is on par with in-person therapy.

BetterHelp does have its limitations for users, though. Its services are often short-term solutions for therapy seekers. “This service is ideal for someone in life transition or who is having worries about what to do next,” explains Mieses. “It can also be a great booster for those who have had therapy in the past but need some tuning up.”

One of our subject matter experts, licensed social worker Hannah Owens, agrees. “Someone needing a higher level of care, which also often involves medication management, probably won’t find the support they need through BetterHelp,” she explains, “especially since it only offers one subscription plan limited to four sessions per month. For those living with more serious mental illness, just those four sessions and texting in between might not be enough.” 

BetterHelp has also received significant media coverage about its therapists’ low pay and high caseloads. We asked the company about both of these, and while it declined to share the average caseload for its therapists with us, saying that it doesn’t share this information publicly, it did share information about its compensation.

BetterHelp told us that the therapists are paid depending on the number of hours they work and the rates are as follows:

• 1-5 $30/hr
• 6-10 $35/hr
• 11-15 $40/hr
• 16-20 $45/hr
• 21-25 $50/hr
• 26-30 $55/hr
• 30-35 $60/hr
• 35+ $70/hr

The company also stated that “these numbers above do not reflect potential bonuses for caseload incentives, group sessions, or monthly stipends.” In addition, BetterHelp told us that therapists are given a $650 health benefit stipend if they continuously work for BetterHelp 30 hours a week, as well as free access to BetterHelp’s services. 

When we asked the company how it felt about how its pay compared to market rates, it described them as “above average or market rate,” stating that “as of March 2021, the average pay for BetterHelp counselors was 67% higher than the national median pay for licensed professional counselors, 60% higher than the national median pay for licensed marriage and family therapists, and 65% higher than the national median pay for licensed social workers.” It also directed us to its therapist compensation FAQs page for more detail. 

Owens, however, was not convinced their rates are adequate. “It makes sense that the therapists at BetterHelp, as independent contractors, would be rewarded for working with the company more,” she says, “but at $70 for more than 35 hours a week (which is essentially a full-time job), these therapists are still making considerably less than they would in private practice.”

This is a significant issue. The quality of care a therapist provides greatly declines if they are not satisfied with their pay or if they are overworked. During my first video session, I could tell how tired my therapist was and it created reluctance for me to continue using the platform.

Furthermore, the company was criticized in 2018 for its marketing tactics. These tactics involved using popular online influencers to promote BetterHelp to their impressionable fans. While the ethics behind a mental health service paying influencers to promote them are questionable, most users discussed their poor experiences and brought up their concerns with these influencers.

Privacy Policies

BetterHelp’s Terms and Conditions and Privacy Policy contain the standard legal jargon you would find on most online therapy company websites, but one thing that stood out to me in its Privacy Policy was the way it discussed communications data. Below this header, the policy reads, “BetterHelp collects, uses, and stores communications between users and Counselors on the Platform.” 

While the company doesn’t specify how long they store communications or what they use the data for, an investigation in 2020 revealed BetterHelp was sharing information with Facebook, such as how often users were on the app as well as “metadata from every message shared on the platform.” Senators Elizabeth Warren, Cory Booker, and Ron Wyden wrote letters to Talkspace and BetterHelp in June 2022 regarding their compliance with HIPAA. HIPAA is a federal law dating back to 1996, which protects your health information and medical privacy. Our subject matter expert, Amy Marschall, PsyD, notes the company “has had a lot of controversy for their privacy policies [as well as] for not complying with HIPAA and maintaining confidentiality.” 

If you choose, you can request your files be deleted by canceling your membership and requesting erasure in your account settings. Still, it is worth considering these controversies prior to using this company.

BetterHelp vs. Its Competitors

BetterHelp’s main competitor, Talkspace, provides medication management services and a tiered subscription plan. However, the cost of BetterHelp’s financial aid may be cheaper than Talkspace’s most affordable subscription, especially since medication management is considered an add-on service. 

Still, considering BetterHelp provides only individual talk therapy (and directs you to other brands for couples), Talkspace is likely more of a one-stop-shop option for people who aren’t sure what therapy services they want or need—but want to work with one company for all their needs, especially if those needs change over time. 

Other competitors, like Teladoc and Brightside, also provide medication management services, making these services potentially better fits for someone who has more severe anxiety and depression and who could benefit from antidepressant medication. 

Overall, BetterHelp didn’t do quite as well in terms of user satisfaction compared to these companies either. 

While 86% of BetterHelp said services were good, very good, or excellent, 90% said the same about Brightside and Talkspace—and at Teladoc, this number was even higher (97%). 

In addition, while 77% of users at BetterHelp said they were likely or very likely to recommend the service to friends or others like them, 82% at Talkspace and 86% at Teladoc said the same about those companies. Plus, 83% at Talkspace and Teladoc were very satisfied or satisfied with their therapist options at those companies, compared to 77% at BetterHelp.

Of the users who tried BetterHelp, 84% said it was at least a little better, better, or much better—but at Talkspace, the number of respondents that said the same was 97%. 

Final Verdict

BetterHelp is a great alternative for those whose schedules don’t allow them to go to in-person therapy. The company prioritizes accessibility with its convenient, user-friendly website and app as well as its available financial aid.

Of the users we surveyed, 77% said they were likely or very likely to recommend BetterHelp to a friend. Customer satisfaction extends beyond therapy sessions, too. 48% of users rated BetterHelp’s customer service as very good or excellent.

Still, the privacy concerns surrounding BetterHelp are worth considering before using the company for online therapy.

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 interviewed three of therapists we found who either currently work or worked for this company in the past and worked with three subject matter experts to get their expert analysis on how suited this company is to provide quality care to therapy seekers. 

Read our full methodology here.