Cerebral Online Therapy Review

With almost one-fifth of American adults experiencing mental illness every year, mental health care is in high demand across the country—especially in therapy or mental healthcare deserts, where access to mental health providers is severely limited. 

Cerebral aimed to address these issues with nationwide mental health services. We reviewed the company last year, but since then, the company has been involved in a number of scandals, including the death by suicide of a 17-year-old boy who was illegally treated and prescribed medication without his parents’ consent, a history of unethical prescription practices, clinicians reporting being pressured to prescribe stimulants, and an ongoing DOJ investigation. In addition, Cerebral has admitted to selling its patients' personal health information to advertisers, another unethical practice.

While it was obvious that we could no longer recommend its psychiatry services, we still decided to look into Cerebral, especially since it does offer talk therapy-only plans. So we surveyed 105 Cerebral users on their experiences using the company, and I signed up for therapy to test out the psychotherapy services firsthand. And while we still cannot recommend Cerebral as a teletherapy service, here’s a look at what we found. 

What Is Cerebral?

Cerebral is an online mental health care provider that offers therapy, psychiatry, and life coaching, all entirely online. However, it is the psychiatry services, allowing users quick easy access to prescription medications, that take center stage in Cerebral's advertising, as well as its reputation.

In March 2022, Cerebral came under fire for over prescription of controlled substances to patients without proper oversight, putting patients at risk. The main focus of this controversy was stimulant ADHD medication such as Adderall and Ritalin. Nurse practitioners at the company reported feeling pressured to prescribe these controlled substances, even though they felt that the 30-minute psychiatry appointments that Cerebral provides were not sufficient to diagnose and treat ADHD. This led the Department of Justice to launch an investigation into Cerebral's practices in May 2022, citing a possible violation of the Controlled Substances Act. CVS and other pharmacies went so far as to stop filling prescriptions for controlled substances that were written by Cerebral providers. 

The investigation led to former CEO and co-founder Kyle Robertson stepping down in May 2022, as well as a round of layoffs in July. Cerebral is now under the leadership of David Mou, MD, who was already the company’s chief medical officer. Post-scandal, the company has stopped prescribing several controlled drugs, including stimulants like Adderall and benzodiazepines such as Xanax—although it does still offer Suboxone prescriptions for opioid addiction. 

Though Cerebral has changed its practices, it was recently discovered that a 17-year-old boy from Missouri was being illegally treated by Cerebral without his parents’ consent. He died by suicide after being prescribed an antidepressant that carries a warning for adolescents about increased suicidality as a side effect. 

Cerebral insists that the boy misrepresented his age, but he had provided a driver’s license that clearly stated his date of birth—a license that Cerebral did not check before providing services. An internal memo from the company stated that doing so led to more patient attrition. The boy reported to his provider at Cerebral that he was having suicidal ideation, and was prescribed an antidepressant; however, many antidepressants, including the one prescribed in this case, clearly warn of the possibility of increased suicidality in adolescents. Treating and prescribing for anyone with suicidal ideation requires close clinical oversight, as well as the practice of not checking IDs in order to retain more customers, is considered highly unethical.

What Services Does Cerebral Offer?

As of January 2023, Cerebral offers talk therapy, psychiatry, and “coaching” services to treat a range of mental health conditions. 

It is important to note that coaches are not required to be licensed like mental health professionals, and therefore are not held to the same standard as licensed therapists. Coaching from an unlicensed practitioner is not an appropriate substitution for mental health care.

Cerebral specifically states that it can prescribe antidepressants such as SSRIs (such as Prozac) and SNRIs (such as Cymbalta and Effexor) for depression, anxiety, and insomnia. It has halted all prescription of controlled substances, including benzodiazepines (sedatives like Ativan, Klonopin, and Xanax) and amphetamines (stimulants such as Adderall and Ritalin). However, it is still prescribing Suboxone, a controlled substance used for opioid addiction, through an online subscription plan specific to opioid abuse. 

Cerebral specifically lists the following conditions as ones it is prepared to treat with therapy and medication:

• Anxiety
• Depression
• Insomnia
• Postpartum depression
• Menopausal depression
• ADHD (in certain states)
• Bipolar disorder (in certain states)
• Trauma and PTSD (in certain states)
• Alcohol dependence (in certain states)
• Chronic obesity (in certain states)
• Opioid use disorder (in certain states)
• Schizophrenia (coming soon to select states)

Who Is Cerebral For?

Cerebral says it can help people who are dealing with:

• Relationship issues and divorce
• Stress management
• Anger management
• Grief and loss
• Traumatic life events
• Confidence and self-esteem
• Phobias
• Coping with illnesses

“LGBTQI+” is also included in the list of topics Cerebral therapists can discuss, but does not specify what kinds of issues that might come up for someone in the LGBTQIA+ community. As is, this might be interpreted as the issue being the LGBTQI+ identities themselves.

The total range of mental health issues that Cerebral treats is wider than most online therapy providers, but it is also state-specific, with some services only offered in a handful of states. Its database of therapists is also quite limited, so if you’re in a state that qualifies as a therapy desert—meaning there are already not enough mental health providers available in your area—you might have trouble finding a therapist who fits both your needs and your schedule on Cerebral.

How Much Does Cerebral Cost?

Cerebral is a subscription-based online therapy and medication management service, meaning you pay a set price for a therapy plan.

There are three main plans offered right now:

• Medication + care management: This plan includes an evaluation and diagnosis by a medical provider and monthly medication delivery for $99 a month.
• Therapy: This plan includes weekly video or phone sessions with a licensed therapist and secure messaging between sessions for $259 a month.
• Medication + therapy: This plan includes an evaluation and diagnosis by a medical provider, a prescription, and weekly video or phone sessions with your therapist for $325 a month. 

However, you can also sign up for medication-assisted treatment and counseling for opioid use, which starts at $195.

All prices for plans with medication do not include the cost of the medication itself. 

Does Cerebral Take Insurance? 

Yes, Cerebral does accept insurance in the following states: Arkansas, Arizona, California, Connecticut, Florida, Illinois, Iowa, Georgia, Maine, Montana, Nebraska, New Hampshire, New York, Maine, Montana, Pennsylvania, South Dakota, Texas, Vermont, Virginia, Washington, West Virginia, and Wyoming.

If you have an out-of-network insurance, Cerebral can send you an invoice to submit to your company. 

It does not accept Medicaid or Medicare Part B. 

Does Cerebral Offer Free Trials and Discounts?

Cerebral is currently offering discounts up to 65% off for the first month of service for its talk therapy and talk therapy + medication plans. 

Navigating Cerebral’s Website

Cerebral has a clean, easy-to-navigate website with a quick intake process and a welcoming vibe. The homepage features bland yet benign stock photography and a soothing, somewhat clinical color scheme of pastel blue and white. There is a large “Start Today” link featured boldly in the middle of the page, and scrolling down the page offers details like pricing, plan options, and a flow chart of how Cerebral works.

If you’re not quite ready to hit the big green button that starts your sign-up, navigation bars are located at the top and bottom of the page, presented slightly differently but offering links to the same content. The FAQ page is thorough and well-organized, and has answers to most general questions about the service. There’s also a resources page, which basically houses a searchable blog covering mental-health related topics, and a “What We Offer” page, which describes the conditions Cerebral treats and the corresponding treatments.

One thing to note: we chose to test only Cerebral’s talk therapy service, but when you click on that service, the option to “upgrade” to a plan that includes medication prescription and management is constantly lurking one prominent click away—once you’ve selected the “therapy only” option, there is a large button in the middle of the page that takes you back to the “therapy plus medication” page. 

There’s also an unusual page under the “What We Offer” dropdown soliciting your participation in clinical drug trials, namely for new depression treatments. This feels like a bold move for a company currently under fire for its medication management practices.

Does Cerebral Have an App?

Cerebral does have an app, available for iOs and Android. The presentation is somewhat different, as the app opens to a login page—if you haven’t signed up, there is an option to do so, but you cannot access any of the additional pages the website has before sign-up. For a first-time visit, we recommend visiting the website. If you do create an account, the app is a convenient way to access your portal. 

Signing Up for Therapy at Cerebral

Compared to other online therapy sites, the sign-up process at Cerebral is brief and barebones, with the entire process taking only about five minutes. 

The first step is creating an account, and then—without asking any questions about your symptoms or experiences—the site asks you to check a box next to any issues you might want help with, including options like alcohol use, insomnia, ADHD, depression, and anxiety. 

“Without an understanding of your symptoms or your history with mental health care, it’s really impossible to provide appropriate and informed care, especially with medication,” explains Hannah Owens, LMSW, a subject matter expert for this project. “People seeking therapy and psychiatry services are not clean slates. Their prospective therapists and psychiatrists should know things like current and past symptoms, which medications they’ve taken, and past treatment modalities in order to properly understand how to approach the person’s care.”

After you have created an account and noted issues you are seeking help with, the site then asks you to fill in a short survey to see if medication is right for you, asking how often you’ve been feeling depressed, or anxious, or have trouble falling asleep. The reply options are a scale from “not at all” to “nearly every day.” 

It then offers you a “personalized plan,” which, as it turns out, isn’t personalized at all. Even if you click “not at all” to everything, and claim you have no symptoms whatsoever, Cerebral still (after claiming to evaluate your responses) recommends you sign up for medication management and therapy. 

However, the menu in which all of Cerebral’s different plans and their corresponding prices are listed is easily accessible from that point. 

Once you’ve selected your plan and paid for it, you’re taken to your account, which gives you access to your message board, links to independent study videos on mental health topics (like thought distortion), and a way to take your next step: choosing your therapist. 

Choosing a Therapist at Cerebral

After signing up, Cerebral provides a list of available practitioners for you to choose from. You can read their bios, which include a paragraph or two of general information and not much else. Location, insurance accepted, specialty, and ethnicity of the provider are listed in a box in the corner of the bio, but no information about treatment modalities or a more extensive list of topics they are able to address is provided. The therapist selection process at Cerebral does not allow for any back and forth. Once you click on an appointment time with your selected therapist, you’re locked in. 

For anyone who’s done that elaborate dance over phone or email of finding out if a therapist is taking new patients, this quick and painless process is very convenient. It eliminates the worst part of trying to find a new therapist.

How Do Therapy Sessions Work at Cerebral?

Cerebral offers talk therapy, coaching, and medication management. Given the controversy over its prescription practices, we only tested their talk therapy services. 

Therapy Sessions at Cerebral

I scheduled my therapy session for three days after I signed up, and, in the interim, received two emails, two phone calls, and two texts—one of which arrived at three in the morning—reminding me not to miss my appointment. I found the number of reminders excessive—for me, one text message a day ahead of time would have sufficed. 

I clicked the link they had both emailed and texted me (I was using my computer) and was let into the digital waiting room, where I awkwardly stared at myself until my new therapist let me into her office. 

She looked neat, put together, and very young, with big white-framed glasses and a calm, cool demeanor. I would be lying if I said it didn’t bother me that her background was an open cardboard box, a circular fan sitting on the floor, and a bunch of wires hanging above a doorway that had no trim around it. For me, first impressions are important, and the scene behind my therapist was not filling me with confidence. 

My therapist typed into the chat box in my screen asking if there was a loud noise on my end—there was not—so she told me she was going to exit the meeting and come back. I was briefly kicked back into the waiting room, but when she came back, the noise was gone, and we had no connection issues for the rest of the session. 

Much of the intake was a little bit intense—it felt like a job interview. She asked me very seriously why I was there, what I wanted to work on, what I hoped to gain from therapy. She did not smile much, or laugh, or joke around, but she listened carefully and earnestly. I told her I chose her because she listed somatic work in her bio, and she asked me if I wanted to do a breathing exercise, which was nice. 

Overall the session was rather dry, but it started on time, with tolerable connection issues. By the end of it, I didn’t feel like we had clicked on a personal level, which would have been a nice bonus, but it’s also not a requisite for therapy to be effective. She identified good therapeutic goals for me, so I considered our first session a success. 

Medication Management at Cerebral

Medication management is available alone, or combined with therapy. 

Medication Alone

This plan comes with basic “care management” in addition to your session with a prescriber. Care management is essentially customer service, in the form of a person you can also direct medical questions to, in case you have any concerns about your medication (such as side effects or allergic reactions) before you can get in to see your prescribing doctor. The Medication plus care counseling plan costs $99/month. 

Medication Plus Therapy

Medication management can also be coupled with weekly talk therapy, although this is more of a billing issue than a care issue; your therapist and your prescriber do not work together regardless of what plan you choose. However, by bundling the medication management services with your therapy services, you do save $33 per month. While medication alone is $99, it is only $66 more to add medication management to your therapy plan, bringing it to $325 from $259 for therapy alone. 

Coaching at Cerebral 

Coaching was once a service offered by Cerebral, but it has been discontinued. 

What Happens If I Miss a Session?

Cerebral lets you cancel or reschedule an appointment up to three hours before the appointment is scheduled to begin. If you do not cancel in time, the missed appointment counts as one of your four monthly sessions and you are billed for it. 

Switching Therapists at Cerebral

While in theory you can switch therapists at Cerebral, it is not easy to do so. There is actually no way to switch therapists on the Cerebral website, so when I tried to switch, I had to call the company’s support line. The good news is I got through to a person with almost no hold time and the customer support person I spoke with was able to message me a link that allowed me to switch therapists through my private message board. 

Customer support stayed on the phone while I clicked the link they sent. This took me to a list of therapists—the same ones I’d seen when I first signed up. I asked if I could redo the search in order to see different therapists but I was told no: I was already looking at all the therapists available to me. There were only 12 in all of New York State.

I was told by customer service that there are actually 47 therapists on Cerebral in New York State, but maybe some of them weren’t available to me because they’re not accepting new patients or only take patients with insurance. 

After I’d scrubbed out the options that did not work for me time-wise (I can’t do evenings or weekends) I was left with two options, a woman and a man. Since I feel more comfortable with women, I picked her.  

In the end, I was left feeling both disappointed and relieved at the lack of process involved: the whole swap only took about 10 minutes. 

When I went to meet with the therapist I’d switched to, I hit another roadblock: the link was broken, and it suggested I try another three random links, which sent me to three different therapists’ waiting rooms that I had never booked sessions with. 

I posted my dilemma in the message board, and two minutes before the session was supposed to start, my therapist sent me a new link through the message board that worked fine. She explained that Cerebral had spelled her name wrong and she had to send every client this different link before their first session. 

I was relieved our session then went off without a hitch, but also wondered why she had not messaged me about the issue immediately after I’d scheduled the appointment instead of two minutes before it began—or better yet, why Cerebral had not fixed the broken link. 

Cancelling Therapy 

Cancelling therapy at Cerebral is simple: you can do it through your portal. Simply log into your account settings and hit “Cancel Subscription.” 

Once you do this, any appointments set to take place after the rollover date will also be cancelled. If you cancel halfway through the month, you are not reimbursed for any sessions you haven’t taken, but you can still book the four sessions that come with that month, as long as they are scheduled to take place before the day your month-long subscription ends.

Quality of Care and User Satisfaction

Although we cannot recommend Cerebral due to the multiple controversies surrounding its prescription practices and the sale of its patients' personal health information, 79% of our surveyed users rated the company’s overall services as good, very good, or excellent (though this score is low compared to many of the other companies we reviewed). Additionally, 36% of users reported that they found a provider who met all of their needs at Cerebral, and 44% stated that their provider met most of their needs. Only 38% of users thought they would still be with their Cerebral provider in six months’ time, and that number dropped to 30% when asked if they would still be seeing their provider in a year.

I was satisfied with the first therapist I chose, who I selected based on my own criteria. Had I not been writing this review, I wouldn’t have switched on my own accord but I’m so glad I did—the session with my second therapist, who I picked entirely on availability (and gender), was actually much better. I felt she had a lot more experience than the first therapist I had chosen. She took her time introducing herself and chatting with me, making me feel at ease before getting down to the nuts and bolts of my mental health. It made me feel comfortable, and less nervous than I had been in the first session, like we had established a connection before we delved into that private, vulnerable space that therapy occupies. She also had her degree and a watercolor painting hung on the wall behind her, making her space look professional and inviting.

However, the atmosphere around both the sessions and the process of getting there was a little too informal. From the brevity of the intake questionnaire to the supply closet vibe of the first therapist’s office, the broken link to the second session, the limited number of available therapists and their limited availability times, the entire operation felt a little too slap-dash and haphazard. 

We also cannot overstate how serious our concerns remain about Cerebral's medication management practices. Based on the online ads I started receiving for Cerebral in my social media after I visited the site, its selling point appears to be easy access to prescription medication for a variety of mental health conditions, with the talk therapy aspect of the site advertised much less prominently. Considering the recent (and multiple) scandals around its prescription policies, I would be extremely wary of subscribing to a plan that includes medication at this company.

Besides being potentially dangerous, it’s also simply not cost-effective. Most psychiatrists you track down the old-fashioned way might not need to meet with you every month once you’ve established a medication plan that works for you, whereas Cerebral will bill you once a month to maintain access to a prescription. This practice is shady in its own way, too. “Medication management describes the maintenance of a medication regimen over time, as opposed to the process of finding the right medication for you,” says Owens. “Once you are in a stable routine and not changing medications, it is often not necessary to see your psychiatrist once a month unless an issue arises. So the fact that Cerebral bills you for monthly appointments is not taking into account what you actually need from your provider or where you are in the treatment process.”

Privacy Policies at Cerebral

As of March 2023, it's been confirmed that Cerebral has been selling its patients' personal health information, including full names, birth dates, contact information, and even the results of the mental health self-assessments Cerebral has available on its website. This information has been sold to third-party advertisers like Google, Facebook, and Tik Tok for profit.

Cerebral’s privacy policy does disclose that it will use your information to provide tailored advertising for its services on third-party websites. This means that if you fill in medical information about addiction issues, you will see that information reflected in the form of Cerebral ads in your Facebook feed tailored toward a drug-assisted journey toward sobriety. 

It also does not prevent these third parties from collecting this information, and using it to tailor your content. This is, unfortunately, pretty par for the course. 

However, reports on the dangers around the privacy policies of online therapy companies, and how these polices reserve the right to change at any time, are certainly not limited to Cerebral. BetterHelp, for example, is not HIPAA-compliant and has come under fire for its lack of privacy practices, including selling clients’ personal health information to advertisers. Cerebral’s privacy policy brings up similar concerns.

Cerebral vs. Its Competitors

Though Cerebral claims to specialize in anxiety and depression, Brightside—another specialized service specifically for anxiety and depression—outperformed Cerebral by far in our user survey, with 89% of respondents finding Brightside’s services to be good, very good, or excellent compared to Cerebral’s 79%. Talkspace, another big name in the online therapy industry, also beat out Cerebral with an overall positive satisfaction rating of 91%. 

In addition, when compared to other companies that offer medication management and prescription services, Cerebral once again underdelivers. Teladoc comes out far ahead of Cerebral with a 97% rating of its services as good, very good, or excellent, as does Talkiatry, with a 96% rating. 

Cerebral also falters when it comes to meeting client needs. Only 36% of users said that they were able to find a provider at Cerebral who met all of their needs, as opposed to 41% at Brightside and 48% at Teladoc. Additionally, 47% of Teladoc users said they were very likely to recommend its services to others, whereas only 33% of Cerebral users said the same.

It is also imperative to note that none of Cerebral’s competitors are being investigated for unethical prescription practices, making Cerebral stand out for all the wrong reasons.

Final Verdict

We cannot endorse Cerebral as an online therapy service in light of its unethical and illegal prescription practices. Although Cerebral makes it very simple to see a provider and obtain medication, that is precisely the problem with the service. Its documented lack of oversight of controlled substances, as well as practices clearly outlined by the company of not checking potential patient IDs in the hopes of retaining more customers, is disturbing and raises too many serious red flags to ignore. If you are looking for psychiatric care, look elsewhere.

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.