E-Therapy Cafe Online Therapy Review

The state of mental health in America has been on a downward trajectory for years. Nearly 20% of American adults have a diagnosable mental illness and the portion of those who feel they cannot access adequate mental health care has steadily risen since 2011. Cost, access, and the time commitment that therapy requires all play a role. According to a 2022 Verywell Mind Cost of Therapy Survey, eight out of ten people thought that therapy was a good investment, but nearly 50% were worried about paying for therapy long-term and said they’d need to stop going if costs increased.

Enter E-Therapy Cafe, an eclectic, small, boutique online therapy and coaching service that aims to provide accessible, affordable, and convenient counseling to busy adults ages 18 and over. The standard video or chat session is 30 minutes (online journaling is also an option) and costs less than the average online therapy appointment. With an emphasis on “getting unstuck,” E-Therapy Cafe practitioners are a mix of licensed practitioners and certified life coaches.

It seems not much has changed since we last reviewed E-Therapy Cafe in the summer of 2021. It continues to curate diversified practitioners who can help with diagnosed mental illness, day-to-day stress, and everything in between. It’s important to note that if you are looking for a therapist, you may get paired with a coach. If you do get paired with a therapist who isn’t licensed in your state, you’ll receive coaching services, not therapy. (More on this below.)

In Verywell Mind’s review of online therapy platforms, we surveyed 105 E-Therapy Cafe users, in addition to testing out the service ourselves. We also spoke to subject matter experts about the service. Read on to see how E-Therapy Cafe works and how it compares to other online therapy services.

What Is E-Therapy Cafe?

Company founder and clinical psychologist Jude Black, PhD, has been providing virtual therapy for almost 20 years. She started providing online therapy services in 2003 to military members overseas. The cause was important to her because she was a military spouse herself, and knew how difficult it could be to make time for therapy when you have a busy and demanding schedule. So, in 2016, she launched E-Therapy Cafe with the goal of delivering personalized care to people anywhere at any time. 

Her goal for the company was “to create a diversified team of licensed and certified professionals focused on breaking down barriers and providing support professionally, ethically, and affordably.” The team of therapists and practitioners she has hired may be small, but they offer a wide range of services for a diverse clientele.

The sign-up process is relatively straightforward. You begin by filling out a brief questionnaire about your goals for therapy, how you’ve been feeling lately, and what your daily stressors are. If you’re interested in the wedding coaching sessions, you’ll note that in your questionnaire. If you’re looking for couples counseling, you can register your partner at the same time.

Next, you'll state whether you’re interested in working with a particular therapist. A staff member will do their best to match you with your choice, as long as the therapist is accepting new clients. If they aren’t, the staff will work with you to find another good fit. As the last step, you’ll pick your subscription plan and pay.

Once your registration form is completed, you’ll receive an email with access to your private portal.

What Services Does E-Therapy Cafe Offer?

While Dr. Black continues to serve veterans, first responders, and their families with trauma and relationship counseling, she has expanded the scope of E-Therapy Cafe as a company. Its primary areas of service are now:

• Individual therapy
• Couples and marriage counseling
• Wedding and bridal coaching
• Emotional support animal therapy

This unusual mix of services helps distinguish E-Therapy Cafe from the competition. The diversity of approaches, credentials, and techniques means that there is something for everyone. 

E-Therapy Cafe’s therapists also use a wide mix of modalities and techniques, including:

• Eye movement desensitization reprocessing (EMDR)
• Life coaching
• Dialectical behavioral therapy (DBT) 
• Cognitive behavioral therapy (CBT)
• Trauma-focused cognitive behavioral therapy (TF-CBT)
• Mindfulness
• Motivational interviewing
• Positive psychology
• Psychoanalytic psychotherapy
• Emotionally focused therapy (EFT)
• Acceptance and commitment therapy (ACT)
• The Gottman Method
• Hypnosis
• Neuro-linguistic programming
• Art therapy
• Narrative therapy
• College counseling
  
  Many of these modalities can be helpful for working through stress, anxiety, depression, loneliness, trauma, transition, grief, addiction, burnout, behavior change, and more.
  

Who Is E-Therapy Cafe For?

E-Therapy Cafe is for anyone looking for individual therapy or relationship-focused therapy (it also advertises LGBTQIA+ affirming therapy, but it is unclear from the website how many therapists and coaches are specialized in this). 

Because of its traditional focus on the military, it is a good option for anyone enlisted, as well as military spouses and veterans. It also focuses on coaching young adults through college decisions and challenges.

The company can also help people looking for emotional support animals, as well as those suffering from eating disorders, personality and mood disorders, anxiety, addiction, chronic pain and illness, and learning issues.

Of the 16, all are certified life coaches and 10 are licensed practitioners or social workers. The roster of therapists at E-Therapy Cafe seems to be growing, with promises of new practitioners coming on the meet the team page. Quick external searches of some of the names already on the list revealed a mix of folks who work as full-time practitioners and social workers, and at least one person who seems to moonlight as a life coach.

How Much Does E-Therapy Cafe Cost?

E-Therapy Cafe offers you the ability to pay-as-you-go for sessions, or the option to purchase monthly subscription bundles of four or eight sessions. These discounted packages automatically renew every month. 

The prices are as follows:

• $55 per 30-minute therapy session
• $196 for a monthly four-session package 
• $360 for a monthly eight-session package

As a new client, you can purchase one 30-minute trial session for $50 to make sure you’re happy with the service. 

The company will also evaluate you for an emotional support animal and write a professional letter endorsing the use of a support animal for $165.

All sessions expire after 30 days from purchase and monthly four- and eight-session bundles auto-renew each month, like a subscription.

Does E-Therapy Cafe Accept Insurance?

No. E-Therapy Cafe does not take insurance, Medicaid, or Medicare. 

“This allows us to provide cost-effective, quality services,” a customer service representative wrote in an email, explaining that the administrative burdens of accepting insurance take time away from the patient. “The process for insurance credentialing is time-consuming and can be costly, especially with claims, denials, and collections.” (E-Therapy Cafe will provide a superbill for possible reimbursement, if you ask for one, though.)

Of the users we surveyed, 68% found E-Therapy Cafe's service very affordable or affordable. When you account for the length of a session, its prices, on average, are slightly lower than most large competitors’ out-of-pocket prices, especially if you opt for one of the subscription bundles. 

Clients may not have been more impressed with E-Therapy Cafe’s rates because fees are all out-of-pocket. 93% of all E-Therapy Cafe users had insurance and 27% told us they wished the company accepted insurance. Of the users that were no longer using E-Therapy Cafe for therapy, 9% said they left because they found a provider that did take insurance.

Does E-Therapy Cafe Offer Discounts?

Yes, there are discounts for veterans, first responders, and students upon request.

Navigating the E-Therapy Cafe Website

Despite the fact that E-Therapy Cafe has updated its homepage since we reviewed it last year, its new design still feels somewhat outdated. The website font is large and unevenly spaced, giving the page a crowded feel, there is a carousel of stock photos that cycles too quickly (which adds to the busy feel), and the page is packed with information, which feels overwhelming, despite its statement that “Life is Messy. We Can Help.” You’d be forgiven for having doubts from your first impressions alone. 

However, don’t let E-Therapy Cafe’s website (and lack of social media engagement) turn you off. While other online therapy platforms may have slicker sites, E-Therapy Cafe's services are unique—and if you take the time to explore the site, you can find all the information you need about its services, pricing, process, terms, mission, and team. In fact, 75% of our survey respondents reported that the site was either very easy or easy to navigate.

If you click on any of the “Take the First Step Now” buttons scattered around the website, you’ll be taken to the intake form to sign up for services.

Scrolling down the homepage, you’ll find information about the company’s services, its mission, and its team. For example, by clicking on “Find a Therapist Online” (easily missed in the clutter of black text, and slightly misleading since many are employed as coaches, not therapists), you’ll be taken to a page where you can read detailed bios of all the therapists and coaches on staff. Each profile also clearly states which providers are taking new clients and which ones are not. 

Helpful homepage graphics (when they are working) also link you to platform options, the site’s blog (which hasn’t been updated since 2018), and practitioner bios.

The blog content, although not updated in years, still provides helpful information about topics ranging from resiliency to time management. However, if you’re looking for the basics on mental health conditions, you’ll have to go elsewhere.

The website has landing pages on couples counseling, military counseling, LGBTQIA+ counseling, and more, all of which can be found in the global navigation. Each of these pages provides context for why these types of therapy are needed and what topics and issues may come up during these sessions.

If you can’t find what you’re looking for on the homepage or in the crowded global navigation, it’s likely that your questions can be answered in the FAQs, which are linked to at the bottom of the page.

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

Unlike navigating the website, signing up for therapy at E-Therapy Cafe is a pretty simple process. Seventy-nine percent of our survey respondents said they found the sign-up process very easy or easy. 

On the registration form, you’ll first be prompted to choose a type of therapy: individual, couple, or bridal coaching. Then, you’ll be asked to provide your name, email, phone number, address, and age. 

The next series of multiple-choice intake questions addresses your gender and relationship status; employment status; current levels of stress, anxiety, and energy; how you are feeling today; and whether or not you are feeling suicidal. 

The online therapy service’s intake form then prompts you to pick a coach or therapist. The ability to choose your own therapist can be empowering, if you know what you are looking for. If you’re not sure, you can ask E-Therapy Cafe to pick for you.

If you want to pick your own therapist or coach, the process is tedious, requiring you to read through the bios of every practitioner, each on a separate website page. The form does not indicate which therapists and coaches are no longer taking new clients, so while this information can be found on their bios, you’ll have to keep two browsers open to double-check before making your choice. 

While still a bit laborious, the process of finding a therapist is smoother on E-Therapy Cafe than it is on many other online therapy platforms. In fact, 73% of our survey respondents reported that it was very easy or easy to find a therapist on E-Therapy Cafe.  

If you ask for E-Therapy Cafe’s help in finding a therapist, its leadership team will make the decision based on several factors, including practitioner availability, according to a customer service representative who responded via email. The company does not use a tech-based algorithm to pair practitioners with clients. “We are a boutique team that believes in personalizing care,” the customer service rep wrote. (This process is not outlined on the website.) 

I started out by asking E-Therapy Cafe to choose a therapist for me, then switched to one I had chosen. Both times, I got an email from my new therapist within 24 hours.

Next on the intake form is a question about which service plan you’re interested in, followed by open-ended questions about what your goals are for therapy. The form also asks you how you found E-Therapy Cafe. Payment was not part of the intake process; it was nice to feel that my care came before my credit card.

After completing the form, the email with the link to the client portal comes almost immediately.

Once you click on the email link provided, you’re taken to your secure client portal on SimplePractice, a third-party platform. This is where you’ll be able to do all your scheduling, payment records, and standard paperwork to begin therapy. You’ll also be able to review the company’s practice policies, privacy practices, and terms of use, as well as sign your consent form for your telehealth consultation. You can also access your televideo sessions here, review instructions for clients, and provide payment information. 

Once you have filled in your portal paperwork, you can schedule your first session with your therapist via SimplePractice. To do this, you use the interactive calendar.

The “therapist” I was assigned was actually a coach and had availability almost immediately. Once I booked, I could add my appointment to my Google calendar (there were other calendar integrations as well), and I got an email reminder from the platform 24 hours in advance of my session. 

One nice feature is that you can book back-to-back sessions, depending on the practitioner’s availability; this means that, in theory, you could book an hour with your therapist if you find the standard 30-minute session too short.

While this strategy may make sense for the company, there is a notable lack of transparency around it. My first session was with a certified life coach that customer service or a site administrator had selected for me. And while the paperwork and website FAQs may have covered some of what was within and not within the scope of her practice, she did not discuss the difference between coaching and therapy during our session. 

On the intake form, I had indicated that my stress levels were out of control, my anxiety levels were high, and I felt like I was losing it. I was expecting a match with a licensed therapist who could address some of the underlying trauma that had led me to this worrisome state. I’m accustomed to initial therapy sessions in which the practitioner reviews key points in the policy and consent paperwork and sets the frame for what we can accomplish together, including state regulations about mandatory reporting and suicidality protocol. When she didn’t start this way, or address the difference between coaching and therapy, I felt slightly unnerved. 

I asked one of our subject matter experts on this project, Amy Marschall, PsyD, a licensed clinical psychologist who is certified in trauma-focused cognitive behavioral therapy and tele-mental health, what she thought of the practice of using therapists and coaches somewhat interchangeably. 

“Coaches who do not have training in psychology and mental health are not therapists and should not be advertised as such,” she replied. “Depending on the state, terms like ‘therapist’ and ‘counselor’ are legally protected, so it could be illegal for a coach to state that they are a therapist without the proper training. California is known for being quite particular about these terms, so the California therapist may be practicing illegally using these terms.”

She added: “Some people do find coaching beneficial, but because coaching is so unregulated, many coaches use the lack of oversight to basically offer therapy illegally and unethically.”

How Do Therapy Sessions Work at E-Therapy Cafe?

Sessions at E-Therapy Cafe are held in a variety of different ways:

• Live video call
• Phone/audio call
• Real-time chat
• e-journal

Live Video Session

Once you’ve scheduled your video session, you will receive an email confirmation, which contains a link for the video call. So when it came time to hop online for my first individual counseling session, I simply clicked the link, which took me to the video platform, called VSee, and waited (for five minutes) for my practitioner to join. 

Once the practitioner was on camera, I was a little shocked and disappointed to see her conducting the session from her bed. This felt much more informal than I was used to, and set a tone that eroded some of my trust. She apologized for being sick, and we dove straight into my goals. 

It became clear very quickly that she was a coach, as she kept my focus on goal-setting, decision-making, and behavior change skills such as using affirmations to help me rewire negative thinking. We did not discuss past traumas, family dynamics, emotional wounds, or dysregulation. I was assigned homework, we wrapped with decisions about scheduling future sessions, and we ended five minutes late.

The video platform was impeccable, with no hiccups, delays, or glitches. 

I switched to a second therapist (one I chose, but more on that below) who was a certified clinical traumatologist who used our first session to both lay out expectations (she did not like using the e-journals and said that in order to see progress I should schedule at least every other week, but still, there was no discussion of coaching versus therapy) and collect my family history using a genogram.

We also started and ended five minutes late, wrapping up by talking through the logistics of scheduling the next session.

E-Journal Sessions

I was interested in the e-journal option at E-Therapy Cafe. This feature, considered a session from a pricing perspective, allows you to submit up to 700 words about anything that is on your mind. Your therapist or coach answers within 24 hours with a similarly lengthy response. 

This sounded appealing with my busy schedule—however, it became clear that writing to your therapist is not technically therapy and that this option doesn’t hold the same value as real-time, two-way communication. 

My coach’s response was full of typos and errors—likely the result of voice-to-text dictation. The advice was mildly helpful, but fairly status quo. It was also difficult for me to communicate all I was feeling in 700 words and the one-way communication in response didn’t cover everything. 

Plus, to switch from video session to journal, I had to go through customer service via email (there are no platform options for scheduling journals), and then ask customer service about where to find the response, which didn’t appear in the client portal when my coach said it would. 

My discomfort with this format was validated by the second therapist I saw, who, again, said she did not like, or work with, the e-journal format.

Live Chat

If you opt for a live chat option for your therapy or coaching session, you schedule with your therapist, then request over email to use chat instead of video. The live chat happens over a feature within the secure SimplePractice client portal.

Email Communication Between Sessions

Email communication at E-Therapy Cafe is spectacular, with therapists, coaches, and customer service representatives turning around responses within 24 hours. 

Their responses were generally thorough, thoughtful, and personalized. There is also a chat feature within the client portal that your practitioner can activate for you. Both this feature and email are available for communicating with your practitioner between sessions.

The company also offers an online library of free worksheets to help clients outside of sessions and drive meaningful reflection. 

What Happens If You Miss a Session?

Unless you cancel 24 hours in advance, by messaging or emailing your therapist, you are charged the full rate for your session.

Switching Therapists

There is not a way to switch therapists within the client portal, nor is this process explained on the website; all requests need to be made via email to customer service. However, once I figured this out, the process was simple: Customer service asked me who I’d like to see, I told them, and my new practitioner reached out via email within hours. 

Finding the right therapist at E-Therapy Cafe can take work (as it often does in person, too). Beyond poring over practitioner bios, you may have to meet with a few coaches or therapists before feeling the promise of a productive therapeutic relationship. 

In our user survey, 51% of E-Therapy Cafe customers said they stayed with the first practitioner they met with, while the rest of folks switched up to five times before finding a good fit.

E-Therapy Cafe has no psychiatrists on staff and no medication management services. Instead, clients who require medications are referred to local practitioners for evaluation and prescriptions. This is a big drawback because multiple competitors, including Wellnite and Talkspace, offer both talk therapy in addition to medication management services. 

Pausing or Canceling Your Subscription

You can cancel, upgrade, downgrade, or freeze your membership—but only by emailing customer service. 

With pay-as-you-go sessions, you always have the option of ending services by simply not scheduling any more sessions, which is the perk of this option. But since monthly subscription plans auto-renew, you have to request termination through customer service at least 24 hours prior to your renewal date.

Quality of Care and User Satisfaction

To an almost overwhelming degree, E-Therapy Cafe coaches and therapists have a bountiful mix of certifications, specializations, and training. One therapist specializes in compassion fatigue, for example, while another is a certified meditation and breathwork facilitator. You can also find a registered alcohol and drug technician, as well as a marriage and family therapist. I consider the diversity of specializations and credentials a benefit. There is seemingly something for everyone, but it takes a bit of sleuthing to understand what various credentials mean and what will best serve you as a client. 

As noted above, my experience with practitioners on the platform was a mixed bag, though. I felt cared for, and connected to both of the people I worked with, but it took a couple of tries to find a practitioner I trusted—someone who created a therapeutic alliance that I felt was both safe and productive. And even then, the service I was receiving was technically coaching.

E-Therapy Cafe is growing, promising on its website that more practitioner options are coming soon. One therapist told me that customer service is not as quick as it used to be because of the growth the company has seen in the number of clients and contract practitioners it works with. When I asked practitioners about platform functionality, I was referred to customer service and told that practitioners, at least the ones on contract, were not trained in platform functionality and flow from the client side. This means that my therapist didn’t know what it was like to be a client on E-Therapy Cafe

When we surveyed users, the response was overwhelmingly positive: 85% of our survey respondents reported that the mental health services they experienced at E-Therapy Cafe were above average. Additionally, 50% reported that they thought the platform was excellent, and 40% said their practitioner’s qualifications were excellent. When it came to getting mental health needs met, 82% said all or most of their needs were met by their E-Therapy Cafe practitioner.

Regarding the 30-minute baseline sessions at E-Therapy Cafe, I had one practitioner tell me that it’s potentially too draining, or even boring, for a client to do anything longer. All of my previous in-person and online therapy sessions had been 50 minutes, so I was surprised by this response. In my experience, it sometimes takes 30 minutes just to settle into a session and get to the troubling content, emotions, and reactions. The peer-reviewed science on effective session length is scant, with one study suggesting that 30 minutes may be enough to have an impact on anxiety and depression in teens. But this research was done on a very specific intervention aimed at teaching study subjects that personality and thought patterning are malleable.  

Licensed master social worker and Verywell Mind mental health editor Hannah Owens confirmed that 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,” Owens said, adding that it could potentially be productive with an extremely structured approach like cognitive behavioral therapy.

Privacy Policies

E-Therapy Cafe is HIPAA-compliant, meaning it has systems and processes in place to protect your confidentiality and health information, as required by U.S. law under the Health Insurance Portability and Accountability Act. 

While there has been nothing written (that I can find) about security breaches at E-Therapy Cafe, the platform does not explain the privacy measures they take before you fill out their initial intake form, which asks for your name, phone number, email, date of birth, and some sensitive information about gender identity and mental health. 

Once you have filled out the intake and been paired with a practitioner, you are taken to SimplePractice, where forms, including E-Therapy Cafe’s privacy policy, feel more secure.

SimplePractice protects your account information through a series of protocols it publicizes on its website, including multiple layers of encryption and using servers that are housed in a secure facility protected by proximity readers, biometric scanners, and security guards. It boasts several security certifications and aggressive security testing.

According to our survey of users:

• Thirty-four percent have been clients at E-Therapy Cafe for three to six months
• Twenty-six percent have been clients for six to 12 months
• Twenty-six percent have been clients for one to two years

This suggests that a fairly good percentage of customers stick with the company for a while.

E-Therapy Cafe vs. Its Competitors

Compared to larger platforms like Talkspace and BetterHelp, E-Therapy Cafe does a better job of meeting clients’ therapeutic needs. In our client survey, users of E-Therapy Cafe were 10% more likely to get all of their needs met than they were at Talkspace and BetterHelp—and at a slightly lower cost. 

Survey respondents also reported that finding the right therapist was easier on E-Therapy Cafe, with 68% of Talkspace and BetterHelp clients and 73% of E-Therapy Cafe clients saying they found the process very easy or easy.

Fifty-eight percent of surveyed users said they thought they would still be seeing their E-Therapy Cafe practitioner six months from now, while this number was lower at most other online therapy services (at Talkspace this was 50% and at BetterHelp it was 47%).

E-Therapy Cafe outperformed other platforms—big and small—in terms of overall satisfaction. A whopping 94% of users said they would rate the service excellent, very good, or good. Scores in this category at Talkspace and BetterHelp were 90 and 86%, respectively. Smaller platforms like Gay Therapy Center and Two Chairs saw feedback in the excellent, very good, or good spectrum with 84% and 75% of survey respondents. 

Seventy-four percent of survey respondents said they thought E-Therapy Cafe was much better or better than other online therapy services they’d used, citing ease of use (54% said this was something E-Therapy Cafe did better than other sites) and specialized and qualified therapists (also 54%) as the top two reasons. Survey responses suggest the company could do better when it comes to taking insurance, switching practitioners, and offering more information and additional resources about mental health.

Final Verdict

Overall, E-Therapy Cafe ranks high amongst our survey respondents when it comes to platform usability, the quality of practitioners, and pricing. The services this small online therapy business offers are diverse and easily accessible. The experience was so positive for survey respondents that 77% said that, if they needed to find a new therapist, they would stick with E-Therapy Cafe. 

It may not be the best place to start your therapy journey, since finding the right therapist with E-Therapy Cafe requires some knowledge or research of therapy modalities, techniques, certifications, and trainings, but if you know what you’re looking for, you may find it among the diverse collection of practitioners. 

It’s also not for you if you are looking for a modern app or shiny new website. The essence of E-Therapy Cafe is grassroots, personalized, and authentic, helping you feel noticed and cared for.

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