Monument Online Therapy Review

Alcohol use disorder is a health condition in which a person can’t manage how often they consume alcohol, even when it negatively impacts their health and well-being. It affected nearly 15 million people ages 12 and older in 2019, yet only about one in 10 people with a substance use disorder gets specialty treatment. Research suggests telemedicine platforms may help improve access to and availability of specialty treatment for substance use disorder.

Monument is a telemedicine mental health platform that seeks to make alcohol use disorder treatment more affordable and accessible. It works with licensed therapists and physicians that guide you through a personalized alcohol treatment plan, which may include talk therapy, support groups, substance use counseling, and medication. We surveyed 105 Monument users on their experiences with the company and spoke to experts to help inform our review. Here’s what we learned about how the company works and what it currently offers.

What Is Monument?

Monument is an online mental health company founded by Mike Russell in 2019 to provide evidence-based treatment, counseling, and support to people who want a healthier relationship with alcohol. 

Russell founded Monument after realizing that alcohol use disorder treatment needed to be more accessible and available based on his own experiences seeking help for alcohol addiction. According to an article published on the Monument website in 2020, the founder believes a successful alcohol use disorder service “means getting as many people as possible the help they need whenever they need it” and “changing how the world views alcohol dependence.”

Monument’s mission is to help anyone seeking to change their relationship with their drinking habits and improve their quality of life. Since Monument was founded, it has provided therapy to thousands of people and hosts a free community with 60,000 members.

What Services Does Monument Offer?

Monument offers online individual talk therapy and medication management services to people seeking treatment for alcohol use disorder or those looking to change their drinking habits. Its providers can prescribe two FDA-approved medications for alcohol use disorder—disulfiram or naltrexone—and Monument helps you manage your prescription via its pharmacy partner, which ships directly to your doorstep.

It also provides a free, anonymous support forum where people can discuss their experiences and get support as they change their relationship with alcohol. 

In addition to this community, Monument offers 60 free, ​​therapist-moderated online alcohol support groups to connect people with similar experiences and goals, and give them comfortable and judgment-free spaces to share their feelings and thoughts and practice accountability.

Who Is Monument For?

Monument is for people with alcohol use disorder and people who want to either build healthier drinking habits or eliminate drinking altogether. The company works with licensed therapists and prescribers to deliver a personalized treatment plan based on your specific needs.

Therapy might involve:

• Cognitive behavioral therapy (CBT)
• Dialectical behavioral therapy (DBT)
• Trauma-focused therapy
• Motivational interviewing
• Integrated modality approach

Monument treatment plans and community membership are only available to people 18 years or older. Therapy services are currently only available in 20 U.S. states: Arizona, California, Colorado, Connecticut, Florida, Georgia, Iowa, Kentucky, Maryland, Mississippi, New Jersey, New York, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, Texas, Virginia, and Washington, plus Washington, DC.

How Much Does Monument Cost?

Monument offers three care plans with monthly pricing ranging from $9.99 a month to $249 a month. Community membership is free.

Physician Care

This plan costs $9.99 a month plus a doctor's appointment fee of $45 per appointment. Monument recommends this plan for people who may benefit from prescription medication and support from a licensed doctor. This plan includes the following:

• One appointment with a doctor per month (with additional sessions available for $45 each)
• Medication management services 
• Unlimited chat-based messaging with your doctor
• Access to therapist-moderated support groups and a 24/7 community forum

Total Care (Biweekly)

This plan costs $149 a month. It’s recommended for people who want a personalized treatment plan that caters to their needs and goals for improving their relationship with alcohol. It includes:

• Two 45-minute therapy sessions a month
• Unlimited appointments with a doctor
• Medication management services
• Unlimited chat-based messaging with your doctor and therapist
• Access to therapist-moderated support groups and a 24/7 community forum

Total Care (Weekly)

This plan costs $249 a month. Monument says people looking for comprehensive, personalized care and support may benefit from this plan. It includes every service Total Care (Biweekly) offers, with four 45-minute therapy sessions monthly instead of two.

Fifty-seven percent of users we surveyed said they found Monument’s services very affordable and affordable, while 5% said they found its services not at all affordable.

Does Monument Take Insurance?

Yes, Monument accepts insurance. According to its website, it aims to expand its insurance coverage for all members. But so far, Monument is in network with major insurance providers including Aetna, Oscar, Cigna, and Oxford Health Plans. 

You can check your insurance eligibility on its website. If you don't have insurance coverage, Monument says you can pay for treatment using health savings account (HSA) or flexible spending account (FSA) funds.

Monument doesn’t offer discounts. Members also cannot apply for financial aid or sliding scale  rates.

Navigating the Monument Website 

You’ll see Monument’s tagline—“Online alcohol treatment on your terms”—and its reason for operating—“With personalized online alcohol treatment, drinking will become less important to you. You can make a change, and we’re here to help”—on its homepage. The obvious yellow “Get started” button beneath this text directs you to sign up for its services. 

When you scroll down the homepage, you’ll see user reviews, brief descriptions of the company’s services, a summary explaining why Monument was founded, publications Monument has appeared in, and answers to frequently asked questions.  

The homepage has links in the menu bar at the top of the page that direct you to:

• Monument’s group support programs
• How Monument works
• Insurance coverage information
• Monument’s plan and pricing
• Reviews
• Educational resources hosted on a blog

Monument’s website ensures that you find the information you need as soon as you need it by including key information and reviews on its homepage and a Frequently Asked Questions (FAQ) section that answers many of the common questions you may have, such as cost and what to expect when using its services. Navigating it is hassle-free, and you can connect with the support team by filling out an online form if you can’t find what you need. Sixty-two percent of our users found navigating the website to be easy, and only 4% said it was difficult. 

Unfortunately, unlike some of the other companies we reviewed, Monument doesn’t have an app.

How Do You Sign Up for Therapy at Monument?

You’ll see two buttons that say “Login” and “Sign up” at the top of every page on the website.  You can sign up for free with your Google account or email by clicking “Sign up.” This process does not ask you any questions about your history or preferences, and you don’t need to provide any information other than an email and password. After creating your account, you’ll be prompted to enter your state of residence and create a password and nickname for the Monument Community. 

If you want to sign up for a therapy plan, you’ll be required to upload a photo ID and fill out a form. The answers you provide on the form give Monument information about your medical history. Then you can book appointments on its platform with your care team, including a doctor, a therapist, and a Monument care coordination team member.

Matching With a Therapist at Monument

After becoming a member and signing up for a therapy plan, Monument allows you to select the gender or sex, background, race, ethnicity, and other preferences you want in your ideal therapist and uses those preferences to match you with a licensed therapist. 

All therapists have experience treating substance use disorder and have received training in evidence-based treatment for substance use disorder. Their qualifications include:

• Master’s degree in social work from an accredited college or university 
• Unrestricted licensure for independent clinical practice in specific states
• Experience working with patients with alcohol dependence
• Training, certification, or experience using CBT, DBT, contingency management, motivational interviewing, and trauma-informed treatment
• Understanding of and support for the harm-reduction model for treating SUDs (substance use disorders)—this is an approach that focuses on managing the adverse effects of substance use and improving well-being in people with substance use disorder without forcing them to quit
• Knowledge of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for substance use disorders

How Do Therapy Sessions Work at Monument?

Therapy sessions are individual and last for 45 minutes. Your treatment program will determine how many sessions you’ll have and the treatment phases you must go through to meet your goal. You can decide which day you have your sessions with your therapist, too.

As with most online therapy companies, you will schedule appointments and message your therapists and doctor through your personal portal on the Monument site. You will also be able to access the moderated support groups and online group forums. Seventy-nine percent of survey respondents said this platform was very good or excellent in terms of ease of use. 

Although Monument says it has a diverse staff, therapists conduct sessions only in English. You can communicate with your therapist via live video sessions or asynchronous messaging through the patient portal. You can text your therapist non-urgent questions at any time of the day.

What Happens If I Miss a Session at Monument?

You can schedule therapy sessions on days convenient for you. Monument advises canceling as soon as you know you’ll miss your session. If you can’t cancel 24 hours before your therapy session, you’ll have to pay a late cancellation fee of $25. You can cancel on the Appointments page on your dashboard. If you miss an appointment, you’ll pay a $50 missed appointment fee.

Switching Therapists at Monument

You can change your therapist and request a new one whenever you want to. You can ask for a new therapist by contacting the Care Coordination team via the patient portal.

Twenty-five percent of users surveyed switched therapists at Monument once, 29% switched therapists two to three times, 7% switched therapists four to five times, and 5% changed therapists five or more times. Meanwhile, 46% of users surveyed said it took a few days to get assigned to a new therapist. 

These numbers are comparable to those of the other mental health companies we surveyed, like NOCD, Brightside Health, Ginger, and Included Health.

Pausing or Canceling Therapy at Monument

You can pause or cancel therapy at any time via the patient portal. There are no fees for canceling your subscription, but it will run until your current billing cycle ends.

Quality of Care and User Satisfaction

Since Monument launched in May 2020, it has had a low turnover rate with its therapists, meaning therapists don’t leave often. And when they decide to, they have to give a 30-day notice period, which allows Monument to provide members with the help they need to cope with the care transition. 

Seventy-seven percent of clients we surveyed rated their therapist’s qualifications as good, very good, or excellent, and 75% said the number of quality providers on Monument’s directory licensed in their state was excellent, very good, or good. 

Additionally, most users surveyed found Monument's online therapy service beneficial for their mental health. Forty-eight percent said it provided better care than they’ve ever received, and 30% said it’s just as helpful as care they’ve received before. Only 7% said it isn’t as helpful as in-person therapy. 

Plus, 73% of Monument users found a therapist that met all or most of their needs, and 42% of users said they’ll still be seeing their therapist at Monument 12 months from now.

Telehealth services for alcohol use disorder can be as effective and practical as in-person mental health services. “Telehealth services have been proven to be often equally as effective as in-person services, and this is true for alcohol addiction treatment as well,” says Hannah Owens, LMSW, a subject matter expert. "Many of the modalities utilized in treating substance abuse (such as motivational interviewing) are easily translated to a telehealth format.” 

Plus, according to Owens, the accessibility and flexibility of telehealth services could make seeking treatment more feasible for many.

However, Owens says that people who need more therapy support may benefit from in-person therapy services. This is because in-person sessions provide a higher level of care than virtual sessions. For instance, “it might feel bolstering to connect with a therapist in person and to establish a specific and personal safe space to discuss challenges,” Owens explains.

Privacy Policies at Monument

According to the Monument representative we spoke to, its platform is compliant with all relevant privacy laws. All users' data is encrypted, and it follows “industry-leading security practices” to keep users’ privacy and data safe, although those security practices were not explained. Additionally, Monument’s privacy policy makes no mention of HIPAA, the federal law protecting personal health information.

Its community forum keeps members anonymous. Members can also join therapist-moderated support groups without turning on their cameras and microphone. 

A representative told us that Monument ensures its staff takes HIPAA training. In addition, contractors and vendors with access to protected health information sign a Business Associate Agreement (BAA). This agreement outlines how parties handle protected health information.

Monument vs. Competitors 

Monument and Oar are both telehealth providers that offer alcohol use disorder treatment. Unlike Monument, Oar doesn’t provide therapy, only medication-assisted treatment. This medication is naltrexone, an FDA-approved drug for treating alcohol use disorder. Monument also offers free groups for its clients, which is not true of Oar. These groups are important for clients to receive peer support from others who are experiencing similar problems and to whom they can be held accountable in their recovery journey.

Monument runs on a monthly subscription model with pricing ranging from $9.99 to $249, while Oar’s medication management service is also a subscription that starts at $39 monthly. You’ll have to take an online test that a doctor within Oar’s network will use to confirm if you may benefit from medication and create a treatment plan. Your monthly subscription also allows 24/7 access to a doctor for guidance and support. Unlike Monument, Oar doesn’t accept insurance, which gives Monument the edge in this area, as accepting insurance makes its services far more accessible and affordable to many people in need of substance use treatment. 

Despite this, Oar had overall better ratings than Monument in our user survey. Ninety percent of Oar users rated it as excellent, very good, or good, whereas only 78% of Monument users rated Monument’s services this way. Additionally, 62% of Oar users said it was easy navigating its website; 60% said the same for Monument. Just under 70% said they were likely or very likely to recommend Oar to others; this was slightly higher than Monument’s 62%. Seventy-eight percent of Oar’s users rated its medication services as excellent, very good, or good.  At Monument, 75% of its users rated its medication services positively. 

Still, Monument comes out on top in terms of available services, as it offers therapy and group support as well as medication management.

Final Verdict

Monument uses individual talk therapy, medications, and community support to help people with alcohol use disorder get the help they seek. Based on our expert-guided review, people with alcohol use disorder or unhealthy relationships with alcohol who are comfortable receiving treatment and community support online may benefit from using its services.

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.