Online Therapy Directories Review Methodology

Every year, Verywell Mind helps 150 million people find answers to their mental health questions. That’s why, as part of our mission, we aim to provide you with thorough, data-driven, and unbiased reviews of services that can improve your health and well-being, such as online therapist directories—websites that aim to make it easier for therapy seekers and therapists to connect, both in-person and online. 

Since 2020, more and more people are seeking mental health care, especially for anxiety or depression—and this has made it increasingly difficult for people to find a therapist that is both available and appropriate for their needs. This is especially true if you live in a therapy desert, (i.e., a place where there is, even pre-pandemic, a shortage of mental health professionals), such as Mississippi and South Carolina. These two states have the lowest representation of licensed therapists in the United States with only 11.9 and 13 per 100,000 people, respectively. (For comparison, Washington, D.C. had 173.3 and Vermont had 100.5 per 100,000 people).

We wanted to evaluate whether some of the most popular therapist directories were actually achieving their main goals of making it easier for therapy seekers to find appropriate care and locating therapists to fill their practice. To accomplish this, we evaluated 27 different companies (though two eventually didn’t make the cut for us to review fully) in order to determine whether they really are helpful. Here is how we researched these businesses.

Selecting Our Directories

In order to determine which directories we wanted to evaluate, we first created a list of all the companies we’d either heard of through word-of-mouth or discovered while conducting our research, either through internet ads, news articles, or google keyword searches. 

From there, we narrowed down the list of companies to those that had higher traffic, the most news coverage, and the best word-of-mouth or social media presence. We also sought out those that work to help connect underserved or marginalized communities with therapists that look like them or share a similar gender identity, sexual orientation, or cultural background. 

Companies that prioritize underserved communities stood out to us in particular because the mental health field has long had a diversity problem. Only about 4% of mental health providers identify as Black in the U.S., 4% as Asian, and 6% as Latinx. We wanted to ensure that we were reviewing the companies that would be most useful to our readers, regardless of where they live or how they identify. 

As such, we initially intended to review Therapy for Muslims; there are very few therapy websites aimed at members of the Muslim community, even though roughly 3.45 million Muslims live in the country. This was the only directory we found that seemed to focus exclusively on connecting members of this religion with providers who share the same religious beliefs. 

However, during our initial research into the company, we were unable to use the search function without getting consistent page errors. The company also did not respond to our repeated outreach to ask if there were plans to address the website errors and update the information. We were also unable to connect with a single therapist listed in the directory. This left us no choice but to disqualify the Therapy for Muslim directory from our project. 

We also ruled out AllAboutCounseling.com during this initial process due to repeated issues with its website navigation.

Data Collection

In order to truly get a sense of the companies we were writing about, how their services operate, and how useful they are for potential therapy seekers, we began by doing some data collection. 

This involved three steps:

• Figuring out what states the companies served (and how many therapists they had in each)
• Sending a company questionnaire to the companies themselves
• Engaging a freelance researcher to gather research about the company through reputational research and website analysis

States Served

Not all directories serve all 50 states, so to get a sense of which states they do serve, our editors counted the number of states covered by a directory and the number of therapists in each state.

Here are the geographical regions covered by each company:

And here are the number of therapists we counted as of April 2022 across all states:

Admittedly, the number is fluid—therapists are likely joining or leaving a company every day—but this number gives us a rough estimate of what a user might be able to find on each website. This count also allowed us to crosscheck the information with the companies that responded to our surveys.

(Note: The Financial Therapist Association is not listed on the map or table above because this was the one company where the states served and the number of therapists per state was unclear from the website alone.)

Our counts also gave us an average number of therapists per state, information we could use to compare against national averages (in order to determine if a company was serving a “therapy desert”) and against its competitors.

Company Questionnaire

Our goal with the company questionnaire was to give each directory the opportunity to tell us about themselves and comment on their offerings. It was their chance to tell us their story, pitch us about why they were helpful to therapy seekers, and how they stood out from the competition. It was also an opportunity for us to get clarification on certain aspects of their company that we had questions about. 

Our questionnaire was 43 questions long, and focused on these areas:

• Why they started their directory
• The types of therapists and therapy seekers they were trying to attract
• States they served
• How they vetted and supported the therapists who used their service and handled user complaints
• Whether they handled billing, scheduling, or insurance
• How they helped make access to mental health care more accessible
• Other services they offered therapy seekers or therapists

If any answers were unclear or we had additional questions, we followed up with the companies afterward. 

We reached out to all 25 companies we wrote about via their media contact (if they had one), customer service, and social media sites, such as LinkedIn. We originally tried to get all the answers within a month, but due to lower response rates, we extended our deadline. However, despite repeated outreach attempts, only 13 of the 25 companies responded. 

While the answers mostly revealed information we expected, there were some things that we learned that we hadn’t anticipated. For example, two companies do not have a process for handling user complaints about the therapists on the directory and most companies said they offer guidance to therapists about what information to put in their profiles. 

The questionnaire also allowed us to fact-check our manual count of the number of therapists on the site and follow up regarding any discrepancies. 

Website Data Collection

Since not all companies responded to our questionnaire, we conducted our own data collection to obtain answers to all the questions we’d asked through our research. In order to also fact-check (or ask clarifying questions to the companies we did hear from), we decided to collect data on all 25, regardless of whether they had responded. 

We also found this process to be illuminating: Since our research would always begin on the website, it would give us insight into how easily a potential user could find answers to their questions as well. As a result, we asked our data collectors to gather information not only about the company’s services, but also the site’s general design, user-friendliness, and any potential obtrusive ads or errors they encountered. 

This process was exhaustive and comprehensive. We asked our data collectors to answer 86 questions as they conducted their research via the company website, third-party news coverage, customer service calls or messages, and, where necessary, a phone interview with a company representative. (Only one interview was conducted in the end, with Melanin & Mental Health’s founder.) 

Our researchers compiled this information into a spreadsheet and took documenting screenshots wherever necessary. 

User Surveys

In order to try to get an accurate sense of how therapy seekers use and feel about the directories we reviewed, we surveyed 180 users or more at each of the 27 directories we evaluated.

The survey included 46 questions about the directory company itself, including: 

• How users heard about the directory
• The type of therapist they were looking for on the platform
• The important factors or features to them on the directory
• Website navigation and ease of use
• Ability to find a therapist that met their needs
• Overall satisfaction with the service as a tool for finding a therapist
• How the directory compared to other directories or online therapy services they’d used

These answers gave us some idea of how satisfied users were with the directory as a tool to find a therapist.

In fact, overall user satisfaction with the directory became one of our most important ways to evaluate the company. For example, the survey gave us insight into how many users would recommend the company to others like them:

And it gave us insight into how users felt the company compared to other services they’d used:

It also told us what they thought the company could do better:

Who Were the Users We Surveyed?

Before we opened our survey to respondents, we sought to make our survey data representative of the U.S. population. This meant ensuring that our respondents came from most (if not all) 50 states. 

In the end, we were able to secure at least two respondents in every state, including at least one respondent from every territory except Guam. We also surveyed three users currently in Canada, four in Mexico, and five in another country. Here is a breakdown of our users by state:

Approximately 46 million Americans (or 14% of the population) live in rural areas of the country. Rural areas also often have inadequate mental health services, forcing therapy seekers to struggle to find providers or making them travel long distances just to get help. For example, one study found that there is only one psychiatrist available for every 30,000 people living in rural America.

So, in order to try to discern whether therapist directories were helping rural residents connect with therapists, we felt it was important to try to survey therapy seekers from those regions. Thus, we originally capped our respondents at 81% from urban and suburban areas. 

However, we eventually loosened this restriction a bit when we struggled to find enough respondents to participate in the survey. In the end, 84.3% of our respondents were residents of urban or suburban areas and 15.7% came from rural regions—which was fairly representative of the U.S. population. 

Income was also an important variable for us, as it would greatly influence how users felt about the affordability of therapist rates. The median income in the U.S. is $67,521, according to the U.S. Census, so we limited the number of respondents who made over $100,000 to 40% of respondents. Here is the breakdown of our 4,863 respondents:

According to the 2020 U.S. Census, the United States is more racially and ethnically diverse than in the previous 10 years—a trend that has been ongoing with every census since 1980. In fact, a 2020 report suggests that the country is diversifying even faster than previously predicted. 

As a result, our team felt very strongly that our user survey should reflect the diversity of the U.S. population. So using 2020 census data, we tried to approximate, as best we could, the racial and ethnic diversity of the country, even with our small survey sample size by setting a firm quota: No more than 60% of our respondents could identify as white.

Here is what our final results were:

Since so many companies claim to be serving users of a number of different religions and backgrounds, we also asked users about what languages they spoke and which religion they followed.

Ninety-three percent of the users said they spoke English, but many also spoke other languages, including:

Languages Spoken by Respondents
American Sign Language	2%
Arabic	2%
Cantonese	2%
French	3%
German	2%
Japanese	1%
Korean	1%
Mandarin	1%
Portuguese	1%
Russian	1%
Spanish	12%
Tagalog	1%
Vietnamese	1%
Other	2%

As for religious beliefs, here is how our users responded compared to the national population:

Religion	User Survey	U.S. Population
Protestant (Baptist, Methodist, Non-denominational, Lutheran, Presbyterian, Pentecostal, Episcopalian, Reformed, Church of Christ, Evangelical, etc.)	28%	7.7%
Catholic	25%	11%
Mormon (Church of Jesus Christ of Latter-day Saints/LDS)	3%	1.1%
Other Christian	3%	1.1%
Orthodox (Greek, Russian, or some other orthodox church)	2%	0.5%
Jewish (Judaism)	2%	2.4%
Muslim (Islam)	9%	1.1%
Buddhist	2%	0.7%
Hindu	1%	0.7%
Other Christian	0%	0.4%
Jehovah’s Witness	1%	0.8%
Nothing in particular, atheist or agnostic	20%	23.8%
Prefer not to say	4%
Other/Please specify	4%	4.5%

Roughly 7.1% of the U.S. population identifies as LGBTQ+, another number that has been on the rise since 2012. As a result, we wanted to ensure that we were surveying users from this population so we set a number of quotas, including:

• Aiming for a maximum number of respondents who identified as male or female to be both 49% (meaning a target of 2% would identify as nonbinary, two-spirit, or those who prefer to self-describe)
• Ensuring at least 1% of all survey respondents identified as transgender
• Capping the number of straight or heterosexual respondents at 94%.

Here is our final breakdown of respondents:

In addition, 12% of respondents identified as intersex and 3% preferred not to say.

Finally, roughly 61% of Americans—or 26% of the adult population—have some type of disability. In addition, according to the Centers for Disease Control and Prevention (CDC), adults with disabilities report experiencing mental health issues at a five times higher rate than people with disabilities, including traumatic stress from the painful treatments they receive as well as depression and anxiety.

As a result, it was clear to us that people with disabilities might be frequent users of online therapist directories, so it was important for our survey to target this demographic. Originally, we set our quota to 26% of people with disabilities, but due to difficulties finding respondents, we were forced to loosen our restrictions. 

In the end, only 18.9% of our users said they lived with a disability, though 4.3% said they were unsure and 0.8% said they preferred not to disclose. Nineteen percent of our survey respondents also identified as neurodivergent, meaning they live with autism, ADHD, OCD, dyspraxia, or another condition.

To keep our survey representative of therapy seekers nationwide, we also worked to ensure our respondents represented different ages. Here are our final results:

User Survey Respondents’ Ages
Under 18	2%
18⁠–24	19%
25 –34	32%
35⁠–44	30%
45⁠–54	10%
55⁠–64	4%
65⁠–74	2%
75⁠–84	1%
85⁠–94	0%
95⁠–100	0%
101+	0%

User Testing

Companies may have great mission statements to combat inequities in mental health care, but the best of intentions cannot compensate for a poorly designed search function. When you’re already not feeling your best and looking for therapy, small setbacks like result pages that don’t load, limited search filters, and confusing website navigation can be all the more frustrating. 

Directories might also be intuitive to certain types of therapy seekers, but difficult for others due to their limited focus or lack of accessibility features. Thus, we decided that user testing must be a fundamental part of our research.

As a result, we devised a series of steps our testers could undertake in order to test the search functionality, website navigation, and usefulness for a range of therapy seekers.

Hypothetical Therapy Seeker Scenarios

To conduct this testing research, the Verywell Mind team members researched and came up with 37 hypothetical therapy reasons for why a person might seek therapy through an online directory. These scenarios were inspired by real-world examples we knew of or read about in news articles and or personal essays as well as on social media to reflect actual therapy seeker’s concerns; they were then vetted by our anti-bias review board to ensure sensitivity. 

Once these scenarios were finalized, they were grouped into six main categories relating to specific techniques, specific conditions, relationship-related issues, parenting-relating problems, cultural sensibility, and accessibility.

Regions to Test

In an ideal world, we would have the time to test all 50 states for all 25 directories, but due to limited resources and time, we decided instead to test 18 different ZIP codes that represent a wide range of demographics, incomes, education levels, and therapist availability. 

These ZIP codes we tested, based on demographic research and health professional shortage areas (HPSAs), included the following:

User Testing

Once we had finalized our ZIP codes and hypothetical therapy seeker scenarios, we began user testing. To do this, a combination of Verywell Mind editors and independent contractors searched each directory for therapists who might fit each of the 37 hypothetical scenarios in all 18 ZIP codes, choosing the therapist they thought to be the best fit for the scenario in 10 minutes or less using the site’s navigation and search function. Once they found their therapist, they noted the link to the therapist’s bio, which search filters they were able to find and use, and any other issues they ran into (such as errors using the search function, lack of therapists available, etc.).

Once this data had been collected, our three subject matter experts, Dr. Nic Hardy, Dr. Amy Marschall, and Hannah Owens, scored each result on a scale of 0 to 5 based on how well the tester was able to find a therapist who matched the hypothetical scenario. To be clear, our experts were not scoring the therapists themselves—we scored the user’s ability to find a suitable therapist in their ZIP code for each scenario. For example, if the tester wasn’t able to find any therapist at all (i.e., because there were very limited or no therapists in that ZIP code or the therapists didn’t specialize in the condition they were seeking treatment for), the score was low. But if the therapy seeker was able to find a highly specialized therapist who matched the hypothetical scenario well, the score was high.

In general, the most useful directories offered a variety of filters relevant to the target user/demographic, allowing the user to quickly and effectively find a therapist who met the needs of the scenario with few or no issues with design or programming; lower-scoring directories offered few or irrelevant filters and/or had bugs or other issues. 

Once the scores for each of the 37 scenarios across all 18 ZIP codes had been determined, we calculated averages based on the six results. Here is the ranking of each company for each category after this scoring was complete:

Our subject matter experts also took notes explaining their scoring, which we shared with our writers to incorporate into the reviews. 

Therapist Surveys and Interviews

Directories market their services not just to therapy seekers, but also to therapists they want to recruit. After all, the more therapists each company has in each state, the more useful the site is to therapy seekers. Many companies offer therapists a way to advertise, seek legitimacy, and grow their practice. Others offer help scheduling sessions or processing billing. 

We were curious about how effective the companies were at delivering on their promises to the therapists who joined, so we designed a 60+ question survey asking them about why they signed up, what they liked and disliked about the directory, and what the sign-up process was. We also asked them if they had tried other services, including other directories or online therapy companies, and how the company compared to those services. 

We then reached out to hundreds of therapists at each directory (in batches of 20 at a time) in order to try to receive a minimum of 10 therapists' responses to our survey. We also contacted the companies themselves, asking them to share our survey with their users, and looked for therapists through services such as Help a Reporter Out (HARO) and social media platforms. 

In order to make our outreach fair, we began by reaching out to therapists in the same 18 ZIP codes (if possible) that we tested, then slowly expanded out from those regions in subsequent rounds. 

However, after a month of outreach, we were still far from our goal of hearing back from a minimum of 10 therapists from each company, so we changed our approach and hired freelance journalists to conduct phone interviews with therapists at the company instead. This method helped us meet (and in some places exceed) our goals of a minimum of 10 therapists per company.

Analysis

At each step of the way in our research, our subject matter experts reviewed the research and provided notes and comments to assist with our research. These notes were not only useful for our writers, who quoted these comments in many of their reviews, but also in helping us evaluate each company and create a scoring system. 

Once all our data was collected, we created a rubric to help us evaluate each company in the following areas:

• Convenience and search functionality: Was the directory easy to use and navigate? How did the users we surveyed and our testers find the experience of searching for a therapist and using the website? Does the directory serve the therapists' needs as well? Does the directory assist with therapist communication or session scheduling?
• General user satisfaction: Would the users we surveyed recommend the directory to others like them? Were they satisfied with the directory itself and its usefulness in helping them connect with a therapist? What do they wish it did better? 
• Quality of therapists listed on the site: Does the directory vet the therapists that list themselves in the directory in order to protect the users? Does the directory provide qualified individuals who have high levels of education, training, and experience?
• Accessibility: Does the directory have accessibility features, such as sites that are screen-reader friendly, in multiple languages, or available in color-blind-friendly colors? 
• Pricing and Insurance Options: Does the directory list a range of therapists with a wide variety of rates so users can find affordable mental health care? Does the directory include therapists who offer sliding scales or accept insurance? Does the company help process insurance claims?
• Cultural sensibility: Does the directory have a social justice mission statement? Is the directory inclusive of different racial and ethnic backgrounds, religions, gender identities, and more? Is the directory actively working towards improving therapy deserts or serving marginalized communities?
• Benefits for therapists: Does the directory help therapists build their roster and find the kinds of clients they want to treat? Does it provide any other professional services?
• Company reputation: Has the company (or its parent companies/affiliated brands) been associated with any scandals or negative news coverage? Does the directory have good word of mouth? 
• Specific Techniques: Are users able to find therapists in the directory who use a variety of different therapeutic techniques? 
• Specific conditions: Are users able to find therapists in the directory who can treat a wide range of mental health conditions?
• Usefulness for couples, parents, and families: Does the directory help clients find couples therapists, family therapists, or therapists who specialize in kids, teens, or pre-and postpartum care?

We created a scoring system based on the answers to these questions to determine star ratings for each company and help compare each directory against its competitors. This allowed us to rank the companies in order to determine not only the best overall directory but also the best for specific therapy seekers’ needs. 

Our Team