Finding Online Therapy: What to Know Before You Choose

Ways to access online therapy

• Subscription therapy platforms: match you with a therapist and bill weekly or monthly. Some accept insurance.
• Insurance-network telehealth: your insurer’s directory may list therapists who offer video sessions.
• Local private practices: many therapists offer video appointments, which can be useful if you later want to meet in person.
• Employer or school programs: Employee Assistance Programs and campus counseling often offer free short-term sessions.

Examples include BetterHelp, a subscription platform that includes messaging between sessions; PlushCare, which bills per session and accepts insurance; and Sesame, a marketplace where you choose a therapist and pay a cash price upfront.

What it typically costs

Costs vary widely by provider, location and format. Out-of-pocket prices for private sessions and subscription plans can differ substantially, and insurance copays depend on your plan. Always check the total monthly cost and cancellation terms before you begin.

What to look for

• Licensed professionals (for example LPC, LCSW, LMFT, psychologist) who can practice in your state or country
• Transparent pricing and easy cancellation
• Clear privacy practices — including whether data is shared for advertising
• Ability to choose or switch therapists
• A clear crisis policy

When online therapy may not be the right fit

If you are in crisis, have severe symptoms, or need close monitoring, in-person or more intensive care may be more appropriate. See Get Help Now for urgent support.

How to get started, step by step

1. Clarify your goals. What would you like help with, and what would a good outcome look like?
2. Set a budget and check coverage. Find out what your insurance covers for telehealth, whether you have HSA or FSA funds and what you can afford to pay each month.
3. Choose a model. Do you want a matched therapist and a weekly subscription, a therapist you choose and pay per session, or an insurance-network provider?
4. Shortlist and compare. Read reviews and pricing pages; our online therapy guide and provider reviews, including BetterHelp, Talkspace, PlushCare and Sesame, can help.
5. Verify credentials. Check that your therapist is licensed in the state where you’ll be during sessions.
6. Try a few sessions. Judge fit after three or four sessions, and switch if it isn’t working.

Preparing for your first session

Choose a private room, test your technology, use headphones if possible and have a note of what you want to cover. Think about a back-up plan, such as switching to phone, if the connection fails, and where you’ll be if you need to leave the call. It’s fine to feel nervous. Therapists expect the first session to be about getting to know each other, and you can ask about their training, approach and what a typical session looks like.

How online formats differ

Video is the most studied and closest to in-person care, phone is simple and accessible, live chat suits some people who prefer to write and messaging gives flexibility but has less research support and no immediate replies. Many services let you mix formats. Choose the one that helps you open up and stay consistent. See online therapy for what the evidence says.

Paying for online therapy

• With insurance: look for in-network telehealth providers, and ask about copays and visit limits.
• Without insurance: compare per-session and subscription prices, and ask about sliding scales. See online therapy without insurance and affordable therapy.
• HSA/FSA: most online therapy qualifies, and you can ask for receipts.
• Free options: EAPs, school counseling centers and community programs.

Privacy checklist

Read the privacy policy and ask whether your data is used for advertising or analytics. Use a private space and a secure network, protect your account with a strong password and ask how session records and messages are stored. Our provider reviews summarize each service’s privacy practices and relevant regulatory actions.

Common concerns

• “Will it work as well as in-person therapy?” For many people with mild to moderate depression, anxiety and stress, research suggests video therapy can be as effective, although it isn’t ideal for everyone.
• “Will I connect with a therapist through a screen?” Many people do; the therapeutic relationship tends to matter more than the medium.
• “What if I need medication?” Therapists don’t prescribe, but you can see a separate prescriber; see online psychiatry.
• “What if I’m in crisis?” Online therapy isn’t for emergencies; see Get Help Now.

What a good online therapist will do

A good online therapist explains how sessions work, confidentiality and its limits, and what to do if the connection fails or you are in crisis. They’ll ask about your goals and history, suggest an approach, such as CBT, and check in about progress. They should be licensed where you’re located and be willing to say what they can’t help with. If a therapist doesn’t answer your questions, pushes you to commit to a long plan before you’ve met, or makes you feel unsafe, it’s reasonable to stop and find someone else. A good fit usually brings a sense of being heard and of having a clear next step, even if therapy itself can be hard work.

Next steps

Learn how online therapy works, compare online therapy services, or read how to find the right therapist.