Is online therapy as effective as in-person?

For common concerns like depression and anxiety, research has generally found video-based therapy comparably effective to meeting in person. Messaging-only therapy is less studied, and the evidence is thinner. The consistent finding across formats is that the working relationship with the therapist matters more than the medium, which is why the quality of the match is worth prioritizing.

How much does online therapy cost?

It depends on the route. Flat-fee subscription platforms run roughly $65 to $100 a week out of pocket. Insurance-based options cost a normal copay, often far less. Sliding-scale networks like Open Path Collective run $40 to $70 a session. If you have insurance, starting with an in-network option almost always costs less than a subscription platform.

Does insurance cover online therapy?

Increasingly, yes. Talkspace, Brightside Health, and Headway are all built around insurance, and Headway exists specifically to surface in-network therapists. BetterHelp and Two Chairs are more limited on coverage. The first practical question when choosing a service is simply whether you want to use insurance or pay out of pocket.

How do I choose between these services?

Start with insurance: if you have it, Headway, Talkspace, or Brightside will likely cost the least. If you do not, Open Path Collective is the affordability route and BetterHelp is the fastest. Then consider format — open-ended talk versus a structured program — and whether you also need psychiatry, which Talkspace and Brightside provide.

When is online therapy not the right fit?

Online platforms are not built for acute crisis or emergencies. If you are in danger or thinking about harming yourself, contact emergency services or call or text 988, the Suicide and Crisis Lifeline in the US. Some conditions are also better served by in-person, higher-intensity care. Online therapy is a strong front door for many people; it is not a substitute for crisis or emergency care.

Online Therapy

Best Online Therapy Services

Six ways to reach a licensed therapist, weighed on match, access, cost, and care.

At a Glance

Quick comparison

Tap any row to jump to the full review

Service	Best For	Format	Price	Insurance
BetterHelp	Fast, flexible access	Messaging, phone, video	~$70 to $100 / week	Out of pocket
Talkspace	Insurance and psychiatry	Messaging, video, psychiatry	Varies with plan	In-network with many insurers
Brightside Health	Depression and anxiety, clinically	Video therapy, psychiatry	~$95 to $115 / mo, plus visits	In-network with major insurers
Two Chairs	A careful therapist match	Video therapy, some in-person	~$150 to $250 / session	In-network in some states
Open Path Collective	Affordability without insurance	Therapist directory; video or in-person	$40 to $70 / session	Sliding scale; no insurance needed
Headway	Using your insurance	Therapist marketplace; video or in-person	Your insurance copay	In-network; built around insurance

BetterHelp

Fast, flexible access

BetterHelp is the largest online therapy platform, and its strength is speed. You answer a short intake questionnaire, and the service usually pairs you with a licensed therapist within a day or two. From there you can message your therapist between sessions and meet by phone or video on a weekly cadence, all on one subscription.

The scale is the draw and also the caveat. BetterHelp does not bill insurance, so the weekly fee is fully out of pocket, and the subscription bundles messaging and live sessions rather than itemizing them. It is also worth knowing that in 2023 the company settled with the Federal Trade Commission over sharing user data with advertisers; it has since changed those practices. For someone who wants to be talking to a therapist this week, it remains the most frictionless way in.

The fastest way to be in front of a licensed therapist, for people for whom the cost and data tradeoffs are acceptable.

FormatMessaging, phone, video

Pricing~$70 to $100 / week

InsuranceOut of pocket

Strengths

Matched with a therapist in a day or two
Message your therapist between live sessions
Switch therapists at any time, at no cost

Tradeoffs

No insurance; the weekly fee is fully out of pocket
Subscription bundles messaging and sessions rather than itemizing
Settled a 2023 FTC case over advertising data sharing

Visit BetterHelp →

Talkspace

Insurance and psychiatry

The silhouette of a person sitting at a curtained window

Talkspace is the other major subscription platform, and the practical difference from BetterHelp is coverage. It is in-network with many large insurers, available through a number of employer benefit programs, and offers psychiatry and medication management alongside talk therapy, so the two can be coordinated in one place.

The model is still messaging-led, with live video sessions layered on, which suits some people more than others. What you pay and which therapists are available depend heavily on your specific plan and state, so the experience is less uniform than the flat-fee platforms.

The large-platform option that actually works with insurance, and keeps therapy and psychiatry under one roof.

FormatMessaging, video, psychiatry

PricingVaries with plan

InsuranceIn-network with many insurers

Strengths

In-network with many major insurers
Offers psychiatry and medication management
Often available through employer benefits

Tradeoffs

Cost and coverage depend heavily on your plan
Messaging-led model does not suit everyone
Therapist availability varies by state

Visit Talkspace →

Brightside Health

Depression and anxiety, clinically

A close-up of hands typing on a laptop keyboard

Brightside Health is the most clinically structured service in this guide. It is built around depression and anxiety specifically, pairs therapy with psychiatry, and runs on measurement-based care: you complete brief standardized check-ins between visits, so your clinician can see whether you are actually improving rather than guessing.

That focus is the tradeoff. Brightside is less of an open-ended, talk-about-anything space and more of a treatment program with a defined arc. For someone whose main concern is depression or anxiety and who wants progress tracked, that structure is a feature; for someone seeking exploratory, long-horizon therapy, a different model may fit better.

The most clinically rigorous option here, with measurement-based care and coordinated psychiatry.

FormatVideo therapy, psychiatry

Pricing~$95 to $115 / mo, plus visits

InsuranceIn-network with major insurers

Strengths

Measurement-based care tracks progress over time
Therapy and psychiatry coordinated together
In-network with major insurers

Tradeoffs

Built narrowly around depression and anxiety
Less suited to open-ended, exploratory therapy
Video sessions only; no messaging as therapy

Visit Brightside Health →

Two Chairs

A careful therapist match

A laptop in a calm, spare room, seen from across the space

Two Chairs is built on a single conviction: the match between client and therapist is the thing that most determines whether therapy works. You begin with a dedicated matching consultation, and the service uses it to pair you with a therapist it believes is a genuine fit, rematching at no cost if the first pairing is not right.

It is the most deliberate, and among the most expensive, services here. Sessions run at private-practice rates, insurance coverage is limited and depends on your state, and availability is concentrated in certain regions. What you are paying for is the matching care and, in some areas, a blend of virtual and in-person sessions.

Treats the therapist match as the decisive variable, and invests real care in getting it right.

FormatVideo therapy, some in-person

Pricing~$150 to $250 / session

InsuranceIn-network in some states

Strengths

A structured matching consultation before you begin
Free rematch if the fit is wrong
Blended virtual and in-person in some regions

Tradeoffs

Among the most expensive options in this guide
Insurance coverage is limited and region-dependent
Availability concentrated in certain states

Visit Two Chairs →

Open Path Collective

Affordability without insurance

A person at a laptop by a sunlit window, seen from behind

Open Path Collective is not a platform so much as a nonprofit directory. For a one-time membership fee, you get access to therapists who have agreed to see Open Path members at a reduced rate, generally $40 to $70 a session, and lower for students. You are working with an independent licensed therapist, not a gig-style platform clinician.

It is the clearest answer for someone without insurance who cannot carry a full market rate. The tradeoff is that you do the work the platforms do for you: you search the directory and book yourself, availability depends on your area, and reduced-rate slots can be limited.

The honest answer to 'I have no insurance and can't afford full rate' — real therapists at a sustainable reduced fee.

FormatTherapist directory; video or in-person

Pricing$40 to $70 / session

InsuranceSliding scale; no insurance needed

Strengths

Sessions well below the typical market rate
You see an independent, licensed therapist
Nonprofit; one-time fee, no subscription

Tradeoffs

You search and book yourself; no matching service
Therapist availability varies by location
Reduced-rate slots can be limited

Visit Open Path Collective →

Headway

Using your insurance

Headway is a marketplace whose entire purpose is making insurance work. You filter therapists by your specific plan, every therapist listed is in-network, and you pay an ordinary copay rather than full freight. Headway handles the billing in the background, which removes the part of finding a therapist that most often stalls people.

You are booking an independent therapist, in-person or virtual, not a platform employee. The obvious limit is that Headway is only useful if you have insurance, and the accuracy of the plan filter depends on entering your plan details correctly. Selection still varies by state.

The simplest path to a licensed therapist who takes your insurance, without the in-network runaround.

FormatTherapist marketplace; video or in-person

PricingYour insurance copay

InsuranceIn-network; built around insurance

Strengths

Every therapist shown is in-network with your plan
You pay a standard copay, not the full rate
Independent therapists, in-person or virtual

Tradeoffs

Only useful if you have insurance
Plan matching depends on accurate plan details
Coverage and selection vary by state

Visit Headway →

Methodology

How we evaluate

Therapist quality

Licensed, verified clinicians, and how carefully the service vets, supports, and retains them.

Matching

How well the service pairs you with a therapist who fits, and how easy it is to switch.

Access and format

How you actually meet — video, phone, messaging, in-person — and how quickly you can start.

Cost and insurance

What it costs out of pocket, whether it takes insurance, and how transparent the pricing is.

Evidence and outcomes

Whether the service measures progress and grounds its model in clinical evidence.

Frequently asked

Newsletter

Stay in the Loop

A monthly letter on what we are reading, watching, and learning.

Service

Best For

Format

Price

Insurance

BetterHelp

Fast, flexible access

Messaging, phone, video

~$70 to $100 / week

Out of pocket

Talkspace

Insurance and psychiatry

Messaging, video, psychiatry

Varies with plan

In-network with many insurers

Brightside Health

Depression and anxiety, clinically

Video therapy, psychiatry

~$95 to $115 / mo, plus visits

In-network with major insurers

Two Chairs

A careful therapist match

Video therapy, some in-person

~$150 to $250 / session

In-network in some states

Open Path Collective

Affordability without insurance

Therapist directory; video or in-person

$40 to $70 / session

Sliding scale; no insurance needed

Headway

Using your insurance

Therapist marketplace; video or in-person

Your insurance copay

In-network; built around insurance