- Our Review Team spent over 7,500 hours researching over 70 online therapy platforms, looking closely at the platforms offering online couples therapy.
- Our testers tested the platform for at least four weeks alongside a partner, focusing on the sign-up process, therapist selection, therapy session quality, and customer service interactions.
- We surveyed over 1,200 online therapy users, held focus group interviews with both users and therapists, and consulted over 60 mental health experts.
- We scored each platform on four different indexes: affordability, data privacy, availability, and inclusivity.
- Learn more about how we tested online couples therapy platforms.
Key takeaways
- Regain by BetterHelp is our best online couples therapy platform overall due to the site’s extensive therapist network, extra features, and competitive pricing.
- We’ve learned that online therapy users without insurance can expect to pay between $200–$800 a month for virtual couples therapy. With insurance, copays can be as low as $20 or less per visit.
- Research shows that couples who participate in therapy together experience increased relationship satisfaction, improved communication, and overall better well-being compared to those who don’t use couples therapy.
- Cognitive behavioral therapy, emotionally focused couples therapy, and the Gottman Method are modalities commonly used in online couples therapy.
Whether you’re newly engaged or celebrating decades of marriage, you and your partner may benefit from couples counseling. Research shows that your relationships can impact mental health, and working on your relationship together could be mutually beneficial. Online therapy is one way to work on your relationship at home.
We’ve researched and tested some of the best online therapy platforms to help you find the right one for your relationship. We evaluate each platform for therapist availability, the onboarding process, additional learning materials, and cost. Read about our top five picks.
Our picks of the best online couples counseling platforms
- Regain by BetterHelp: Best overall
- Talkspace: Best for using insurance
- Online-therapy.com: Best for improving communication
- Little Otter: Best for parenting issues
- Thriveworks: Best for choosing your own provider
Data privacy on mental health platforms
In addition to understanding how your data is collected and used before signing up for a platform, we recommend the following basic steps that we learned from the U.S. Department of Health and Human Services (HSS) and Mozilla Foundation’s *Privacy Not Included project:
- Attend your online therapy appointment in a private location, preferably not on a public Wi-Fi network.
- Use your personal computer when possible.
- Look out for checkboxes during sign-up to opt out of data tracking or medical information disclosure.
- Sign up with your email, not using a social login like Facebook.
- Choose a strong password to create a secure account login.
- Review each platform’s privacy guidelines for confirmation of HIPAA compliance along with use of encrypted methods for written communication.
Regain: Best overall
Why Regain is our pick for best overall
Regain by BetterHelp is our pick for the best overall online couples therapy platform. We like the ability to choose a therapist and the flexible appointment times. You can schedule a session after work hours, an option some online therapy platforms do not provide.
Who should consider Regain: Regain by BetterHelp is a great option for those seeking user-friendly, online couples therapy with competitive prices, flexible scheduling, and message-based therapy options in addition to live video and phone therapy.
Who should consider other options: Those who are seeking an online therapy platform that takes insurance or those who require psychiatric care may want to look at a different platform.
Regain tester insights
Our testers like being able to request therapists for couples counseling based on preferences like gender, faith, age, or allyship with the LGBTQ+ community. When you’re matched with a therapist, Regain also sends a list of other therapists in your state who match your preferences. You can read bios of potential therapists and even chat with them in the app to see if they’re a good fit. This feature allows you to switch therapists even before your first session if you find a provider you think you’ll like better.
Between sessions, the therapist will message the couple to check in on how they’re doing, a feature we really love on this platform. It’s important to note that messages to and from the therapist are visible to both partners. Entries in your digital journal are private unless you share them with your therapist and partner in the group messaging room.
Regain matches couples with a therapist trained in the Gottman Method, an approach to relationship therapy based on more than 40 years of research in helping couples improve their relationships. This method is founded on the idea that couples who can reframe conflict and engage in more positive interactions can improve communication and intimacy.
While our Regain testers didn’t love their first therapist match, they were able to easily find a second provider they felt they could trust. They found the sessions to be engaging and helpful and were offered tangible strategies for building a deeper connection in their relationship.
From one of our Regain testers
“Our therapist has been sending us interesting and unique ideas. It doesn’t feel like she’s going off of a script. She had us write down fun things we could do at night together after we put the girls to bed instead of watching TV or scrolling through our phones, and we put them in a big jar. Once per week, we have a ‘jar night’ where we grab a slip of paper from the jar and do whatever is on the paper. We’ve played new games, gotten back into puzzles, and explored mixology. It’s been so fun and was such a creative idea on her part!”
What other Regain users say
In a survey of 600 online therapy users we conducted in October 2023, 55 percent of respondents find online therapy through platforms like Regain more effective than in-person counseling sessions. When searching online rather than locally, you may have more choices of therapists, especially if you live in a rural area or have transportation barriers.
A note on Regain’s legal filings
BetterHelp faced legal issues in 2023 related to consumer data breaches across all its apps, including Regain.us, BetterHelp.com, TeenCounseling.com, FaithfulCounseling.com, and PrideCounseling.com. According to the Federal Trade Commission (FTC), BetterHelp used third-party online tracking codes dating back to August 1, 2017, and shared users’ email addresses, IP addresses, and health information on Facebook, Snapchat, Pinterest, and Criteo for targeted advertising. The FTC ordered BetterHelp to pay $7.8 million in partial refunds to affected users and banned the company from using business practices like these going forward. BetterHelp platforms are now certified by HITRUST, which ensures that companies use the strictest possible requirements with sensitive information.
To learn more about Regain, read our Regain review.
Talkspace: Best for using insurance
Why Talkspace is our pick for using insurance
Talkspace is our choice for the best online couples counseling that takes insurance. Talkspace has therapists specifically licensed in relationship and marriage counseling, and they accept insurance from Premera, Cigna, Optum, Aetna, and more. For couples who have insurance, Talkspace offers an affordable, convenient way to work on their relationship from home.
Who should consider Talkspace: Talkspace is our top choice for couples looking for online therapy that is covered by insurance. This would work well for couples who live apart or have demanding schedules because partners can participate in live therapy from separate devices.
Who should consider other options: Online therapy is generally not a good fit for couples when one or both individuals are experiencing a mental health crisis. Since Talkspace offers 30-minute sessions, we feel couples requiring more intensive therapy may want to find a service with longer sessions better suited to their needs.
Talkspace tester insights
To start with Talkspace, you and your partner will answer a few questions about your relationship issues and your therapist preferences. While the initial assessment is brief, it may be a good opportunity for you and your partner to get on the same page about what you’re looking for in a couples counselor. Next, you’ll indicate whether you’ll pay out-of-pocket or with insurance. We like that Talkspace tells you whether or not they take your insurance before you create an account.
According to the American Psychological Association’s 2023 Stress in America survey, 60 percent of Americans surveyed report that money is a cause of a lot of stress and fights in the family. If financial strain is an issue in your marriage but you have access to insurance, Talkspace could be a great choice for couples therapy. Average insurance copays for Talkspace are $30 or less, while out-of-pocket per-session fees for in-person couples therapy usually start around $100 per session but can be as high as $200 or more per session. Removing the financial stress of therapy may make it easier for both partners to feel positive about moving forward with couples counseling.
It’s important to note that Talkspace offers both marriage counseling and relationship counseling for couples who aren’t yet married or choose not to be married. Premarital counseling is also a key Talkspace offering for couples who want help navigating new changes in their relationship as they had towards marriage. Research shows couples who have premarital counseling generally have better outcomes than those who don’t. “Every couple would benefit from pre-marital counseling,” says Audrey Schoen, a licensed marriage and family therapist (LMFT) at Balanced Private Practice. “Couples can have difficult but important conversations in a safe and facilitated environment, providing them with valuable skills and deep understanding of each other that will serve them for a lifetime.”
For couples saving for a wedding or buying a house, insurance could allow them to fit counseling within a tight budget. Typically, only one person’s insurance is billed for couples counseling, and often billing is connected to one partner’s diagnosis. For example, if one partner has a diagnosis of depression that affects the overall relationship, their insurance will cover couples therapy. It’s always a good idea, though, to confirm coverage with your insurance company.
For couples counseling, know the details of each person’s personal insurance plan and what is covered. When providers bill insurance, we use billing codes that identify what kind of therapy was provided (individual, family, couples). A good way to know is to inquire with the insurance company to see if they offer coverage for a partner in support of an existing client with a diagnosis. But, if someone is billing for an individual therapy session and a different kind of session took place, that can be considered insurance fraud.
Johanna Padilla, AMFT
What other Talkspace users say
Talkspace offers a seven-day free trial, but you must put a credit card on file. We appreciate the option to “try before you buy.” However, this free trial is mobile-only and might not be a good option for people who prefer to use a computer.
Online-therapy.com: Best for improving communication
Why Online-Therapy is our pick for best for improving communication
Online-Therapy.com is our choice for improving communication between couples because all of its therapists are trained in solution-focused cognitive behavioral therapy (CBT). We also like that Online-Therapy.com offers bonus features, including yoga videos, and is a more affordable option for couples paying out-of-pocket. Subscription plans start at just $88 per week for the first month (with the 20% discount offered at checkout).
Who should consider Online-Therapy.com: Online-Therapy.com is our choice for improving communication between couples because all of its therapists are trained in solution-focused cognitive behavioral therapy (CBT). We also like that Online-Therapy.com offers bonus features, including yoga videos, and is a more affordable option for couples paying out-of-pocket. Subscription plans start at just $88 per week for the first month (with the 20% discount offered at checkout).
Who should consider other options: Couples with demanding schedules or opposite schedules may struggle to find an appointment time that works for them. Users reported that appointment availability was inconsistent and that some states have limited provider availability.
Online-Therapy.com tester insights
All of Online-Therapy.com’s providers are trained in CBT, which has been shown to be effective in improving communication and resolving conflicts between partners. The Online-Therapy.com couples program is intended to help you identify issues and patterns, create long-term goals, and break the patterns that are holding you back.
Through Online-Therapy.com, couples can work with their therapist on CBT-specific communication skills, such as changing negative beliefs about oneself or one’s partner and developing self-awareness and self-regulation. According to Johanna Padilla, AMFT, the CBT approach in couples counseling “supports clear and concise language with an emphasis on exploring evidence for negative thoughts and beliefs.” For motivated couples, Online-Therapy.com also offers an intensive CBT-based program—offered on mobile or desktop— that can be completed as a complement to therapy. Our testers liked that Online-Therapy.com offers worksheets, activity plans, and even yoga videos for use outside of sessions. Couples can work through the materials individually or together.
Notes from our testers indicate that Online-Therapy.com providers interact with the platform’s CBT features to a varying degree. If you’re focused on improving communication skills and want to use the platform’s CBT tools to develop those skills, be sure to make this clear to your therapist early in your sessions.
What other Online-Therapy.com users say
Unfortunately, setting up appointments on Online-Therapy.com is a pain point for some users. Availability of therapists varies by location, and some testers encountered a poor selection of available appointment slots when trying to schedule with different therapists, including:
- Appointments only available for two hours during the weekday.
- A few random time slots are available during the weekday.
- Appointments only available on Sunday.
Because couples are balancing more than one schedule, using the Online-Therapy.com platform could be challenging. Be aware that you can always request to switch providers to find someone with a schedule that better matches your and your partners’ needs.
Little Otter: Best for parenting issues
Why Little Otter is our pick for best for parenting issues
Little Otter is our top choice for couples seeking therapy specifically to address parenting issues. The providers on this platform are licensed therapists trained in child and family mental health. In addition to live video sessions, couples can take assessments to track their progress and get access to content curated for their family’s needs.
Who should consider Little Otter: Little Otter is a great option for couples who specifically need support in their parenting journey. It could also be a fit for relationship therapy between a parent and a child.
Who should consider other options: Since Little Otter is only available in 14 states, you may find therapy isn’t available for you using this platform. Additionally, if you are looking for insurance-covered therapy, keep in mind that Little Otter is only in network with Independence Blue Cross, AmeriHealth, and Sana.
Little Otter tester insights
Little Otter is a platform with a cute name but a serious approach to your family’s mental health. Their offerings are focused on helping the entire family get through hard times. To get started on Little Otter, you’ll take a brief assessment about your family and receive a free, personalized report with a summary of your responses. The report outlines behaviors within your family, identifying them as either typical or concerning, and offers an analysis of those behaviors and tangible ways to start finding solutions. Our tester’s report showed typical levels of family stress but still offered the suggestion that it’s a good idea to work on family dynamics when things are going well in preparation for harder times. After reading your report, you’ll book a “kickoff” session during which a provider will get the information they need to build a care plan.
For couples, Little Otter offers either parent support counseling or parent specialist sessions.
Parent therapy helps couples build a better atmosphere for their children by learning to manage their stress and improve their communication skills. The parent specialty program is a little different in that it helps parents develop strategies for specific parenting challenges, such as managing difficult behaviors in their children, helping their children cope with grief, or easing sibling rivalry.
The Little Otter app includes ongoing assessments, educational resources, and progress trackers. We like that the platform takes a team approach to counseling, bringing in different providers depending on your needs. For example, if medication management becomes part of your care plan, you can see a psychiatrist in one of your monthly sessions.
What other Little Otter users say
The availability of Little Otter therapists may be limited depending on your location. The platform is currently only available to patients in California, Colorado, Washington D.C., Florida, Georgia, Illinois, Maryland, New Jersey, New York, North Carolina, Pennsylvania, Texas, Utah, and Virginia. Little Otter is currently only in-network with Independence Blue Cross, AmeriHealth, and Sana, which means that most clients pay out of pocket.
Thriveworks: Best for choosing your own provider
Why Thriveworks is our pick for best for choosing your own provider
Thriveworks is our top choice for couples who want to choose their own therapist. Their directory has multiple filters for selecting a therapist based on the language spoken, counseling approach, and more. We also like that many Thriveworks providers offer in-person options in addition to their audio and video offerings.
Who should consider Thriveworks: Thriveworks is a great choice for couples with insurance coverage through one of the 585+ insurance plans partnered with the platform.
Who should consider other options: Uninsured or underinsured individuals will find that the self-pay price of $200 per session is one of the most expensive online therapy options.
Thriveworks tester insights
To get started with Thriveworks, head to their website and click on the “couples/marriage counseling” icon. From there, you’ll be directed to a page listing licensed therapists in your geographic area. You can narrow the results using the following filters:
- Visit type (in-person or video visit).
- Clinician gender (female, male, non-binary/non-conforming).
- Client age.
- Language spoken by therapist (options include English, Spanish, French, Hindi, and more).
- Counseling approach (options include cognitive behavioral therapy, Gottman trained, Internal family systems (IFS), and more).
We like that Thriveworks offers so many filters for finding a therapist. Also, most of the therapist bios are highly detailed and informative, including information about fees (including insurances accepted), degrees and certifications, number of years practicing, and a detailed explanation of their approach. Each bio includes a “get to know your therapist” section with answers to questions like, “What types of clients do you work best with?” and “What’s one thing you wish all clients knew?”
For couples who are just starting therapy, working together to find a therapist they both feel comfortable with could help them feel like equal partners in the therapy process. According to associate marriage and family therapist (AMFT) Johanna Padilla, it’s important to agree on a therapist who is “a good fit for the goals and struggles of the relationship itself, not each person’s needs individually. Choosing a therapist who is more aligned with one partner than the other can breed additional arguments or impair the therapeutic alliance in sessions.”
What other Thriveworks users say
It’s important to know that the availability of couples counselors on Thriveworks will vary by location. For example, a search for couples counselors in Tallahassee, Florida, yields 21 providers, a search in Dallas, Texas, yields 17 results, and a search in Bloomington, Indiana, yields only three. Some states, like Idaho and North Dakota, do not appear to have Thriveworks providers who offer couples counseling at this time.
How we test and choose the best online couples counseling platforms
The Handbook Team researched over 70 online therapy and psychiatry platforms, directories, and networks in search of the best online couples therapy. Based on our research, we signed up for the top 14 platforms, with 11 offering couples counseling, and tested them out for ourselves.
First-hand testing experience
Testers explored the platforms and attended online therapy sessions with their partner for at least four weeks. We asked these testers, who were located throughout the United States, to note how easy or difficult it was to find a couples therapist who could accommodate both partners’ schedules. This allowed us to gauge the flexibility and availability of providers in different locations.
During testing, they kept a diary detailing their experience and then shared their findings when the testing period ended. This was a true mystery shop of online couples therapy, with our testers using the services as real clients. In some cases, they switched therapists during the trial to assess how well the platform accommodated changing providers.
Online therapy surveys
To get a broader picture of online couples therapy platforms, we received survey responses from over 1,200 online therapy and psychiatry users in varying age groups. These surveys asked current users of 14 of the most popular online therapy and online psychiatry platforms to evaluate each service, including those specifically focused on couples counseling. The feedback they provided taught us firsthand how users in different circumstances leverage each platform’s unique features and helped us learn how users feel about important issues such as data privacy.
Focus groups
During testing, we also facilitated hosted focus groups of practicing online therapists and current online couples therapy users to understand what each group values on their side of the screen. We asked the therapists about the pros and cons of teletherapy for relationships and learned what factors influence online therapy and psychiatry users to choose one platform over another.
Our online therapy and psychiatry rating indexes
We created a unique rating index to see how varying online couples therapy platforms measure up to four key factors:
- Affordability: We looked for platforms with affordable out-of-pocket prices. We also included counseling services that accept insurance or offer financial aid.
- Data privacy: We examined how each platform collects and handles user data. If a brand didn’t have this information available on their website, we reached out to learn from them directly.
- Therapist availability: We collected data on a brand’s total number of in-network therapists and their appointment availability in different states.
- Inclusivity: We evaluated platforms on their inclusivity and diversity of practitioners. We also noted if a platform allows you to filter therapists by ethnicity or gender identity.
Mental health experts
A group of 60 seasoned mental health professionals offered insight on online therapy platforms for this article, helping us ensure that it contains up-to-date information and expert knowledge on couples therapy.
Learn more about our online couples therapy testing and review methodology.
Our online therapy testing process
Fill out the intake assessment.
Subscribe as a new user and invite their teen to join the platform.
Get matched with a therapist.
Go through steps to change therapists.
Schedule and attend four weeks of appointments.
Contact customer support with questions.
Explore other platform features, including digital journals and worksheets.
Review billing policies and cancel subscription.
In a mental health emergency:
Online therapists may not be the most appropriate resource to help in a mental health crisis. If you or someone you know is a danger to themselves or others around them, it is an emergency, and cannot wait for an online therapist’s response.
Don’t wait. You can find help immediately by:
- Visiting urgent care
- Calling or texting 988 for the Suicide & Crisis Lifeline
- Chatting online at 988lifeline.org
- Calling the Substance Abuse and Mental Health Services Administration (SAMHSA)’s Helpline at 1-800-662-4357 or text your zip code to 435748
If you’re experiencing domestic violence, also known as intimate partner violence (IPV), there are free, confidential, and immediate ways to get help.
- Chat with someone from the National Domestic Violence Hotline at https://www.thehotline.org/
- Call 1-800-799-SAFE (7233)
- Text “START” to 88788
All the above options will connect you with trained professionals who can provide crisis support. You can find even more resources, including international options, on our helpline directory page.
How to choose the best online couples therapy
When you are working with a partner to find the best online couples therapy option, finding a provider that works well for both individuals can be a challenge. Each relationship is unique, and what each relationship needs to thrive is unique, but here are the considerations we suggest you keep in mind as you are looking for an online couples therapy provider:
- Pricing: The cost of couples therapy may be as low as $20 or less or $200 or more per session. Taking pricing into account and the sustainability of paying for sessions for several weeks or months can help narrow down your online therapy options.
- Type of therapy: Cognitive behavior therapy (CBT) is a popular type of online therapy, focusing on the link between patterns of thinking and the behaviors that follow. Emotionally focused couples therapy (EFCT) relies on attachment theory to build stronger connections and increase satisfaction in relationships. The Gottman Method, a type of therapy focused on problem-solving, may also be offered in online therapy.
- Communication method: Online couples therapy is available using live video or phone sessions as well as messaging-based therapy. Many couples benefit from having multiple methods to connect with their therapist.
- Therapist availability: During testing and research, we found that online therapy options tend to offer a lot of scheduling flexibility. That being said, this does seem to vary from state-to-state, with some states having fewer therapists available than others.
- Therapist inclusivity: Many online therapy options allow users to filter their search to take inclusivity into account, including gender, sexuality, age, language, and religious preferences.
- Additional features: We noticed that many of the online therapy platforms we tested had additional features that were offered to their members. These include workshops, worksheets, educational resources, and guided yoga and meditation videos.
Who should try couples therapy?
Anyone in a relationship, whether it be a long-term partnership, a marriage, or even a parent-child relationship, could benefit from couples therapy. While counseling can be useful for relationships in crisis, this is not the only reason to see a counselor with your partner.
The benefits of couples therapy could extend to anyone who is hoping to improve communication in their relationship. Couples counseling has been found to improve overall satisfaction in relationships. It is also associated with improved well-being for the individuals in the relationships.
Anyone who wants to feel more satisfied in their relationship or improve how they communicate with their partner may benefit from online couples therapy. Online therapy may not be a good fit for couples when one or both partners are in a mental health crisis and need emergency care or if the home is not safe for one partner or the children in the home.
How much does online couples counseling cost?
The cost of online couples counseling can vary depending on factors such as where you live, who your provider is, and whether or not the provider is in-network with your insurance. With insurance coverage, online counseling at Talkspace, Little Otter, and ThriveWorks will cost your copay, which could make couples therapy as affordable as $20 or less per session.
For self-pay online therapy, the lowest cost on this list is Talkspace, which charges $436 for four 30-minute sessions each month and $65 for any additional sessions booked during the billing period. The most expensive self-pay option was Thriveworks, with 45-minute sessions starting at $200 each or $800 per month.
Is online couples therapy covered by insurance?
While many online therapy platforms offer competitive self-pay rates, Talkspace, Little Otter, and Thriveworks are all options that accept insurance. Using these services, your out-of-pocket cost will be whatever your copay is for therapy sessions.
Our final verdict
Our top pick for the best online couples therapy overall is Regain by BetterHelp because of the flexible scheduling options, the ability to choose your own therapist, and the added resources included with their monthly plan. Regain allows you to switch providers easily if your first option is not a great fit or doesn’t have the availability to accommodate your schedule.
While Regain by BetterHelp doesn’t accept insurance, they do have an affordable starting price and financial assistance options. We appreciate their transparent pricing and the ability to apply search filters to find a therapist who is an inclusive fit for your sexuality, gender, religion, language, or age. Online couples therapy can be an effective option for improving communication, satisfaction, and wellbeing within relationships, and we feel Regain would be an excellent therapy platform for couples looking for an online option.
Compare the best online couples therapy of 2024
| Monthly Cost* | $260–$360** | $436 or the cost of your insurance copay per session | $440 | $800*** | $640–$700**** or the cost of your insurance copay per session |
| Services Offered | Individual and couples therapy | Individual and couples therapy; Psychiatry | Individual and couples therapy | Child and parent therapy; Psychiatry | Individual, couples, child, teen, and family therapy; Psychiatry |
| Accepts Insurance? | No | Yes | No | Yes | Yes |
* Monthly cost for four weekly live therapy sessions without using insurance.
** Price increases if you choose to do both individual and couples therapy.
*** Estimated monthly cost for kickoff session ($20) and four follow-up sessions ($195 each).
**** Estimated monthly cost for an initial session ($220) and three follow-up sessions ($160 each), or four follow-up sessions. Actual costs may vary by clinician or location, per Thriveworks customer service.
Frequently asked questions
Couples therapy can be effective for people in relationships whether they are newly dating, engaged to be married, or have been together for decades. In fact, research has shown that couples who participate in therapy are better off than more than two-thirds of couples who don’t participate in couples therapy.
In-person couples therapy is a good alternative to online options. Additionally, individual therapy may be a good fit for couples who are struggling to book appointment times that work with the schedules of both individuals.
- American Psychological Association. What is Cognitive Behavioral Therapy? Link
- International Centre for Excellence in Emotionally Focused Therapy. What is EFT? Link
- Source 3: Davoodvandi, M. et al., Examining the Effectiveness of Gottman Couple Therapy on Improving Marital Adjustment and Couples’ Intimacy. Iranian Journal of Psychiatry. Link
- Lebow, J., Snyder, D.K., Couple therapy in the 2020s: Current status and emerging developments. Family Process. Link
- UCLA Health. Is Online Therapy Right for you? Link
- Kynsley, A., et al., Couples Therapy Delivered Through Videoconferencing: Effects on Relationship Outcomes, Mental Health and the Therapeutic Alliance. Frontiers in Psychology. 2021. Link