- We’ve spent more than 10,000 hours researching over 70 online therapy platforms, and our testers signed up for the 26 most popular platforms to bring you our top picks.
- Our testers use each platform for at least two to four weeks, focusing on the sign-up process, therapist selection, therapy session quality, and customer service interactions.
- We surveyed over 2,000 online therapy users, held focus group interviews with both users and therapists, and consulted over 60 mental health experts.
- We vet each platform to see if it offers text-based therapy and how the experience compares to other online therapy options.
- Learn more about how we test online therapy platforms with text therapy.
Key takeaways
- Text therapy and messaging support are different. Text or messaging therapy involves texting in a live conversation with your therapist. This is also sometimes called live chat therapy. Messaging support involves messaging between therapy sessions and is good for checking in without the need for an immediate response.
- Talkspace is our pick for the best online text therapy platform that takes insurance. Online therapy users without insurance can expect to pay $276–$436 a month for plans that include text-only or a mix of live sessions and text.
- Through surveys, focus groups, and testing, we determine important factors to consider when choosing an online therapy platform, including pricing, types of therapy offered, therapist availability and communication methods, data privacy, and ease of use.
Therapy can be an effective way to work through emotional issues and mental roadblocks. While face-to-face sessions, whether in-person or online, are widely considered the most effective means of therapy, they may not be the right choice for everyone. If you’re looking for an alternative to traditional face-to-face sessions, you might want to consider text therapy. Online therapy providers that support text-based therapy may offer it as an exclusive treatment option, or in conjunction with other forms of communication like video, group, or in-person visits.
“Text-based therapy may be beneficial for individuals who would otherwise not see a therapist,” says Ken Fierheller, registered psychotherapist and owner of One Life Counseling & Coaching.
Our Handbook Team testers take their text therapy sessions seriously, addressing the real issues they are dealing with. We also review these platforms to see if they offer additional services like guided meditation, yoga, worksheets, and group sessions. These are our top three text-therapy platform picks.
Best online therapy services with text therapy
- Talkspace: Best for using insurance
- Teen Counseling: Best for teens
- Online-Therapy.com: Best for CBT
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 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 by using a social login like Facebook.
- Choose a strong password to create a secure account login.
- When choosing an online therapy platform, review its privacy guidelines to understand whether it shares private information.
Talkspace: Best for using insurance
Why Talkspace is our pick for the best online text therapy for using insurance
Talkspace earned our top spot thanks to a combination of user satisfaction, therapist selection, and the fact that it is an online therapy platform that takes insurance from major companies, including:
- Aetna
- Anthem
- Cigna
- Cigna + Oscar
- Gatorcare
- Optum
- Premera
Talkspace provides an extensive list of accepted insurance plans and companies offering EAPs on its website. You can only schedule a 30-minute session without insurance, but members who pay using insurance get an extra 15 minutes per session.
“Having insurance provides access to mental health care more than in the past,” says Angel Gavilanes, licensed clinical social worker (LCSW) at Saint Joseph’s Medical Center. “Insurance companies can improve with reimbursing therapists, but many have improved with how much money they reimburse. This has encouraged many therapists to accept more insurance, so more people have gained access to therapy.”
Who may want to use Talkspace: Those seeking an online therapy platform offering live text therapy that takes insurance.
Who may want to avoid Talkspace: Those who will be paying for therapy out of pocket and want longer than a 30-minute session.
Talkspace has over 5,000 licensed mental health providers on the platform. Our Handbook Team tester went through the therapist matching and switching process to discover how easy it was to find a good fit. Not all therapists offer live text therapy, so it’s a good idea to confirm their availability for this before beginning therapy with them.
Talkspace tester insights
In addition to online video and messaging therapy, our tester likes how Talkspace offers workshops (with the video + messaging + workshop plan) to attend between sessions. Not all platforms offer extras like workshops, so this is an added bonus. They also tried short exercises, including a four-minute exercise called “Navigating the negative.”
Our tester says they found themselves feeling rushed during their live session, trying to get all the information to their therapist in 30 minutes, and would have liked more time. In their previous experiences with other therapy platforms, they were able to have longer sessions. They prefer longer sessions, they say, especially the first appointment, where they establish the groundwork for why they are seeking therapy in the first place. People who pay out of pocket, which our tester did, get 30-minute sessions. With insurance, Talkspace gives subscribers 15 more minutes per session, for a total of 45 minutes.
Despite the time constraint, our tester enjoyed their live text therapy sessions with their provider, and felt they were listened to and supported.
From one of our Talkspace testers
“We actually ran a little over the 30-minute time slot during the text session, which I appreciated. It was challenging to get all my thoughts down over text, and I felt some pressure with the time constraint. But overall, the text session was much more impactful than I thought it would be. I may have been able to cover more in a video session, but I still feel I left the text session having gained some meaningful insights. For someone who prefers or only has access to text therapy, I recommend writing down your thoughts as much as you can beforehand so you aren’t wasting too much time typing.”
What other Talkpace users say
In our February 2024 survey of Talkspace users who engaged with a variety of plans (not only text therapy), 81 percent say they used insurance to pay for online therapy, and the rest paid out of pocket. In the same survey, 80 percent of respondents say they are either satisfied or very satisfied with Talkspace for reducing their mental health symptoms.
Read our in-depth Talkspace review for more information on this platform.
Teen Counseling: Best for teens
Why Teen Counseling is our pick for the best online text therapy for teens
Teen Counseling by BetterHelp offers teens a safe place to discuss their mental health concerns and learn skills to build resilience.
“Understanding why I felt certain ways when I couldn’t explain it myself. Learning coping skills to deal with anger and depression,” one teen says of their goals for therapy in a May 2024 survey conducted by our Handbook Team.
Research demonstrates how young people may benefit from text-based therapy, experiencing improvements in distress, depression, and anxiety. Live text therapy is easy to use and works well for teens who may not be comfortable in a face-to-face setting or face geographical barriers to in-person sessions. Another small study found that text messaging may be a useful tool for following up with teens who have been recently hospitalized or who are at elevated risk for suicide.
According to our tester, the Teen Counseling app is easy to use to set up appointments, meet with the therapist, and receive daily prompts for self reflection. An example of a prompt is: “Some ways my anxiety has helped me achieve something are …” Teens also have access to a private journal they can share with their therapist or parents if they choose to.
For live text therapy sessions, you will schedule an appointment time for both your teen and the therapist to log on to the platform and message back and forth in the platform after the therapist invites your teen to join the session. Parents cannot attend these sessions, but you can schedule a separate live text therapy session with the therapist.
You can also message your therapist between sessions. Messages between parents and the therapist are private, as are the communications between the teen and the therapist, unless there is a risk of the teen harming themselves or others, or if they report parental neglect or abuse.
Who may want to use Teen Counseling: Teens ages 13–19 who need a safe space to discuss their feelings and mental health concerns and receive guidance on coping skills. Live text therapy may be a good choice for teens, who are often very comfortable communicating via text messaging.
Who may want to avoid Teen Counseling: Teens with severe mental health conditions should seek care from in-person providers. Families looking for therapy for all members should consider a different platform, as Teen Counseling only offers individual therapy for teens.
Teen Counseling has more than 14,000 licensed mental health providers on the platform. Our Handbook Team tester went through the therapist matching and switching process to discover how easy it was to find a good therapist fit. Here are a few of the features we found that can help you find the right therapist:
- Ability to select areas of concern during sign-up, like anxiety or problems at school.
- Ability to switch therapists.
TeenCounseling tester insights
We like being able to select specific areas of focus when signing up for Teen Counseling, such as anxiety, depression, or family conflict. We also like how easy it is to set up appointments and communicate with the therapist between sessions.
Many teens we spoke to feel more comfortable expressing themselves via live text or messaging sessions versus phone or video sessions.
“[One] reason I like online therapy is you can have an appointment anywhere. For example, sometimes I’m at work, and I have to tell my manager about my appointment, and they don’t have a problem with me stepping off the floor for a little bit,” says one teen in a May 2024 survey our Handbook Team conducted.
Our tester specifically liked that both the parent and the teen can conduct live text therapy and message the therapist separately through the platform. They used the messaging feature as a parent to get in touch with the therapist for scheduling appointments and follow-up questions between sessions. Our tester also switched therapists and found that response times varied when they sent out-of-session messages.
From one of our Teen Counseling testers
“The most helpful aspect of online [text] therapy is it saves time. You don’t have to rush to drive to the doctor’s office because you can have an appointment through your phone, computer, or tablet.”
What other Teen Counseling users say
In 2020, approximately 7.9 million U.S. teens between the ages of 12–17 received some form of mental health service, according to a 2021 report from the Substance Abuse and Mental Health Services Administration (SAMHSA).
In our February 2024 survey of 100 parents with children who tried the Teen Counseling platform, 82 percent felt that the therapist provided a safe space for their teen, and 77 percent saw a reduction in the symptoms that led their teen to therapy.
Online-Therapy.com: Best for CBT
Why Online-Therapy.com is our pick for best for CBT
Online-Therapy.com specializes in cognitive behavioral therapy (CBT), a form of talk therapy developed to help people reframe their thoughts and regulate emotions and behaviors. Research shows that CBT is helpful in mitigating symptoms of depression, anxiety, post-traumatic stress disorder (PTSD), and grief. A meta-analysis of mental health apps found that apps using CBT techniques with patients had larger and more positive effects on patients than apps that didn’t offer CBT as part of the treatment plan.
Online-Therapy.com provides a tool kit with all packages to help you between sessions with your therapist. It includes a self-paced course, digital journal, and worksheets to work through, as well as yoga and meditation videos. The CBT lessons in the course offer tips along the way to helping you identify, confront, and overcome challenges.
The basic plan, which starts at $200 per month, includes unlimited messaging and therapy support, but not live chat sessions. Live therapy sessions, which can be conducted via real-time texting, video, or phone, are available with the standard and premium plans at $320 and $440, respectively. With the standard plan, you will have a weekly 45-minute live therapy session with your therapist and unlimited messaging. The premium plan includes two weekly 45-minute live sessions and unlimited messaging.
CBT delivered over live text works very similarly to an in-person or video session. Your therapist will ask you questions that allow you to explore and reflect on your emotions and behaviors, and may ask follow up questions to further explore specific areas or subjects. This is paired with the homework between sessions in the therapy toolbox that allow you to build on what you’ve learned in your live text therapy sessions.
Between sessions, users are encouraged to message their therapist, complete worksheets, journals, and activity plans. The therapist will respond to your text messages within 24–48 hours and can leave messages of support within the worksheets to create an ongoing conversation.
According to Online-Therapy.com, your conversations are encrypted and confidential.
Who may want to use Online-Therapy.com: People interested in learning coping skills through CBT to make lasting changes.
Who may want to avoid Online-Therapy.com: Anyone who wants to pay for therapy using insurance.
Online-Therapy.com has more than 30,000 licensed mental health providers. Our Handbook Team tester went through the therapist matching and switching process to discover how easy it was to find a good therapist fit. Here are some of the features we found can help you find the right therapist:
- A therapist-matching questionnaire that helps you to identify what you need help with, from a range of mental health issues.
- The ability to select a therapist who specializes in your area of focus or concern.
Online-Therapy.com tester insights
Our tester likes the chat feature of the platform and notes that their therapist reached out to them over text with an additional resource after one of their sessions. They appreciate the thoughtful follow-up message and say it made them feel supported.
In addition to online therapy, our tester likes how Online-Therapy.com offers resources that include a digital journal, worksheets, and yoga to try between sessions. Different yoga classes are available, from a quick 15-minute class to a 60-minute session.
Our tester appreciates that many of the bonus features, like the yoga and meditation videos, focus on mindfulness. They find the features to be very helpful supplements to their mental health care plan.
From one of our Online-Therapy.com testers
“The chat feature of the platform was decent. My therapist followed up with me after a session with a resource she felt I needed, but would have potentially been awkward for her to give me in the moment.”
What other Online-Therapy.com users say
In our February 2024 survey of 100 Online-Therapy.com users, 79 percent reported that their therapist shared part of their identity, whether it was gender, sexual orientation, or religion. Shared identity can be an important part of making interpersonal connections. Another 60 percent responded that the platform is intuitive and easy to use, and 68 percent said their therapist created a safe space for them.
Read our in-depth Online-Therapy.com review for more information.
How we test and choose the best text therapy platforms
The Handbook team researches more than 70 online therapy and psychiatry platforms, directories, and networks. Based on our research, we sign up for the top 26 platforms to test them for ourselves for two to four weeks.
Firsthand testing experience
Testers explore the platforms and attend online therapy sessions for at least four weeks. Our testers are instructed to test the platforms through the lens of a real user, paying attention to how easy or difficult it is to find a therapist they can talk to. Additionally, testers are located throughout the United States, allowing us to gauge the availability of providers in different locations. Testers log their experiences in a diary and come together to share their findings when testing concludes.
Online therapy surveys
We received survey responses from over 2,000 online therapy and psychiatry users in varying age groups. These surveys ask current users of 10 of the most popular online therapy and online psychiatry platforms to evaluate each service. Their feedback teaches us firsthand how users leverage each platform’s unique features and helps us learn how users feel about important issues such as data privacy.
Focus groups
We host focus groups of practicing online therapists and current online therapy and psychiatry users to understand what each group values on their side of the screen. We ask the therapists about the pros and cons of teletherapy and learn what factors influence online therapy and psychiatry users to choose one platform over another.
Mental health experts
A group of seasoned mental health professionals offered insight on online therapy platforms for this article, helping us ensure it contains up-to-date information and expert knowledge.
Learn more about our online therapy testing and review methodology.
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, it is an emergency, and it cannot wait for an online therapist’s response. Don’t wait. You can find help immediately by:
- Calling 911
- Visiting your local urgent care or emergency room
- Calling or texting 988 for the Suicide & Crisis Lifeline
- Chatting online at 988lifeline.org
- Calling the Substance Abuse and Mental Health Services Administration (SAMHSA) Helpline at 800-662-4357 or texting your zip code to 435748
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 therapy platform with text therapy
Consider the following when choosing an online therapy platform with text therapy:
- Whether you want text therapy or messaging support: Text therapy and messaging support are not the same. Text therapy, or messaging therapy, is texting in a live back-and-forth conversation with your therapist. Messaging support is asynchronous messaging between therapy sessions and is good for checking in without the need for an immediate response.
- Whether you want to use insurance: Some therapy plans accept health insurance as payment, which can lower your costs but may limit your options. If you pay out of pocket, you will have more options, but they may be more expensive.
- Choice of therapist: Most platforms will guide you through a list of questions to understand your preferences better and match you with the right therapist. If the platform chooses a therapist for you and you want to switch, it should be easy to switch to another until you find one who better suits you, but you may need to reach customer service to do so, depending on the platform, and you’ll want to confirm before switching that the new therapist also offers text therapy.
- Extra mental health resources: Some online therapy platforms have additional resources you can use to support your mental health journey. These can include journals, yoga, meditation, articles, and educational resources. Availability of these extras may also depend on the plan you purchase.
What is text therapy?
Text therapy is texting in a live back-and-forth conversation with your therapist. It may be good for people who are more comfortable with texting than with being on a phone call or live video therapy session.
Who should use text therapy services?
Natalie Rosado, a licensed mental health counselor at Tampa Counseling Place, shares the rewards of text therapy. “Text-based therapy can democratize access to mental health support, offering a lifeline to those who might otherwise be left without help due to geographic or social barriers,” she says.
A recent study looked at how text-based therapy could be used to benefit people living in rural and remote areas with poor access to mental health care, or who were limited by social conventions regarding mental health. Researchers found that text-based mental health services were “particularly well suited to clients concerned with privacy and self-presentation,” and further helped by allowing them to save their chat logs and “reflect on the therapy session after it has ended.”
In addition, some people may be more comfortable texting instead of using face-to-face communication when tackling topics that are difficult to talk about, or they may not have the privacy needed to have a spoken conversation. Text therapy can also be a good choice for young adults who are typically familiar with texting already.
Who should not use text therapy services?
If you communicate best by observing a person’s body language, facial expressions, and voice intonations while talking to them, text therapy may not work for you. It can be difficult to understand the nuances of statements when the words are written instead of spoken.
Rosado also offers some words of caution: “While text-based therapy opens new avenues for connection and convenience, it’s crucial to recognize its limitations and seek in-person support when facing severe or complex mental health challenges.”
Text therapy is not an appropriate solution for all mental health conditions and it is not meant to offer the same level of support and therapeutic value that comes from an in-person or virtual video session. Text therapy should primarily be seen as a tool to help supplement live therapy sessions.
How much does text therapy cost?
The text therapy subscriptions in this review range from $260–$440. Though Online-Therapy.com offers a basic plan for $200 a month, it does not include live text therapy sessions, only messaging support. If you pay for services with insurance, like you can for Talkspace, your copay could be as low as $30 per session.
Cost of text therapy relative to other online therapy services
Text therapy is generally less expensive than phone and video therapy services. If you go with Talkspace, for example, the therapy price increases from $276 for text only to $396 per month for video plus text therapy sessions, and up to $436 per month if you add workshops to your subscription.
Our final verdict
Our Handbook Team reviews online therapy providers to find the best one for you, which varies based on your preferences, budget, and insurance status. If you’re looking for a platform with text therapy that takes insurance, Talkspace may be the one for you.
Teen Counseling may be a good choice if you’re looking for care for your teenager. Its therapists have experience with people ages 13–19. Folks looking for cognitive behavioral therapy (CBT) may find Online-Therapy.com to be the best platform, as it helps them reach their goals by reframing emotions and behaviors.
Compare the best online therapy platforms with text therapy
| Best for | Using insurance | Teens | CBT |
| Monthly cost | $276–$436 | $260–$360 | $200–$440 |
| Communication options | Phone, video, and text sessions; messaging between sessions | Phone, video, or chat sessions; messaging between sessions | Phone, video, or chat sessions; messaging between sessions |
| Accepts insurance | Yes | No | No |
Frequently asked questions
Text therapy varies by platform. The live text therapy subscriptions in this review range from $260 for teen therapy to $440 for premium plans.
Yes, some platforms take insurance and offer text therapy. Talkspace is the only brand in our review that does so.
Research has found that text therapy can be effective for people who are more comfortable using messaging instead of phone calls or live video chats, and for those who live in rural areas. However, text-only therapy communication can lack a personal touch, and you may miss visual cues like eye contact and body language.
Most online therapy is not free, but the Crisis Text Line is free if you are in a crisis and want to talk with a trained counselor. If you or someone you care about is experiencing a mental health emergency, dial 911 or visit your local emergency department. Teens living in New York City can access free mental health support through NYC Teenspace, a New York City Health Department program that provides therapy to local teens. References
- U.S. Department of Health and Human Services. (2023, October 17). Telehealth Privacy and Security Tips for Patients. Link
- Mozilla Foundation. Make Smart Choices to Protect Your Privacy. Search for Products. Read Expert Reviews. Get Tips and Tricks. Link
- NYC Health. NYC Teenspace. Link
- Karnik, V., Henderson, H., Khan, U.R. & Boyd, J. (2023, December 14). Phone-Based Text Therapy for Youth Mental Health: Rapid Review. Interactive Journal of Medical Research. Link
- Substance Abuse and Mental Health Services Administration (SAMHSA). (2021). Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health. U.S. Department of Health and Human Services. Link
- Thew, G.R., Rozental, A., & Hadjistavropoulos, H.D. (2022, October 19). Advances in digital CBT: where are we now, and where next? The Cognitive Behavior Therapist, 15(44). Link
- National Association of Mandated Reporters. What is a Mandated Reporter? Link
- Gould, M.S., Pisani, A., Gallo, C., Ertefaie, A., Harrington, D., Kelberman, C., & Green, S. (2022, May 22). Crisis text-line interventions: Evaluation of texters’ perceptions of effectiveness. Suicide and Life Threatening Behavior, 52(3), 583–595. Link
- Antoniou, M., Estival, D., Lam-Cassettari, C., Li, W., Dwyer, A., & Neto, A.A. (2022, June 21). Predicting Mental Health Status in Remote and Rural Farming Communities: Computational Analysis of Text-Based Counseling. JMIR Formative Research, 6(6). Link
- Czyz, E.K., Arango, A., Healy, N., King, C.A., & Walton, M. (2020, May 25). Augmenting Safety Planning With Text Messaging Support for Adolescents at Elevated Suicide Risk: Development and Acceptability Study. JMIR Mental Health, 7(5). Link
- Talkspace Online Therapy Survey. 600 respondents. Conducted using Pollfish. Launched February 2024.
- Brightside Survey. 600 respondents. Conducted using Pollfish. Launched February 2024.
- Teen Counseling Survey. 100 respondents. Conducted using Pollfish. Launched May 2024.