09/13/2024 | Press release | Archived content
Guide to Choosing the Best Text-Based Therapy Services
Here are some factors to take into consideration when choosing a text-based therapy service :
Who Are Text Therapy Services or Apps Right For?
Text-assisted therapy may be right for you if you:
Text-assisted therapy services may not be suitable for you if you:
If you have an urgent mental health need, you shouldn't rely on text-assisted therapy. Please call or text the Suicide and Crisis Lifeline at 988, text "HOME" to the Crisis Text Line at 741741, or seek emergency medical help right away.
Frequently Asked Questions
Text-based therapy, or text-assisted therapy, is online therapy that is conducted through texting, live chat rooms, messaging, or e-journaling. Some text therapy services offer live chats in a designated "session room," while others allow you to text your therapist at any time-aka asynchronous texting-via SMS or messaging in an app or online portal.
Online therapy is typically paid for via a weekly or monthly subscription. Prices can range from $95 per month to $400 a month or more. Many online therapy subscriptions include at least one weekly live session (via text, audio, or video), as well as unlimited messaging with a mental health provider. Some online therapy platforms also offer pay-per-session payment models, which often cost $50 or more per session.
Some online therapy services that offer text-based therapy, such as Brightside and Talkspace, take insurance. Other platforms will provide you with a superbill that you can submit to your insurance provider for potential reimbursement.
One recent study suggests that text-based therapy with a licensed therapist effectively treats certain mental health conditions, such as depression. Research has also found that two-way text messaging therapy can help to treat symptoms of generalized anxiety disorder (GAD). Another study found that text-based therapy is also effective in treating substance use disorders (SUD) and psychotic disorders.
Most text-assisted therapy platforms require payment, especially if you're working with a licensed therapist. However, some crisis/emergency text therapy resources-such as the Crisis Text Line-are free to use. Others, such as 7 Cups, offer free peer support and advice from trained volunteers.
How We Tested and Reviewed Online Text Therapy Services
We evaluated 80 online therapy companies and therapist directories in order to compile this list.
Firsthand Experience
As part of our research, we signed up for talk therapy at all 55 online therapy companies we reviewed. We tested each company's therapy services, and if the company offered other services (such as couples therapy and child or teen therapy), we tested those too. Our testers are located all across the United States and abroad, meaning we have extensive information about each company's services in a variety of areas.
User and Brand Surveys
In addition, we surveyed more than 8,000 therapy users: 100 at each of the 55 online therapy companies and the 25 therapist directories we researched and tested. We collected over 100 different data points in which we asked users to evaluate each company's services, from their therapist's qualifications to whether they found a therapist who met all their needs to how they'd rate the company overall. We also sent questionnaires to each company we considered, asking for their perspectives on the services they provide, and we interviewed former patients and therapists at the companies where possible.
Research
In addition to the extensive research we performed on each of the 55 online therapy companies we reviewed, we also researched dozens of therapy directories. We tested each by searching for appropriate therapists for 37 hypothetical scenarios that might lead someone to search for a mental health provider across 18 ZIP codes. We then rated the results by how well the therapists we found in each directory could address each scenario, looking into whether it had competent, licensed therapists who were qualified to treat these issues.
Expert Recommendations
Once we completed this testing and these surveys, we evaluated our findings with the help of three licensed therapists-Amy Marschall, PsyD; Nic Hardy, PhD, LCSW; and Hannah Owens, LMSW-in order to make our recommendations. These therapists provided extensive insight into the ethics and efficacy of online therapy as well as information about relevant therapeutic modalities and approaches.