BetterHelp Review: Does Online Therapy Work?

BetterHelp Review: Does Online Therapy Work?


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Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to online therapy.

BetterHelp is one of the most popular online therapy apps. The platform allows patients to connect with licensed therapists in the comfort of their own home, and charges a lower price than an out-of-pocket visit would typically cost. 

But is online therapy as effective as in-person therapy? Are BetterHelp's methods clinically proven to work? What data violations caused BetterHelp to recently settle with the FTC for over $7 million? And how do real patients rate and describe their experience using BetterHelp?

In this article we'll answer all of these questions and more as we review the clinical trial on BetterHelp to determine if the service is proven to be effective. We'll overview the potential FTC settlement with BetterHelp and what it means for consumers.

We'll also review clinical studies on online versus in-person therapy to determine if online therapy is really as effective. We'll compare BetterHelp to another popular online therapy platform called Talkspace and feature real, unsponsored BetterHelp user reviews.

Is BetterHelp Clinically Proven to Work?

We can only locate one clinical trial testing the effectiveness of BetterHelp. A 2019 clinical trial examined whether patients using BetterHelp experienced improvements in their depression. The results were impressive.

At baseline, 33 of the 318 patients were diagnosed as having severe depression, and at the end of the three month trial only 18 patients received such a diagnosis. This equates to a 45% reduction in those defined as "severely depressed" in only three months.

No patients were diagnosed with minimal depression pre-trial, and 63 patients (20% of the total) had this diagnosis post-trial. This represents a shift from more severe to less severe diagnoses over the course of the trial, and the study authors concluded that overall patients experienced “significant symptom reduction.”

Based on this data, we consider BetterHelp likely to be effective for depression. We cannot determine its efficacy for other health conditions until the platform has been tested for those conditions.

But why did the FTC recently propose a settlement of over $7 million to BetterHelp over data security issues? We'll review the controversies that BetterHelp has been a subject of in the next section.

BetterHelp's Many Controversies

BetterHelp has been the subject of many controversies since its inception.

In March of 2023, the Federal Trade Commission (FTC) published information on its website detailing a proposed $7.8 million settlement with BetterHelp over allegations that the company sold consumer data without properly disclosing such.

From the above-linked FTC document: 

"And it promised to keep that information private through statements like: 'Rest assured – any information provided in this questionnaire will stay private between you and your counselor.' But from the FTC’s perspective, a truthful statement would have been 'Rest assured – we plan to share your information with major advertising platforms, including Facebook, Snapchat, Criteo, and Pinterest.'"

BetterHelp also faces several class-action lawsuits regarding the alleged data violations, according to the American Bar Association.

A YouTube video with over 200,000 views from a therapist named Mickey Atkins involves her reacting to "horror stories" from BetterHelp patients:

Is In-Person Therapy More Effective?

When considering any of the popular online therapy apps, the main question patients have is whether it’s likely to be as effective as in-person therapy. Thankfully, there have been more and more research studies comparing the efficacy of online and in-person therapy.

A 2021 meta-review compared clinical trials on in-person versus online therapy. It’s the most thorough research review on the topic to date, as the researchers cited over 100 individual trials. What they found was encouraging for BetterHelp users: that online therapy was just as effective as in-person therapy for improving mental health.

One type of therapy, called cognitive behavioral therapy (CBT) was actually found to be more effective in a virtual setting than an in-person setting.

CBT is commonly used for treating anxiety disorders-including phobias, social anxiety disorder, and generalized anxiety disorder. Patients can more comfortably actualize and work through these anxiety symptoms in a comfortable setting like their home compared to a therapist’s office.

Another clinical trial comparing in-person and online therapy had a similar conclusion to the previously-linked review: that there was no statistical difference between the two methods of therapy. 

The patient population in this study had an eating disorder, and both groups (online and in-person) showed similar improvements in eating habits and weight gain (when there was a doctor’s recommendation for weight gain).

A fascinating medical review published in the Frontiers in Psychology journal examined how therapists’ attitude and perception of online therapy may impact patients. The researchers tracked different metrics like emotional connection with patients, distraction and perceived efficacy of online therapy.

What they found was that therapists who started online therapy with a preconceived notion that it would be ineffective ended up more likely to have negative attitudes about online therapy and more likely to report it as ineffective after trying it (as a provider).

What this suggests is that it’s imperative for patients to find a therapist they really trust, who believes in the effectiveness of online therapy, because how enthusiastic and open the therapist is towards online therapy as a whole may influence how effective therapy is for the patient.

It may be worthwhile for patients to ask prospective therapists about their thoughts on online therapy generally, and to only consider working with therapists who are enthusiastic about the practice.

Real, Unsponsored BetterHelp User Reviews

A YouTube creator named Nazra explained her experience using BetterHelp:

Another YouTube creator named "Viannca with a V" shared her experience on the platform:

How Much Does BetterHelp Cost?

BetterHelp costs between $60 to $90 per week depending on patient location and preferences. This is actually a significant price decrease. When we first published this article, the brand charged between $90 and $120 per week.

Patients should expect to pay this cost out-of-pocket, because BetterHelp's FAQ page states that the company does not submit insurance claims, and that their services are rarely covered.

It’s worth noting that around $60 to $90 per session is cheaper than the out-of-pocket cost for a therapy session at most clinics, but may be more expensive than a therapy session that’s covered by health insurance.

For patients who can pay for the convenience, BetterHelp seems like a good option in terms of cost. For patients on a lower income, it may be worthwhile to see if your health insurance has an in-network therapist with subsidized pricing.

BetterHelp vs. Talkspace

Talkspace is another popular online therapy platform, so patients are often curious about which is a better option.

We recommend that patients choose a therapist first and a platform second. Feel free to browse the therapists on both platforms before making a selection.  The individual therapist is a much better predictor of treatment success than the platform in our opinion.

As far as cost, which app will be the better option depends mostly on insurance coverage. Talkspace is covered by some insurers and employers, so for patients with health insurance it's probably the better option.

For patients without medical insurance or with poor-quality medical insurance with a high deductible, BetterHelp may be the superior option since its per-session cost is lower. Talkspace text and video therapy starts at $129 per week (higher than the upper range of BetterHelp) and has no fixed upper limit published on their site.

Talkspace has been proven effective in more clinical trials than BetterHelp, and doesn't appear to have been sued over data impropriety, so we consider Talkspace to be a slightly better option than BetterHelp for patients who can afford both.

Pros and Cons of BetterHelp

Here are the pros and cons of BetterHelp as a brand in our opinion.

Pros:

  • Affordable without insurance
  • Price recently decreased significantly
  • Clinically shown to be effective for depression
  • Intuitive website

Cons:

  • Doesn't currently accept insurance
  • FTC proposing settlement due to selling customer data
  • Less clinical trials than Talkspace
  • Unimpressive customer reviews

Our Mental Wellness Recommendation

We recommend a platform called Brightside to patients on a mental health journey. It's an online therapy and medication platform that connects patients with licensed therapists and doctors from the comfort of their home.

medical review published in the Clinical Psychology & Psychotherapy journal found that online therapy was equally effective to in-person therapy for treating depression, anxiety and PTSD. Therapy may be a good first option for patients who want to avoid the side effects of medication.

Brightside also can connect patients with licensed psychiatrists that can prescribe medication. Some patients choose only therapy, some choose only medication, and some choose both. The brand reports that 86% of members feel significantly better within 12 weeks of treatment.

Patients with and without health insurance can use Brightside. For many patients with health insurance, treatment is entirely covered by insurance.

The cost for medication without health insurance is capped at $95/month and the cost for therapy without health insurance is capped at $299/month.

Interested patients can check out Brightside at this link to the brand's website.

Stay up-to-date on our research reviews

Conclusion

BetterHelp may be a good option for patients who can afford paying for therapy out-of-pocket and who want the convenience of therapy from home. 

Online therapy is clinically shown to be just as effective as in-person therapy, and BetterHelp is clinically shown in one trial to significantly improve depression.

BetterHelp does not currently accept any health insurance, which is a negative compared to some platforms like Talkspace and Brightside that do. Due to the out-of-pocket costs, BetterHelp may not be the best option for lower-income patients, and those patients may benefit from seeking an in-network therapist that accepts insurance (which can make the cost free or much reduced).

The FTC is pursuing a settlement with BetterHelp for over $7 million over allegations that the company was selling customer data without disclosing such, which is a major red flag in our opinion.

Overall we think that therapy is a great option for patients on a mental health journey, and may have reduced risk of adverse effects compared to pharmacological treatment.