This review examines the best platforms for online CBT, including options with free resources and financial assistance programs.
Engaged in ongoing independent researchMystery shopped each of the brandsContacted the brands’ customer service teams to ask questions and gauge responsivenessConsulted six leading psychologists and psychiatristsBecame customers of online therapy providers ourselvesReviewed academic research about the efficacy of online therapy versus in-person therapy
- Only users with in-network insurance plans can book therapist sessions.
All therapists are trained in CBTIncludes online CBT support materials like worksheetsCan choose from three plans that include unlimited messaging
Cons
Does not accept insuranceOnly way to contact customer service is through emailSelf-guided resources aren’t available offline
Session Format Text messaging; live video, voice, or text sessions Cost $50 to $110 per week Accepts Insurance No Online-Therapy.com supports users with both live sessions with a CBT therapist and online resources. All subscription plans provide access to a learning program to help you better understand your issues from a CBT perspective. They also include CBT exercises and worksheets to complete on your own time, an online journal for self-reflection to help shift your mindset, an activity plan designed to track your progress, and videos with guided yoga and meditation instruction for practicing mindfulness. The standard subscription includes one 45-minute live therapy session per week, while the premium subscription includes two 45-minute sessions per week. These are conducted by licensed therapists, all trained in administering CBT. Beyond regular sessions, you’ll be able to message your provider throughout the week, and they will track your progress and provide daily feedback on your homework Monday through Friday. Unfortunately, the worksheets are online forms that cannot be downloaded or accessed offline. Online-Therapy.com recommends sticking with its services for at least a month, but users who benefit from ongoing support can stay longer. In our April 2022 survey of 1,000 online therapy users, 184 respondents used Online-Therapy.com. Of these, 57 percent of subscribers used the platform for eight months or fewer.
Online-Therapy.com Plan Options and Pricing
All Online-Therapy.com plans provide access to the following CBT support materials:
An eight-section online program to learn about CBT principles and how they relate to your mental health, including worksheets and activity plans that go along with the program’s sectionsDaily worksheet replies from your therapist Monday through FridayYoga and meditation videosA journal that prompts you with questions when you start and end your dayA progress test you can take any time to reflect on your emotional well-being over the previous two weeks
The basic plan does not include live sessions but does include CBT support materials, unlimited messaging, and daily worksheet replies Monday through Friday. Standard and premium subscription plans include the same features, but the standard plan comes with one live session per week versus two live sessions per week with the premium plan. Live therapy sessions can be conducted via video, voice, or text. Although all subscribers receive daily responses, a customer service representative informed us on October 21, 2022, that premium subscribers get express replies, meaning that their messages are put at the top of their therapist’s list of messages to respond to.
Compare Online-Therapy.com Plans
Includes live sessions and unlimited video, audio, and text messagingOffers financial assistance to qualified applicants
Cons
Doesn’t accept insuranceNeed to request a CBT therapist during the matching processNeed to reapply for financial assistance every three months, if needed
Session Format Unlimited messaging; live video, phone, or text sessions Cost $60 to $90 per week Accepts Insurance No The BetterHelp platform has an extensive therapist-matching questionnaire to help users find a therapist who can support their mental health. Although BetterHelp users can indicate certain therapist preferences, such as age, sexual orientation, spirituality, or gender, users can’t specifically choose therapists who specialize in CBT. Instead, users need to email customer service or use the “change therapists” feature to request one. Although it has licensed therapists in all 50 states, and a BetterHelp article states that it has many CBT therapists, BetterHelp doesn’t clarify whether it has CBT therapists available in all 50 states. BetterHelp allows you to send unlimited messages to your provider between appointments. Therapist response rates vary. According to our online survey, of the 162 BetterHelp subscribers, 50 percent received responses within a day, 17 percent received responses within a few days, and 25 percent received responses within a week. For 8 percent of the BetterHelp users we surveyed, it regularly took more than a week to get a response. In addition to unlimited asynchronous messaging, you also get weekly live therapy sessions via video, phone, or text (synchronous messaging in real time). BetterHelp live sessions generally last between 30 and 45 minutes, depending on how much time you and your therapist need. The platform has licensed therapists available in every state.
BetterHelp Plan Options and Pricing
A BetterHelp subscription costs between $60 to $90 per week, billed monthly. Your cost depends on your preferences, location, and therapist availability. BetterHelp has a financial assistance program that can discount your subscription by up to 40 percent, based on an application that assesses your financial situation. The application is available to subscribers during the sign-up process and can also be requested during the course of a subscription by contacting customer service. Users who qualify for financial assistance have to reapply every three months to keep their discounts active.
Can select a CBT therapist via the provider search toolResponsive customer serviceAccepts insurance
Cons
Requires a monthly membership to contact therapists between sessionsNot available in all states
Session Format Live video; email and phone access to therapists between sessions with a membership Cost Starting at $99 per session, depending on provider and location; memberships start at $39 per month, depending on location Accepts Insurance Yes Thriveworks providers offer sessions online and in person. Unlike Online-Therapy.com and BetterHelp, which match you with a therapist, Thriveworks lets you book sessions with the therapist of your choice. In addition to the ease of using the provider search tool, we were pleased with the live chat feature on the Thriveworks website. All of the agents we contacted were knowledgeable and tried to help us find a therapist that matched our requested approach, insurance plan, and location. Thriveworks offers email and phone access to therapists between each 50- to 60-minute live session. But users can only access this feature if they sign up for a monthly membership, which starts at $39 per month but can be higher depending on your location. All Thriveworks users get access to its app, Therapy Buddy, which helps users stay on track with their CBT journey. Features like a “Helpful Takeaway” prompt after sessions, a section to note topics or events to bring up in the next session, and a homework assignment task list can help keep users focused and engaged. As of October 2022, Thriveworks does not have therapists licensed to practice in New Mexico, New York, North Dakota, South Dakota, Vermont, and West Virginia.
Thriveworks Plan Options and Pricing
Thriveworks providers have different rates depending on their location and experience. Online live video sessions with a therapist are billed per session and start at $99 per session. For email and phone access to your therapist between sessions, you need to pay an additional fee for a Thriveworks membership. The membership starts at $39 per month, depending on where your provider is licensed to practice.
Free mood tracker and CBT resourcesLow-cost premium subscription to access self-guided CBT toolsPeer support chat groups available on the free version
Cons
Only users with in-network insurance plans are eligible for therapy sessionsTherapy option not available in all statesMessaging option with a coach, not a therapist
Session Format Live video sessions Cost $8.99 per month for premium app features without insurance; an average of $140 for an initial therapy session and $85 for follow-up sessions depending on insurance coverage Accepts Insurance Yes Sanvello, formerly known as Pacifica, is an app that combines both CBT and mindfulness, which Sanvello defines as “the practice of worrying less and noticing more.” It offers free CBT features such as mood tracking and paid features such as live therapy sessions. The free self-guided content includes access to audio and video lessons, guided meditations, breathing exercises, journaling prompts, and trackers for mood, physical health, and thoughts. The free version also provides access to unmoderated group chats with individuals who have similar interests and mental health concerns. A clinical study published in June 2019 in the Journal of Medical Internet Research showed that the mindfulness tools on the app were effective in reducing users’ self-reported symptoms of depression, anxiety, and stress after one month. The study was funded by Sanvello (formerly Pacifica Labs), and two of the study’s authors received a salary from the company. Online therapy sessions are only available to Sanvello Premium subscribers with in-network insurance or those who have Sanvello as an employee benefit. Sanvello therapy sessions are only available to users in Arizona, California, Colorado, Florida, Georgia, Indiana, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Tennessee, Texas, Virginia, Washington, and Wisconsin.
Sanvello Plan Options and Pricing
In addition to its free tools, Sanvello offers three plans: premium, coaching, and therapy. The premium plan is the only one that you can access without insurance. If Sanvello accepts your insurance, you can use it to pay for the premium option; the price depends on the details of your insurance plan. Without insurance, the premium plan costs $8.99 per month. It includes access to a full meditation library and additional guided journeys and tools not offered by the free plan. The coaching plan is only available to users who have Sanvello as part of their employee assistance program. It includes everything in the premium plan, plus a personal trained mental health coach. Coaches have a background in mental wellness and over 200 hours of CBT training, but they are not necessarily licensed therapists. The coaching plan also provides access to live group classes that help users learn how to apply Sanvello techniques to their lives. During the live classes, coaches talk through real-world scenarios, and attendees can use live chat and emoji reactions to participate in real time. You need in-network insurance to use Sanvello’s therapy plan. The therapy plan adds the ability to schedule live video sessions with a licensed therapist. According to Sanvello, therapy appointments are billed per session in addition to the subscription cost. Sessions cost an average of $140 for the initial appointment and $85 per follow-up appointment, depending on your insurance plan.To see whether your insurance plan covers Sanvello, click Upgrade within the app and enter your insurance information for an instant eligibility check.
Compare Sanvello Plans
There is a set agenda for sessions, and patients are typically assigned at-home exercises to complete between sessions. Homework for CBT can include journaling or tracking unhelpful thoughts as they arise and the emotions that come up, and then challenging them. These exercises help reinforce the work done during sessions, according to the Mayo Clinic. “CBT builds on the assumption that our thoughts, feelings, and behaviors are all related to one another,” says Jaclyn Ross, PhD, clinical psychologist and postdoctoral research fellow at the University of Illinois at Chicago. For example, a person with depression may think that they are a burden to their friends —an unhelpful belief that can exacerbate negative feelings. A CBT therapist would point out that this belief is a cognitive distortion. The therapist then asks questions that may help the person reevaluate and think more flexibly, according to Dr. Ross. This is the cognitive aspect of CBT. To address the behavioral aspect, the person and their therapist work together to modify dysfunctional behavior patterns. For example, they might use exposure therapy, which is a form of CBT used to reduce responses of fear and anxiety, according to the Anxiety and Depression Association of America. In exposure therapy, a person is gradually exposed to a feared situation or object, learning to become less sensitive over time. Online CBT allows for the convenience of connecting virtually with your therapist, and some platforms have extra resources like worksheets or journals to help. Virtual sessions may be easier for individuals with busy schedules or social anxiety issues that make it challenging to meet in person. Remote sessions have made therapy of all kinds more accessible than ever before — and in one study, more effective. A review published in July 2020 in eClinicalMedicine found that online CBT was at least as effective as in-person CBT for reducing the severity of depression. “There is some evidence that online CBT — self-guided programs without a therapist — can be useful in treating mild to moderate depressive disorders, and even severe anxiety,” says Ross. “This is exciting because it’s a potential avenue for providing healthcare to those who might otherwise remain untreated.”
What Can CBT Treat?
According to the Mayo Clinic, CBT can help improve many mental health disorders, such as depression, anxiety disorders, phobias, post-traumatic stress disorder, insomnia and sleep disorders, eating disorders, sexual disorders, bipolar disorders, obsessive-compulsive disorder, and substance use disorders. Beyond treating mental health conditions, CBT can be used to address a broad spectrum of emotional challenges, according to Dr. Hafeez, such as navigating loss or grief, resolving relationship issues, and even chronic physical symptoms. Hafeez explains, “CBT can help teach techniques for coping with overwhelming life situations and identify how to manage emotions.”
Different Types of CBT
The many types of CBT “work to address underlying thought patterns that may contribute to psychological distress,” says Hafeez. For example, multimodal therapy is based on the theory that “psychological issues can be treated by addressing the seven different yet interconnected modalities: behavior, imagery, affect, cognition, sensation, interpersonal factors, and drug or biological considerations,” says Hafeez. The exact balance is tailored to the patient’s specific needs.
Therapist Preferences Consider what type of therapist may make you feel most comfortable. Some sites, like BetterHelp and Thriveworks, allow you to filter therapists by gender, sexual orientation, languages spoken, years of experience, and other user preferences.Session Type Determine whether you’d rather have your sessions via video calls, audio calls, or live chat messaging. If you prefer quick feedback, live sessions may be more important than asynchronous messaging.CBT Resources If you’re motivated by completing activities, you may find it helpful to have mood trackers, activity plans, and worksheets assigned between therapy sessions. Online-Therapy.com and Sanvello offer these CBT-supporting resources for their users.
BetterHelp customer service representatives can match users with a therapist who specializes in CBT, and it has a financial assistance program for those who qualify. We found BetterHelp to be the best online CBT platform with financial aid. For those who have specific preferences in therapists, Thriveworks has a provider search tool that can narrow down online CBT providers near you, making it our pick for the best online CBT option that lets you choose your therapist. Sanvello is our pick for the best self-guided CBT app, with its free CBT tools and optional live therapy sessions for individuals with in-network insurance. Additional reporting by Emily Orofino. You can also reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-HELP (4357). The SAMHSA help line is a free, confidential, 24/7, 365-days-a-year treatment referral and information service for individuals facing mental or substance abuse disorders.
