Text-based therapy can feel like a lifeline, especially for people who aren’t comfortable doing video or in-person chats, or who live in therapy deserts—places where mental healthcare is hard to find. As a licensed social worker and former therapist, I wouldn’t necessarily recommend text-only sessions, but texting can be a great support to therapy seekers who feel more comfortable, for whatever reason, behind a phone. Thankfully, therapy via text has been proven to be an effective alternative to in-person or online therapy.
While it sounds straightforward, text therapy can take a few formats. For some, it involves conducting your therapy session entirely via text message, so during your scheduled session, you communicate with your therapist exclusively via messaging, not with a video or phone session. Otherwise (or in addition), many companies offer texting between sessions, where you can ask your therapist questions and get mid-week support if you feel like the wait for your next session is too long. There are even crisis text lines where you can get emergency help without having to talk to someone on the phone.
My list of the best text-based online therapy services covers all these formats, so that you can find the right company for your needs, right at your fingertips.
Compare Our Top Picks
Best for Text-Only Sessions
Talkspace
Best for Text-Only Sessions Talkspace
talkspace
See Retailer
People who want text-based therapy for both individual and couples
Yes, check to see if you’re covered
$69 per week for asynchronous text-only therapy, billed as a monthly subscription ($99 to $109 per week for subscriptions with live sessions)
Individual, couples, teen, psychiatry/medication management
Text-only sessions, asynchronous messaging
Best for Anxiety and Depression
Brightside
Best for Anxiety and Depression Brightside
brightside
See Retailer
People living with anxiety and/or depression and related conditions
Yes, check to see if you’re covered
$95-$349 per month, billed as a monthly subscription
Individual, teen, psychiatry/medication management
Asynchronous messaging
Most Text-Based Options
E-Therapy Cafe
Most Text-Based Options E-Therapy Cafe
e-therapycafe
See Retailer
People who want multiple text-based options for communicating with their therapist
No
$55-$65 per session, including subscriptions
Individual, couples, coaching
Text-only sessions, email, e-journal, asynchronous messaging
Best for CBT
Online-Therapy.com
Best for CBT Online-Therapy.com
Online-Therapy.com
See Retailer
People who want to try cognitive behavioral therapy
No
$60 per week for unlimited messaging, billed as a monthly subscription ($90 to $120 per week for subscriptions with live sessions)
Individual, couples
Text-only sessions, asynchronous messaging
Best for Crisis
Crisis Text Line
Best for Crisis Crisis Text Line
crisistextline
See Retailer
People in crisis who are feeling suicidal or in danger of self-harm
N/A
Free
Crisis management
Live chat
Full Review
What to Expect from Online Text Therapy
- How much does it cost? The therapy services recommended here range in cost from $55 per session up to $480 per month. Some peer-based services and hotlines are free.
- Who is it for? For those living with social anxiety or agoraphobia, even video or phone sessions are uncomfortable or even impossible. Similarly, kids and teens who have grown up on technology might be more uncomfortable with face-to-face services. Or you might only have time for a therapy session on your lunch break at work, where a phone conversation might be overheard. In all these cases, text therapy could be a good option.
- Will insurance cover it? Maybe. Some of the companies on this list accept insurance, and others don’t. I’ve indicated which companies on this list do.
- Is it confidential? Be sure to read through any company’s privacy policy to better understand whether it is HIPAA-compliant (HIPAA is the law that protects personal health information) and whether it shares any private information with third parties; we recommend opting out of data collection.
- What’s the time commitment? Sometimes you might start feeling better after just a couple of sessions, and other times you might need to see your therapist for a few months or even years.
- Does it work? You get out of therapy what you put in. If you are dedicated to doing the work and tackling your issues, you’re likely to see success.
Text Therapy vs. AI
People are turning to AI, like ChatGPT, for mental health advice, guidance, and even therapy—but I’m here to tell you why that might not be a good idea.
First of all, the difference between text therapy and AI is that even though you’re communicating via text, in text therapy you are still talking to a human, and a therapist to boot. This is a trained professional who follows an ethical code and who, as they get to know you, will provide personalized mental health support.
All of the companies on this list employ real (read: human) therapists. This means that, even when you are communicating via text, you are always talking to an actual person. Not so, obviously, with AI—and this is where AI falls down on the job.
ChatGPT does not know you, and—worse than that—has been trained to be a sycophant, telling you what it thinks you want to hear. Where a human therapist can and will challenge your unhealthy or inaccurate ideas about yourself and others, you cannot count on ChatGPT to do the same. And as you get sucked in further and further to ChatGPT’s potentially biased responses, you can lose sight of any objectivity that an outside (therapist) perspective might have offered.
In addition, AI conversations cannot (and should not) take the place of human interaction. It might seem nice to have a “friend” in your pocket who tells you exactly what you want to hear, but there is so much to be said for cultivating and maintaining human connection, which can open you up to new experiences, help you practice empathy, and be there for you in-person for a hang or a hug when you need it.
While ChatGPT and other LLMs can certainly be useful for some therapy-related things, such as helping you organize your thoughts around a difficult subject, provide education about different therapeutic techniques, and assist you in developing a self-care plan, they should never be used to replace therapy with a real-life human therapist.
Paying for Online Text Therapy
Most of the services on this list operate as subscriptions, meaning you are charged for a month at a time for a certain number of sessions. Some services accept insurance (like Talkspace and Brightside), while others require you to pay out-of-pocket (but might be able to provide a superbill that you can submit to your insurance company for reimbursement). In some cases, like Talkspace, text-based therapy is the cheapest subscription option, while in others text communication is included in each option. Text chats with crisis services, such as the Crisis Text Line, are free.
How I Review Online Therapy Services
I’ve spent years testing and surveying real therapy users and reviewing their experiences to help rate and share the best online therapy services. You can see a full breakdown of our online therapy research and testing process on Verywell Mind. Here is an overview of how I capture and evaluate firsthand experience and survey data.
Firsthand Experience
I had 65 different people sign up for talk therapy with all 55 online therapy companies reviewed. Over the past three years, I’ve published 153 reviews (here are our reviews for BetterHelp and Talkspace, for instance). I had my testers try out each company’s therapy services, and if the company offered other services (like couples therapy and kid or teen therapy) we tested those too.
I asked each tester to try each service for at least a month, which usually meant between two and six sessions at each company. I also asked testers to switch therapists partway through, if possible, in order to get a holistic idea of the offerings and quality of each company. My testers were located all across the United States and abroad, meaning I gained extensive information about each company’s services in a variety of areas.
Texting Services
When testing companies that offer text-based services, I made sure my testers tried this format as well as video and/or audio sessions. I paid special attention to how my testers felt about this type of communication—did they feel they could connect with their therapist this way, did they come away from the session feeling heard and supported, and the pros and cons about texting versus other session formats.
User Surveys
I surveyed more than 8,000 therapy clients who are currently using one of the 55 online therapy companies tested or who had used one in the recent past, as well as users of 27 different online therapy directories. I 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—all told, I gathered 350 different data points.
Why Trust Verywell Mind
Hannah Owens is Verywell Mind’s Mental Health Editor. Hannah is a licensed social worker with a clinical background in community mental health. She’s worked at programs treating those with serious mental illness, providing both individual and group therapy. In her time at Verywell Mind, Hannah has designed and run years of online therapy testing, overseeing and editing reviews of the top online therapy companies out there and writing and editing roundups of the best online therapy services based on our extensive and thorough testing. Hannah brings her unique combination of both clinical and editorial expertise to her work for Verywell Mind.
- Licensed social worker since 2019
- Clinical background in community mental health
- Specializes in serious mental illness
- Believes in the mission of online therapy to make mental healthcare more accessible
