A lifelong GAD conquerer, Em talks to her therapist daily to manage her anxiety and live her best life.
I have Generalized Anxiety Disorder. For years I tried to ignore it, convinced I’d grow out of it or grow into it, so to speak, but as the years wane on and I gain more and more responsibility, the anxiety just shifts, it never fully goes away.
That’s why last year, after seeing all of those big-eyed guys and gals in the BetterHelp ads plastered all over my Facebook and Reddit feeds I decided to sign up and see what this online therapy thing is all about. Here’s how it went and what I learned about seeing a therapist from home.
What is Online Therapy and How Does it Work?
Just like in-person therapy, with an online platform like BetterHelp, you’ll speak with a therapist who specializes in mental health conditions like phobias, panic attacks and disorders.
How Does it Work?
To start, you’re going to go through a short screening process and the first question will be if you feel you’re a harm to yourself or others. If that’s the case, you probably won’t be accepted to platform, instead you’ll be directed to your local emergency room.
If you indicate that you are NOT a harm to yourself or others, you’ll enter the website to get matched to a counselor. From platform to the platform, this process might vary. On BetterHelp, they asked me questions like:
- Did I want a counselor with religious leanings?
- Did I want a counselor that was experienced with the LGBTQ+ community?
- Did I prefer a counselor of the same sex?
- What my specific mental health concerns were?
What Happened After I Was Matched With a Counselor
After giving that initial information, which took just a couple of minutes to complete, I was matched with a counselor. I was asked to provide my matched counselor with even more information that included questions and criteria like:
- My age
- My gender identity
- A quick screening for depression and other mood disorders (questions included how often I feel down or hopeless, any recent appetite changes and how well/often I sleep).
All of this was done in my “counseling” room.
What the "Counseling Room" Looks Like
How My Therapist Got to Know Me
After reviewing my initial screenings my therapist began to communicate with me in the virtual counseling room. Here, she would send messages asking me questions about my childhood, my current struggles, my mental health history and any concerns I might have (like how my dad has bipolar disorder and one of my siblings has a personality disorder) to help her narrow down her best approach for making sure I benefit from therapy.
She sent me even more screenings to see if I have any bipolar tendencies (which the TOS specifies they can not help me with), since it can be genetic, and even screened me for OCD at my request. In the first week we exchanged several emails each day as she got to know me.
Getting a Diagnosis
Within the first couple of weeks, my therapist had ruled out a lot of things and narrowed in on some obvious concerns, finding that most likely, I have and have dealt with since childhood, Generalized Anxiety Disorder.
It’s nice because now when I’m filling out forms at the doctor or even just trying to navigate life, it helps me to have a name for this thing and it helps other providers, from my dentist to my GP to know how best to treat me based on this GAD diagnosis.
Seeking Help for a Life Event
Now, you may not be looking to online therapy for any kind of diagnosis. Maybe you’re going through a hard time, like a job loss or the loss of a loved one and you want to talk to a qualified counselor to keep your mental and emotional health steady. Or maybe you already know you have seasonal affective disorder and you’re simply looking for support to help you stick to a routine - online therapy is great for those things too, you don’t have to go into it hot and heavy looking for someone to fix you like I did.
Communicating With My Therapist
Something that’s really cool about online therapy is that I stay in touch with my therapist daily. I can email her whenever I want and if she hasn’t heard from me in a few days she’ll message me to see how I’m doing.
I can also schedule “live” sessions and the options for these are:
Live Instant Message Chat
This is best when you're in a situation where you may not feel comfortable expressing yourself verbally. Maybe you're squeezing in a session on your lunch break or having your therapist talk you through in the waiting room of your oral surgeon.
So far, I almost always pick a phone call, that way I’m not adding stress to myself trying to clean up my home office but so I’m still getting a more personal way to talk with my therapist besides just chatting through instant message.
Video calls can be done on any device with a camera. I've done these a couple of times and they're helpful in that sometimes the best way a therapist can assess how you're doing is by taking a visual survey of you.
Homework and Resources
Apart from our weekly live sessions and daily email correspondence, my therapist can also assign homework or informational sheets for me to do. This helps her guage where I’m at and how to handle certain events like a panic attack or a negative social encounter. For the most part, these resources are rooted in cognitive behavioral therapy (or CBT) techniques.
When there isn't any assigned homework for me, I work in this CBT workbook and then snap a picture to send to my therapist. It's a book that you can do on your own or work in tandem with a licensed therapist on. From there she'll use my answers to challenge my perspective on certain situations or negative thoughts.
What I Like About BetterHelp
Full disclosure, I’ve never seen a therapist in person, so I have nothing to compare this experience to but I can say that this has been way less scary than I thought it was going to be.
Because, I mean, outside of the fear I feel thanks to my anxiety disorder, I also think most people would agree that it’s kind of uncomfortable to bare your most embarrassing stuff to a complete stranger.
That’s one of the best things about BetterHelp - you’re not just diving in, in-person and dealing with all of the social anxiety that comes from that. Instead, you have a level of control over the interactions and what you share, when.
9 Things I Love About BetterHelp Vs. Traditional Counseling
- You can proof-read your message before you send it to make sure you’re not just babbling and focus on the things that are really bothering you, like say, panic in the grocery store checkout line or feeling sad every time you get off the phone with your mom.
- Therapists only have a limited amount of time they can spend on you, online or not. Online gives you the advantage of spending your time together wisely.
- How easy it is to choose how I communicate with my therapist. I love that when I’m busy I can just email or chat with her and that during the duller, colder months we can video chat and it gives me good reason to do my hair that morning.
- I can switch counselors. I don’t WANT to switch counselors, but if I did, the option is right there in my platform, easy peasy. No calling up an office and cancelling appointments, no searching for a new therapist.
- The platform is customized to ensure you’re matched with a counselor who suits your needs and does all of the vetting for you. That means that instead of culling through Google trying to find a local therapist near my home who fits the criteria that’s important to me (female, non-religious, specializes in mood disorders) and then calling their office to see if they’re accepting new clients, BetterHelp does this for me in just a few minutes.
- I didn’t have to wait for an appointment. If I were seeking an in-person therapist, I might have to wait days to weeks to even longer to actually meet with one. That’s because I’d need to pick from the limited availability in my area and go by their schedule. The truth is, when I was looking for a therapist, it was because I really needed to talk to someone right then. Within just a couple of hours of signing up, I was talking to my therapist. What a relief!
- Using an online therapy platform ensures that there are checks and balances for your counselor. This is so cool to me. As stressful as the idea of a ratings and review system can seem, when it comes to the person aiding me in my mental health journey, I appreciate that they’re held accountable by a company whose name depends on the success and quality of their therapists. If I were to visit a private therapist locally, and felt like things weren’t working well for me or the therapist wasn’t high quality, or worse, somehow harmful, who could I even go to in order to remedy that? This is a way to receive help from therapists who are regulated and continually assessed.
- I have social anxiety! Having access to a therapist from a place where I feel comfortable is imperative to me actually following through with seeking therapy.
- They offer financial aid. If your income is under a certain level (likely dependent on your tax status in each individual state) you'll qualify for a subsidy. Personally, I get a discount of about $35 per week off from the original cost.
Now that I've been using the platform for a year, there's some stuff I don't dig about it, like:
- They really push surveys on you. I frequently receive surveys within the app asking me to review my therapist. I understand that this is an attempt to hold counselors accountable and measure whether or not they should be on the app at all and I think that's smart but I also hate the idea of people's jobs hinging on arbitrary surveys. The first time I was prompted to take one, the survey wanted to know if I'd been feeling down in the past two weeks. I had been, because of circumstances outside of my control. It seems like the platform could have used my answer to decide that my therapist wasn't doing their job properly when really they have no control over my mood, they can only encourage me to keep a healthy perspective.
- It's pricey. All therapy is pricey and I'm not going to get into my frustrations with the state of healthcare in America, however, with my particular disorder it's very helpful for me to see a therapist long term and BetterHelp won't take my insurance.
The Kind of Weird
As much as I appreciate BetterHelp and online therapy in general, there are drawbacks.
Here’s what you need to remember about seeing a therapist online:
- They can’t help you if you indicate that you’re suicidal. In this case, they’re going to direct you to your local emergency room. This is for your own safety.
- It’s not on-demand. Yes, you’ll receive way more communication than you would with an in-person therapist, but this is still not an on-demand service.
- An online therapist can’t assess your physical state. This might not seem important but I do believe that with some disorders, it’s good for a therapist to be able to assess your physical state to be able to give you the best help possible. Unless you video chat regularly, they won’t be able to see if you’re displaying weight loss or weight gain, if you look like you haven’t slept much recently or if you’ve bit your nails down ‘til they’re bleeding.
Frequently Asked Questions About Online Therapy
Is online therapy free and if not, how much does it cost?
No, online therapy isn’t free. I don’t know what other services cost, but through BetterHelp I’m paying a couple hundred per month for therapy. This is including a special discount based on my income.
Remember, an in-person therapy session will also usually be offered on a sliding scale and one session typically costs somewhere north of $100.
In my area, an in-person therapy session is around $95. So, considering this, I’m saving several hundred dollars per month by utilizing an online platform.
Is BetterHelp covered by insurance?
No, BetterHelp is not covered by insurance.
What is the Deal with Philip Defranco and BetterHelp?
Back in the fall of 2018 the teletherapy platform ran into controversy regarding their use of “celebrity” endorsements from YouTubers like Philip Defranco. These YouTubers would create sponsored (meaning they were paid by BetterHelp) videos about their experience with the service and some of what they said didn’t actually jive with BetterHelp’s terms of service, including that BetterHelp is not meant to treat complex disorders like Schizophrenia and Bipolar Disorder.
These terms of service also stated that the company could not guarantee a counselor’s abilities and this raised a lot of red flags. Here’s the thing, TOS are there to cover a company’s butt. It doesn’t mean there’s a bunch of quacks hanging out on the platform, it means BetterHelp’s lawyers put a lot of legal jargon into their Terms of Service.
Think of it this way, unlike with local in-person counseling, you can’t ask your friends if they’ve had a good experience with the counselor you’re thinking about seeing because BetterHelp matches you to a counselor (you don’t pick your counselor) and this counselor will likely be regional, not local. The wording of the terms of service protects them from complaints from users who don’t like the counselor they’re matched with.
What should you do if you don’t like your counselor?
Switch counselors. You can switch your counselor any time on the BetterHelp platform.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Questions & Answers
Question: What do I do if I don't like my BetterHelp therapist?
Answer: Switch therapists! You can do this for free on the platform. To do this do the following:
1. Login to BetterHelp (either from a computer or app).
2. Click your profile in the upper right corner (it will have your profile picture and name).
3. A drop-down menu will appear which gives you the "Change Counselor" option.
Question: My girlfriend has really bad anxiety, is it okay to suggest she see a therapist?
Answer: Yes, I think that's totally okay, as long as it's in a kind and helpful way and not in a way that makes her feel alienated from you. Suggest it in a way that shows you want to support her, not that you're trying to change or fix her. In my own opinion, everyone, including you, could benefit from chatting with a therapist every now and then, and I think this would be good to keep in mind when you approach your girlfriend.
© 2018 Em Clark
jennkesler on May 06, 2020:
Very informative article!
Personally, I prefer in-person sessions to online sessions. BetterHelp has been helpful for me when I didn't have the time or resources to find a long-term therapist.
Em Clark (author) on December 05, 2019:
To add - BetterHelp’s terms of service do not prohibit providers on the platform from diagnosing.
What it prohibits is providers diagnosing conditions that would warrant a physical exam. I understand this could be a gray area but conditions like GAD are easily assessed via psychological questionnaires and criteria met in the DSM-5.
Em Clark (author) on December 05, 2019:
Thanks for the insight, Roaming Seagull! It's all very interesting to take in and ponder. You seem to know a lot about the pay - do you mind answering if you're a former counselor?
To be clear, my father was diagnosed in a hospital with doctors after a nervous breakdown and his diagnosis has been confirmed and treated since then.
I agree, I think that being diagnosed remotely via BetterHelp or any other teleservice would garner a in-person visit for confirmation :)
Roaming Seagull on December 05, 2019:
Hi; I'm sorry to tell you this, but your counsellor, although attentive (which is not many people's experience), was unethical when diagnosing you. First of all, they are not allowed to diagnose anyone through the platform and the TOS state if you are given a diagnosis at any point, you should disregard it entirely. Instead, you are now telling your GP you suffer from GAD, your GP assuming you have been properly diagnosed and taking things from there.
Secondly, although you state your father wasn't diagnosed by a professional, your counsellor proceeded to enquire whether you had similar symptoms.That is incredibly unethical since she had nothing to go on but your suspicion. I understand you must have read a lot on the subject, but a professional would be more thorough than to take that for granted. Her superficiality can only be detrimental to you.
Regarding the company, it's renowned for treating its service users and counsellors equally poorly, while raking in the cash as the "middle man". If you read reviews from former counsellors there, they explain the abysmal pay, expectations to be unreasonably available, lack of support etc. Some have reported earning 30$ a week or less, while you pay on average 65$.
You may not know there is a pay cap once you and your counsellor have used up 7500 words each. Beyond that point, if your counsellor decides to keep supporting you, they are doing it for free (most however abandon the service user, who is very confused and can't understand why - well, this is why).
Nowhere do they advertise that there is a word limit of 7500 for you and 7500 for them (calls, video sessions and forms are counted as well with a standard number of words attributed to each). That can drive your counsellor to stop responding after that point, with you being none the wiser.
Of course the complaints are far more numerous (people being turned away after being charged and refunds taking a long time, repeated missed appointments, people being charged again and again after cancelling etc). What few know is that BH pairs people up with counsellors who state they have no more time available (hence the missed appointments). I assume there aren't enough counsellors available for everyone; BH resorts to this to keep them from cancelling, although they know for a fact those people will receive no help at all.
Sorry to be so negative; it's worrying to see people labelled with disorders in this manner.
Em Clark (author) on October 15, 2019:
This is an interesting perspective but I feel like without elaboration it's not totally helpful. I'd really like to know how BetterHelp is a scam. In my own experience I felt that they were forthcoming about the services they could provide as well as the services they couldn't provide and I felt that my therapist was capable and helpful.
I'm genuinely curious about any bad/unethical experiences on BetterHelp and won't say that they're incapable of that, even if that's not the experience that I had.
Yeahnoyeahso on September 22, 2019:
BetterHealth is a scam that practices bait and switch tactics, horrendous "therapists" and capitalizes on individuals suffering with mental health disorders. I've filed complaints w/ the FTC and FCC regarding my experiences with this company and I strongly urge others whom have been victims of BetterHealth's unethical business practices to do the same.
There are FREE mental health resources out there to find help, including hotlines and chat services that people can use that won't cost a penny.and are significantly better than Betterhelp's paid services. Here's a link with dozens of resources: https://www.healthyplace.com/other-info/resources/...
Ellison Hartley from Maryland, USA on October 09, 2018:
I see my therapist in person only every three weeks, I haven't found anyone else to work with that I can get in with more frequently. He gives me specific things to do and work on, I'm doing CBT also.
Em Clark (author) on October 07, 2018:
Ellison, I agree! It worked out that I connected with my therapist right away but there are still things that we don't have in common and I think that if I found a therapist with a similar background it would be beneficial. For now I'm happy to have someone to work on CBT with.
Ellison Hartley from Maryland, USA on October 04, 2018:
Great article! Really answers pretty much every question that I think someone might come up with about online counseling. I did better help before I started face to face counseling. Sometimes it just takes trial and error to find out what works best for each person. It can be hard to find someone you connect with on the first try!