Is text therapy right for you? Everything you need to know

Looking for mental health care? There’s an app for that — or, more accurately, several apps. Whether you're struggling with depression or anxiety or looking to improve your mental health generally, there is a wide variety of options to suit every need. 

In this article, we'll explore how text-based therapy works, examine its benefits and limitations, compare a few of the leading online therapy platforms, and help you determine if this increasingly popular form of mental health support is right for you.

What is text therapy? 

Text therapy, or messaging therapy, is an asynchronous and therapeutic way to access a mental health professional via a mobile device or computer. In simple terms, that means you don't have to wait until you have an appointment with your therapist to share with them or seek counsel. When you feel the need, therapeutic help is literally just a text away. 

Though you might be skeptical about whether or not an online therapy service is right for you, specifically when it comes to texting, research shows that text-based therapy can be just as effective as traditional face-to-face sessions for many people, offering a convenient and accessible way to get support when you need it most.

How does it work?

There are a number of text therapy providers available in the mental health care and online therapy market today, but they all generally work in the same way:

1. The platform will prompt you to answer questions about yourself, including about your history in therapy and any mental health diagnoses. The platform will use this information to choose a licensed therapist to pair you with.
2. Once paired with a counselor, you can send messages via the online therapy platform. In text therapy services, the bulk of your contact will be via the secure messaging service. Some platforms also offer the opportunity to connect with your therapist for video or phone calls. While most of your communication will be asynchronous, meaning you send a message and then wait a while (most providers set the response window upfront so that you know what to expect), you may also have the option to request a live chat session.
3. Some platforms offer a free trial, some run as a subscription, while others offer pay-as-you-go methods with different service tiers. These are determined based on the level of access you have to your therapist and how frequently you meet. Almost all plans include unlimited messaging, but some include weekly live sessions. It really depends on what each individual person is looking for.

What is the average price of text therapy? 

The price of text therapy varies by platform. On the low end, plans usually cost around $40 to $60 per week. Plans that allow for live sessions — whether by video or text — typically cost more. Most plans give the option of paying per week, per month, or annually, with a discount for longer commitments.

Often, online therapy services specifically for texting do not accept insurance. However, plans that include real-time, virtual sessions may be covered by insurance. Plans may also be HSA/FSA-eligible. You can check the details with the individual platform or with your insurance.

What are the benefits of text therapy?

Increased convenience

Text therapy is extremely convenient. If you have a device and a data connection, you can contact your therapist via texting. You’re not limited by geographic location, and you don’t need to commit to a certain schedule. If you're not gelling with your provider, you can always switch therapists.

Expanded availability

If your therapist has a full roster of clients, you may have to wait for an appointment. With text therapy, that’s not a concern. You can reach out to your therapist whenever you have something on your mind, or you have free time. 

It may be easier to open up

Because the therapy platform provides a degree of anonymity, some may find it easier to open up to their therapist. Writing itself can be therapeutic, so the act of communicating via text or even email may help make you feel better, even before you receive anything back from your therapist.

Unlimited communication

Unlike online therapy services with video calls, text therapy plans generally don’t limit your texting or how often you can contact your therapist. This is different from traditional therapy programs, which are typically limited to one or two visits a week.

What are the disadvantages of text therapy? 

It could feel impersonal and static 

Because all of the hallmarks of face-to-face communication (including inflection, voice, eye contact, and body language) are missing, text therapy can feel impersonal. It can take a long time — if ever — to develop rapport with a therapist you never see. 

Similarly, therapists are trained to use all subtle signals of body language, inflection, and reaction to guide their interaction with a client. Therapy is typically a dynamic, relationship-based treatment. 

Could be costly 

Message-based psychotherapy usually isn’t covered by insurance. While traditional therapy sessions are actually more expensive, since many therapists accept insurance, you are often not responsible for the majority of the cost. Because of that, the out-of-pocket expense for text therapy or an online therapy service (depending on the platform) can be considerably higher than that of traditional psychotherapy.

Delayed response

It's true that you can reach out to your therapist at any time — but that doesn’t mean that you’ll hear back right away. Your therapist is not sitting by the phone waiting for your text 24-7. If you send a text message at 3 a.m., you probably won’t get a response until normal business hours resume. The response you experience may feel closer to the schedule of a traditional therapist. That may not feel like enough responsiveness and engagement, especially if you need immediate support or are in crisis.

Limited application

Text therapy is only appropriate for mild stressors and conditions. If you’re having a mental health emergency, like an anxiety or panic attack or thoughts of self-harm, text messaging won’t be able to help you as quickly as you might need. You’ll need a “backup” support system on standby for situations where you need immediate help. Though the Crisis Text Line provides emergency support via message, if you've needed immediate intervention in the past or currently feel this way, text therapy might not be the best therapy option for you. 

Therapy vs coaching

When it comes to therapy versus coaching, there are some overlaps. But generally, they serve unique purposes for unique needs.

When it comes to mental health support, understanding the distinction between therapy and coaching is crucial. Therapy is provided by licensed mental health professionals who treat diagnosed mental illnesses and past trauma, while coaching focuses on building mental fitness and achieving forward-looking goals like career growth and stress management.

While both aim to create positive change, they serve different purposes. With this said, it's good to take some time and really dive into whether you're in need of therapy or would benefit more from coaching. There also is a world where people do both!

Is text therapy right for you?

There’s no doubt that text therapy is convenient and may seem easier to get started with or less intimidating. But that doesn’t mean it’s the right modality for everyone.

When choosing a therapist, it’s important to take the time to find the right person on the right platform that suits both your needs and your lifestyle. Here are some clues that text therapy might be a good fit for you:

• You’re always on your phone or computer
• You’re too busy to commit to a regular meeting time
• You’re comfortable with expressing your emotions and feelings in words
• You have regular access to a device with a data connection
• You’re comfortable with the cost
• You're looking to dip your toe into therapy and see how it feels
• You don't need psychiatry or medication management

Even with traditional therapy options, though, it’s possible for you and your therapist to not be a good fit. If text therapy doesn’t work out, it could be a mismatch in the platform or practitioner. Or it could be the format itself.

Here are some ways that you know text therapy is working well for you:

• You feel better after communicating with your therapist
• You use the platform regularly
• You refer to your therapist by name
• You are intentional about check-ins with your therapist
• You feel that you’re making progress
• You have more insight into the original concerns that brought you to therapy
• You tell other people about the impact that the platform has had on you

In short, if the platform’s making a positive impact on your life, then it’s working for you — and worth the investment of both money and time.

13 questions to consider when choosing an online therapy platform

With numerous online therapy platforms available with texting options, making the right choice for your mental health needs requires careful consideration. Before committing to any service, there are several key questions you should ask yourself and the provider to ensure you're making an informed decision that aligns with your wellness goals and personal circumstances.

1. What are my specific mental health needs, and does this platform have therapists who specialize in treating issues like anxiety, depression, or other mental health conditions I want to address?
2. How quickly can I expect responses to my text messages from my therapist, and what is their typical response time during weekdays versus weekends?
3. Does the online therapy platform accept insurance from my provider, or will I need to pay out of pocket and seek reimbursement? (Can I use my FSA or HSA funds?)
4. What is the pricing structure for therapy sessions, and are there different service tiers for text-only versus more traditional virtual therapy?
5. Am I able to add on video sessions if I feel I want/need to?
6. What are the therapists' credentials? Are they licensed? And how does the platform verify their licenses and qualifications?
7. What security measures are in place to protect my privacy and text messages with my therapist?
8. Can I switch my mental health provider easily if I don't think my first therapist is a good fit?
9. Besides text messaging, what other communication options are available (video calls, voice messages, live chat)?
10. How does the platform handle mental health emergencies or crisis situations?
11. What is the cancellation policy, and how easy is it to pause or stop therapy sessions if needed?
12. Does the platform provide additional mental health resources beyond one-on-one therapy sessions?
13. Is the service accessible across different devices and operating systems?

Other mental health support options 

If text therapy doesn’t seem like the right fit for you, there are other virtual options out there. Some digital and online therapy options include:

Video counseling

Meeting with a counselor via a video conferencing platform can feel very similar to an in-person session. An online therapy service, or what is known as teletherapy, preserves much of the face-to-face experience and allows you to video chat with your therapist in real-time. Most online platforms are HIPAA compliant, so your video sessions are secure.

Video offers some of the benefits of improved accessibility and convenience, as well as offering a bit of distance that can make some people feel safer or more comfortable opening up. In addition, video therapy gives the therapist more information to work with as they can pick up more of the non-verbal cues. Both therapist and client benefit from a real-time exchange that enables thoughts and reactions to flow more freely.

Group counseling

Therapy groups are usually small groups (about five to fifteen people) that one or two licensed therapists lead. This form of therapy is often offered to complement individual therapy, although it is possible to experience benefits from group therapy alone. Like support groups, group therapy can help treat disorders related to social connection. This might include social anxiety, loss, eating disorders, or low self-esteem.

Support groups 

Support groups are spaces for people going through a similar experience to connect with and help each other heal. They were traditionally in-person, but the format can be translated into virtual experiences as well, either in real-time or asynchronously.

Usually led by a trained peer instead of a clinician, support groups have a long track record and are immensely effective. People often rely on their support groups when, due to trauma, they have trouble relating to the people in their lives. This might include depression, loss of a family member, infertility issues, or addiction.

Sliding scale therapy

Many gravitate towards text therapy because it’s available at a set rate, even to those who don’t have insurance. However, if you’d rather meet with a therapist face-to-face (even if virtual), text therapy isn’t your only option. You can always contact a practitioner who is willing to charge on a sliding scale. This can make the cost of in-person therapy much more manageable, even without the help of insurance.

Emergency services

One of the main drawbacks of text therapy is its limited use in emergency situations. If you find yourself in need of immediate mental health treatment help, you can reach out to one of several emergency support services. The Crisis Text Line and National Suicide Prevention Hotline provide free, on-demand services no matter where you are.

3 text therapy platforms to consider

For whatever reason, if texting a therapist through an online therapy platform sounds like the type of therapy for you, below are three of the more popular text therapy platforms available and some information about each service. Below, we'll cover a few of the more popular online therapy services that offer text therapy: BetterHelp, Talkspace, and 7 Cups.

BetterHelp 

According to Forbes Health, BetterHelp is their top pick for an online therapy platform that offers text therapy if you're looking for a vast pool of therapists to choose from. 

Pros

• A vast network of licensed therapists to choose from

• Offer both text therapy and video therapy sessions

• Accepts HSA/FSA under most providers

Cons

• Not available for children

• Can take a few days to match with a licensed professional

• Does not offer psychiatry services or medication consults

Talkspace

Forbes Health rated Talkspace as another one of its top picks for mental health services, rating it #1 for having the best options for plan variety.

Pros

• Text-only therapy options with licensed therapists are reasonably priced

• Ability to send audio and video messages as well

• They provide medication management and psychiatry services

Cons

• They have a low Trust Pilot rating

• Can text your provider whenever you like, but might not get a response during busy days

• Can't pick your provider

7 Cups

If you're looking not to spend much money or don't have the option of using insurance of FHA/FSA funds, Forbes Health rated 7 Cups as the best text therapy online platform when it comes to best value.

Pros

• BBB-accredited

• Can choose your therapist 

• Has apps for Android and iOS

Cons

• Only take insurance from one company, and it is unclear whether they accept FSA/HSA

• The website can be confusing and difficult to navigate

• Only available for ages 18 and up

There’s no wrong way to reach out

Text therapy has changed many people's lives by making it easier to connect with a therapist through online therapy. If it helps you access mental health support or makes therapy seem less intimidating, try it out.

For many people, some connection with a therapist is better than no connection, and having a prompt and structure to reflect and begin processing thoughts and feelings can be helpful. The thoughtful, self-paced nature of text-based therapy provides a comfortable space to work through their mental health journey.

If, after reading about text therapy, you feel it might not be exactly what you're looking for, coaching could be a better fit for what you need right now. Working with a BetterUp Coach can help you find your passion and purpose.