Pros & Cons

In an attempt to provide greater access to therapy resources for this age range, online therapy company BetterHelp created Teen Counseling, a subsidiary aimed at helping young adults and their parents navigate challenging times. Telehealth platforms such as Teen Counseling were developed to give young adults (and their parents) access to licensed therapists anytime, and anywhere.  Whether you’re a teen seeking help or a parent searching for a way to help, Teen Counseling’s goal is to provide what is needed whenever it is convenient. After reviewing the data provided by our survey of 105 users, speaking to experts, and conducting my own research into online therapy platforms, I decided that the best way to gauge how successful Teen Counseling might be was to put it to the test. I asked my 13-year-old to try the platform and see if Teen Counseling lives up to its promises. 

What Is Teen Counseling?

Teen Counseling is a teen-focused telehealth service that lives under the BetterHelp umbrella.  BetterHelp co-founders Alon Matas and Danny Bragonier thought that by connecting licensed therapists with those seeking mental health services through an online platform, people seeking assistance could get it more quickly than via local, in-person therapy services. The Teen Counseling branch of BetterHelp caters to teens aged 13 to 19 and their parents. While teens don’t necessarily need parental engagement to be successful with therapy, parental involvement and support may prove invaluable, especially in younger teens.  BetterHelp has weathered some criticism, most notably around data protection. Recently, the Senate asked BetterHelp to provide details about how it secures user information after allegations of possible data mining. Furthermore, I found online complaints about billing issues and a lack of customer support. Since BetterHelp is the parent company, these complaints and issues are relevant for Teen Counseling users.

What Services Does Teen Counseling Offer?

Teen Counseling provides talk therapy in every U.S. state for teenagers 13 through 19, as well as parents of teens. You can receive individual therapy or do family therapy with your teen or parent.  Teen Counseling therapists use various treatment modalities detailed in each therapist’s bio. Once a therapist is assigned, you can see which methods they use. Unfortunately, the website doesn’t provide a comprehensive list of modalities. However, some common treatment methods used in teen therapy include cognitive behavioral therapy, acceptance and commitment therapy, and mentalization-based therapy. Therapy sessions at Teen Counseling are conducted via video, audio, or live chat and last approximately 30 to 45 minutes. They take place through the company’s website or the app. 

Who Is Teen Counseling For?

Teen Counseling seeks to assist teens with some of their most pressing issues and concerns, including:

AngerAnxietyBullyingCoping skillsDepressionEating disordersGender identificationSelf-esteemSexualityStress

Teen Counseling is not a platform for those experiencing suicidal thoughts. The footer on every page includes a link to resources for emergency assistance should someone be experiencing a mental health crisis. Every communication I exchanged with someone at Teen Counseling also contained this information. In our user survey, 60% of respondents indicated that anxiety is what prompted them to sign up with Teen Counseling. The survey did not differentiate between teen and parent users.

How Much Does Teen Counseling Cost?

Unlike some competitors, Teen Counseling only offers one subscription plan for therapy services. The cost ranges from $60 to $90 per week, depending on your state and the provider’s qualifications. Teen Counseling bills each month in advance. A subscription to Teen Counseling allows you to exchange messages with your therapist at any time, in addition to your one weekly live video, audio, or chat session. The session prices are lower than the average cost of face-to-face therapy, which averages between $100 and $200 for a one-hour session. However, of the users who discontinued treatment with Teen Counseling, 17% reported their decision was associated with the cost.

Does Teen Counseling Take Insurance?

No, as of November 2022, Teen Counseling does not take insurance. However, you can use FSA or HSA accounts for payment.

Does Teen Counseling Offer Discounts?

Teen Counseling offers a reduced cost if you qualify for assistance. The financial aid questionnaire generates at sign-up. From what I could see, veterans and their families may qualify automatically. I reached out to the company for more details and was told hardship was determined on a case-by-case basis.  I didn’t find any other Teen Counseling promotional rate or discount.

The Teen Counseling homepage is easy to understand and navigate, with a cool color palette in shades of blue.  Below this main banner is a series of photos of therapists, as well as the specialties of Teen Counseling’s network of providers. Right underneath this short snippet is another green button urging users to get matched with a therapist. This will also take you through the sign-up process.  If you continue to scroll down the homepage, you will get a brief three-step explanation of how the service works and another green “get matched” button. Below this and the note that Teen Counseling is a part of BetterHelp, “the world’s largest therapy service,” are three scrolling tickers representing user data: Messages, chat, phone, video sessions; licensed therapists; people helped. There are no links for Teen Counseling’s social media pages. I found the company on Facebook, where it had very few followers and reviews. I didn’t find it on Twitter or Instagram. 

Does Teen Counseling Have an App?

Teen Counseling offers an easy-to-use app for iOS and Android devices. The app gives users full access to the portal, just like the website. Here, subscribers can participate in live video, audio, and chat sessions. The app also allows you to view your schedule, use your journal, and complete homework.

How Do You Sign Up for Therapy at Teen Counseling?

The Teen Counseling site does an adequate job of gathering information during sign-up. I chose to go through the process as a parent seeking help for my teen. One thing about sign-up I didn’t like: If you hit the back arrow at any time during the process, you have to start over. After filling out basic questions, such as my name and email address,I was asked whether my teen had experienced any of the following over the past two weeks:

Panic attacks, anxiety, or phobiasOverwhelming sadness, grief, or depressionA loss of interest in normal activitiesBeen violent or had violent outburstsTrouble concentrating on things Feeling down, hopeless, or depressed 

The site then asked whether my child ever expressed suicidal thoughts. Next, I got to express any concerns I found relevant regarding:

Family relationship dynamicsIssues with friends/peersTrouble coping with changes in lifeAttention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD)Challenges in schoolProblems with breaking the lawAbuse and use of substancesIssues with sexuality

After this, the site brought me to the financial aid determination: 

StudentMilitary veteranDisabledUnemployedEmployed, but low income Finances impacted by COVID-19

A note on financial aid: I spoke with someone at the help desk who said everyone should apply for financial assistance, since it provides a sliding scale for payment and may make therapy more affordable. I then was asked to provide payment information and received an email stating that I would be matched with a therapist within two days.

Matching With a Therapist

It took a day for Teen Counseling to match my teen with a therapist. I then had a message from the therapist on the website. All communication and therapy sessions are conducted through a personal portal. The message from the therapist related directly to the information I provided. I was pleasantly surprised it was that personalized at this stage. I booked the first video session for my teen through the calendar system. His therapist and I continued to exchange messages about any concerns I had regarding my teen’s mental health and any background information that might aid in her treatment plan. The portal also contained a journal feature with daily prompts. My teen could fill these out and keep them private or share them with the therapist. As he began therapy, the provider would upload homework sheets into the portal for him to complete. Even though you cannot choose your own therapist at Teen Counseling, our user survey data showed that 76% of respondents felt their needs were met by the therapist they were matched with by Teen Counseling. This data doesn’t specify whether this was their initial provider match or a subsequent one.

How Do Therapy Sessions Work at Teen Counseling?

Therapy sessions can take place via live chat, video call, or phone. Parents can choose to attend with their teen, have them meet with the therapist alone, or schedule an individual session for themselves.  For individual sessions, Teen Counseling will send a link you can use to join the session to just the parent or teen. 

Messaging Your Therapist

The Teen Counseling portal hosts every interaction with the therapist, including messaging. Our provider sent messages at various intervals, including the weekends. I got an email and text anytime the therapist sent a message through the portal.  Teens may be more receptive to text therapy since they grew up texting, so it’s a comfortable form of communication. It’s also less confrontational than video or phone calls, so they may feel like they can open up more.  Although I created the account, I could link my teen to it. The system sent him a text and email giving him access to the portal but created a dedicated room for his exclusive use. This allowed our respective messages with the therapist to remain confidential, a practice that could help build trust between skittish teens and providers.

Video Sessions

My teen’s first therapy session was scheduled to be a video session, however, we could not make the technology work. After trying for 20 minutes, the therapist converted it to an audio session. I appreciated that the session was extended by 20 minutes to give us the full 45 minutes. My teen could only get a video session to work through the Teen Counseling app on my phone. He reported no issues when doing it this way.

Audio Sessions

The audio session my teen participated in worked well. The therapist initiated the call through the portal on my laptop. My teen said it was effective and easy to use. Audio therapy sessions may not feel as effective as video sessions, because your therapist can’t read your body language, and therefore may miss important aspects of what you’re imparting to them. That said, some teens may appreciate audio sessions because they can feel less self-conscious, which may, in turn, make them more open and receptive to treatment. 

Live Chat Sessions

A live chat session acts like a video or audio session, except all of the exchanges are done via messaging. My teen had one live chat session and used the app to send and receive messages in real time with his therapist. The live chat session took the place of an audio or video chat for that week and lasted the standard 45 minutes.  I can appreciate how this method provides an extra measure of privacy. This was my teen’s least favorite therapy method, mostly because he doesn’t type as quickly. However, he still found it beneficial.

What Happens If I Miss a Session at Teen Counseling?

Teen Counseling requests 24 hours notice if a counseling session needs to be canceled. I didn’t see any information about a missed-appointment fee, only that giving the therapist notice frees up that time for another user. However, there is no make-up credit to use if you cannot make a therapy session one week. Since the company charges on a monthly basis, you lose any sessions you don’t use.

Switching Therapists at Teen Counseling

After three sessions, we switched therapists. It was a simple process, initiated under the drop-down menu in the portal under my name. Once I clicked the “Change Therapist” link, the site prompted me to rate the current therapist and gave me a list of preferences for a new therapist, including gender, age, sexuality, religion, ethnicity, and race. I didn’t have these choices at sign-up and would have preferred them at that time as well. It took about a day to match with a new therapist. When we switched therapists, all correspondence in the portal was erased, including the homework. I would have appreciated the subsequent therapist having access to those since I had to repeat my concerns and background information. While I can understand that some users want a fresh start with a new provider, I do think the site should give the option to transfer the records or delete them. After a session with the second therapist, my teen declared he enjoyed working with the first therapist better than the new one. Part of this was the rapport the original provider built with him. I contacted Teen Counseling to find out if we could return to the original therapist and were told that we could as long as that provider had time.

Pausing or Canceling Therapy at Teen Counseling

Canceling therapy through the Teen Counseling portal is easy and quick. We found the cancellation option in payment options and account settings in the drop-down menu. When I clicked “cancel the subscription,” the site asked if I wanted to change my membership subscription.  The new option would allow us to pay $95 per week for the same services. The difference between this and the original plan is that this one is not a monthly commitment and allows users to remain in therapy, but attend fewer sessions. It’s an excellent plan for those who don’t need weekly sessions or can’t afford them. This alternative might be a good one for those looking to check in with their therapist once or twice a month. I was also asked if I resubscribed whether I’d want to return to the same therapist.

Quality of Care and User Satisfaction

With the rate of self-harming behavior on the rise in teens across the board, having access to a licensed therapist can help de-escalate mental health issues. Parents like me might wonder whether an effective therapist-client relationship can be forged online. I asked a subject matter expert, Amy Marschall, PsyD, whether it was possible to establish a favorable online relationship. “Good rapport is possible in digital or telehealth settings,” she says. “For some clients, this method of service isn’t the best fit, but for most, they are able to establish rapport as well as they would in an in-person setting.”  This may be truer for teens since they have been using smartphones to build online relationships for years. Our user satisfaction survey indicates that 80% of Teen Counseling users were between 13 and 24 years old, and for 25% of users, it was their first time engaging in any therapy. Another 24% said they made the switch to virtual during the pandemic shutdown.  I also asked Dr. Marschall about her thoughts on parental involvement in teen therapy. She agreed that some support from parents might aid in improving a teenager’s mental health situation, but it is not a critical component. She went on to say that “especially for older teens, it’s possible that individual therapy without parent involvement is more appropriate. It depends on their presenting problem, comfort level with parents being involved, and personal preference.” Teens may open up more with a counselor if they know that their confidentiality is being maintained. The exception to this, Dr. Marschall notes, is if a teen expresses suicidal thoughts or reveals abuse. In these cases, parents or guardians may need to be brought into the picture. My teen willingly shared what happened in his therapy sessions. He said he enjoyed talking to his therapist and that she was giving him “a different way to look at things” that he hadn’t thought about before. He indicated that he wanted to keep engaging in therapy using the Teen Counseling platform even after this review was complete. And he is not the only user to feel this way. Data from our survey revealed that 76% of Teen Counseling users felt that all or most of their needs were met by the therapist they were matched with, and 85% reported that their therapist’s qualifications were excellent, very good, or good  Overall, 85% of survey respondents had a positive experience with the Teen Counseling platform as a whole. 72% of users said they were very likely or likely to recommend Teen Counseling to others, and 53% who had left the service indicated that they would return if necessary

Privacy Policies at Teen Counseling

It is easy to locate Teen Counseling’s privacy policies on its website. The company has also done an excellent job at making them easier to read. Since medical and other sensitive information is at stake, users should have a good understanding of what the company does with data. With the scrutiny surrounding how companies such as BetterHelp protect their users’ sensitive information, it is crucial that the privacy policy explains what the company does and doesn’t do with users’ information. Teen Counseling abides by federal HIPAA regulations when it comes to medical information. Counseling and therapy fall under these protections, so Teen Counseling doesn’t share your interactions with a therapist on its platform with anyone outside of it. You may agree to allow an internal review team to look at your messages to ensure therapists are performing as expected. Outside of that, your interactions remain private. When it comes to collecting data, Teen Counseling does this to enhance the user experience with the site, and make suggestions on additional services. However, users can opt out of these internal marketing emails at any time. The data that the company processes is for specific uses within the site. These are outlined in more specificity in the Privacy Policy under the “Why do you collect and process my data?” That said, considering Teen Counseling is part of BetterHelp, and BetterHelp’s been under fire for inappropriate data sharing of late, it’s best to check these policies with your provider if you’re concerned about privacy.

Teen Counseling vs. Its Competitors

With 85% of users rating the site excellent, very good, or good overall, Teen Counseling seems to be succeeding in a market inundated with telehealth options. Talkspace is a direct competitor of BetterHelp/Teen Counseling. While Talkspace doesn’t have a dedicated website for this demographic, it does offer counseling services to teens. In our user survey, Talkspace edges out BetterHelp and Teen Counseling, with 90% rating the site excellent, very good, or good overall. Talkspace also offers promotional rates and accepts insurance, which may tip the scales in its favor for some users. I am in the unique position of having another teen who tried Talkspace. Her biggest complaint was that she didn’t feel like either of the therapists she talked to were very personable. The sessions were shorter—30 minutes, compared to Teen Counseling, where my other teen had 45 minutes with his therapist. Finally, as a parent, I appreciate having the option to participate on the Teen Counseling website. Talkspace didn’t offer any kind of option for parents to be involved. However, the user survey data does favor of Talkspace in some areas. When asked if they would be still using the platform in six months, 50% of Talkspace users indicated they were very likely or likely to be, while only 30% of Teen Counseling users thought they would. But, when looking at the breakdown of ages using the two services, Teen Counseling clocks in at 80% of users between the ages of 13 and 24 compared to Talkspace with 55% in this same age range. Obviously, this makes sense since the primary target for Teen Counseling falls between 13 and 24. It may also be a factor in the results of the user survey data.

Final Verdict

Telehealth companies such as Teen Counseling promise to fill a void in the mental health system by making it easier to establish a rapport with a licensed provider from anywhere. For teens and their parents, this may prove especially critical in helping to diffuse a worsening mental health situation.  While it is unfortunate that Teen Counseling doesn’t allow users to use health insurance benefits, it does try to keep the cost of sessions down, including financial hardship calculations. Based on my teen’s experience and my own, I believe Teen Counseling succeeds in providing help to an age group in need.

Methodology

To fairly and accurately review the best online therapy programs, we sent questionnaires to 55 companies and surveyed 105 current users of each. This allowed us to directly compare services offered by gathering qualitative and quantitative data about each company and its users’ experiences. Specifically, we evaluated each company on the following factors: website usability, the sign-up and therapist matching processes, therapist qualifications, types of therapy offered, the service’s quality of care, client-therapist communication options, session length, subscription offerings, client privacy protections, average cost and value for money, whether it accepts insurance, how easy it is to change therapists, overall user satisfaction, and the likelihood that clients would recommend them. We also signed up for the companies in order to get a sense of how this process worked, how easy to use the platform is, and how therapy takes place at the company. Then, we worked with three subject matter experts to get their expert analysis on how suited this company is to provide quality care to therapy seekers.