Charlie, a 21-year-old from Maryland, was in the midst of a painful break-up. She was struggling to find an in-person therapist, so when she saw ads on her feed for BetterHelp — an online counselling platform with over 23,000 therapists — it felt like a reason to be hopeful. After being matched with a therapist within just over a day, she was relieved. However, these feelings quickly evaporated in her first session.
Things got off to a bad start when the therapist showed up seven minutes late to the session. From there, it only got worse. “About ten minutes into the call (17 minutes after it was supposed to start) he got a phone call,” says Charlie, “to my shock, he answered it while on our call and did not mute himself or anything.” He proceeded to talk on the phone for five minutes before returning to their session.
The therapist then started advising her to “seek attention from other males”, while also remarking on her appearance. “He made numerous comments about me being pretty, making me very uncomfortable.” After the session, Charlie says she felt even more lost than before. “It honestly just blew me away – like, how could this even happen?”
While Charlie’s account is shocking, there are countless stories of people who say they have been met with inadequate — and in some cases harmful — therapy via BetterHelp and similar platforms. When the pandemic shifted in-person doctor visits online, therapy apps like BetterHelp, TalkSpace and 7 Cups saw a huge surge in users. With mental health services stripped to the bone, these apps seek to plug the gap by marketing themselves as a cheaper and more accessible option. Advertising for BetterHelp, in particular, is virtually inescapable, with the company deploying an army of influencers to promote its product and, perhaps most controversially, partnering with Travis Scott in the wake of the AstroWorld disaster to offer those affected a month of free therapy — a move widely labeled as exploitative.
A BetterHelp spokesperson told i-D: “BetterHelp provided free support to those affected by Astroworld tragedy, as we did in other traumatic situations, such as the California wildfires and Hurricane Dorian. This was not a brand deal or sponsorship, and Travis Scott was not compensated in any way.”
More recently, people have been sharing their experience of therapy apps on TikTok, often stitched with a clip originally posted by @mojojojokes, in which she poses the question: “How long till there’s a true crime documentary about BetterHelp?” From therapists having their identities stolen, to a client with an eating disorder being congratulated by their therapist for losing weight, there is a seemingly endless stream of horror stories emerging from these platforms.
A number of people I spoke to describe being assigned totally unsuitable therapists after filling out BetterHelp’s questionnaire, which is intended to ‘match’ people with therapists. Kat, age 28 from Miami, says that she specifically stated in her questionnaire that she was looking for help escaping an abusive relationship and needed a therapist who specialises in trauma. She was assigned a therapist, and by her third session, Kat brought up the fact that her boyfriend was trying to convince her to be in an open relationship — despite her not wanting to be in one. At that point the therapist “flipped”, Kat says. “He cut me off and was like, ‘Don’t kink shame people, just because non-monogamy might not be for you’.”
“It made me question my whole experience,” Kat says, “I was like, am I wrong? Is this my fault?” She later realised this person wasn’t a therapist, but a social worker. “It felt like false advertising,” Kat says, adding: “He shouldn’t have been working with me.”
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Other users report therapists showing up late — like Charlie’s therapist — or in some cases, not turning up at all. “I messaged 15 minutes before the session, and got no response,” Meg, a 21-year-old from Kentucky, says. “I joined the chat room, no response for another 20 minutes. And then [the therapist] messaged me on the BetterHelp app and was like ‘Actually, our appointment is scheduled for tomorrow’.”
When Meg sent her therapist screenshots proving that she was in fact right about the timing of the session, the therapist blamed it on a “technical error”. “That just felt like gaslighting to me, because I know for a fact that I scheduled this correctly,” Meg says, “so I highly doubt that it was a technical issue.” Kat was similarly left confused and hurt after the second therapist she was assigned by BetterHelp ghosted on their second session. Meg and Kat both complained to BetterHelp, and were offered a discount for future sessions, despite having asked for a full refund.
A BetterHelp spokesperson told i-D that “any suggestion that therapists operating on the BetterHelp platform are somehow less responsive or less professional than traditional therapists is deceptive”.
In a now-deleted viral TikTok, Jeff Guenther, a counsellor based in Portland, explained how BetterHelp allegedly shortchanges therapists. “Most BetterHelp therapists get paid $20 to $30 dollars an hour,” says Jeff in the video, “usually we’d be getting over $100 in private practice”. Therapists are self-employed, meaning they are not given sick pay or other worker protections. (A BetterHelp spokesperson told i-D that they pay “licensed therapists above the median compensation in many metropolitan areas. In addition, our therapists are paid in accordance with their engagement with our users and therefore, their hourly pay can vary accordingly.”)
This is a phenomenon Dr Elizabeth Cotton, an academic writing about mental health and therapeutic work and founder of Surviving Work, has termed the “uberisation” of mental health services. She argues that it is impossible for therapists to create safe relationships under these working conditions. “It’s easy for the conversation to flip into blaming the therapists for not being qualified enough,” Elizabeth says. “But the issue is that they’re insecure workers — much like Uber drivers. She adds that the therapists “may potentially be excellent” but conditions like these hamper their ability to provide care to every individual patient.
“You’re relying on the individual paying for supervision out of their own money to make sure they’re safe to practise,” Elizabeth continues, “when you’re getting half the standard hourly rate, you’re unlikely to just spend all of it on supervision.”
The texting service that apps like BetterHelp and TalkSpace offer — which mean that clients can essentially message their therapists whenever — has also been criticised on social media. As Jeff explained in his TikTok, therapists are only paid for a certain word count; they are not paid for any conversations with clients that go beyond that wordcount.
What’s concerning is that these experiences could stop people seeking out help again. Kat hasn’t returned to therapy since her BetterHelp sessions, citing lasting “trust issues” with therapists. “The second therapist I worked with is no longer on the BetterHelp platform, and I’m sure that she just got burned out and one day said, I’m fed up — but that obviously had a terrible effect on me.”
“Where is the duty of care in these online therapy providers? I think that’s very unclear,” Elizabeth agrees. “They’re promising something which doesn’t exist in the therapeutic world, which is therapy on demand.”