The 10 Best Online Couples Therapy Services We Tried and Tested in 2024

We had six people from four different locations (New York, Ohio, South Dakota, and the United Kingdom) test out ReGain’s couples counseling services, both with and without their partners—and overall, our experience was positive, with ReGain’s flexibility standing out to us the most.

We found it easy to schedule therapy sessions at all different times of the day, from early morning to mid-day (on our work lunch breaks) to in the evening after work. We could schedule sessions on weekends with some therapists, and one of our therapists was even willing to accommodate appointment times not listed on their schedule upon request. In addition, the company also allowed us and our partners to access our therapy sessions from two different locations, making it even easier for us to use its services. After being assigned a therapist, we had the option to select that therapist or to request someone else; this flexibility was important when choosing a provider because it allowed us to keep searching until we found our best match.

There are a few things to consider before trying ReGain, though. First, ReGain offers messaging for both partners in a shared "room," in addition to live sessions—this means that whatever you write to your therapist in the room is visible to your partner. We found this to be uncomfortable, and it discouraged us from using this chat function. In addition, live sessions range from 30 to 45 minutes long—and we did not feel this was an adequate amount of time for a couples therapy session. Something else to keep in mind is that ReGain uses location-based surge pricing. This means that the exact fee will vary based on your location, your preferences for the type of therapist you’d like to work with, and the demand for therapists in your area.

• Insurance Accepted: No, and does not accept payment through flexible spending accounts (FSAs) or health savings accounts (HSAs)
• Subscription Required: Yes
• Out-of-Pocket Costs: $65 to $90 per week, billed on a monthly basis

We surveyed 100 users of ReGain:

• 87% rated ReGain as very good or excellent overall
• 93% rated their therapist’s qualifications as very good or excellent
• 98% said that most or all of their needs were met at ReGain
• 98% are likely or very likely to recommend ReGain to a friend or someone like them
• 28% were seeking couples counseling, 18% were seeking marriage counseling, and 7% were seeking premarital counseling

We asked eleven people to test Talkspace for us. Of those, three specifically tried Talkspace’s couples counseling services from Indiana, New York, and California—and overall, we were pleased with the services we received. The video sessions can be scheduled by either partner, and we were pleased to find that we didn’t have to be in the same physical location to join our session—so we entered our therapy room on different devices.

We could choose from video, audio, or live chat sessions, and our talk therapy sessions varied in length from 30 to 45 minutes during our testing, though most tended to be 30 minutes. We thought that this was a bit short for two people to talk—especially if you’re dealing with a difficult issue in your relationship. However, if you have a jam-packed schedule or you’re dealing with less serious issues in your relationship and/or looking for advice to make it better (say, looking for tips to improve communication, as we were), the shorter sessions work.

Although we were often pleased with the therapists we were matched with in this process, it wasn't the case every time. There was one instance of a therapist having technical issues and signing off early and another therapist not asking many questions or offering guidance. However, we found other therapists were warm, supportive, and invested in our growth.

We appreciate that Talkspace is a very versatile therapy company so even if you’re primarily interested in couples therapy, you can also find help for yourself outside your relationship. In addition to its individual therapy plans, you can also add on psychiatry services if you want and/or need them. This is a highly unusual option when it comes to companies that offer couples counseling, and we appreciate the ability to include this service if we choose to, making Talkspace truly a one-stop shop for a busy person with a variety of therapeutic needs.

• Insurance Accepted: Currently accepts Aetna, Optum, Cigna, Carelon, and Regence health insurance plans. It also accepts payments through HSAs and FSAs.
• Subscription Required: Yes for therapy; no for psychiatry services
• Out-of-Pocket Costs: Couples therapy is $436 a month ($109 per week) for four live sessions; medication management (psychiatry) services are priced per session, with the initial session costing $249 and follow-up sessions costing $125 each. Individual therapy plans range from $69-$109 a month.

We surveyed 100 users of Talkspace:

• 92% rated Talkspace as very good or excellent overall
• 89% rated their therapist’s qualifications as very good or excellent
• 100% said that most or all of their needs were met at Talkspace
• 97% are likely or very likely to recommend Talkspace to a friend or someone like them
• 8% were seeking couples counseling, 4% were seeking marriage counseling, and 2% were seeking premarital counseling

• Insurance Accepted: No, but a superbill can be provided to try to seek reimbursement through your provider.
• Subscription Required: Yes
• Out-of-Pocket Costs: Couples therapy is $440 per month ($110 per week) for weekly 45-minute long sessions, unlimited messaging, and virtual coping tools and resources. The company is currently offering 20% off your first month of services, making the price of couples therapy $88 per week. Individual therapy plans range from $50 to $110 a week.

We surveyed 100 users of Online-Therapy.com:

• 89% rated Online-Therapy.com as very good or excellent overall
• 88% rated their therapist’s qualifications as very good or excellent
• 97% said that most or all of their needs were met at Online-Therapy.com
• 100% are likely or very likely to recommend Online-Therapy.com to a friend or someone like them
• 7% were seeking couples counseling and 6% were seeking marriage counseling

When we tested the Gottman Referral Network directory, we started our search with some specific filters: We were looking for a therapist who accepted our insurance, could treat anxiety, and offered individual counseling as well as couples therapy. Even within these particular parameters, we were given 30 different therapists as options—which made us confident in the Gottman Referral Network’s ability to connect us with a provider who would suit our needs. In fact, we were able to find qualified therapists in all 50 states, as well as in 40 other countries.

We also tested how easy or difficult it was to find couples therapists that met 37 different criteria across 16 ZIP codes in the United States. And, by far, the Gottman Referral Network outperformed the 26 other directories we researched in terms of finding therapists that specialized in relationship issues such as communication problems, infidelity, and whether or not to get a divorce, as well as navigating issues in a polyamorous relationship. 

Each Gottman Referral Network profile indicated the provider's level of training in the Gottman Method, from level one (having been taught foundational skills) to level three (having completed multiple training intensives). Certified Gottman therapists have completed all levels of training and have a minimum of 1,000 hours of post-graduate therapy experience. The only thing to keep in mind is that this directory might not be our first choice for LGBTQ+ or BIPOC couples. Although the Gottman Method is based on 40 years of research, only a minimal amount included homosexual couples, and it was also almost exclusively centered on white couples.

• Insurance Accepted: Yes, but the majority of providers do not accept insurance.
• Subscription Required: No
• Out-of-Pocket Costs: Varies by provider and insurance. Therapy sessions generally range between $60 and $200 each and are typically 50 minutes long. 

We surveyed 100 users of the Gottman Referral Network:

• 93% rated Gottman Referral Network as very good or excellent overall
• 83% rated their therapist’s qualifications as very good or excellent
• 98% said that most or all of their needs were met at Gottman Referral Network
• 97% are likely or very likely to recommend Gottman Referral Network to a friend or someone like them
• 11% were seeking counseling for relationship and marriage issues, 2% were seeking premarital counseling, and 13% were considering divorce

We had five different testers try out Thriveworks—in Kansas, Missouri, Kentucky, Massachusetts, and New York—and although we did not test couples therapy specifically, overall, we were impressed with the level of care we received at Thriveworks.

It is easy to filter for therapists by specialization and expertise at the company—which is why we also found it easy to narrow our results to those who offer Christian counseling. And because Thriveworks serves all 50 states and Washington, D.C., we didn’t have any trouble finding therapists with the background and expertise we wanted in a variety of locations. In addition, Thriveworks is one of the few online couples therapy platforms we found that offers faith-based counseling without having “statements of faith” that discriminate against the LGBTQIA+ community by citing Bible verses that denounce homosexuality.

We found most therapy sessions to be generally comfortable and supportive; however, in one instance, a therapist was late for the appointment and then came across as pushy and blaming. This therapist also mentioned having very limited availability for scheduling appointments.

• Insurance Accepted: Yes, in-network with most insurance plans, but the insurance accepted will vary by provider and insurance plan
• Subscription Required: No
• Out-of-Pocket Costs: Varies by therapist and insurance provider; self-pay sessions start at $200.

We surveyed 100 users of Thriveworks:

• 88% rated Thriveworks as very good or excellent overall
• 90% rated their therapist’s qualifications as very good or excellent
• 96% said that most or all of their needs were met at Thriveworks
• 96% are likely or very likely to recommend Thriveworks to a friend or someone like them
• 19% were seeking couples counseling, 2% were seeking marriage counseling, and 4% were seeking premarital counseling

Going to couples therapy is hard enough as it is. Seeking out therapy specifically for intimacy and sex stressors in a relationship can be even more challenging. That’s why we recommend Modern Intimacy: It has a roster of therapists who are either certified or working toward getting certified in sex therapy. Licensed sex therapists specialize in sex and sexual relationships and have much more background and experience than therapists who don’t have a sex therapy license—when seeking sex therapy, you should always look for a licensed therapist to ensure you get the most professional care possible. Plus, it's inclusive, offering specialized support aimed at those healing from trauma, the LGBTQIA+ community, and the BDSM/kink communities. 

Modern Intimacy prides itself on a nonjudgmental approach, and our experience testing its services with our husband confirms this. We found its therapists to be well-versed in a number of therapy techniques, including: 

• Attachment theory (focuses on long-term relationships and bonds)
• PACT couples therapy (combo of attachment theory, neuroscience, and biology of arousal)
• The Gottman Method 
• Imago therapy (turns conflicts into opportunities for growth and healing)
• Emotionally focused therapy (short-term therapy that improves attachment and bonding)
• Internal family systems therapy (a focus on the “true self” and turning unhealthy parts of ourselves back into healthy parts)
• Cognitive behavioral therapy (CBT)

Providers may also use trauma-informed therapy, ensuring they cultivate a safe space for both you and your partner. 

After working with a Modern Intimacy sex therapist, we felt that our already successful relationship came out even stronger than before; that's why we think this highly specialized company deserves a place on our list. However, unfortunately, Modern Intimacy only serves a few states: California, Colorado, Florida, Illinois, and New York.

• Insurance Accepted: No, but they can offer a superbill to submit to insurance
• Subscription Required: No
• Out-of-Pocket Costs: Free 30-minute consultation; the cost depends on the credentials and experience of the provider (we paid $300 per 50-minute session)

We have not yet had the opportunity to survey Modern Intimacy users, but we tested it ourselves to great success. Our additional research also found that most past and present users who have shared online reviews or testimonials are satisfied with the services they’ve received. 

We also consulted three licensed therapists and Stefani Goerlich, a licensed sex therapist, and across the board, all felt strongly that Modern Intimacy deserved a place on this list because of its specialization, the expertise and licensure of its therapists, and its inclusivity. 

“When seeking help with and treatment for sexual issues and concerns, it’s always better to see a specialist,” explains Owens. “Just like you’d go to a cardiologist rather than a general practitioner for a heart problem, going to a sex therapist with specific expertise will always be better than seeing a therapist who does not have that specialty or experience.”

Mindful Care is one of the only online therapy companies we tested that offers true group therapy rather than just group support. Group therapy is led by a licensed mental health professional and involves the same small group of people who share a common experience, characteristic, or identity, meeting regularly, often for a set period of time. And when we tested Mindful Care in New York, we found its MindFit groups to be especially welcoming and effective. 

When we signed up, we received an email with all of the MindFit groups available that week. We chose the group focused on facing everyday challenges rather than the "CONNECT" relationship group, but our experiences with the group we attended made us confident in our recommendation. Our group was capped at 15 people, and we found that nine to 15 people attended depending on the day. Our group met for an hour on Zoom, and our facilitator (a licensed therapist) was professional and welcoming. The group felt like a space where it was safe to talk about anything and everything because everyone in the group was there to give support and help each other work towards our goals. The facilitator also made sure everyone had the chance to speak and be heard.

Of course, though, group therapy is not for everyone. Part of the group therapy experience is hearing others’ perspectives and noticing how they are navigating their healing journey. If this doesn’t sound like you—or you’re more interested in seeking individualized feedback—this might not be the company for you. Similarly, if you want to discuss sensitive issues and the thought of doing so in a group format makes you uncomfortable, group therapy may not be the best for you. But if you are eager, as we were, to develop community and strengthen your communication skills, or you are seeking a lower-fee therapy option, group therapy could be a great fit for you—and Mindful Care does it particularly well.

Plans & Pricing

• Insurance Accepted: Yes, in-network with many insurance providers, though group therapy might not be covered by insurance
• Subscription Required: No
• Out-of-Pocket Costs: Varies by insurance plan; Group therapy generally costs $35 per session

We surveyed 100 users of Mindful Care:

• 83% rated Mindful Care as very good or excellent overall
• 86% rated their therapist’s qualifications as very good or excellent
• 90% said that most or all of their needs were met at Mindful Care
• 96% are likely or very likely to recommend Mindful Care to a friend or someone like them
• 12% were seeking couples counseling, 3% were seeking marriage counseling, and 1% were seeking premarital counseling

We had four parents and their families test Little Otter from California, Pennsylvania, and New York so we could get a sense of how well the company served kids and their parents alike—and it delivers. This focus on parenting sets Little Otter apart from the other companies we reviewed and makes it a great resource for parents and kids in need of support.

Since this platform is specifically for families, we expected strong support on parenting challenges—and Little Otter did not let us down on this front. We found that no matter the parenting service we chose, be it parent coaching or couples therapy, we could discuss co-parenting, differences in parenting styles, and communication issues that were impeding our parenting. Additionally, we found it helpful for individual child therapy with parents joining sessions intermittently. Little Otter's services work best, however, for a kid who responds well to video communication.

Be aware, though, that Little Otter is currently not available in all 50 states, which is a drawback compared to many other companies on our list. As of August 2024, Little Otter is only available in California, Colorado, D.C., Florida, Georgia, Illinois, Maryland, New Jersey, New York, North Carolina, Pennsylvania, Texas, Utah, and Virginia. It is also on the pricier side compared to other companies we evaluated. However, we still felt like its unique emphasis on children and parenting support made the company stand out and deserving of a spot on our list.

• Insurance Accepted: Yes, but only four companies: Independence Blue Cross, AmeriHealth, Sana, and Florida Blue. Payments can be made through an FSA or HSA.
• Subscription Required: No
• Out-of-Pocket Costs: A standard therapy session costs $195; An assessment costs $390; A 75-minute psychiatric evaluation costs $500, and each follow-up psychiatry session costs $250.

We surveyed 100 users of Little Otter:

• 86% rated Little Otter as very good or excellent overall
• 86% rated their therapist’s qualifications as very good or excellent
• 96% said that most or all of their needs were met at Little Otter
• 95% are likely or very likely to recommend Little Otter to a friend or someone like them
• 33% were seeking couples counseling, 18% were seeking marriage counseling, and 16% were seeking divorce/discernment counseling

When we tested Growing Self twice from Colorado, we found it excelled in its relationship therapy and coaching offerings because it offered more tailored services than its competitors. Not only can you find traditional couples therapy at Growing Self, but you can also find individual relationship-focused therapy, premarital counseling, sex therapy, long-distance relationship counseling, affair recovery counseling, divorce coaching, and—most uniquely compared to the other 54 companies we evaluated—divorce or breakup support groups. 

The breakup and divorce support group is a 60-75-minute group session, capped at six people, that meets weekly for eight weeks. We learned that the group is facilitated by a divorce counselor and breakup recovery coach who leads the group through various exercises and guided discussions. Plus, each session is only $40, ensuring it is financially accessible even in the midst of an expensive divorce. The only thing to know: This is a coaching-oriented support group, which means that while the facilitator is a divorce counselor and breakup recovery coach, the groups will be focused on more actionable activities and guided discussions rather than in-depth emotional processing or sharing in a group setting like you might find at other support groups, including some we included on our list after testing. 

We also tested Growing Self’s individual relationship counseling and were very pleased with the care we received. We found our therapists to vary in experience: One was an early-career therapist currently obtaining her counseling and marriage and family therapist licensures, and the other was a licensed counselor with a PhD, but both were supportive and highly educated, with direct, strengths-based, and solution-oriented focuses on counseling. We also found that both created a comfortable space for discussing relationship issues and developing goals.

• Insurance Accepted: No
• Subscription Required: No
• Out-of-Pocket Costs: Support groups cost $40 per 60- to 75-minute group session. Couples therapy ranges from $65 to $160 per 45-minute session based on the therapist’s level of training. Sliding scale pricing is available.

We surveyed 100 users of Growing Self:

• 85% rated Growing Self as very good or excellent overall
• 93% rated their therapist’s qualifications as very good or excellent
• 97% said that most or all of their needs were met at Growing Self
• 96% are likely or very likely to recommend Growing Self to a friend or someone like them
• 17% were seeking couples counseling, 2% were seeking marriage counseling, and 3% were seeking divorce/discernment counseling

We asked four people to test Octave’s therapy services from California, New York, and Florida; two of them tested Octave’s couples counseling specifically. And overall, we had a very positive experience. Our couples therapists were thoughtful, informed, and attentive, asking us thought-provoking questions and making sure to encourage us and our partners to speak up equally during the session.

Octave’s therapists have a wide range of training and specializations, including repair after infidelity, a specialty that we found was hard to come by, even at companies that specialize in couples counseling. These therapists can help support couples in moving forward together or deciding if it’s better to end the relationship, giving them the tools to move on in a healthy way for future relationships. We felt seen and respected in session, and while some therapists were a bit more goal-oriented than others, our therapists seemed to use therapy techniques that aligned with our stated goals for therapy from the intake process. 

The biggest drawback for Octave is that it is a relatively smaller company than most of the others we reviewed, so it only currently serves patients in California, Connecticut, Florida, New Jersey, New York, Texas, and Washington, D.C.

• Insurance Accepted: Yes, coverage varies by state. Accepts Anthem Blue Cross of California, Aetna, Health Net and Managed Health Network (MHN), and UnitedHealthcare UMR plan for Mount Sinai.
• Subscription Required: No
• Out-of-Pocket Costs: Varies by the provider you choose, insurance plan, and location. Couples sessions at Octave are 55 minutes long and range from $190 to $275.

We surveyed 100 users of Octave:

• 92% rated Octave Online Therapy as very good or excellent overall
• 92% rated their therapist’s qualifications as very good or excellent
• 100% said that most or all of their needs were met at Octave Online Therapy
• 100% are likely or very likely to recommend Octave Online Therapy to a friend or someone like them
• 14% were seeking couples counseling, 12% were seeking marriage counseling, and 6% were seeking divorce/discernment counseling