Online Therapy Services for Kids and Families, Tried and Tested in 2024

We asked five parents to sign up with their teens for Teen Counseling’s therapy services in Florida, Pennsylvania, and Michigan—and our experience was overwhelmingly positive. The therapists were knowledgeable and approachable toward their teen patients, and we appreciated that we, as parents, could be part of the process without infringing on our children’s privacy. 

There are over 15,000 licensed therapists in Teen Counseling’s network across all 50 U.S. states, meaning it's easier for the company to make good matches. That said, we had mixed feelings about the therapists we were matched with, and, in some cases, we switched to a different therapist, which was a simple process through the patient portal. We also liked that there were a lot of different ways to communicate with our therapists at Teen Counseling. We could have our weekly live therapy sessions through a live video call, phone call, or live chat—a format that we found some teens really liked (or even preferred). That said, live chat isn’t a great fit for every teen and can make some feel like they have to type as fast as they can to get the most out of a session, which can be stressful.

Teen Counseling also offers “e-journaling” in the portal. It’s basically a virtual journal where you write a longer message that you can choose to share with your therapist or not. If you share,  your therapist responds in their own time. We found in testing that most teens were not interested in this option because it felt like homework. However, from what we could see in the patient portal, it seems like a relatively easy-to-use service that’s an excellent option, especially if you’re feeling rushed in live chat sessions but don’t wish to do a video session.

• Insurance Accepted: No
• Subscription Required: Yes
• Out-of-Pocket Costs: Ranges from $260 to $360 per month, depending on your location and therapist availability, and includes four live sessions (typically one $65 to $90 session per week) in the format of your choice, plus 24/7 messaging with your teen’s therapist.

We surveyed 100 users of Teen Counseling:

• 86% rated Teen Counseling as very good or excellent overall
• 87% rated their therapist’s qualifications as very good or excellent
• 93% said that most or all of their needs were met at Teen Counseling
• 93% are likely or very likely to recommend Teen Counseling to a friend or someone like them
• 57% were looking for a therapist for their child

We had 12 people with different backgrounds (including several parents and their teens) sign up for Talkspace and try its therapy services from states like North Carolina, Iowa, Missouri, and New York to see how family-friendly its various services actually are. One of Talkspace's strengths is its multiple subscription plans—with a video and messaging plan, for example, we could schedule a live 30-minute video session with our therapist each week and message them anytime on the platform’s secure app.

We felt like the quality of care was generally high, and our teens felt heard and supported. All of Talkspace’s therapists are licensed, and all the providers designated for teen therapy have ample experience working with adolescents. There are also providers available who specialize in couples therapy, psychiatry (for adults), and individual therapy, so you’ll likely find a subscription plan that fits anyone in your family who needs it. We found that most therapists provided helpful insights, and the app made it easy to access messages and to do sessions from anywhere.

Starting at $69 per week, Talkspace’s messaging-only plan is a cheaper alternative than most other services we tested. Text-assisted therapy may be a good option for teens who feel nervous about starting therapy, and for the most part, we really appreciated the communication style. However, we sometimes felt like the responses from our therapists were rather general, as if they’d been lifted from a prompt script. 

• Insurance Accepted: Yes, accepts Aetna, Optum, Cigna, Carelon, and Regence health insurance plans; accepts FSA/HSA payments
• Subscription Required: Yes
• Out-of-Pocket Costs: Messaging-only plans start at $69 per week; video and messaging therapy starts at $99 per week; video, messaging, and workshops start at $109 per week

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
• 9% were looking for a therapist for their child

Because Talkiatry is a psychiatry company, we did not think it was ethical to ask someone to test the company for us with their child. However, we did test the service with two adults who were already looking for new psychiatrists in New York, which allowed us to get some insight into how the company provides psychiatric care. There was a thorough intake process and we were left confident that most users would be comfortable recommending this service for parents and children because both our testers were parents. Finding a service that can treat kids as young as five years old is also a rarity.

We appreciated that Talkiatry allowed us to choose our provider from a list of three different psychiatrists—and if we didn’t like those three options, we could call for a better match. We could also switch providers at any time if we didn’t feel comfortable after the first session (though it should be noted that you’ll have to email or call to get this switch). Talkiatry only accepts patients who are in-network with its accepted insurance plans, but we actually thought this was a good thing because it reduced our out-of-pocket costs (and psychiatrists who accept insurance are notoriously difficult to find). It was very easy to check if our insurance was accepted: We simply clicked the “check my insurance” button on the home page, which was also where we could find out what our copay would be.

The biggest drawback of Talkiatry is that there is a wait time between sign-up and your first session; for every provider we considered, the soonest appointments were at least a week to 10 days away, which could be disappointing if you were hoping to get an appointment quickly. However, this is on par with more traditional, in-person therapy, so we didn’t see it as too much of a drawback. We also found that when we switched providers, we also needed to wait up to 10 days for a new match and then another week or two for our first session with them.

• Insurance Accepted: Yes, only accepts new patients who are covered by insurance; accepted insurance includes BlueCross BlueShield, Optum, UnitedHealthcare, Aetna, and Cigna; accepts Medicare but not Medicaid (yet)
• Subscription Required: Yes
• Out-of-Pocket Costs: Varies by insurance

We surveyed 100 users of Talkiatry:

• 86% rated Talkiatry as very good or excellent overall
• 87% rated their therapist’s qualifications as very good or excellent
• 96% said that most or all of their needs were met at Talkiatry
• 95% are likely or very likely to recommend Talkiatry to a friend or someone like them
• 8% were seeking psychiatry services for their child
  

We had four parents and their kids of varying ages from California, Pennsylvania, and New York test Little Otter’s therapy services (including parental coaching), and our experience was generally positive. Little Otter takes a personalized approach to care and has a unique selection of qualified providers, from board-certified child psychiatrists and licensed family therapists to parenting specialists. While it is on the more expensive end of the services we tried, we feel the value for the money is worth it; not only did our children receive extremely thorough care, but we felt the extra resources were invaluable. 

We liked how good the therapists were at building a connection with our kids and getting them to open up (even the ones as young as 10).

We were impressed with how experienced Little Otter's providers are in the stages of early childhood development, meaning they’re uniquely qualified to diagnose and treat mental health conditions that commonly impact children such as ADHD, aggression, anxiety disorders, and depression, and issues such as tantrums, sleep difficulties, relationship conflicts, and body image issues. We felt that the parental coaching was also helpful in giving us concrete advice on how to adjust our behavior to better support our family and our growing kids. We were also able to message therapists between sessions, which was helpful.

While we felt the thorough intake sessions were useful, we can see how some parents (especially those with busy schedules) might find them a bit much. We didn’t appreciate that there was limited availability for them; in some cases, there were no appointments outside when our children were in school, so we had to disrupt their routine to meet that requirement. That said, we felt the intake process helped us match with great therapists who were patient and kind, and who knew just how to draw our children into the conversation.

• Insurance Accepted: Yes, but only four insurance plans: AmeriHealth, Sana, Independence Blue Cross (in Delaware and Pennsylvania), and Florida Blue. However, the providers will fill out reimbursement forms and accept HSA/FSA.
• Subscription Required: No
• Out-of-Pocket Costs: $195 per standard therapy session; $390 for a 90-minute assessment; $500 for a 75-minute psychiatry evaluation; $250 per 30-minute psychiatry follow-up. You can also sign up for discounted bundles: $525 for an assessment bundle (90-min assessment and one standard therapy session); $700 for a 4-session bundle, $1,320 for an 8-session bundle, and $1,980 for a 12-session bundle
  

We surveyed 100 users of Little Otter:

• 86% rated Little Otter as good, very good, or excellent overall
• 86% rated their therapist’s qualifications as good, 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
• 27% were looking for a therapist for their child

We had six people from across the country (in California, Kentucky, New York, Mississippi, and Missouri) sign up and try Amwell, including testing the service with our 11-year-old so we could see how Amwell’s children's therapy compared to its adult and couples counseling. Overall, we felt the therapists were well-qualified, knowledgeable, and adept at engaging with us—even our shy 11-year-old.

Amwell works with a wide range of insurance providers. The platform also offers talk therapy to adults, making it a great option if multiple family members are looking for online mental health care. All of Amwell’s therapists are specially trained in online therapy and licensed to practice in their state. We could specifically request a provider with either a master’s degree or a doctorate, which gave us greater freedom of choice over who our child worked with. We could also opt to hide our faces during the video chat, which could help shy or anxious kids feel more comfortable. 

One issue that came up during our search, however, was a lack of therapists who treat children in certain areas of the country. For example, we only found one in Kentucky, and his first available appointment wasn’t for two weeks. That said, once our child met with him, it was clear he had ample experience working with young kids, and our child was receptive to him. He asked several questions about what they liked and didn’t like and did his best to keep our child engaged whenever possible to help them open up, which we appreciated.  Additionally, we experienced some technical issues with the platform in a couple of cases, including call drops. 

• Insurance Accepted: Yes, accepts most major insurance plans, including Aetna, Anthem, BlueCross BlueShield, Emblem Health, Horizon, and UnitedHealthcare
• Subscription Required: No
• Out-of-Pocket Costs: Varies by insurance; Up to $99 for therapy sessions; $199 for initial psychiatry appointment and $95 for follow-up sessions; in one instance, we paid $109 for a therapy session

We surveyed 100 users of Amwell:

• 88% rated Amwell 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 Amwell
• 95% are likely or very likely to recommend Amwell to a friend or someone like them
• 11% were looking for a therapist for their child

We tried parent counseling, couples counseling, and adult therapy with LifeStance Health from Illinois, Oregon, New York, and Florida, and across the board, we felt that our therapists were compassionate, knowledgeable, willing to listen, and offered sound advice. For example, when we tried couples counseling, we found our therapists facilitated conversations between partners and helped us gain insight into our relationship. We learned how to better show appreciation for each other, too, especially when stressors—like those common in the life of a parent—crop up.

We especially appreciated how many listed conditions seemed to cater directly to parents, families, and kids, including attachment styles (which can affect both couples and parent-child relationships), childhood trauma, and perinatal and postpartum depression. Some LifeStance psychologists are trained in child-parent relationship therapy (CPRT), a type of play therapy and parental training program aimed at helping children ages three to eight.

We loved that we could choose our own therapists and filter according to factors such as specialty, gender, languages spoken, the ages of the patients they treat, and the insurance plan(s) they accept, just to name a few. That said, it is worth noting that the number of therapists that offer specific therapy—like family therapy or teen therapy—does vary quite a bit across different states. As a result, we were forced to work with customer service to find a therapist that met our needs in some states.

• Insurance Accepted: Yes, accepts most insurance plans, including Aetna, BlueCross BlueShield, Cigna, Carelon, and Humana
• Subscription Required: No
• Out-of-Pocket Costs: Varies by insurance and doesn’t list its exact prices until you sign up and check on your insurance coverage

We surveyed 100 users of LifeStance Health:

• 77% rated LifeStance Health as very good or excellent overall
• 84% rated their therapist’s qualifications as very good or excellent
• 95% said that most or all of their needs were met at LifeStance Health
• 89% are likely or very likely to recommend LifeStance Health to a friend or someone like them
• 61% said they were a parent or guardian

We had five people test Thriveworks’ therapy services, including family, child, and individual adult therapy, in four states—Florida, Illinois, Oregon, and New York—and we appreciated how flexible the company aims to be. It’s among one of the most accessible, family-friendly companies we reviewed, offering both online and in-person care with qualified providers in over 340 locations across the U.S. (with over 2,200 mental health professionals). Therapists are available at all times of the day (and week), and the platform accepts most major insurance plans.

We felt like the scheduling process at Thriveworks allows for a great deal of flexibility, which is key for a family with often conflicting schedules. Many providers are available from 7:30 a.m. to 12 a.m. ET from Monday to Friday, as well as on weekends and certain holidays. We could also cancel or reschedule for free within 48 hours of our scheduled appointment. Additionally, intake sessions are typically 50 to 60 minutes long, allowing for a more in-depth initial assessment, and we loved that they clearly were trying to provide exactly the sort of therapy that would suit our family’s needs best. For example, when we did family therapy with an 11-year-old, the therapist encouraged her to sit with her mother on her bed, since that’s where she felt the most secure; that level of sensitivity was not lost on us.

That said, we found that not all therapy types were available in locations where Thriveworks provides services. For example, we were looking to test virtual family therapy in Kentucky, but couldn’t find any available providers. Then, our first therapy session with our kid got off to a bit of a rocky start as the therapist decided to go through billing information at the top before diving immediately into sensitive questions, such as suicidal ideation. However, our therapist seemed to read the situation and was able to get our 11-year-old back on track by taking a gentler approach. We appreciated that consideration, and while there were a few technical difficulties during our second video session, ultimately, our child took to the virtual sessions very well.

• Insurance Accepted: Different providers accept different insurance plans, but you can filter therapists by the insurance plans they accept; Thriveworks accepts major insurance plans such as BlueCross, Anthem, Optum, United, Aetna, Cigna, Humana, and many others
• Subscription Required: No
• Out-of-Pocket Costs: Varies by insurance and provider (rates can be found on provider bio pages); self-pay options start at $200 per session

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
• 16% were looking for family therapy

We tested Alma’s website search filters and matching service across 18 ZIP codes, and in one case, we tried scheduling sessions (and paying for them) through Alma’s platform. Overall, we appreciated how intuitive the directory is, and we felt like we could find what we were looking for without much effort.

We could browse Alma's therapists by filtering for those who offered child and adolescent therapy, and we were able to find a therapist who could treat a specific mental health issue (such as one who treats neurodivergence in children) in as little as 30 seconds to as much as 30 minutes, depending on our location. We also appreciated that, in our latest testing of this directory, we could search for therapists who offered specific price ranges.

One thing to note, however, is that, while Alma advertises that it accepts a variety of insurance plans, one of our testers (who checked the website before scheduling a session to make sure her plan was accepted) ended up finding out at the end of her initial consultation that her plan wasn’t accepted after all. Her provider mentioned that this confusion happens all the time, which is concerning.

• Insurance Accepted: Yes, but varies by provider; most accept some form of insurance, such as Aetna, Cigna, United Healthcare, or Oscar
• Subscription Required: No
• Out-of-Pocket Costs: Free to use directory; therapy varies by insurance and care provider (providers set their own prices and makes their own decisions about insurance coverage); you can use the directory to search for providers who accept your insurance plan

We surveyed 100 users of Alma:

• 93% rated Alma as very good or excellent overall
• 92% rated their therapist’s qualifications as very good or excellent
• 97% said that most or all of their needs were met at Alma
• 97% are likely or very likely to recommend Alma to a friend or someone like them
• 12% were looking for a therapist for their child