Opinion: Why BetterHelp is a Risk to Our Collective Mental Health

Updated November 4, 2026. This is an opinion piece by Rob Pintwala, founder of First Session. First Session runs a Canadian therapist directory, so I'm not a neutral party. In this update, I corrected our survey figures and added the sample size and dates, updated BetterHelp's insurance status, added sources for the advertising and therapist pay figures, removed two claims I couldn't support, and closed the survey.

The world's largest online therapy platform is a juggernaut. BetterHelp's proliferation across every conceivable marketing medium (podcasts, especially) is sure to appear as a case study in marketing courses for years to come. Never has therapy existed on such an immense scale. In 2023, BetterHelp's parent company, Teladoc Health, spent $689 million on advertising and marketing, and said the increase was driven mainly by BetterHelp ads.

At first glance, that might come off as a positive. Millions of people attending therapy! Accessible therapy for all! It's therapy, but as convenient as swiping through Tinder or ordering a kitchen scale from Amazon!

Well, the reality is a bit different. In 2023, BetterHelp paid US$7.8 million to settle US Federal Trade Commission allegations that it shared users' health information with advertisers, including Facebook and Snapchat, between 2013 and 2020. BetterHelp didn't admit wrongdoing, and it's now barred from sharing health data for advertising.

But let's put that aside. Google "BetterHelp reviews" and you'll see a pretty nice picture! But add one word to that search ("reddit"), or talk to real humans who have used BetterHelp, and that picture changes very quickly.

BetterHelp Reviews and Experiences

In August 2024, we sent out a survey asking folks about their experience with BetterHelp.

I'll fully admit, this was partly driven by curiosity.

I've heard hundreds if not thousands of BetterHelp podcast ads. One thing that's always bugged me is that "switch therapists any time!" value proposition. There's some bias there, sure. I founded First Session on the entire premise of finding the right "therapist-client" fit, the first time, a concept that's proven to result in longer term progress and change from therapy.

But having talked with hundreds (thousands?) of therapists and professionals over the last 5 years, my interest and suspicion of "convenience first" platforms like BetterHelp has continued to grow.

So, we created a simple survey asking about folks' experiences with BetterHelp.

It revealed a few stats that didn't surprise me, and a handful that highlighted the growing concern that I (and others) have had about BetterHelp and similar platforms for years. Those stats prompted a deeper look into the platform and how real humans have experienced it. Trustpilot and other review sites may show a 4-star rating, but star ratings don't tell the whole story (more on that later).

BetterHelp Survey Results and Takeaways

We sent the survey to people subscribed to First Session's emails. Between August 8 and 25, 2024, 81 people responded, and 44 of them had used BetterHelp. Most respondents who told us where they live were in Canada. Here's what those 44 BetterHelp users told us:

Full disclosure: this is a small, self-selected sample. Everyone we surveyed was already subscribed to First Session's emails, so the results likely lean towards people who were unhappy with platforms like BetterHelp. Treat these numbers as signals, not as statistics about all BetterHelp users.

The survey stayed open after this article was first published, until we closed it on November 4, 2026. By then, 220 people had responded and 99 of them had used BetterHelp. 63% of those 99 described a negative experience, and 40% had tried two or more therapists. Most later respondents probably found the survey through this article, so they're likely even more self-selected.

Still, for me, these early findings reinforce a few thoughts myself, therapists, and others in the mental health and wellness space have been talking about for years:

"Switch therapists as many times as you want" comes at a cost

BetterHelp has been criticized for paying therapists well below private-practice rates (more on that below). My worry is that this leads to burnout and turnover, and that clients pay for it with a long, frustrating process of trial and error to find the right fit. Given that about half of the BetterHelp users we surveyed found switching painful, I find that troubling.

Respondents described rushed, surface-level sessions

While there were exceptions in the survey, the majority of written feedback described sessions as rushed, surface level, disengaged, and generally unhelpful. Advice and insight from therapists was, in many cases, non-existent or generic.

On the topic of "matching," several respondents highlighted how the therapist they matched with did not feel like a good personality fit, or lacked the expertise needed to address their specific needs and preferences.

Communication between providers and clients was another recurring problem. Respondents described therapists arriving late to appointments and taking weeks to respond to messages (BetterHelp touts that you can "message your therapist anytime, from anywhere").

Why a bad first experience matters

With its marketing budget, BetterHelp's reach far exceeds anything we've seen before in the therapy and mental health space.

Because of that, BetterHelp will be the first experience many folks have with therapy. In our small sample, 70% of BetterHelp users had a poor experience, and 27% came away exhausted with therapy or feeling it wasn't for them.

Again, this is concerning. Mass awareness of therapy and the importance of mental well-being is at an all time high, and more people are likely to seek counselling now than ever in human history. That's an amazing thing! But massive tech companies like BetterHelp, with huge advertising budgets and unthinkable reach, hold a lot of power. Because of that, many of that "first time" cohort will experience BetterHelp's convenience-first approach to therapy.

Therapy is work. It's hard. The very process of being honest with oneself and saying "okay, I'm going to therapy" is a huge step. The amount of friction in the process of "deciding to seek therapy" and "finding therapy that works" is staggering. Sure, BetterHelp might win on the "find a therapist ASAP" point, but in my view the risk of frustration and disillusionment with therapy is high.

Therapy seekers are brave. They deserve the benefits that come with long-term therapy and the right patient-therapist fit.

Again, this is a limited dataset, and the results may not reflect BetterHelp users overall.

So, let's ask the question:

Do BetterHelp reviews reveal something different?

Type "BetterHelp reviews" into Google and you'll quickly come across review sites like Trustpilot or Capterra.

When we checked Trustpilot in September 2024, BetterHelp had a rating of 4.4 out of 5 from over 7,800 reviews. That's a strong score.

Star ratings are a blunt tool, though. They don't tell you how many therapists someone tried, or why they left. So, where do we look for more detail? Well, if you're anything like me, the process of Googling for a product or service involves adding a single word to your search query: "reddit."

The truth is out there (on BetterHelp reddit)

Simply Googling "BetterHelp reviews reddit" reveals a wildly different outlook and set of experiences.

"Steer far away from this service if you're thinking about getting help with any issues going on in your life," recounts one review, where a user paid hundreds for four weeks of BetterHelp and worked with four separate therapists who were either late, unresponsive, or both.

Another post describes BetterHelp's subscription model. The poster says they were charged while waiting to be matched (it took a week to match them with a therapist, and another week to finally meet). They report an unhelpful and unresponsive experience, and say they paid $1,280 in four months. At the time, BetterHelp didn't accept insurance anywhere, so it was all out of pocket. It still doesn't accept insurance in Canada. In the US, it started accepting insurance in 2025 and expanded to every state in 2026.

The anecdotes, subreddits, and contributing comments are endless and in stark contrast to what you'll come across on Trustpilot.

Do they offer the definitive view or objectively conclude that BetterHelp is inherently problematic? Of course not. Reddit is not a peer-reviewed academic resource (nor is this blog post). Neither our survey nor Reddit tells us what share of BetterHelp clients have a bad experience. But both suggest it isn't rare.

BetterHelp therapist quality and working conditions

All of this prompts the question: who or what is to blame when it comes to these negative experiences?

On one hand, yes, the subscription model is a factor. But monthly subscriptions are common (Netflix, for example), so BetterHelp's payment model could theoretically work.

Instead, I think the issue is the quality of therapists offered by BetterHelp. Or, more precisely, how BetterHelp treats its therapists.

The first comment in this reddit thread gives a glimpse into the issue: low therapist pay and no formal "exit process" between client and therapist. In the same thread, a commenter who says they worked for BetterHelp for four months describes being paid $30 an hour and constantly bombarded with client messages, without being paid for the time spent answering them.

Other therapists describe a similar pay structure. In a Glassdoor review from August 2024, a BetterHelp therapist says pay starts at $30 an hour and rises by $5 for every five additional client hours, up to $70. BetterHelp's own TikTok account has said that "more than 90% of our therapists earn more than $30/hour", and its current job postings estimate $43 to $70 an hour for live sessions.

In another thread, a social worker says BetterHelp matched therapists licensed in one state with clients in other states, which could put a therapist's license at risk. We haven't been able to verify this.

A therapist who works with First Session (who asked not to be named) told us that in 2024 they asked about working for BetterHelp while licensed and practising in Canada, and were turned down because of their location.

That raises a question for Canadian clients: who are BetterHelp's Canadian therapists? BetterHelp's Canada page mentions "qualified psychologists in Canada" but doesn't say which province its therapists are registered in. That matters. If your therapist isn't registered in your province, your provincial regulator may not be able to act on a complaint, and your benefits plan may not reimburse your sessions. Before you start, ask which province your therapist is registered in.

What low pay means for therapists, and for clients

Becoming a therapist isn't easy. The education required is extensive, and the associated costs add up quickly (insurance, licensing, continuing education). Some therapists value BetterHelp's steady flow of clients, especially to fill gaps in their schedule. But when pay sits well below private-practice rates, I worry about burnout, and burnt-out therapists can't give clients the care and attention they deserve. The result? A growing cohort of therapy seekers who are disappointed, disillusioned, and potentially turned off from therapy altogether.

Do I blame these therapists? No. Therapists, like anyone else, need to make a living.

Is BetterHelp worth it? Not for me

It might seem like I'm really ganging up on BetterHelp. And I guess I am. I have no doubt there are thousands of people who had a positive experience with BetterHelp, and I'm happy for them, genuinely. I want BetterHelp to succeed in providing ethical, quality therapy for millions of people. But that's not what our survey, the experiences people share online, and my own perception of BetterHelp reflect.

BetterHelp is a huge company, and this article only scratches the surface of its impact on therapy and mental wellness more generally.

Given that BetterHelp is no stranger to controversy, I think it's important to keep a critical conversation going about heavily advertised, "convenience first" online therapy platforms (Talkspace is another major player).

Why? Because millions of people's mental health depend on it.

For a side-by-side look at cost, insurance and how matching works, see our BetterHelp vs First Session comparison. If you'd rather choose a therapist yourself, browse online therapists across Canada, watch their intro videos and book a free consultation.