BetterHelp: The Good, The Bad, and a Whole Bunch of Ugly for Therapists
NOTE: below is a review of the BetterHelp platform to offer information to other mental health professionals who are considering joining. If you are a current/potential client, this review is not meant for you. This is simply my personal opinion and meant as nothing more.
Technology and mental health are becoming more integrated everyday. BetterHelp is one of multiple online therapy platforms that have entered the market over the past few years, providing clients and therapists alternatives to the traditional counseling setting.
As someone that likes to experiment with new technologies, I decided to give BetterHelp a try and below is my opinion. Again, just my opinion and I respect that yours may differ. I am simply offering this information to mental health professionals that are considering BetterHelp as an option for full/part-time work to help you decide if it’s the right fit for you. Let’s get started…
Brief overview of BetterHelp
BetterHelp was founded in 2013 to remove the traditional barriers to therapy and make mental health care more accessible to everyone. Today, it is the world’s largest therapy service — providing professional, affordable, and personalized therapy in a convenient online format. BetterHelp’s network of over 30,000 licensed therapists has helped millions of people take ownership of their mental health and work towards their personal goals. As the unmet need for mental health services continues to grow, BetterHelp is committed to expanding access to therapy globally.
Basically, BetterHelp is an online counseling platform where clients pay a subscription fee for services and work with a therapist of his/her choosing. All services are provided virtually and come in different formats: video, audio, text, or chat. There’s also a journaling component, classes and groups, as well as assignments that can be completed throughout the therapeutic process.
The Good
Completely Remote- you can work from anywhere as long as it’s in compliance with your licensing board rules.
Easy Onboarding Process- this might have been the easiest onboarding process I’ve ever had.
Tons of referrals- my brief experience has been no shortage of referrals. You can also accept or dismiss the referral based on the information provided which is nice.
No overhead costs- there’s no cost to be a provider with BetterHelp. You’re not out any money by joining or using the platform.
Support- seems like the support team is quick to respond and provide answers to your questions.
Client contact- based on what I’m told from BetterHelp, you can conduct a 45 minute virtual session as much as once per day. If you believe a client needs more than one session per week, you can schedule additional sessions to meet those needs and you will be reimbursed for each session. Update: after being provided this info from a support person, I responded to confirm and then got a second email to “clarify” what they said. Turns out, clients can only have one 45 minute session per week, or they have to pay additional fees to have more sessions.
Free CEUs- BetterHelp offers free continuing education for it’s contractors.
Health Insurance Stipend- BetterHelp will provide you $450 per month (but you have to meet specific criteria including averaging over 100 hours per month of services)
The Bad
Though it’s a positive that BetterHelp gives you the opportunity to select clients when initially referred to you, there’s no way to remove them from your caseload after that point. Your only option is to message the client and ask them to “change therapist”. There might be a way to discharge a client from your caseload by reaching out to support, but I’m not sure as I’ve never done it.
It can feel like a 24/7 platform. Though BetterHelp doesn’t require you to constantly be “on”, you receive messages requesting that you continue to follow up with clients. In traditional therapy, there’s a session once a week, and that’s pretty much it. This platform tends to create expectations of greater engagement with the client. That would be great, except for…
The Ugly
This, my fellow mental health professionals, is where we cover the real issues with BetterHelp (in my opinion).
Reimbursement- no other way to say it. It’s horrible! It starts at $30 an hour for the first five hours, then goes up by $5 increments for every additional 5 hours of service. Keep in mind, the increased rate only applies to those 5 hours of work. Here’s a quick example:
Let’s say you worked 12 hours this week in the BetterHelp platform. Here’s the breakdown:
5 hours at $30 + 5 hours at $35 + 2 hours at $40 = $405 (this is before taxes)
That comes out to an average of $33.75 an hour, but there’s a lot more to consider based on BetterHelp’s compensation model (and not in a good way).
Let’s dig in further to the math…
Let’s say you have 4 clients scheduled as a half-day of work. BetterHelp only allows for a max session length of 45 minutes, so each session you schedule is really paying 75% of the $30 fee (for the first five hours of work). If you budget an extra 15 minutes between sessions and schedule clients on the hour, here’s what your true payment for those four hours of work looks like:
4 sessions for 45 minutes is a total of 3 billable hours (45 minutes X 4)
3 hours X $30 = $90
Yep, that’s your actual GROSS payment for four hours of work, $90 (again, before taxes!). I promise you, I’m not making this up.
When I messaged BetterHelp requesting higher rates they informed me that wasn’t an option. Instead, they referred back to the additional revenue streams they offer such as writing/reading client messages, and reviewing assignments and journal entries. So far, I’ve seen that as minuscule additional reimbursement. Without covering all the details, it’s a lot of work for very little compensation.
No shows and late cancellations: very little reimbursement. For example, if a late cancellation occurs, you may receive 10 minutes of compensation. At $30 per hour, ten minutes is about $5.
So let’s do another financial scenario:
Let’s take the same one as before where you have 4 clients scheduled on the hour (total of 4 hours you’re committing to BetterHelp that day). One client in the middle of your day cancels at the last minute. Here’s the breakdown:
3 sessions for 45 minutes: approx $67.50 + $5 for late cancellation = $72.50 for those four hours of your day.
Keep in mind this breakdown is based on the billable hours you spend providing services. It doesn’t include all the time you’re going to spend setting up calendars, scheduling clients, etc.
My Personal Experience:
After joining the site and beginning to receive referrals, for 3 days I had 1.6 hours of reimbursable time…. that’s about $47 dollars. My real time spent messing with setting up my schedule, dealing with emails from BetterHelp and logging into view potential clients, reading the material provided by potential clients, responding to those clients with an invitation to schedule a session, plus multiple other logistical things, probably was around 4-5 hours.
Another example: my first real day of seeing clients. I had three sessions scheduled, all with new clients. One person attended, one canceled five minutes before the session started, the third never even showed up (It’s really annoying to stare at yourself on the computer for 15 minutes waiting for the client to show up). I reached out to both people that didn’t attend and never heard back. For committing to being present for those three sessions, and blocking off the time (remember, you can’t schedule anything else because you are committed to seeing clients during those times), I will be reimbursed a grand total of .9 hours of work. That’s about $27 for the entire day! That’s it, three hours of my time committed for $27.
Maybe you could be a lot more efficient, but it wasn’t a good fit for me. I’ve already stopped accepting new referrals and this experiment will come to an end within a week or two as I notify clients I will be transitioning off this platform.
If you’ve had a different experience, please message me. I would love to hear your thoughts and will be happy to share your experience on this post as well to provide therapists with another point of view.
One Strategy for How It Could Work for a Therapist:
Go all in!! Yes, it might sound strange, but here’s my rationale:
BetterHelp appears to have no shortage of referrals. If you fully committed to providing 35 total billable hours each week, here’s what it could potentially look like:
As of writing this, you would qualify for a $450 health insurance stipend
And here’s the potential income opportunity:
5 hours at $30 = $150; next 5 hours at $35 = $175; next 5 hours at $40 = $200; next 5 hours at $45 = $225; next 5 hours at $50 = $250; 5 hours at $55 = $275; and 5 hours at $60 = $300
This is a grand total of $1575 per week. On average, it would gross around $6300 per month and the health stipend of $450 puts you at $6750 per month. This would be an annual salary of $81,000. If you want to stay at home, have zero overhead costs, work 35 direct service hours plus at least 5-10 hours of admin per week, this could be your thing. Keep in mind these are all very general numbers and this fee structure is based in the magical world where all your clients show up on time each week and you don’t lose money to no-shows and late cancellations. This also doesn’t budget for getting sick, or time off for vacation. With this model, if you don’t work you don’t get paid!
Also, if you are going to use the BetterHelp platform, I found this article to be extremely helpful.
Final Takeaways:
If these numbers are good for you, definitely sign up for BetterHelp immediately. My guess is they are losing providers as quick as they can contract with them. Instead, I urge you to resist this type of work and any platform that pays such low rates. The only way for our profession to be considered equals within the healthcare industry is to only accept fair wages. I would urge you to consider other options that will pay more, and not require the “on-call” feel of BetterHelp.
I’ll be exploring other models of private practice in the upcoming blog posts, and if you have any questions or suggestions, please let me know what you’d like to learn more about and I’ll see what I can find.
As mentioned at the beginning of this post, this is simply one professional’s opinion and you are welcome to your own. My goal is to provide you a realistic view of BetterHelp’s platform as of January 2024. This may change over time, so please go to BetterHelp.com to learn of the most recent updates and information regarding their therapy platform.