Given that addiction is such a serious mental health concern, researchers have evaluated the efficacy of telehealth in comparison with in-person treatment for addiction. A literature review published in Psychiatric Services in October 2021 reported that seven out of the eight published studies they reviewed found telehealth addiction treatment to be as effective as in-person treatment, though not more effective. The review noted that telehealth may improve access and convenience for patients to encourage better engagement with treatment. We reviewed the top online therapy platforms that help support individuals struggling with addiction and SUDs and narrowed them down to a list of five: Talkspace, Online-Therapy.com, Zocdoc, Charlie Health, and Monument, which was our top pick for treating alcohol use disorder (AUD) in our roundup of the best online therapy platforms of 2023. Cost $276 to $436 per month Prescribes Medication Yes, with psychiatry plan Accepts Insurance Yes Talkspace is an online therapy platform with plans that offer various ways to connect with therapists online, including live sessions and unlimited messaging. It also allows you to specify that you’re looking for help with addiction up front during the sign-up process. If you need to contact Talkspace customer service about your match requests or any questions about your membership, the only way to reach them is through a contact form or email to support@talkspace.com. Despite this, 72 percent of the 178 Talkspace users who responded to our reviews team’s April 2022 online therapy survey said they had positive experiences with the platform’s customer service. In addition to offering 30-minute live therapy sessions, Talkspace offers unlimited messaging therapy in all its plans. Individuals can message their therapist anytime, and Talkspace guarantees responses five days a week. This form of therapy may be preferrable for those who prefer asynchronous professional support. Messages can be sent as text, video, or audio. Individuals considering medication management alongside therapy can purchase Talkspace psychiatry sessions for a psychiatric evaluation to see if medication is appropriate. According to the National Institute on Drug Abuse (NIDA), prescription medications should be the first line of treatment, usually combined with some form of behavioral therapy, when treating addictions to opiates. Talkspace psychiatry providers do not prescribe controlled substances, such as buprenorphine and naloxone (Suboxone), which are sometimes used to treat opioid use disorder. Examples of noncontrolled substances used to treat substance abuse include naltrexone (Vivitrol) and disulfiram (Antabuse). Talkspace live workshops included with the Video Plus Messaging Plus Workshops plan are 60-minute group classes held via Zoom. Despite being led by licensed therapists, they are not therapy sessions. You can attend them with your camera off and with a nickname to remain anonymous. At the time of writing this article, there were 30 different scheduled workshops, with one devoted to addiction. After the therapist guides the class through exercises and personal reflections, they’ll open the class for questions, which attendees can ask anonymously by using a nickname. Talkspace has therapists licensed to practice in all states, but the availability of addiction specialists may vary by location.
Talkspace Plan Options and Pricing
Talkspace has three plans that cost between $69 and $109 per week, billed monthly. Although Monument and Online-Therapy.com cost less, Talkspace plans can be more financially accessible for individuals using insurance or their employee assistance program (EAP). According to our April 2022 survey of 1,000 online therapy users, 75 percent of Talkspace users reported that they felt they got a good value for what they paid. Talkspace psychiatry sessions are billed per session or can be purchased in bundles. The initial psychiatry evaluation costs $249, and the following appointments cost $125 each without insurance. A bundle of an initial evaluation with one follow-up appointment costs $365, and a bundle of an initial evaluation with three follow-up appointments costs $565 without insurance. Talkspace accepts insurance, and some employers offer it as an EAP benefit. If Talkspace isn’t in network with your insurance plan, you can request a superbill to submit to your insurance carrier for reimbursement if you have out-of-network benefits.
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Cost $9.99 to $249 per month; free community membership available Prescribes Medication Yes Accepts Insurance Yes Monument is an online platform that specializes in supporting people with alcohol use disorder. It has plans that offer different ways of supporting sobriety: therapist-moderated group sessions, a peer support forum, medication management, and therapy sessions. When signing up, individuals will complete a 15-item questionnaire that assesses the severity of the AUD symptoms they’re experiencing. After viewing their assessment results, Monument will recommend one of four plans: Free, Physician Care, Total Care Biweekly, or Total Care Weekly. In its therapy sessions, licensed therapists use cognitive behavioral therapy (CBT) and motivational interviewing (MI) techniques with the aim of empowering sustainable behavioral changes. According to the Motivational Interviewing Network of Trainers Incorporated, MI involves the therapist engaging with their client as an equal partner while refraining from offering unsolicited advice. A meta-analysis published in Addiction found that the combination of CBT and MI had a clinically significant effect in the treatment of people with both AUD and major depressive disorder. Monument does not have licensed providers in all 50 states. For therapy and medication management, you must live in New York, New Jersey, Connecticut, California, Pennsylvania, Washington, Virginia, Georgia, Colorado, Oregon, South Carolina, Texas, Kentucky, Florida, Ohio, Arizona, Iowa, or Washington, DC. Therapist-moderated support groups on Monument happen weekly or twice a week at set times. Subscribers can join with their nickname and have the option to participate however they feel comfortable. It’s optional to turn on the microphone or camera or join the group chat. The therapists moderating the groups can offer guidance and reminders of lessons or resources, as well as encourage connections and shared experiences in the group. After the group session concludes, attendees can join a discussion group with other attendees to continue with chat-based peer support. When a member of our reviews team joined a support group session, they found it to be a welcoming space where attendees were gently encouraged to take advantage of the support offered by their peers.
Monument Plan Options and Pricing
Monument offers four plan options to support people with AUD: a free community membership, a Physician Care plan, and two Total Care Plans (one with weekly therapy sessions and one with biweekly therapy sessions). The community membership includes access to 60-minute therapist-moderated group sessions and an anonymous 24/7 group discussion forum where attendees can get support from their peers. The Physician Care plan costs $9.99 a month, plus a $45 initial fee for one online physician appointment and a medical intake assessment. The plan includes unlimited messaging with your physician, but follow-up visits with the physician cost $45 per session. Monument recommends that subscribers to this plan check in with their physician every 90 days. The cost of the medication is not included. You can either use your pharmacy copay or pay out of pocket. Monument states that, on average, a 30-day supply of daily medication costs less than $40 per month, out of pocket. The Total Care plans include everything offered in the Physician Care plan and the community membership, plus 45-minute live video therapy sessions with a licensed therapist. There are two types of Total Care plans:
Total Care (Biweekly) Two therapy appointments per monthTotal Care (Weekly) Four therapy appointments per month
Monument accepts insurance and lists the carriers it accepts by state on its insurance webpage. If your insurance carrier isn’t listed, you can check your eligibility by completing an online form, and Monument will get back to you via email within 24 hours. Monument accepts Medicare in Arizona, California, Colorado, Connecticut, the District of Columbia, Florida, Georgia, Iowa, Kentucky, Maryland, New Jersey, New York, Pennsylvania, Ohio, Oregon, South Carolina, Texas, Virginia, and Washington. It accepts Medicaid in New York and Virginia.
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$45 for additional prescriber appointments Cost $200 to $440 per month Prescribes Medication No Accepts Insurance No Online-Therapy.com is a platform that specializes in supporting its subscribers with cognitive behavioral therapy, or CBT, a type of therapy that helps people change distorted thinking patterns and build healthy behaviors, according to the American Psychological Association. A randomized clinical trial published in 2016 in Alcoholism Clinical and Experimental Research found that computer-based CBT was safe and effective for reducing alcohol use, and it helped test patients think about their alcohol use in a new way. Unlike Talkspace and Charlie Health, which also have therapists who offer CBT, all Online-Therapy.com plans include self-paced CBT lessons, worksheets, journals, and videos to help patients stay accountable to their goals. Online-Therapy.com was our pick for the best overall online CBT platform in our review of the best online CBT platforms. According to Olivia Grace, PhD, a clinical psychologist in London specializing in therapy for video game addiction at the Mindful Gamer, CBT benefits people living with behavioral addictions like gambling, gaming, and sex addiction by helping them break the negative thought cycles that lead to addictive behaviors. Dr. Grace adds that CBT can be used as a complementary treatment for many substance-related addictions. Online-Therapy.com doesn’t give new subscribers an easy way to get matched with therapists who specialize in supporting people with addictions. When individuals sign up for the platform, they will be asked to select what they’re struggling with, such as relationship issues or an eating disorder, though there isn’t a selection for addictions or dependencies explicitly. Our reviews team contacted Online-Therapy.com via email and was told that, if not initially matched with an addiction specialist, anyone who prefers a therapist with specialized experience can get matched again by going through the following steps:
Online-Therapy.com Plan Options and Pricing
All Online-Therapy.com plans have CBT support materials to help individuals learn more about CBT and keep them accountable for behavioral change. That includes readings and videos to learn about CBT principles as it relates to their mental health issues, CBT worksheets that their therapist replies to, an activity planner, and a progress test to gauge on their mental well-being. The basic plan includes unlimited messaging with your licensed therapist, in addition to the worksheet responses. Online-Therapy.com states that its therapists respond to messages within a maximum of 24 hours, Monday through Friday, but that therapists often reply within a few hours. The standard and premium plans offer the same features as the basic plan, but with the addition of live therapy sessions. With the standard plan, you get one weekly live session, and with the premium plan you get two live sessions per week. Individuals can join live therapy sessions and communicate through video, voice, or text options. Premium subscribers also get the benefit of “express replies.” Online-Therapy.com does not note how much more quickly therapists will respond to premium subscribers, only stating that their questions are put in a priority queue for their therapists to respond to.
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Cost Varies by provider Prescribes Medication Yes Accepts Insurance Yes Zocdoc is an online platform with a search tool that allows individuals looking for addiction therapy to find licensed psychiatry and therapy providers. It also supplies each provider’s appointment availability up front before requiring users to pay for or book an appointment. This approach differs from platforms that require you to subscribe and pay in advance before having access to your therapist’s appointment availability. Some providers may have same-day availability. In addition to the ability to refine providers by location and insurance accepted, Zocdoc has filters to help you find a provider who meets your preferences, including the following:
Desired appointment date and timeConditions they specialize inSame-day availability or availability for the next three daysProvider genderLanguages spoken
Individuals looking for support for addiction can select the “Addiction/Substance Abuse” filter under “Conditions and Services” or search for the specialization in the search bar. They can also view each provider’s profile to see their educational background and any specializations, insurance coverage information, and reviews from other Zocdoc users. Live video sessions can be conducted through Zocdoc’s platform or an external video conference platform. Provider listings with “Zocdoc” indicate that the provider uses the Zocdoc website or app for their online sessions, meaning patients won’t have to download or install third-party software. Zocdoc has licensed providers who can provide addiction therapy in every state.
Zocdoc Plan Options and Pricing
Provider sessions on Zocdoc are billed per session, and costs vary by provider. A filter allows you to search for providers who accept your insurance plan, but you can also call the provider’s office to clarify costs that you may be responsible for or any other questions you might have before booking and submitting your payment information. Cost $10,500 per program Prescribes Medication Yes Accepts Insurance Yes Charlie Health is an online mental health platform that supports adolescents between ages 11 to 18 and young adults between ages 18 to 32. It offers an intensive outpatient program (IOP) with a combination of group therapy, family therapy, and individual therapy that lasts 9 to 12 weeks, depending on the needs of the patient. According to the American Addiction Centers (AAC), an IOP is a treatment program that does not require detoxification or round-the-clock medical supervision. They support individuals who need more support than weekly therapy provides, but without requiring residential treatment. The American Society of Addiction Medicine (ASAM) divides addiction treatments into four levels that form on a continuum of care, level one being outpatient care and level four being intensive inpatient care. IOPs are defined as a level two addiction treatment. The right level of care for a particular patient is determined by addiction or healthcare professionals using a specially designed diagnostic assessment, such as the ASAM Criteria. In the case of Charlie Health, IOPs can be attended virtually from home. Each IOP is a personalized treatment plan for an individual based on the results of their intake assessment. Each person is matched to therapists and groups with the same or similar concerns. Charlie Health reports that their IOPs involve, on average:
Three hours of group therapy, three days per weekOne hour of individual therapy per weekOne to two hours of family therapy per week
IOPs are not recommended for severe addiction where inpatient treatment may be more appropriate. According to the AAC, inpatient treatment, also known as residential rehab or inpatient rehab, is “a form of addiction treatment that provides clients with 24-hour care under the supervision of professionals” and is often recommended in cases of severe or long-term addiction and for those with existing psychiatric diagnoses. David Seitz, MD, acting medical director at Ascendant New York, an inpatient rehabilitation clinic in New York City, explains why family therapy can be helpful for those recovering from addictions. “This type of therapy can help improve communication within your family, address conflict resolution, and build a stronger sense of connection. Through family therapy, you and your loved ones can learn more about addiction and how it affects you both. This can help to reduce any feelings of shame or stigma that you might be experiencing. Plus, it can provide a space for you to openly share your experiences and feelings. That can help your loved ones understand what you’re going through and offer support.” Grace adds that the accountability gained from family therapy can help motivate individuals recovering from addiction to make the right decisions on a daily basis. In addition, family therapy may help decrease the isolation individuals can experience when going through recovery, reducing the risk of relapse by creating a supportive and understanding social environment. For adolescents and young adults struggling with addiction, Charlie Health IOPs support SUDs, internet addiction, gaming addiction, social media addiction, gambling addiction, relationship addiction, and sex addiction. It also supports youth struggling with dissociative disorders, trauma, depression, gender identity, gender dysphoria, self-harm, mood disorders, behavioral issues, and anxiety disorders. Like Monument, Charlie Health therapists can use CBT and MI to support individuals in their IOPs. Other modalities offered by therapists on the platform include the following:
Art and music therapyAttachment-based and multidimensional family therapiesDance and movement therapyDialectical behavior therapy (DBT) skillsDrama therapyExperiential therapyEye movement desensitization and reprocessing (EMDR)Peer and parent support groupsYoga, mindfulness, and meditation
We reached out to a Charlie Health customer service representative to ask how messaging works and where its IOPs are offered. They stated that individuals in a Charlie Health IOP can securely message their therapists and engage in peer support through the external app Discord with their therapy group. Charlie Health customer service also told us that its IOPs are offered in Arizona, California, Colorado, Delaware, Florida, Idaho, Illinois, Indiana, Georgia, Maryland, Michigan, Montana, Nevada, New Jersey, New Mexico, New York, Oregon, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Washington, and Wyoming.
Charlie Health Plan Options and Pricing
Charlie Health accepts Medicaid and insurance plans from major companies including United Healthcare, Aetna, Cigna, Humana, BlueCross BlueShield, Optum, and Tricare. If using insurance, your cost will depend on the details of your insurance plan. For the uninsured, the total cost of a program is $10,500. Charlie Health offers an individualized financial assistance program that may include total cost reduction or a payment plan, but it doesn’t offer specifics about that program on its website. It only states on its insurance page that it “works with families who are uninsured or whose insurance is out of network to create a financial plan that works for their budget.” You need to fill out an online form or call Charlie health at 1-804-632-4366 to discuss your options. Dr. Seitz explains that online therapy can be a great way of providing additional support and accountability, along with other forms of addiction treatment like in-person therapy or 12-step meetings, which are peer support groups first developed by Alcoholics Anonymous, according to the AAC. Seitz adds that cases of severe addiction may benefit from in-person treatment because of the level of support, structure, and monitoring needed to stay on track to recovery. Individuals looking for support may consider a few more factors when choosing the best online therapy platform to help with addiction:
Type of Addiction Depending on the type of addiction, one treatment method may be more appropriate than others. For example, someone with AUD may require medication management in addition to online therapy. Monument specializes in supporting people with AUD.A Proper Assessment A trained addiction specialist, which is either a licensed therapist or psychiatrist, can be a helpful first point of care for creating a strong recovery plan. Talkspace, Zocdoc, and Charlie Health have questionnaires or search filters to connect you with addiction specialists. All Monument physicians and therapists specialize in AUD assessment and treatment.Type of Therapy According to the AAC, many types of therapy can benefit people who are recovering from addictions. In addition to individual therapy, the group and family therapy that Charlie Health and Monument offer can build a network of accountability among peers and close family members. Specific techniques like CBT, MI, DBT, and EMDR all have different approaches to supporting addiction recovery. Online-Therapy.com has CBT-trained therapists and CBT resources available on the platform.Resources Available Depending on your treatment plan, resources like group forums from Monument and Charlie Health and the CBT worksheets and activity logs from Online-Therapy.com can reinforce the progress from online therapy sessions.
Engaged in ongoing independent researchMystery shopped each of the brandsContacted the brands’ customer service teams to ask questions and gauge responsivenessConsulted six leading psychologists and psychiatristsBecame customers of online therapy providers ourselvesReviewed academic research about the efficacy of online therapy versus in-person therapyRead hundreds of verified customer reviews from trusted third parties such as the Better Business Bureau (BBB) and Trustpilot.
Monument is a platform that has providers, plans, and resources dedicated to supporting individuals with AUD online. Online-Therapy.com specializes in CBT, a well-researched and beneficial technique for the treatment of addiction. But it is the only platform on our list that does not accept insurance. If you’re looking for online therapy that accepts insurance, Talkspace, Monument, Zocdoc, and Charlie Health may be better options. For individuals who prefer choosing their own providers and making an appointment that fits their schedule, Zocdoc was our choice for the best platform for on-demand appointments. The providers on this platform also accept insurance. We liked Charlie Health for adolescents and young adults looking for an intensive outpatient program that offers group therapy, peer support, family therapy, and individual therapy. Each individual’s recovery may look different based on many factors, but seeking professional mental health support online can be a beneficial stage in someone’s addiction management journey. Furthermore, you can reach out to the SAMHSA National Helpline at 800-662-HELP (4357). The SAMHSA helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service for individuals facing mental health or substance abuse disorders.
