Pros & Cons

E-Therapy Cafe markets itself as a solution for busy individuals or couples who are looking for a convenient, simple platform through which they can e-chat or video chat confidentially with a therapist. The company is focused on providing professional, ethical, and affordable mental health support and offers a wide range of professionals to work with, including board-certified licensed clinical counselors, master’s-level counselors, registered dietitian nutritionists, and certified expert-level life coaches.    So to evaluate how well the company is achieving its goals, we surveyed 105 E-Therapy Cafe users, in addition to testing out the couples therapy service ourselves. We also spoke to subject matter experts about the service and gathered additional information from previous E-Therapy Cafe clients online. Here’s how it compares to other online therapy services.

What Is E-Therapy Cafe?

Therapist Jude Black, PhD, LPC, got the idea for E-Therapy Cafe over 25 years ago when she was a young military spouse on a base in North Carolina and her husband was deployed overseas. The couple were able to talk and connect using virtual teleconference, her first experience with the possibilities of telehealth.  In 2003, she worked for one of the first online therapy platforms, Cope Today, providing real-time online video sessions, instant chats, and virtual journal exchanges with military members and veterans deployed around the world. Wanting to branch out on her own, in 2016 Dr. Black set out to create her own boutique team of licensed and certified professionals.  Today, E-Therapy Cafe has a staff of skilled practitioners who can help with diagnosed mental illness, day-to-day stress, and everything in between. It contributes a portion of every session fee to its charity affiliates: the Gary Sinise Foundation and Freedom Service Dogs of America. Important to note: Even if you are looking for a therapist, you may get paired with a coach. If you get paired with a therapist who isn’t licensed in your state, you’ll receive coaching services from that professional, not therapy. 

What Services Does E-Therapy Cafe Offer?

Individual, couples, relationship, and marriage counseling are all offered, making E-Therapy Cafe one of the most focused platforms on partnership therapy. It also offers specialized coaching and therapy services for college transitions and upcoming weddings, in addition to military/veteran counseling. It advertises LGBTQIA+ affirming therapy, but it is unclear from the website how many therapists and coaches specialize in this. In addition to licensed therapists, there are registered dietitians and certified expert-level life coaches available to connect with. E-Therapy Cafe does not offer psychiatric help or medication management services.  Sessions last 30 minutes, with the option to pay for an additional 30-minute session and do them back-to-back for an hour session.  One session is equivalent to:

30 minutes real-time video30 minutes instant e-chat 700 words e-journal with a detailed response from your therapist 

Who Is E-Therapy Cafe For?

E-Therapy Cafe is for on-the-go students, military personnel, busy couples, and others who need help managing their mental and emotional reactions and patterms, but who don’t require psychiatric medication or lengthy therapy sessions.  There is an emphasis on military personnel and on couples therapy, perhaps because of the specific history of the founder of the company. The overall pool of therapists to choose from is fairly young-to-middle aged and very white. Of the 17 therapists available, only four are male and none are BIPOC. Only one offers services in other languages (Dutch and French). There is a heavy lean toward “expert-level life coaching” as opposed to clinical therapy.  While other companies target clients looking for help with heavier, longer-term issues, E-Therapy Cafe fills a gap in the market and works well for those looking for a helping hand through a transitional or temporarily difficult time. Its couples therapy is ideal for partners who just need a little extra support to help clarify and resolve relationship issues.  E-Therapy Cafe’s therapists use a wide mix of therapy techniques, including:

Eye movement desensitization reprocessing (EMDR)Life coachingDialectical behavioral therapy (DBT) Cognitive behavioral therapy (CBT)Trauma-focused cognitive behavioral therapy (TF-CBT)MindfulnessMotivational interviewingPositive psychologyPsychoanalytic psychotherapyEmotionally focused therapy (EFT)Acceptance and commitment therapy (ACT)The Gottman MethodHypnosisNeuro-linguistic programmingArt therapyNarrative therapy

How Much Does E-Therapy Cafe Cost?

There is a $50 one-time trial option that lets you experiment with a 30-minute instant chat, live video, or virtual journal entry with a response from a therapist.  After this, if you want to continue with services, there are three ways to go about it.

E-Therapy Shot

The E-Therapy Shot is a pay-as-you-go 30-minute session that can be bought a la carte and used for instant chat, live video or virtual journal. All E-Sessions expire 30 days from date of purchase and all fees have to be prepaid 24 hours prior to services rendered. 

E-Therapy Four

For a monthly subscription service that offers a slight discount, there’s the E-Therapy Four, which gives you four 30-minute sessions to be used per month at $49 a session ($196 a month). 

E-Therapy Eight

E-Therapy Eight is the same concept as E-Therapy Four, but with eight 30-minute sessions (that you can double up for four one-hour sessions), but that raises the price to $360 a month. Your monthly subscription auto-renews each month.  While at first glance the company’s “most popular” $196 a month option seems in line with average online therapy costs, keep in mind that many other companies offer 45-minute or hour-long sessions at a similar rate. To do weekly one-hour sessions here, it costs $360 a month, which is somewhat more than at other similar companies we surveyed. 

Does E-Therapy Cafe Accept Insurance?

No, E-Therapy Cafe does not accept insurance.  “This allows us to provide cost-effective, quality services,” a customer service representative wrote in an email, explaining that the administrative burdens of accepting insurance take time away from the patient. “The process for insurance credentialing is time-consuming and can be costly, especially with claims, denials, and collections.”  Upon request, the company can provide a detailed monthly superbill for you to submit to your insurance provider for reimbursement.  In our survey, 93% of all E-Therapy Cafe users had insurance and 27% told us they wished the company accepted insurance. Of the users that were no longer using E-Therapy Cafe for therapy, 9% said they left because they found a provider that did take insurance.

Does E-Therapy Cafe Offer Discounts?

Yes, there is a 10% discount offered to all military members, their dependents, veterans, first responders, and actively enrolled college students. The discount applies to subscriptions only, not individually paid sessions. 

The company motto is “Life is Messy. We Can Help.” Yet it doesn’t go unnoticed that the website feels, well, messy.  Despite the fact that E-Therapy Cafe updated its homepage in the last year or so, it still feels outdated. Website fonts are not consistent, the wording is large and unevenly spaced, and there is a carousel of stock photos that cycle really quickly, giving the whole homepage a scattered, frenetic feel.  One thing I disliked was that on certain pages, the top menu disappears, so instead of being able to simply check out the next menu option, like pricing, I would have to backtrack through some of the pages I’d visited to try to find a page with the menu showing.  On social media, I also found only neglected profiles with next-to-no engagement. Still, if you take the time to explore the site, you can eventually find all of the information you need about its services, pricing, process, terms, mission, and team. Despite my issues with the site, 75% of our survey respondents reported that they found it either very easy or easy to navigate the website.  The website has landing pages on couples counseling, military counseling, LGBTQIA+ counseling, and more, all of which can be found by going through the top menu on the home page. Each of these pages provides context for why these types of therapy are needed and what topics and issues may come up during these sessions. If you click on any of the “Take the First Step Now” buttons scattered around the homepage, you’ll be taken straight to the intake form to sign up for services.  Scrolling down the homepage, you’ll find information about the company’s services, its mission, and its team. For example, by clicking on “Find a Therapist Online” (easily missed in the clutter of black text, and slightly misleading since many employees are coaches, not therapists), you’ll be taken to a page where you can read the detailed bios of all the therapists and coaches on staff. Each profile also clearly states whether or not providers are taking on new clients.  The website does lack a diversity statement, inclusive imagery, and practitioner pronouns, despite Dr. Black’s stated goal to prioritize a diversified team of therapists and coaches. However, 89% of survey respondents rated e-Therapy’s diversity positively. 

Does E-Therapy Cafe Have an App?

E-Therapy Cafe doesn’t have its own app, but to use its services, you’ll need to download the free Teleheath by SimplePractice app. This is where video calls take place. When you click the link in your appointment reminder email, you will be taken directly to your appointment. 

How Do You Sign Up for Therapy at E-Therapy Cafe?

The sign-up process is pretty straightforward. Seventy-nine percent of our survey respondents said they found the sign-up process very easy or easy.  Hit one of the many “Take the First Step Now” buttons on the homepage and you will be directed to the registration form where you choose a type of therapy: individual, couples, or bridal coaching.  Then, you fill in a form that asks for your name, email, phone number, address, age, gender, relationship status, employment status, how you are feeling today, whether or not you are feeling suicidal, and your current levels of stress, anxiety, and energy.  The intake form then asks you to pick a coach or therapist. If this feels overwhelming, you can ask E-Therapy Cafe to pick one for you. If you ask for help in finding a therapist, E-Therapy Cafe will choose based on factors such as practitioner availability and the type of therapy you are seeking. The company does not use a tech-based algorithm to pair practitioners with clients. “We are a boutique team that believes in personalizing care,” the customer service rep noted in an email.  Next on the intake form is a question about which plan you’re interested in, followed by open-ended questions about what your goals are for therapy. The form also asks you how you found E-Therapy Cafe.  Once you complete the form, you’ll get a link to a secured client portal, where you’ll be asked for payment details. That felt a bit weird, since I just shared a bunch of private information about myself, and only after that did it tell me I was being sent to a secure place to share my payment information.  After completing payment information, the email with the link to the client portal arrived almost immediately. Within the client portal, you will have access to the company’s practice policies, privacy practices, and terms of use, as well as a consent form for your telehealth consultation. You can also access your video sessions here, review instructions for clients, and provide or change payment information.  Once signed up, it is impossible to directly log in to the client portal through the site. You have to start your login there, receive a link via email, then use that link to login. And if you are inactive on the site for 15 minutes, you are logged out and have to go through the process all over again. 

Matching With a Therapist at E-Therapy Cafe

To pick your own therapist or coach, you must first read through the bios of the 17 practitioners on the site, each on a separate webpage. There are many therapists and coaches who are not taking on new clients and yet still show up as an option on the registration form. You have to look at each individual bio to figure out which practitioners are actually accepting new clients. While not as streamlined as it could be, finding a therapist is smoother on E-Therapy Cafe than on many other online therapy platforms. In fact, 73% of our survey respondents reported that it was very easy or easy to find a therapist on E-Therapy Cafe.  What I appreciated about E-Therapy Cafe was that coaches and therapists seemed to have a diverse mix of certifications, specializations, and training. One therapist specializes in compassion fatigue, for example, while another is a certified breathwork facilitator. It just takes a bit of digging through all of the bios to see what might be a good fit for you. In contrast, I have been on other online therapy platforms where you state your issues and what style of therapy you would prefer, and it filters your choices to appropriate options, but you don’t have any control over who you’re ultimately matched with.  I chose my therapist mostly based on age. Many of the therapist options were a lot younger than me, and I felt more comfortable working with someone who I hoped would have more life experience. She also seemed to take a very holistic approach to therapy. This part of her bio resonated with me: “No story is alike and no single aspect of ourselves can be compartmentalized if we are to truly heal. We are an embodiment of mind, body, and soul, which work collaboratively to foster a healthy and flourishing life.”  Fifty-eight percent of surveyed users said they would still be seeing their E-Therapy Cafe practitioner six months from now, an area in which the company performed better than many of its competitors. At Talkspace, the rate was 50%, and at BetterHelp, it was 47%. Once you have filled in your portal paperwork, you can schedule your first session with your therapist via SimplePractice. To do this, you use the interactive calendar. I was able to request an appointment for the very next day. I got an email reminder from the platform 24 hours in advance of my session, which I appreciated. 

How Do Therapy Sessions Work at E-Therapy Cafe?

After I was in direct contact with my therapist, everything seemed very easy. Through the client portal, I was able to request an appointment time, and there were plenty of slots available. I then had to wait for her to confirm the appointment, but she always did so within an hour or so. I felt very comfortable asking her any questions I had about the platform, scheduling, or billing. She mentioned that a lot of new clients miss their first appointment because they didn’t check time zones or didn’t download the video messaging app. 

Messaging Your Therapist

Messaging my therapist was simple enough through the portal, and she also invited me to email her if that was easier. Since I was trying couples therapy, my partner also had access to a shared client portal. I appreciated the clear option to choose whether to message the therapist directly and privately, or with my partner. 

Video Sessions

My therapist was always incredibly punctual to our video chats, arriving on the dot and ending on the dot. Her video was always clear and her demeanor on screen was professional, yet casual and accessible.  I tried couples therapy and I feel that my therapist did a very good job making sure that both my partner and I felt safe to speak openly and be heard. She would always create room for both perspectives.  I do feel like it took a while to even start to get into any real issues, though. In our first appointment, we just helped her fill in our family tree. I feel like this is something we could have filled out on our own ahead of time and sent in. Then, at appointment number two, she wanted to meet with me individually. In appointment three she met individually with my partner. Only by the fourth appointment did I feel like we even began to look at our couples issues together. 

Medication Management

It is important to note that E-Therapy Cafe has no psychiatrists on staff and no medication management services. This is a big drawback, especially since multiple competitors, including Wellnite and Talkspace, offer both talk therapy in addition to medication management services. 

What Happens If I Miss a Session at E-Therapy Cafe?

As long as you cancel within 24 hours, you incur no penalties. If you cancel or reschedule less than 24 hours before your appointment, you forgo that therapy session but are still charged for it. On the flip side, if your therapist has to cancel on you with less than 24 hours’ notice, they will credit you one free session as a way of showing you that they value your time. All credits for sessions expire exactly one month from the date of purchase. For clients on subscription memberships, unused credits will not roll over between billing cycles. 

Switching Therapists at E-Therapy Cafe

There is no easy way to switch therapists within the client portal, nor is this process ever explained clearly on the website. All change requests have to be emailed to customer service, telling them who you would like to switch to. Then the new practitioner will reach out via email. Because it is a small, boutique company with only 17 therapists, I did feel a bit awkward asking to switch. But, it was handled with nothing but grace on E-Therapy’s end.  Finding the right therapist at E-Therapy Cafe can take work, but since there are only 17 therapists to choose from, that helps to narrow down your choices. The practitioner bios are fairly extensive and you do get a feel for their experience, personality, and the way they like to work.  In our user survey, 51% of E-Therapy Cafe customers said they stayed with the first practitioner they met with, while the rest switched up to five times before finding a good fit.

Pausing or Canceling Therapy at E-Therapy Cafe

With pay-as-you-go “Shot” sessions, you always have the option of ending therapy simply by not scheduling any more sessions. But, if you get a monthly subscription bundle, it auto-renews and you have to request termination through customer service at least 24 hours prior to your renewal date. You cannot get a partial refund if you cancel your subscription mid-month or don’t use all of your allotted sessions.  The company can freeze your subscription for 30 days with management approval, to take into account travel or specific work situations. There is no way to cancel through the client portal; you have to email customer service. 

Quality of Care and User Satisfaction

E-Therapy Cafe is growing, promising on its website that more practitioner options are coming soon. I found my therapist helpful with my questions about scheduling, using the client portal, etc., and when I had a billing question, she even stepped up and told me that she would look into it for me.  When we surveyed users, the responses were overwhelmingly positive: 85% of respondents reported that the mental health services they experienced at E-Therapy Cafe were above average. Additionally, 50% reported that they thought the platform was excellent, and 40% said their practitioner’s qualifications were excellent. When it came to getting mental health needs met, 82% said all or most of their needs were met by their E-Therapy Cafe provider. What’s more, 94% of clients were happy with their experience with E-Therapy overall (36% said their experience was “excellent,” 29% “very good,” and 30% “good”). Negative reviews mostly had to do with an incompatibility with the therapist or with not loving the short, 30-minute sessions.  I am also not a fan of the 30-minute structure. I felt like it took us about 25 minutes to get into the swing of things and relax into the session, and then it was over.  Our subject matter expert, Hannah Owens, LMSW, confirmed that 30-minute sessions are, in general, not ideal. “That doesn’t leave much time to build rapport or really delve into issues, and the end of the session might be jarring and potentially leave the user in a heightened emotional state that they would otherwise be able to wind down from with a longer session,” Owens says. She adds that it could potentially be productive with an extremely structured approach like cognitive behavioral therapy. Bear in mind that if you sign up for coaching, you aren’t really getting therapy. Coaching, whether it is at an “expert level” or not, is not the same thing as therapy. “Sessions with a life coach who is not certified are not an appropriate alternative to therapy with a licensed practitioner, as coaches are not held to the same standards or accountability as licensed therapists, who are regulated by the state they are licensed in,” says Owens.

Privacy Policies at E-Therapy Cafe

E-Therapy Cafe is HIPAA-compliant, meaning it has systems and processes in place to protect your confidentiality and health information, as required by U.S. law under the Health Insurance Portability and Accountability Act.  While there has been nothing reported about security breaches at E-Therapy Cafe, the platform does not explain the privacy measures it takes before you fill out the initial intake form, which asks for your name, phone number, email, date of birth, and some sensitive information about gender identity and mental health. Once you have filled out the intake and been paired with a practitioner, you are then taken to SimplePractice, where forms, including E-Therapy Cafe’s privacy policy, feel more secure. SimplePractice protects your account information through a series of protocols it publicizes on its website, including multiple layers of encryption and using servers that are housed in a secure facility protected by proximity readers, biometric scanners, and security guards. It boasts several security certifications and aggressive security testing.

E-Therapy Cafe vs. Its Competitors

Compared to larger platforms like Talkspace, Wellnite, and BetterHelp, E-Therapy Cafe does a better job of meeting clients’ therapeutic needs. In our client survey, 36% of users of E-Therapy Cafe rated their overall experience as excellent, whereas only 17% of Wellnite clients and 27% of BetterHelp and Talkspace clients could say the same.  Survey respondents also reported that finding the right therapist was easier on E-Therapy Cafe. 31% of survey users that had used Wellnite said that their therapist met all of their needs, and 38% of Talkspace and BetterHelp clients said the same. That number went up to 48% for E-Therapy Cafe users.  Fifty-eight percent of surveyed users said they thought they would still be seeing their E-Therapy Cafe practitioner six months from now, while this number was lower at most other online therapy services (at Talkspace it was 50%, at BetterHelp it was 47%, and Wellnite came in at 39%). The experience was so positive for survey respondents that 77% said if they needed to find a new therapist, they would stick with E-Therapy Cafe.  E-Therapy Cafe also outperformed other platforms—big and small—in terms of overall satisfaction. A whopping 94% of users said they would rate the service excellent, very good, or good. Scores in this category at Talkspace and BetterHelp were 90% and 86%, respectively. Smaller platforms like Gay Therapy Center and Two Chairs saw feedback in the excellent, very good, or good spectrum with 84% and 75% of survey respondents, respectively.  Seventy-four percent of survey respondents said they thought E-Therapy Cafe was much better or better than other online therapy services they’d used in the past, citing ease of use (54% said this was something E-Therapy Cafe did better than other sites) and specialized and qualified therapists (also 54%) as the top two reasons. Survey responses suggested the company could do better when it comes to taking insurance, switching practitioners, and offering more information and additional resources about mental health. It is important to reiterate that E-Therapy Cafe has no psychiatrists on staff and no medication management services. This is a big drawback, especially since multiple competitors, including Wellnite and Talkspace, offer both talk therapy in addition to medication management services. 

Final Verdict

Based on my experience with the couples counseling services, it took much too long to even get into the basic details of our issues. Not until the fourth appointment—almost a month in—did we get to all meet together and focus on an aspect of our relationship that we wanted to work on. This could be acceptable if your relationship is fairly strong and just needs some help getting back on track, but if a couple is going through something more serious, waiting a month to address it together is not ideal.  Overall, E-Therapy Cafe ranks high among our survey respondents when it comes to platform usability, the quality of practitioners, and pricing. The services this small online therapy company offers are diverse and easily accessible. It’s not for those who want a swanky website or an ultra-modern app. It is also not the best for people who want a comprehensive therapist matching service, or for those who need to work with a psychiatrist or have their medication managed. However, it is ideal if you just want some guidance through a life challenge, and are hoping for a little bit of accountability, perspective, and consistent (but short) check-ins. 

Methodology

To fairly and accurately review the best online therapy programs, we sent questionnaires to 55 companies and surveyed 105 current users of each. This allowed us to directly compare services offered by gathering qualitative and quantitative data about each company and its users’ experiences. Specifically, we evaluated each company on the following factors: website usability, the sign-up and therapist matching processes, therapist qualifications, types of therapy offered, the service’s quality of care, client-therapist communication options, session length, subscription offerings, client privacy protections, average cost and value for money, whether it accepts insurance, how easy it is to change therapists, overall user satisfaction, and the likelihood that clients would recommend them. We also signed up for the companies in order to get a sense of how this process worked, how easy to use the platform is, and how therapy takes place at the company. Then, we interviewed three therapists we found who either currently work or worked for this company in the past and worked with three subject matter experts to get their expert analysis on how suited this company is to provide quality care to therapy seekers.