We Tried Couples Therapy Online and In-Person With LifeStance Health — Here’s What Happened

My partner and I have been to couples therapy several times before. After four years together, we’ve found that even popping in for a few therapy sessions here and there can help boost our relationship. Sometimes it can be hard to see things from the other person’s perspective, so having a neutral third party there to help can really go a long way.

Signing up for LifeStance Health was incredibly quick and easy. To start, I entered my ZIP code, the service I was interested in, my date of birth, and how I wanted to pay. I opted for the self-pay option, but LifeStance Health accepts a number of popular insurance companies, including Aetna, Cigna, and Humana.

From there, I was directed to a list of potential providers near me who offered couples therapy — in my area, that was a total of 22 providers. It doesn’t offer therapist matching, so instead you’ll need to browse through the provider list to find the best fit for you. Luckily, the process of finding a therapist was relatively easy. At the top of the page, there are several filters you can use to narrow down your search:

• Type of Visit There’s a box for video visits and one for in-office visits. I checked both so that we could try out each type of session.
• Issues This filter featured a drop-down list of specific concerns, such as anxiety or couples issues; populations, such as LGBTQ+ or veterans; and interventions, such as cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT).
• Availability You can choose a specific time of day, such as before 10 a.m. or after 3 p.m., and how soon you’d like to see someone.
• Gender Options for a male, female, or nonbinary provider.
• Language You can select a provider who spoke another language, such as Spanish or German.

Aside from the various filters, the directory was easy to browse. Right away, I could scroll through the list of providers and see their photo and the next three available appointments they had. To learn more about a particular provider, I could click to view their profile page with their bio, areas of expertise, and qualifications. All of the providers were licensed counselors or clinical social workers and most practiced CBT. Many also had expertise in parenting, family therapy, mindfulness, parenting, and couples issues.

Scheduling Appointments

Since my partner and I have busy schedules, I wanted to try and find a provider with weekend or evening availability. It can be a challenge to find weekend therapy appointments, but I was happy to see that there were four providers near me with some availability.

After finding a therapist who seemed like a good fit, I selected a date and time I wanted to book. Unfortunately, since I wanted a Saturday appointment, I had to wait a little over three weeks for my first appointment. However, knowing how difficult it can be to find weekend therapy in the first place, this didn’t seem unreasonable to me.

As a new patient, I was instructed to create a profile with some basic information, including my name, email address, date of birth, phone number, and gender. Within a few minutes I received an email with a link to the patient portal, which had a series of forms to fill out, including a services agreement and a HIPPA notice. At this point, however, there was still no indication of how much the session would actually cost.

Providing Payment

Something that really stood out to me with LifeStance Health was how unclear and, honestly frustrating, the pricing was. Even after I scheduled my first appointment and created my account in the patient portal, there was still no information about how much my therapy sessions would cost.

LifeStance Health requires a credit card on file, so you’ll need to input that information into the portal. While I wasn’t billed for my session right away, I didn’t love the fact that I was asked to provide my credit card information prior to learning the full cost I would be expected to pay.

Rather than give you a set price, it will provide a good faith estimate to give you an idea of how much each session will cost. I also received a call from customer service after signing up and creating my account in the patient portal and they explained more about the pricing structure.

For both individual and couples therapy, the initial appointment was priced at $300. According to my good faith estimate, the cost of follow-up appointments could range from $140 to $450 depending on the session type and length. Our first session was billed at $300 since it was considered an evaluation. I found this a little off-putting considering that this was simply an introductory therapy session and not a longer session or psychiatry evaluation.

Our second session was priced at $270. After signing up for our second session, we were billed $190, so I assumed that was the cost of all follow-up sessions. However, a few days after the appointment, I received a bill for $80. Looking at the statement, it suggests follow-up appointments are priced at $270, but for whatever reason, unlike the first appointment, I wasn’t asked to pay the entire fee up front. Again, the unclear pricing left a bad taste in my mouth. The total cost was the same as what was listed on my good faith estimate, but I didn’t like how disjointed the process felt.

We were asked to test LifeStance Health for one month, but because of our provider’s limited availability, that equated to only two therapy sessions. We waited a little over three weeks for our first session in order to secure a Saturday appointment. There was an even longer wait for our second appointment — about 40 days, actually. But because my partner and I needed weekend or evening appointments, I wasn’t surprised that availability was limited.

In order to get the most out of LifeStance Health, we opted to try both in-person and online sessions. Prior to each scheduled session I received reminders via email and text message.

Our Virtual Couples Therapy Session

We chose to start our therapy with the online option. After scheduling my first appointment, I was provided several different documents and forms, including a welcome letter with instructions on how to log on to the virtual video platform. I liked that the company sent these out well before the actual appointment. As someone who habitually struggles with technology, it was reassuring to have a step-by-step guide on hand.

Even without this letter, though, I found the platform incredibly easy to navigate. Along with the welcome letter, which included a link to our provider’s virtual waiting room, I received a reminder email with a “Click Here to Start” button.

Our therapist arrived to our scheduled appointment on time, and there were no technical issues with the virtual platform. The first appointment is billed as an initial evaluation, and while it was structured much like any other session, it did last 60 minutes. I’ve had a lot of experience with therapy over the years, and most of the time the therapist starts with a brief introduction, a bit about their background, and an explanation of how couples counseling works, but our LifeStance Health provider did things a little differently.

She started out by having each of us introduce ourselves and asked us to tell her a little more about our relationship and what we were hoping to achieve with therapy. When I explained that we were seeking therapy as more of a maintenance tool than for any specific issue, she seemed a little put out. She told us that she preferred to work with couples over a longer period of time in order to get the most out of therapy. Knowing that we were only going to be able to test the service for a month, I actually felt a little guilty when she said this.

But she didn’t press the issue, and we quickly moved on to talk more about our relationship. She listened to each of us share some of our concerns and then offered a way for us to compromise more. She gave us space to talk, but she also added some of her own experiences, which I found really relatable.

Our therapist offered both online and in-person therapy, so at the end of our session we booked our next appointment as an in-person one. She only offered video visits on Saturdays, but when we explained that we needed flexible scheduling, she was able to offer us a weekday appointment at 5 p.m.

Our In-Person Couples Therapy Session

Our second session took place in person at a LifeStance Health clinic about 15 minutes from our house. When we arrived, we checked in with the receptionist and took a seat in the waiting area. The waiting room had a very cold, clinical atmosphere, with harsh fluorescent lighting and white walls with little decoration. After just a minute or two, though, our therapist came to escort us to her office, and I was happy to see that it didn’t have the same neutral, overly sterile aura.

Her office was small, with soft lighting, a large window, and several seating options, including two big, plush chairs for us to sit on. Her walls were also covered in artwork and framed diplomas, and she had a slightly cluttered desk. Instead of sitting at her desk, though, she sat in a chair closer to us, which made it feel like a more personal experience. It wasn’t exactly a calm or relaxing vibe, but I found the atmosphere incredibly warm, welcoming, and cozy, which I really liked.

Since this was a follow-up appointment, it lasted 50 minutes, which is a good amount of time for a couples therapy session. Again, she started the session by asking us a little bit about how things were going for us. We then jumped into some of the issues we wanted to work on. Once again, she gave us space to talk and then offered some self-disclosure and advice on how to best work through the issues. At the end of the session she asked if we wanted to set up our next appointment or wait, and I was relieved that she didn’t push us to make a commitment. Instead, she hugged each of us goodbye and reminded us that we could always call the office or schedule an appointment online.

We had another tester try out individual therapy at LifeStance Health.

Sign-Up

When signing up, she was able to choose whether she wanted to get matched with a provider or browse providers and select her own.

“I’m a therapist myself and have spent over a decade in my own personal therapy, so I am fairly clear on what I am looking for in a clinician. With this in mind, I opted to browse providers and select the person I wanted to work with,” said Julia Childs Heyl, MSW, a psychotherapist who tried individual therapy at LifeStance Health for us.

At the top of the page it read: “Choose from approximately 560 LifeStance-supported therapists that serve patients in Pasadena, California.” While this number is impressive, it’s also a bit misleading, since LifeStance has more than 500 therapists licensed to work in the entire state of California. This isn’t an issue if you are looking for online therapy because you can work with anyone licensed in your state.

It didn’t take long for Childs Heyl to find a provider whose photo instantly stood out to her: “She was a woman of color, like me. Her photo looked professional, warm, and approachable. Upon clicking on her image, I was taken to her full biography page. She had an extensive bio, listing various issues she worked with that aligned with my needs as well as the 20 insurance platforms she partnered with. I was sold and ready to book.”

After choosing a time that worked for her on the therapist’s calendar of open sessions, she was prompted to create an account by filling out some basic information, such as her name, address, and contact information. Next, she was directed to the patient portal to fill out some paperwork, including a questionnaire about her mental health and reasons for seeking treatment, and her credit card information.

Childs Heyl also had issues with the timing of receiving a cost estimate for therapy. And when she did finally find her cost estimate, it was incorrect.

“After some digging in my patient portal, I was able to locate a Good Faith Estimate, a document medical providers are required to give clients that outlines the fee schedule for services, and I was prompted to sign off on it,” notes Childs Heyl.

The form stated she would be charged $285 for a 50-minute session with a psychologist and $200 for a 50-minute session with a master’s degree–level therapist. According to her therapist’s licensing and education information on her bio, she was a master’s degree–level therapist. “With this in mind, I expected to be charged $200 after my first session. After I finished my first session, I received a notice that my card on file was charged $345,” Childs Heyl explains. “After my second session, I received a bill for $335.” She reached out to customer service about the discrepancy but has yet to receive a response.

Individual Therapy Sessions

When she logged on to her therapy session, she was pleased to see her therapist was already there waiting. Her therapist noted that their first session may feel very clinical because she would be completing intake paperwork and gathering more information about her history, but that future sessions to be focused solely on whatever she needed to discuss. Childs Heyl appreciated this heads up.

During the following session, Childs Heyl was able to dig into a major life decision she’s facing. She says her therapist was “thoughtful and empathetic in her feedback. I felt she was fully present, interested, and emotionally invested in what I was sharing. While I didn’t leave that session with a major epiphany, I did feel less stressed and like I had a clearer mind.”

While I only tested couples therapy, LifeStance Health offers a variety of other services, including individual and family therapy. Group therapy is also available in certain states.

Individual therapy is available for adults, kids, and adolescents. It doesn’t have a set age range for child therapy; instead, it’s based on specific providers. In my state, I found several providers who accepted children of any age.

LifeStance Health also offers psychiatry and medication management services for both adults and children. Unlike therapy, psychiatry is provided by psychiatric mental health nurse practitioners or clinical psychiatrists who can prescribe medication.

Additionally, LifeStance Health offers a few different specialty services in some states, including ketamine therapy, a treatment approach that uses low doses of ketamine to manage various mental health conditions, biofeedback therapy, a mind-body technique that teaches people how to control involuntary bodily functions such as heart rate, and transcranial magnetic stimulation (TMS), a noninvasive form of brain stimulation.

LifeStance Health is one of the few therapy companies that offers both in-person and online therapy options. Additionally, LifeStance has a wider variety of services than most platforms, including therapy for individuals of all ages, couples therapy, family therapy, psychiatry and medication management.

The closest competitor would be Thriveworks. Like LifeStance Health, Thriveworks offers in-person and online therapy for adults, kids as young as 0, teens, families, and couples, as well as psychiatry. Thriveworks also accepts insurance and care is provided on a pay-per-session model. While it’s not available nationwide, it is offered in 49 states and Washington, DC, significantly more than the 33 states LifeStance Health is currently available in. If you’re paying out of pocket, Thriveworks is also more cost effective.

Grow Therapy is another strong competitor as it offers many of the same services. Therapy is available for adults, kids ages 6 to 17, couples, and families. Sessions can take place in person or online. Grow Therapy is another pay-per-session company and insurance is accepted. It is also available in all 50 states. However, psychiatry and medication management may not be available everywhere. For example, in my state (Missouri), there were no options for psychiatry with Grow Therapy whereas with LifeStance Health, there were 16 different psychiatry providers near me.

MDLive and Octave are also pay-per-session therapy companies that accept insurance, but they only offer virtual services. Octave only offers therapy for adults, couples, and families in 16 states, but visits can be held via video, phone, or live chat. With MDLive, therapy and psychiatry services are available nationwide. Additionally, MDLive offers therapy for adults, kids, teens, and couples. It’s worth noting, though, that the couples therapy option isn’t explicitly stated on the website and it can be confusing trying to find a provider who works with couples. Still, I’ve tried couples therapy with MDLive and it remains one of the best virtual therapy platforms I’ve tested.

Then there are subscription-based platforms, like Talkspace and Online-Therapy.com. Rather than paying per session, you sign up for a therapy plan with weekly sessions. Subscription plans are billed monthly, so these can often be a good option for those who want to save money. Online-Therapy.com is especially cost-effective, with plans starting at just $40 per session. However, insurance isn’t accepted. Talkspace, on the other hand, does accept insurance, but therapy sessions are only 30 minutes long.

Overall, our experience with LifeStance Health was a positive one. It was easy to schedule appointments, and I liked the option of having both in-person and online therapy sessions. We also really liked our therapist. However, the pricing structure left a lot to be desired. For one thing, LifeStance Health doesn’t disclose costs up front. Even after signing up and scheduling my first appointment, it wasn’t clear how much sessions would cost. It’s also worth noting that, from what I’ve seen, LifeStance Health is one of the most expensive therapy platforms on the market. But again, I was paying out of pocket, so it would be a great option for someone using insurance.

I also had a long wait between appointments. I needed a platform that offered therapy on weekends or evenings, but LifeStance Health could work well for someone who either doesn’t have those same scheduling constraints or doesn’t mind a longer wait for the time slot they need.

Our other tester, Julia Childs Heyl, who tried LifeStance’s individual therapy, concluded that it could be a great place to find a solid therapist, but that the company’s main shortcoming is its lack of transparent billing processes.

“It was easy to sign up, there was a wealth of diverse therapists I could choose from, and I enjoyed the clinician I worked with. In fact, I would consider working with her again, but I would not do so through the LifeStance platform because I find the billing issue a bit jarring,” said Childs Heyl. Having to reach out to customer service to resolve the cost estimate discrepancy left a bad taste in her mouth, but she notes that such problems may not be an issue if you’re using insurance.