E-Therapy Cafe Couples Counseling Review

A boutique mental health care company offering effective couples counseling

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E-therapy Cafe Recirc

E-therapy Cafe

E-Therapy Cafe is a boutique mental health care company that offers a wide array of therapy and life coaching services to individuals and couples seeking help with things like relationships and stress and anxiety management. With affordable 30-minute sessions being offered almost any time of day or night, it’s perfect for today’s busy society.

Pros & Cons

Pros:

  • Inexpensive: Pay-as-you-go or discounted subscription packages
  • You can connect with your therapist via video, phone, email, E-Chat, or E-Journal 
  • A wide range of time slots, ideal for busy schedules
  • Licensed therapists and certified life coaches 
  • Provider bios available to browse on the website
  • 10% subscription discounts for first responders, military members, military dependents, veterans, and college students
  • Easy to change or cancel subscription 
  • Thorough assessment questionnaires save you time during your sessions 
  • Wide variety of services offered

Cons:

  • Doesn’t offer medication management
  • No psychiatrists on staff 
  • Small team of therapists and several are not taking new clients
  • Client portal on the website is difficult to navigate
  • Payment system is confusing
  • Customer service can take a while to respond to questions
  • Doesn’t offer a free or deeply discounted trial session.

Many people in a relationship can benefit from couples counseling. But busy and conflicting schedules can make it hard to get both people into an office together. Plus, with 9-to-5 jobs, many aren’t able to take off work to meet with a therapist during their traditional working hours.

E-Therapy Cafe is trying to address this by providing professional, convenient, and affordable online couples (and individual) therapy for all—anytime, anywhere. Its team of licensed clinical counselors, registered dietitians, and certified life coaches strive to make talking to a therapist as easy as possible. With its short sessions and a wide array of therapist hours, patients can go to therapy during a workday break, in the mornings before work, in the evenings, or on the weekends. 

In order to review E-Therapy Cafe’s services, we surveyed 105 users at 55 companies (E-Therapy Cafe included), spoke with a subject matter expert, and my husband and I tried couples counseling ourselves. Here’s how it did.

What Is E-Therapy Cafe?

E-Therapy Cafe was founded in 2016 by clinical psychologist Dr. Jude Black. As a military wife, she understood the importance of therapy and began offering virtual therapy sessions to military members and families with one of the first online therapy platforms, Cope Today, back in 2003. She eventually went on to gather her own team of certified and licensed therapists with a mission to “support, motivate, and encourage people all over the world.”  

Dr. Black, on the E-Therapy website, says that “We are passionate about ‘getting unstuck,’ moving forward, building resilience, and learning to thrive.” People who have used E-Therapy seem happy with the service. In our survey, 89% of users said their experience with E-Therapy was better or much better than other services they had used in the past.

What Services Does E-Therapy Cafe Offer?

E-Therapy Cafe offers a variety of services, including: 

  • Individual Counseling
  • Relationship Counseling
  • Couples/Marriage Counseling
  • Life Coaching
  • Wedding and Bridal Coaching
  • LGBTQIA+ Counseling
  • College Counseling
  • Military Counseling
  • Emotional Support Animal Therapy

All of the providers registered with the platform have multiple qualifications and specialize in everything from relationships to alcohol and drug misuse, fatigue, trauma, and sexual assault counseling. The website even claims to be able to assist people who are feeling suicidal. However, “this is unusual for an online therapy company,” notes Hannah Owens, LMSW and mental health editor, “as a higher level of care, such as in-person sessions or more frequent sessions, is often needed in such times of crisis.”

E-Therapy Cafe’s therapists—many of whom are also certified life coaches—employ various therapeutic techniques, including cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT), as well as movement therapy, yoga, meditation, and breathwork. The company’s certified coaches specialize in life coaching and wedding and bridal coaching. However, it is important to note that life coaches do not have licensure requirements and are therefore not held to the same legal and ethical accountability as licensed therapists. 

Psychiatric and medication management services are not provided by E-Therapy Cafe, but the company does have an emotional support animal program that will qualify your pet as an emotional support animal (ESA). This therapy can help you deal with symptoms such as trauma, depression, anxiety, and PTSD.

Who Is E-Therapy Cafe For?

Over the years, E-Therapy Cafe has added more and more services for individuals and couples. Now, it offers services for people at every stage of their relationship, including military couples, LGBTQIA+ couples, and college-aged couples.

In our survey, 81% of users said they sought individual counseling through E-Therapy Cafe, while 7% wanted couples counseling. Additionally, 50% of people who used the company said anxiety is what brought them to therapy, while 35% said depression.

How Much Does E-Therapy Cafe Cost?

The company’s rate structure is as follows:

  • E-Therapy Cafe Trial: $50: One time-only trial session, no subscriptions, sessions available via Instant Chat, Live Video, or Virtual Journal
  • E-Therapy Cafe Shot: $55/session pay-as-you-go, no subscription, sessions available via Instant Chat, Live Video, or Virtual Journal
  • E-Therapy Cafe Four: $49 per session, $196 for four sessions/month subscription, sessions available via Instant Chat, Live Video, or Virtual Journal  
  • E-Therapy Eight: $45 per session, $360 for eight sessions/month subscription, sessions available via Instant Chat, Live Video, or Virtual Journal
  • E-Therapy ESA Housing: $165 emotional support animal program (one-session assessment), assessment, evaluation, consultation, and prescription (if eligible)

Subscriptions auto-renew every month until canceled, and the sessions don’t “roll over”—they must be used within that 30-day period. 

Overall, E-Therapy Cafe’s prices are lower than most other online therapy competitors as well as the average rate for in-person therapy, which is between $100 and $200 per session. Of our surveyed users, 68% said E-Therapy Cafe’s prices were affordable or very affordable. Sessions can be booked one at a time or as a monthly subscription, which is offered at a discounted rate.

Does E-Therapy Cafe Take Insurance?

E-Therapy Cafe does not accept insurance, Medicaid, or Medicare. 

This is disappointing. However, “while many cannot afford to pay for traditional therapy out-of-pocket and might otherwise rely on their health insurance,” explains Owens, “the low cost of E-Therapy Cafe sessions aligns with its goal to provide accessible and affordable mental health services.”

Does E-Therapy Cafe Offer Discounts?

E-Therapy Cafe offers a 10% subscription discount for first responders, military members, military dependents, veterans, and college students. Simply check the appropriate box on the registration form when signing up. 

A regular half-hour session with E-Therapy is $55, and a trial session is $50, so it’s not a big discount, but there is a discount.

Navigating The E-Therapy Cafe Website

The E-Therapy Cafe website has a soothing light blue and grey color scheme, but the general feel is a bit clunky and outdated. Upon entering the website, you are greeted with stock images of people talking on phones or using laptops, which imply that someone is in a virtual therapy session. 

eTherapy

Right up top, the company addresses that it keeps your information confidential and offers expert advice you can trust. There is a nice “How it Works” section that breaks down the journey, walking potential customers through how to register, connect, and calm. There is a button on the home page that also allows you to connect with a therapist online and a section that boasts about the company’s accolades. 

eTherapy2

While there is a lot of helpful information on the homepage, it’s a bit cluttered and overwhelming at a first glance. Many of the buttons link you to other pages on the website. 

It’s much easier to navigate the website by using the tabs in the navigation bar up top, clicking on “Register” to register for an account, “Our Team” to review the therapists the company employs, and searching through the dropdown menu under “Online Counseling” to read about the different types of services that the company offers. 

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Unlike many of the other companies we reviewed, E-Therapy Cafe does not have an app, but you can access your Client Portal from any smartphone, tablet, or computer. You can also use it to email your therapist.

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


The initial intake form to sign up for therapy at E-Therapy Cafe is pretty short and takes about 10 minutes to fill out. After the personal information, you’re asked if you are in a relationship, to describe your stress level, if you are suicidal, to choose a subscription plan, and finally, to provide a description of what you want to get out of therapy. You also get to pick your therapist or have them choose one for you based on your profile. 

Overall the form is pretty basic, but it did ask some interesting questions, such as “How do you feel today?”

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After you submit the registration form, the company sends you an email with a link to verify your information, sign several legal contracts saying you agree to their conditions of service, and set up your “Client Portal,” which is a private space for you and your therapist. 

The portal is where you can book appointments, message your therapist, keep an E-Journal, and view your billing and payment history. You are also given a more personal questionnaire to describe your mental health situation in more detail, noting anything that’s been challenging you lately, and what you want to get out of therapy. 

Your therapist will review all this before your first session. This was much more in-depth and specific than the initial intake form, with several very personal questions, such as asking about any past mental health diagnosis you may have had, what types of issues you’d like help with, and how satisfied you are with your relationship. The Client Portal also features detailed instructions on how virtual sessions through telehealth work and how to access and use the real-time E-video for your therapy sessions. Lastly, you set up your first appointment and make the payment.

Matching With a Therapist/Choosing a Therapist at E-Therapy Cafe

During the initial registration, you can choose your therapist or have one assigned to you. 

“This is the best of both worlds when it comes to choosing or matching with a therapist,” says Owens. “Some might feel overwhelmed at the prospect of sifting through dozens of therapist bios, whereas others might appreciate the freedom and autonomy. By giving clients the choice, E-Therapy Cafe ensures a system that works for anyone.”

The team at E-Therapy Cafe consists of 16 licensed therapists, social workers, and certified life coaches. All of them have multiple areas of expertise, which are listed in their bios on the website along with their education, background, certifications, therapeutic techniques, and personal information. The therapists’ profiles contain just about all the information you need to pick a good fit. And if you can’t decide, you can ask to have one assigned to you based on your profile. If for any reason you don’t “click” with your therapist, you can switch at any time to a different one. 

Of the users we surveyed, 73% found the process of looking for a therapist on E-Therapy Cafe’s website easy or very easy. Keep in mind, this is a boutique company with a smaller staff. At the time of writing this, out of the 16 therapists, four were not taking new clients and three were new employees who hadn’t set up their profiles yet. So that only left us with nine therapists to choose from for our couples therapy, but that was more than enough. 

We had a hard time choosing between several really good options. The company has some diverse therapists, however, it could focus on adding a bit more to the mix. The first one we went with was a clinical therapist and expert-level life coach.

How Do Therapy Sessions Work at E-Therapy Cafe?

Therapy sessions are conducted via video calls or you can do sessions via E-Chat, which is a text-message-based therapy. E-Journal sessions are also available, where you can write notes to your therapist in a virtual journal and they will respond to your comments. All of these sessions are accessed via the patient portal. Sixteen percent of users surveyed said it was important to them to have multiple virtual session types available to them.

Video sessions are 30 minutes long, but you can book them back-to-back for longer appointments. 

“Thirty-minute sessions are often not long enough for the client to really feel comfortable opening up and delving into issues that might take some time to process,” says Owens. “This is especially true for couples or relational therapy, where there are twice as many people seeking therapy! The client or clients might end up feeling abandoned at the end of a short session if they are exploring deep feelings and are abruptly cut off without the therapist guiding them back to a comfortable emotional place.” Twenty percent of our surveyed users specified that “the lengths of my sessions are appropriate for my needs.”

Messaging Your Therapist

The Client Portal is your own private space where you can interact with your therapist at any time via E-Chat or E-Journal. We sent a few messages back and forth with our therapist before our first session, and she responded within minutes with personal and friendly messages, even using a few fun emojis. This made us feel comfortable going into our first session.

Video Sessions

E-Therapy Cafe uses VSee, an HD-quality video application that works on most computers even with low internet speeds. In our sessions, the quality was excellent and looked similar to Zoom. Before your appointment, you’ll receive a confirmation email that contains a link to access the virtual session. The waiting room was cute. When you log in, you’re greeted by a digital illustration that resembles a therapist’s office with a virtual couch, plants, and an end table. 

When I tried the service with my husband, our therapist was five minutes late to the first appointment but she gave us the full half hour, going beyond our time. We were surprised to see she was using her cellphone, which at one point was muted for a minute when she checked her schedule. The second therapist used his computer and had more of a dedicated spot in his house to do sessions from. 

Overall the sessions went really well though. Our therapists had both reviewed our profile in advance, were easy to talk to, and had a lot of great advice for us. Both therapists started their sessions by introducing themselves and telling us a bit about their expertise. Then, they did a quick review with us using our intake forms and asked us what our goals were for the session. They then asked us a few questions to get things going, let us talk, and commented throughout. 

The first sessions with both therapists involved a lot of going through our backgrounds, and once we did the second session, we were able to cover much more ground, especially when we doubled up for an hour-long session with our second therapist. Both therapists made us feel comfortable, even going so far as to say things like “Oh my partner and I have been through that before” or “We have a friend who dealt with such-and-such situation, so I can totally see what you are going through.” They made us realize that none of us were wrong in what we were saying and that it was more about helping our partners to understand our points of view and taking time to really listen to one another.

They also gave us exercises and homework to do, such as practicing mirroring techniques, where we take turns repeating back what the other person was saying during a conflict to ensure that we both are feeling understood.

Live Chat Sessions

You have the option to spend the 30-minute session with your therapist over the E-Chat. Simply book the session, then let your therapist or customer service know to conduct the session over chat rather than video. Live chat sessions can be a good option if you have personal issues to discuss that would be uncomfortable face-to-face or if you’re sick and are unable to talk.

E-Journal Sessions

If you’re more of a writer than a talker, you may want to opt for E-Journal sessions rather than video. A journal allows you to reflect on your thoughts and gives you time to express them, and you have a running record of your journey along with detailed responses from your therapist. If you choose your sessions to be via E-Journal, you will be sent a template through the secured portal where you start by telling your story in 700 words or less. Once it’s submitted, your therapist will respond and provide you with insight, advice, and homework to help you with your journey.

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

The company has a 24-hour cancellation policy. You can easily cancel or reschedule an appointment on the website if it’s at least 24 hours in advance. If you cancel the same day or are more than 10 minutes late to a session, you will still be charged for the session. Conversely, if your therapist cancels the same day or is more than 10 minutes late, they will give you a free session. One thing we noticed is the calendar defaults to Eastern Time (we accidentally booked the wrong time twice), so you have to manually change it to your time zone every time you book a session.

Switching Therapists at E-Therapy Cafe

In theory, the switching process is pretty simple with this company. In our research, 59% of users surveyed said it took a few days to be matched with a new provider with E-Therapy Cafe. 

My husband and I switched therapists after two sessions to get a different perspective. It took some time to hear back from customer service; you are not able to schedule with a new therapist until the company switches it for you in your records. Eventually, though, it suggested a new therapist, one who had many years of experience in relationship counseling and availability that was better matched with ours.  

After we sent the request, we received an email confirming our new expert, along with a link prompting us to log in to our Client Portal to sign a new contract (same as the first time) and book an appointment with our new therapist. But there was a glitch, and it booked us again with our first therapist. So we had to embarrassingly message her explaining what had happened and requesting she cancel the appointment. We emailed the help desk about this, and it took a few days and multiple emails for them to respond and straighten it out. 

One flaw with the Client Portal is that there is no way to tell whom you are booking your appointment with until you've already paid and confirmed it. In your portal, there is no "This is your therapist" or "Book now with ____.” The only way to tell which therapist you have an appointment with is by going into the chat and seeing the therapist's name. The company felt bad and offered us a free session for the inconvenience, renewing our faith in its customer service. In the end, the second therapist was a great fit, and customer service did well with finding us a good option. 

Before switching therapists, the company highly recommends giving your first therapist some time. Get to know each other and develop a relationship. If there are scheduling conflicts or your therapist isn’t a good fit, the company will happily switch you to a new life expert of your choice or you can have one assigned to you. Simply email the help desk to request this. Of the E-Therapy Cafe users we surveyed, 51% said they never switched therapists when using the service, while 28% switched two or three times. 

“Having to switch therapists is not unusual at all,” explains Owens. “The therapeutic alliance depends on finding a therapist you can trust and with whom you feel comfortable, and this might not happen right away. It’s best to search for a therapist you vibe with rather than settling for one you don’t really like just for convenience.”

Pausing or Canceling Therapy at E-Therapy Cafe

Canceling with this company simply involves sending an email to the help desk with the cancellation request before your monthly subscription auto-renews. For us, this was easy and there was no resistance whatsoever. We simply stated that we had a good experience with our therapists and that our issues were resolved. Within the hour, we received a very pleasant cancellation confirmation from customer service thanking us for using the service and wishing us well.

Quality of Care and User Satisfaction

People who have used E-Therapy Cafe seem satisfied with the service. Thirty-six percent of customers we surveyed said they would rate their experience as excellent. Customers were also impressed by the quality of therapists on the platform, as 44% of users said they received quality care, and 90% of users rated their therapist's qualifications as excellent, very good, or good. Forty-eight percent also said their therapists met all of their needs; however, it seems like the company should add some more.

I worried that the 30-minute sessions would be too short to make any significant progress. But with our thorough questionnaire, which both of our therapists were familiar with, we were able to dive right into issues. As most therapy sessions are for 45 to 55 minutes, this shortened platform does take some getting used to, and you definitely have to cut out the small talk. Since our first appointment seemed a bit too short, for the second, my partner and I opted for a full hour. 

We would both highly recommend one-hour sessions, even if you just throw them in occasionally, as they gave us the chance to dive into a problem and have our therapist provide helpful solutions. In this session, we spent the first half hour talking about an argument that we had in the past and dissecting it with both of us trading off and talking about our viewpoints. Then, in the second half hour, our therapist was able to really dive in and find patterns in this argument that were happening in other arguments, ask us probing questions about how we felt in certain situations, and give us some helpful homework to do when situations like this arise in the future.

At first, we tried out the platform to review it and thought maybe it would be a bit helpful. The care we received was so helpful, though, that my husband and I told our last therapist that we’d be booking a few more sessions in the future, as needed. We were genuinely surprised at how much we got accomplished so fast, even in just 30-minute sessions. The one-hour session really allowed us to dive in, and we walked away feeling very inspired. We’ve already been practicing some of the new techniques we learned.

Therapists that work for E-Therapy Cafe also seem to be satisfied. The company has a 5-star rating on Glassdoor, and 100% of those who reviewed them said they were likely to recommend them to a friend. The pros listed were:

Working for E-Therapy Cafe is a good way to complement their in-person practice 

  • The company work culture is great
  • Leadership team is open to new ideas
  • Employees feel validated

The cons included:

  • The company is still growing
  • Since the company operates across the U.S., it’s hard to cultivate relationships with coworkers

Finally, customer service with this company was very helpful and responsive, with 76% of users surveyed rating customer service as very good or excellent. And 43% said the company made looking for a therapist easy.

Privacy Policies at E-Therapy Cafe

E-Therapy Cafe has a seven-page privacy policy on its website. The company says it is continuously focused on having the proper structures and protocols in place to safeguard and protect your privacy. E-Therapy Cafe is a HIPAA-compliant platform and takes the following safety precautions:

  • Servers housed in Tier-IV data center with SSAE16, HITRUST, ISO 27001 & PCI 2.0 compliance
  • PCI (Payment Card Industry) standards applied to internal systems and software
  • All traffic is required to use SSL (Secure Socket Layer) with 256-bit encryption
  • Unique login for all users
  • Logging of all user activity
  • 256-bit encryption of all sensitive data
  • No sensitive information is sent via email, only notifications to log in will be sent
  • Data backed up hourly using 256-bit encryption

The company does have this caveat about texting: “We cannot ensure the confidentiality of any form of communication through electronic media, including text messages.” Thus, they encourage users to communicate using its secure instant message platform via E-Chat or the E-Journal to increase security and privacy.

The company mentions that the information you share in your sessions is confidential, with the following exceptions:

  • You are a danger to yourself or someone else; providers may be obliged to disclose such information
  • You give written permission to disclose
  • Government, law enforcement officials, and private parties may request our cooperation 

This is pretty standard with any form of therapy. For people who have more questions about these exceptions, the company encourages its members to learn more about these privacy practices at the American Counseling Association (ACA)'s website or the American Psychology Association (APA)'s website.

Since therapy is virtual, E-Therapy Cafe also has a clause about online boundaries, which is interesting. It stresses that members are not allowed to try to be friends with its practitioners, contact them directly, or try to add them as friends on social media platforms. It also stresses that you cannot retweet something they post on Twitter, “@” reply to them, tag them, or respond to their blogs in the comment section. In addition, posting verbatim information from your communications with your practitioner to a third-party site, such as Facebook, is discouraged in order to protect the therapeutic process, and E-Therapy Cafe and its practitioners are not responsible for any effects this action may have.

E-Therapy Cafe vs. Its Competitors

E-Therapy Cafe’s competitors in the mental health field include Talkspace and BetterHelp—two giants in the industry—and Octave—a smaller service similar to E-Therapy in scope. When it came to how satisfied customers were with the service, 94% of E-Therapy users gave the company a good to excellent rating overall. In comparison, 90% of Talkspace users rated the company favorably, 86% rated BetterHelp favorably, as did 71% of Octave users. So when it came to overall satisfaction, E-Therapy was the clear winner over its competitors.

Users also said E-Therapy’s website was easier to use, with 35% noting the website was very easy to navigate. Only 18% of Octave’s users said the same, 33% of Talkspace users said navigation was easy, and 30% of BetterHelp users found the website very easy to navigate. Forty percent of E-Therapy Cafe users said their therapists had excellent qualifications, while 41% of BetterHelp, 34% of Talkspace, and 26% of Octave users said the same about their therapists.

E-Therapy also won out in patient retention—58% of users said they were likely or very likely to be still seeing their therapist six months from now compared to just 50% of Talkspace users, 47% of BetterHelp users, and 30% of Octave users.

Final Verdict

Overall, my husband and I were impressed with E-Therapy Cafe and would recommend it for individuals or couples seeking help with relationships, stress, and anxiety management, or for those who are looking for a life coach. Both of the therapists whom we spoke with were great. We did two sessions with our first therapist that were 30 minutes long, and one 30-minute and one hour-long session with our second therapist. The one-hour sessions are definitely better as they help you really dive in, but once you get going with a therapist and they understand your background, you can probably get away with 30-minute refreshers. 

While E-Therapy Cafe is still lacking a bit in the diversity department, it does look like it has expanded its imagery and therapist pool to include some more diverse options. It still needs a bit of help making its sign-up portal easier to navigate, as it’s confusing when you go to book; it makes it seem like you need to purchase a session every time, even if you have an existing package. 

With the exception of that one glitch, the company’s customer service was very fast and helpful. Even when we accidentally booked with the wrong therapist, our first therapist was quick to offer her support in getting things sorted out. Our therapists arrived at the sessions prepared and really made us feel comfortable. They did a good mix of letting us talk and gently probing us with questions whenever there was silence. They seemed very knowledgeable and gave us homework that we have already used and applied. 

The virtual sessions were great quality, and we appreciated the fact that we could schedule at many different hours. We usually did our sessions after work, with one as late as 9 p.m. We are actually considering booking sessions in the future should we need a refresher, as the exercises that we went through were incredibly helpful.

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 to get a sense of how this process worked, how easy it is to use the platform, and how therapy takes place at the company. Then, we interviewed a therapist we found who either currently works for or had worked for this company in the past, and we worked with three subject matter experts to get their expert analysis on how suited this company is to provide quality care to therapy seekers.

Key Specs

Price:

  • $50 trial session
  • $55/session pay-as-you-go, no subscription 
  • $196 for four sessions/month subscription
  • $360 for eight sessions/month subscription
  • $165 Emotional Support Animal Program one-time appointment


Is Insurance Accepted?(y/n): N


Types of Therapy Offered:

  • Relationship Counseling
  • Couples/Marriage Counseling
  • Life Coaching
  • Wedding and Bridal Coaching
  • LGBTQIA+ Counseling
  • College Counseling
  • Military Counseling
  • Emotional Support Animal Therapy


Communication Options: E-Chat, E-Journal, Video Chat

HIPAA Compliant? (y/n): Y

Is There an App? (y/n): N

Accepts HSA or FSA? (y/n): N

Prescriptions Available? (y/n): N

Billing Cadence (weekly subscription, monthly subscription, pay-per-session):  Per session, per month subscription package

Edited by Ally Hirschlag

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