I'm a Therapist and I Tested Octave Online Therapy—Here's What I Thought

I’m a psychotherapist who happens to offer online services in my private practice. I’m also highly skeptical of Big Tech’s involvement with virtual therapy services. So when I was offered the chance to try out Octave’s online therapy services, I was eager to evaluate its quality of care, accessibility, and overall practices—but also a little wary. I tried the company for a month and despite the initial sticker shock at its pricing, ranging from $175 to over $250 per session (a therapy session generally ranges from $60 to $200), I was pleased with the care my therapist provided and my overall user experience. 

Octave was created by Sandeep Acharya, an entrepreneurial healthcare executive, in 2018 with the goal of making therapy accessible by accepting insurance plans. But that isn’t actually its strong suit, since it only accepts a handful of plans and out-of-pocket fees are pricey. It’s also only available in California, Connecticut, Florida, New Jersey, New York, Texas, and Washington D.C. However, Octave is a fantastic place to receive support from highly qualified therapists if you live in one of those states—and here’s why I think that.

How I Signed Up

The sign-up process at Octave is easy. Its website homepage has a button that says “get started.” From there, I was given a quick primer on the simple steps to sign up. First, I shared basic contact information. 

Then, I filled out a brief questionnaire where I could explain the type of care I needed. Next, I was required to share my mental health history. If Octave feels like it doesn’t receive sufficient information from this step, the company may ask you to hop on a free phone consultation. While that wasn’t my experience, it let me know Octave is doing its ethical due diligence in onboarding clients and is less likely to have clients who aren’t a good fit for virtual therapy (like those who are suicidal or experiencing psychosis) getting matched with an online therapist. In fact, a large concern I have with some online therapy platforms is that there can be a lack of oversight, leading to clients who need a higher level of care than virtual therapy can provide enrolling in services anyway. 

Another point where I was impressed with Octave’s ethical considerations was when I was asked if my partner is also seeing an Octave therapist, explaining that it wants to ensure that it doesn't match you with the same provider. 

The fact that it hand-matches clients with providers at all also speaks to another level of ethical awareness. Rather than relying on an algorithm to randomly match clients to therapists, there is a human that is reviewing every intake form, ensuring the client is an appropriate fit for online therapy, and then matching them to a therapist who can meet their needs. 

Octave has tons of therapists you could be matched with, including psychologists, marriage and family therapists, clinical social workers, and professional counselors. These providers treat a variety of mental health concerns, including ADHD, anxiety, bipolar disorder, eating disorders, and trauma. You can expect to work with a clinician who uses evidence-based practices like cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) therapy. 

Additionally, the intake forms allowed me to both write short answers and check boxes off of what I was hoping to address in therapy. When it came to the options of boxes I could select, it was refreshing to see very pressing clinical issues that are sometimes overlooked—like burnout, chronic illness, and racial stress—listed as issues I could get help for. It was especially impressive to see racial stress as an option, and that set Octave apart from other platforms I’ve tested, especially considering the lack of culturally inclusive care within the mental health industry. 

I was able to request a BIPOC therapist and was confident there would be plenty of options for the care coordinator to choose from, since Octave's website lists plenty of diverse providers. There were also questions that invited me to note any gender identity and sexual orientation provider preferences.

Shortly after being notified I matched with my therapist, I received an email confirming the session fees, which ended up being $205 per session.

While Octave didn’t give me my therapist’s contact information, she reached out and left me a message immediately so I could contact her. By this point, I trusted Octave’s ethics, progressive approach to therapy, and thoughtful patient care. 

How My Therapy Sessions Went

Sessions are held as live video sessions via Zoom and last about 45 minutes. In my case, my therapist asked to extend our sessions by 10 minutes free of charge, which was a generous offer. 

She was skilled at swiftly building rapport and gathering information about my history while sharing practical ways to reduce my stress and anxiety. She ended the session with a guided meditation, which was fantastic. I never felt worried that she wasn’t engaged, didn’t hear me, or couldn’t meet my needs. 

After just one session, I felt comfortable with her and was looking forward to our next session. I noticed rapport was built rather quickly and while she still asked me some questions about my personal history in our second session, she was very attuned to the present moment, helping me troubleshoot a stressful issue occurring in my life.

My therapist didn’t give me any homework, but I wasn’t put off by that. In my own experience, I don’t find homework to be a necessity and believe building the therapeutic relationship is the most important task, especially early on. She appeared to operate from a similar ethos. 

My therapist wasn’t overly directive but was engaged throughout the session and did offer guidance. Though we were only able to meet for two sessions, I felt moved by our time together. I’ve even sent her booking information to friends who have asked me for therapist recommendations.

How I Switched Providers

Had I been receiving therapy at Octave for my own personal healing, I wouldn’t have switched therapists. But, considering I was testing the service as part of writing this review, I wanted to explore what the switching process was like. Unfortunately, this was the most bumpy part of Octave. 

To initiate the switch, you must reach out to the Octave care navigator. From there, they will work to match you with another provider that meets the criteria you requested in your intake form. In my case, there was a two-week wait to meet with a new therapist.

After initiating the switch, I received a text from my therapist asking if I had any feedback for her. I was torn about this. On one hand, I think it is important therapists are open to continually growing, and feedback is part of that process. On the other hand, this situation could feel jarring for a therapy newcomer or someone who is prone to people-pleasing. I could see how that text might make the novice therapy seeker feel guilty for switching providers. 

After each email was sent to them, I received emails asking me to rate my experience. This common customer service practice felt out of place for a therapy company. While I had noticed this during my initial correspondence with the care coordinators on therapist matching and session costs, it became especially annoying when engaging in back-and-forth email discourse during the therapist-switching process.

Our Other Testers' Experiences with Octave

We tested Octave four other times in New York, California, and Florida, each time trying out its couples therapy. For the most part, our experiences were overwhelmingly positive; however, one of our testers had a difficult time.

Generally, we found our couples therapists to be personable and insightful as well as thoughtful and attentive, and in some cases even funny. This made it easy to quickly open up about topics in our marriage that it might otherwise have taken multiple sessions to get to. We appreciated when our therapist took notes during the session—this made us feel as though she was really paying attention—and she led our sessions deftly. She engaged both our partner and ourselves in conversation, making sure we had plenty of opportunity to answer questions and following up on bits of information that seemed important.

Another of our couples therapists created an environment that fostered positive and organic conversation, loosely leading the conversation but leaving room for our own insights and breakthroughs. Our work on communication was helpful, and we found we were better able to identify the sources of conflict within our relationship. We felt like our intimacy and trust improved dramatically after working with our therapist. We especially appreciated that we could reach our provider via email—she always answered with brief but helpful responses that same day. 

It took us nearly a month to connect with our first therapist after a series of mix-ups and problems, and once we did, we were concerned about our therapist’s qualifications. Her profile listed her as “proficient” in every single topic listed; as psychologists ourselves, this made us question whether this provider was a jack of all trades, master of none, and our experience with her reflected this. We wished she had asked more questions in our first session to get a better understanding of our relationship and the issues we were bringing to therapy. But we did appreciate that she took copious notes and ended the session with guidance as to which issues to focus on in our next appointment, and we recognized that most of our problems with this particular provider came down to personal preferences.

Overall, on all couples therapy fronts, Octave delivered; and we left our sessions excited to continue working with our providers.

Pros and Cons

Final Thoughts

Octave shines when it comes to providing quality care, with special attention paid to matching clients with therapists who hold diverse identities, ethical concerns, and excellent clinical care. Where it falls short is in its affordability and the insurance plans it accepts. Though $205 felt a bit steep, my experience with my therapist was worth it and I would have continued my work with her. 

Octave’s website emphasizes providing great therapy from expert providers to support folks on their healing journeys and, in my experience, that was achieved. If they can afford its hefty price tag, I would encourage therapy seekers to try Octave out.