Online therapy options, compared

My first online therapy session, I sat at the kitchen bench in a hoodie and didn't realise the camera was angled up my nose for the first eleven minutes. The therapist was kind enough not to mention it. I figured it out when I caught my reflection in a window.

That's the running theme of online therapy. It's slightly absurd, deeply convenient, and (when it works) just as effective as the office version.

If you're looking at this option because the idea of sitting in a waiting room makes you cancel before you book, you're not alone. Australian men under 50 are now more likely to start therapy online than face-to-face. Here's the field, with the trade-offs each one carries.

What "online therapy" actually means

Three different things get called online therapy:

1. Telehealth with a real psychologist: a normal session, just over video or phone. Same person each time. Often Medicare-rebatable.
2. Subscription platforms: you pay monthly, get matched to a therapist, message them between sessions, sometimes video.
3. Self-guided programs: structured courses (usually CBT) you work through at your own pace, with optional clinician check-ins.

Each one suits a different person. The mistake is treating them as interchangeable.

The Australian Medicare-friendly options

If you want online therapy with a Medicare rebate, you need an MHCP from your GP and a provider who bills Australian Medicare. The big two:

• Lysn: Australian-owned, video and phone sessions, accepts MHCP referrals. Pricing varies by therapist (often $190 to $250 per session, with the rebate bringing it down). Owned by Telstra Health.
• Most local psychologists: many now offer telehealth as an option. Ring any practice and ask. The same Medicare rules apply.

Tip: telehealth sessions with your usual psychologist count the same toward your 10-session yearly cap as in-person ones do. There's no penalty for switching back and forth.

The international subscription platforms

These don't accept Medicare, so you're paying retail. They've grown popular because they're frictionless: sign up, get matched, message your therapist whenever.

• BetterHelp: largest network, around US$260 to $400 per month depending on plan. Text, audio, video, scheduled live sessions. Strong for general depression, anxiety, life transitions. Therapist quality varies (you can switch any time).
• Talkspace: similar pricing, includes psychiatry add-on (medication management). Better integrated with US insurance, neutral for Australian users.
• ReGain: BetterHelp's relationship-focused arm. Useful if you want to do post-divorce work with a focus on co-parenting communication or starting to date again.
• Calmerry: smaller, slightly cheaper (around US$210 per month), text-heavy.

The honest version: these platforms are convenient and consistent. They're not always cheaper than seeing a local psychologist with the Medicare rebate. Run the maths for your situation.

The self-guided programs (criminally underrated)

If you don't yet need or want a regular therapist, structured online programs are excellent. They're built on the same evidence base (CBT, mostly) used in-clinic.

• Mindspot: free, government-funded, run by Macquarie University. Courses for depression, anxiety, PTSD, OCD, chronic pain. Optional therapist phone/email contact. Genuinely free.
• This Way Up: low-cost (around $59 per course), built by St Vincent's. Clinician-supported. Strong for depression and anxiety.
• MoodGYM (no longer free, but cheap): one of the original CBT-based programs.

These work surprisingly well. If you're not sure whether you need a therapist or you want to do some of the work between sessions, they're a smart starting point.

MensLine Australia (the one most men forget)

MensLine isn't a therapy platform in the BetterHelp sense, but it does deliver structured counselling over phone, video, and webchat. Free, 24/7, men-focused. Counsellors trained specifically in relationship breakdowns and co-parenting.

The catch (and the strength) is that you don't usually get the same counsellor each time. So it's better as a stabiliser than a long-term therapy relationship. For a hard Sunday night when you can't sleep, it's hard to beat.

How to choose, fast

Five questions. Answer them honestly and the right option becomes obvious.

1. How much can I spend per month? Under $100, go Mindspot/This Way Up/MensLine. Up to $250, go MHCP psychologist via telehealth or Lysn. Above $250, anything's on the table.
2. Do I want the same person each time? Yes: book a psychologist (in-person or telehealth). No: a platform with messaging or MensLine works.
3. Is there one specific thing I want to work on? Yes (e.g. anxiety, separation, sleep): a structured program like Mindspot is fast. No (general "I'm not okay"): start with talk-based therapy.
4. How private does this need to be? If you're worried about partners/family seeing the bill, BetterHelp and similar are anonymous and don't show up on Medicare records.
5. How urgently do I need this? Today: MensLine, Lifeline. This week: Mindspot/This Way Up signup. This fortnight: GP appointment for an MHCP.

Common traps

• Subscribing to a platform, doing two sessions, and ghosting it (you've lost ~$500 and learned nothing). If a platform isn't working, switch therapists inside the platform, or cancel and pivot to a different model.
• Treating online therapy as "lite therapy". It isn't. Same modalities, same evidence, same potential to dredge up hard stuff. Block out 45 minutes after a session, don't schedule it before a meeting.
• Doing it on the kitchen bench with the kids in the next room. Find a spot where you'll actually talk. Car park. Locked study. Shed.

What I'd do over

If I were starting today, I'd book the long GP appointment for the MHCP this week, sign up for a free Mindspot course tonight, and save MensLine in my phone for the rough nights. Three moves. Zero heroics. The compound effect of small consistent care beats the dramatic one-off every time.

Online therapy isn't second-best. It's the format that finally got most blokes I know to actually start.

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If you're struggling, support is available 24/7: Lifeline 13 11 14, Beyond Blue 1300 22 4636, MensLine Australia 1300 78 99 78.