In recent years, the landscape of mental health care has changed dramatically. Large digital therapy platforms such as BetterHelp and Thriveworks have made therapy more accessible by connecting patients with clinicians through apps and online portals. While these services have helped expand access to mental health support, many patients still choose to work with therapists in private practice. For many individuals, the decision comes down to the depth of the therapeutic relationship, the level of personalized care, and the overall treatment experience.
One of the most important factors in successful therapy is the therapeutic relationship itself. Research consistently shows that the quality of the relationship between therapist and client is one of the strongest predictors of positive outcomes in psychotherapy (Norcross & Lambert, 2018). In private practice settings, therapists often work with smaller caseloads, allowing them to dedicate more time and attention to each individual client.
Private practice therapists typically have greater flexibility in how they structure treatment. Without corporate productivity targets or standardized treatment protocols, they can adapt their approach to meet each client’s specific needs. This may include adjusting the pace of therapy, incorporating different therapeutic models, or tailoring sessions to address evolving concerns over time.
By contrast, large therapy platforms are often designed around scale and efficiency. Companies like BetterHelp connect thousands of users with clinicians, which can be helpful for quickly matching people with providers. However, the structure of these platforms may emphasize standardized processes and high client volume, which can limit how individualized the therapeutic process becomes.
Continuity of care is another important consideration. Many clients in private practice work with the same therapist for months or years, allowing the clinician to develop a nuanced understanding of the client’s personal history, relationships, and behavioral patterns. This continuity can help deepen trust and support more meaningful long-term change.
In contrast, some users of large therapy platforms report switching therapists more frequently due to scheduling changes, provider turnover, or platform logistics. While the ability to change therapists easily can be helpful in some cases, frequent transitions may interrupt the therapeutic process and require clients to repeatedly retell their story.
Caseload size can also influence the therapy experience. Private practice clinicians often have more control over the number of clients they see each week, allowing them to maintain a manageable schedule and prepare carefully for each session. This can translate into more focused, attentive interactions during therapy.
Therapists working through large digital platforms may carry higher caseloads because reimbursement rates can be lower than traditional private practice rates. Some clinicians have reported that this structure requires them to see a greater number of clients in order to maintain a sustainable income (Barnett, 2019). High caseloads can sometimes contribute to clinician fatigue or reduced session preparation.
Another advantage of private practice therapy is the ability to coordinate care with other healthcare providers. Private practice clinicians often communicate with psychiatrists, primary care physicians, or other specialists when appropriate. This coordination can be particularly important for clients who require medication management or multidisciplinary treatment.
Local therapists may also have a deeper understanding of community resources. They can refer clients to nearby support groups, treatment programs, or specialized services that may be relevant to their needs. This type of community-based knowledge can be difficult for large national platforms to replicate.
For individuals experiencing complex or severe mental health conditions, private practice therapy may offer additional benefits. Corporate platforms typically focus on mild to moderate concerns such as stress, relationship challenges, or life transitions. Clients dealing with trauma, severe depression, substance use disorders, or crisis situations may benefit from more intensive clinical support.
Privacy concerns have also become part of the conversation around digital therapy platforms. In 2023, the Federal Trade Commission announced a settlement with BetterHelp regarding allegations that the company shared certain user data with advertising platforms (FTC, 2023). While the company denied wrongdoing and implemented new privacy measures, the case raised broader questions about data practices within app-based mental health services.
Private practice therapists generally collect only the information required for clinical care and insurance billing. Because they operate independently rather than through large digital platforms, some clients feel more comfortable with the limited scope of data collection involved.
Despite these concerns, corporate therapy platforms do offer meaningful advantages. They can make therapy more accessible to people who might otherwise struggle to find a provider, particularly in areas with limited mental health resources. Online scheduling, messaging options, and flexible formats can also appeal to individuals with busy schedules.
Ultimately, the best therapeutic environment depends on the needs and preferences of each individual. Some clients prioritize convenience and rapid access, while others value a more personalized and relationship-focused approach to care. Understanding these differences can help patients choose the setting that best supports their mental health journey.
As the field of mental health continues to evolve, both models of care will likely play important roles in expanding access to treatment. For many patients, however, the personalized attention and continuity offered by private practice therapy remain central to a meaningful and effective therapeutic experience.
References
Barnett, J. E. (2019). Online counseling: Ethical and clinical considerations. Journal of Clinical Psychology, 75(12), 2197–2208.
Federal Trade Commission. (2023). FTC bans BetterHelp from sharing health data for advertising and requires $7.8 million to consumers.
Norcross, J. C., & Lambert, M. J. (2018). Psychotherapy relationships that work III. Psychotherapy, 55(4), 303–315.
