I’m a Busy Mom Who Tried Octave Online Therapy — Here’s What I Discovered

Like most moms I know, I have a lot going on. With the constant juggling required to keep our family of six going, things like taking time for myself and giving my marriage the attention it deserves often take a backseat to the always-urgent tasks related to raising kids. While I know “you can’t pour from an empty cup,” sometimes it can feel logistically impossible to fill mine with anything other than cold coffee.

Enter Octave, an online therapy company that offers individual, couples, and family therapy by connecting you with therapists who are licensed in your state and allowing you to use your health insurance benefits. I decided to give Octave a try for six weeks to see if online therapy from the comfort of my own home (or, well, the front seat of my parked minivan) could help me get back to a more peaceful place. And because Octave advertised that couples therapy was also available, I roped my husband into agreeing to a few sessions as a tune-up as we approached our 13th wedding anniversary. (Those sessions, however, did not actually end up happening; but more on that below.) Here’s everything I learned about Octave during my six-week experiment.

Signing up for Octave was easy — because “Start Today” was the only button I could click on from the homepage, which left me with not the greatest first impression.

There was no “About” section, no way to find out more about the therapists who work with Octave, and no additional information about cost and insurance coverage — unless I did a search for “Octave prices,” which brought me to more information I couldn’t originally find on the site.

The Intake Questionnaire

The first question asked me about my primary reason for seeking therapy. Options included things like stress, burnout, pregnancy or postpartum concerns, and chronic illness. Once I indicated that my main issue was “stress” (clicking multiple concerns was not an option), I moved to the next page, which asked me if I had any other areas I’d like to address. This time I clicked on “anxiety” and the “other” button, which allowed me to type in “wanting to be present and enjoy parenthood.”

Next I was asked whether my spouse was receiving care with Octave, which he is not, and then which days and times were most convenient for my schedule. While weekend appointments were not something I was seeking, I did appreciate that Saturday and Sunday were available because I know many people have trouble taking time off from work for therapy sessions.

Because I clicked “anxiety” as a concern, I was then prompted to fill out an anxiety questionnaire, which let me share how often I was experiencing anxiety and how much this anxiety was impacting my daily life. I then filled out a depression questionnaire that asked many of the same questions about depression rather than anxiety.

The last page of the questionnaire asked me about more specific mental health concerns, such as compulsive thoughts, obsessive behaviors, disordered eating, and self-harm. It also included two open-ended questions: one asking if there was anything else I wanted Octave to be aware of and the other asking if I had any specific preference about the therapist I would be working with.

Insurance

After completing my questionnaire, I was asked to enter my insurance information. During sign-up, my insurance company, Blue Cross Blue Shield, was listed as one Octave accepted, and I was told I’d have a $50 copay.

However, on the new Octave website my insurance is no longer on the list, and when I received my first therapy receipt (several weeks after the session), I learned that I was charged $183 for my intake/assessment session and was being charged $100 for subsequent sessions because I was now considered out of network.

Finding out my insurance was no longer accepted after several sessions wasn’t a pleasant surprise, to say the least. I was upset that Octave never reached out to me to let me know there had been a change. And had I not been writing this review, I would have called for clarification and disputed the charges.

However, by the time I found out what I’d been charged, I’d already decided I wasn’t going to be pursuing therapy through Octave long-term, so I decided I didn’t have the mental energy to dispute the rates. Still, I imagine this unpleasant surprise would be a deal-breaker for a lot of families.

Matching With a Therapist

After I submitted my insurance and payment information, Octave told me I would be matched with a therapist soon.

While I was completing the questionnaire, I didn’t realize that I would be matched with a therapist and not get to choose from a list of possible options. This made me a little uncomfortable: I like having a say in big decisions like this. But Octave isn’t the only online company to match you to a therapist, so this may be more of a personal preference.

Within three days of signing up (which is quite a bit longer than it takes other online therapy companies to match you), I received an email with my therapist match.

I also received six weeks of calendar invitations for therapy appointments with this therapist at a time that I had listed that I would be available. While I appreciated the email notification of my match, I was a little anxious about being scheduled for so many visits before I had even met my therapist.

I was also a little apprehensive about what my therapist would be like because I didn’t get any information about my therapist other than their name. I would have liked to have received a bio or more details about their qualifications before my first appointment, so this was a little disappointing.

Canceled Appointments

As it turned out, my appointments with this therapist never happened. Just before we were scheduled to meet, I got an email from a care navigator who let me know the therapist I had been matched with was no longer working with Octave and that I would be rematched soon.

By early the following week, I received a new therapist match (and all the associated calendar invitations for appointments) in my inbox. Again, I wished I had more information about the therapist, but I was ready to jump in since I already felt like I was a week behind.

However, I later received a message from this new therapist that she had a scheduling conflict and was going to have to cancel my appointment, too.

While I understand that things happen, I was a little frustrated that a sign-up process that had seemed so easy resulted in so much logistical back-and-forth.

Ultimately, my first appointment didn’t take place till several weeks after I started the process — instead of happening within days, as the website had led me to expect.

My Intake Appointments

My first appointment was an intake appointment, but it didn’t go all that smoothly.

Octave uses Zoom as its video chat platform, but my therapist and I experienced some technical difficulties. After trying to connect several times, we resorted to calling one another on the phone. As a result, the appointment was just a half-hour long — too short to serve as an actual intake appointment, especially since most therapy intakes are usually between 60 and 90 minutes. So my therapist let me know that we’d do my intake at our next appointment and spent this one mostly discussing what I hoped to get from therapy.

The next week Zoom functioned well. My therapist and I went through the assessment, but I found the process to be a little impersonal, and I disliked the rapid-fire question style.

When I had started therapy with a local therapist in the past, the assessment had included more basic “get to know you” questions and small talk, so it didn’t seem I was just helping them fill out a form in my chart. By the time we’d talked through each of the assessment questions, our time was mostly up.

Before we wrapped up I asked my therapist if she had any flexibility in appointment time, since my life usually looks a bit different each week. She said she did, and so we shifted my appointments (which had been scheduled for the next six weeks) to a slightly later time of day.

That said, while I put the new appointment time on my calendar, it didn’t seem to link to Octave’s scheduling system because I continued to receive appointment reminders from Octave with my old appointment time listed.

My Third Session

During our next visit my therapist shared a little more information about her own life, which I appreciated because it can feel a little tricky to talk to someone about your problems if you don’t know them at all. My therapist also asked me to fill in some details about my own life during this appointment.

While stress and anxiety were the issues I noted during my original online intake questionnaire, based on the information and resources she shared, I think my therapist and I had slightly different ideas about the sort of anxiety and stress I was experiencing.

As a mom, my anxiety tends to be more focused on longer-term things, such as whether I’m making the right choices for my children or how to ensure they each get the attention and love they’ll need to grow into healthy adults. My therapist seemed to define anxiety in a more situational context, sharing examples of anxiety like being nervous about a presentation at work or giving a speech at a wedding. While I’m sure these sorts of things do cause anxiety for some people, this definition missed the mark on what I was really in therapy to address.

After chatting about our lives for the first half of the appointment, my therapist pulled up a video for me to watch (with her still on Zoom) about what anxiety is. I know videos can be powerful teaching tools, but the content of this video felt basic to me, and I wondered if our time together could have been better spent talking rather than watching an explainer video.

I also felt that if my therapist had videos or resources she thought could be useful to me, I would have appreciated her sending them as an appointment follow-up for me to read or watch on my own instead of watching them during our actual therapy time. We ended that appointment planning to talk the following week.

My Fourth Session

During my next session I felt like I was starting to get to know my therapist a bit better. She was personable, professional, and empathetic to the challenges I’d shared, but I still was bothered by how she and I didn’t seem to align on what I could do for my anxiety. So I brought it up to her and she seemed receptive; we ended the session deciding to discuss this more at my next session.

Another Cancellation

Unfortunately, I never got another therapy session: Once again, my therapist had to cancel my appointment due to a scheduling conflict.

I liked my therapist, and while I don’t know what her educational background is (because I never received a bio), it was clear that she cared about her work and had experience counseling people. However, I didn’t feel like I was really developing a good therapeutic relationship with her, so I decided to stop pursuing individual therapy at Octave after this cancellation.

When I set out to try Octave, the website indicated that it had therapists who offered individual therapy and couples therapy in my state — both services I was interested in trying. But during the Octave sign-up process I was forced to choose one service over the other, so I selected individual first.

However, once my individual therapy sessions were underway, I reached out to Octave via email to see if I could add couples therapy.

But when I heard back from Octave a few days after my request, I was told there were no couples therapists available in my state at that time, and I was added to a wait list.

This news was disappointing. My husband and I have a good relationship, but after 13 years of marriage and four kids we’re still learning and growing, and I was really looking forward to the chance to explore some ways we could be even better partners to one another. In anticipation of our “couples therapy date” (as I’d pitched it to my husband), we’d even both made lists of things we felt we do really well together and some things that seem to cause frustration when they arise.

I stayed on the wait list for several months, but as of time of publication I have not yet been able to try couples therapy because there is still no therapist available.

Octave appears to be a well-rounded online therapy company, offering three different types of online therapy: individual, couples, and family, which is more than many other better-known services offer. BetterHelp, for example, only offers individual therapy, though you can sign up for couples or teen therapy through its sister sites ReGain and Teen Counseling, respectively. Talkspace, meanwhile, offers individual, couples, and teen therapy, too, as well as psychiatry, but it does not allow you to pursue family therapy at all.

However, unlike BetterHelp, Talkspace, and even Brightside Health, the therapist-matching process takes way longer at Octave than it does at those companies. I had to wait three days to get my match. When we tested those other companies, we were matched within hours. The fact that I was also unable to start couples therapy at Octave suggests that it does not have the same vast network of providers, which means you could have to wait a while to start certain services.

I also felt like Octave was a little less forthcoming on its website about how its therapy worked, what you could expect, and its pricing. Because Talkspace, Brightside Health, and BetterHelp all offer therapy subscription services, you have a clearer idea of what you can expect to pay and what your subscription might include per month. Even compared to other per-session therapy companies like Doctor on Demand, the pricing was harder to figure out if you were out of network because it varies by provider.

The biggest advantage of Octave is that it accepts health insurance, while other companies, such as BetterHelp, do not. I think that I would have liked the service more had my insurance been accepted by the service, especially since it would have definitely been more affordable than BetterHelp’s subscription price. However, Doctor on Demand and Teladoc both accept more insurance plans than Octave does.

If you’re looking for individual, couples, or family therapy, Octave might be the right choice for you — particularly if you’re looking to use your insurance benefits. However, because my insurance was not accepted, the service was a little too pricey for me, especially considering all the technical and scheduling issues I encountered during my time testing out the company. I was rematched with a new therapist and had multiple canceled therapy sessions and some technical difficulties, which got my therapy at Octave off to a rocky start and made it difficult for me to develop the kind of relationship I was looking for with my therapist. I also wasn’t a fan of being matched with a therapist.

However, as I noted, Octave does seem to be making some meaningful changes to its service. I think a call with a care navigator before being matched to my therapist would have been really helpful and would have allowed me to ask more questions about what to expect. I think that the new process will help others have a more streamlined sign-up process than I did.

I didn’t have a bad experience with Octave, so if the company accepts your insurance, you like the convenience that comes with being matched to a therapist, and you live in a state that has several therapists accepting new clients, you’ll probably enjoy the company. I think it just wasn’t the right choice for me.