My Sesame Care Review Shows There’s Room for Improvement in the Online Therapy Space

I’m no stranger to online therapy. As someone committed to doing my emotional work, I have found that therapy is one of my favorite tools for personal development. Having a trusted professional to work out my thoughts, beliefs, feelings, and experiences with is invaluable. I honestly think everyone can benefit from it at some point in their lives.

Getting started at Sesame Care was quick: Sign-up simply involved providing my name, email address, and location.

Once I had an account, I could easily search by desired service and view a provider list, complete with schedule availability and pricing. I loved this — it avoids the hassle of going through a lengthy matching process like with many other online therapy companies. On top of that, I also didn’t have to do all the work of contacting each therapist to find out their availability and book myself, because I could see each provider’s page immediately.

Compared with other platforms though, my options felt limited. I kept my location open to anyone in California, but only 10 providers offering individual therapy were listed. Among the providers available were licensed marriage and family therapists, licensed clinical social workers, psychologists, psychiatric nurses, and psychiatrists.

The bios were a bit scanty — each had a few introductory paragraphs, but no list of specialties or therapy modalities and no reviews. With such a small pool of people to choose from, I quickly gave up hope of finding a practitioner who used some of the lesser-known but more progressive modalities I tend to favor, like gestalt therapy and somatic therapy.

Scheduling a Session

To schedule a session, I clicked on my chosen therapist’s schedule and booked from there. As I was doing so, I was given the option to sign up for a membership. This would cost me $10.99 per month or $99 per year but would give me a $10 discount on all sessions. I chose to bypass this.

After I paid, I was prompted to fill out standard medical forms that asked about any medical conditions I had and the medications I was taking. This took less than a minute or so to complete.

The next day, I received a text from my therapist saying that the appointment I’d booked wasn’t available. This was very annoying since I already paid.

She gave me a few other appointment options for the same week. If the appointment slot I booked had been the only time I was available, I would have had to cancel my appointment and get a refund. While Sesame Care’s FAQ page states that you can do so up to three hours before the appointment, this would have been inconvenient and I may have had to wait for the money to hit my bank account. That scheduling error also offsets the convenience of being able to book so quickly and easily — which was the main thing I’d liked so far.

My therapist offered a safe space to vent, but I can’t say that she was very engaged or skilled. Not only did she get me mixed up with other patients, but she also doled out largely generic advice — platitudes that showed me she might not really be picking up on what I was saying.

The biggest value I got from sessions was having dedicated time to unload some of the stressful situations going on in my life, but I found myself regularly irritated with the therapist’s responses.

My colleague Julia Childs Heyl, who is a therapist herself, also tested Sesame Care, and she had a worse experience than I did.

Her therapist didn’t show up for either of the 30-minute sessions they scheduled over two separate weeks. After giving this therapist two chances, she switched therapists. This therapist was able hold longer 50-minute sessions.

“She was great. She made me feel very comfortable and was not overly formal at all,” explains Childs Heyl. “But, the aspect of having the first therapist no-show me and never contact me to apologize or provide an explanation felt like an issue that shouldn’t accompany an online platform.”

My Intake Session

My first session started off a little rocky. My therapist sent me the wrong link to our session, so we texted back and forth trying to figure out what was going on for about 10 minutes before she sent me the right link.

Thankfully, I found her to have a very warm, caring presence. She didn’t waste time going over any intake information and allowed me to guide the session by sharing what was on my mind. I appreciated this, but once I heard her feedback, I realized she either hadn’t truly understood or hadn’t listened to what I’d said. While she was very cheerful, almost like a coach, and tried to help me focus on the positive, her advice was largely generic.

The session ended abruptly and automatically after we’d had a 45-minute session. This was the way my therapist had set things up — she’d emailed me a session Zoom link since we’d gone back and forth figuring out a new time and didn’t officially change it on Sesame — but additional sessions on the Sesame platform also end automatically.

This was my first experience with an automatic end to a session, and I found it disconcerting. Although she did warn me that we had just a few minutes left, I found it difficult to speak naturally and openly knowing that I could be cut off mid-sentence at any point.

Additional Sessions

My other sessions followed in a similar vein. The second one started with her getting me confused with another patient by bringing up my supposedly dying father and dog. That didn’t land well. I also found she glossed over some of the issues I was facing with platitudes like “You’re going to have a really amazing summer!” and “I believe in you!” While those were nice to hear, they didn’t address the actual issues I was relaying to her.

By the third session, she remembered more of who I was, but I noticed that she’d randomly throw out words or concepts that weren’t related to what I was describing. For example, when I was discussing one of my relationships, she randomly brought up the concept of boundaries, even though that truly didn’t have anything to do with what I was talking about. I’m astute and aware of mental health concepts enough to know that she was missing the point. I had the impression she didn’t hear what I was saying. She also ended our sessions with the exact same platitudes.

All of that said, I did get some value out of our sessions. She made a few comments and suggestions that were helpful. Her kind manner was soothing and I sensed she had a good heart. I have to wonder if her generic responses were from simply having too many patients and short session times.

Technical Aspects

Our first session took place via a Zoom link she emailed me, while subsequent ones took place on the platform. We experienced no technical issues or errors.

One thing I had trouble with was booking a regular appointment (rather than an intake session). I tried to do so from my account appointment page, but I only had the option to press “book again” for a new patient appointment. I couldn’t find any other way to do it, and since I wasn’t sure if session lengths varied, it was important to me that I book the right one.

To resolve this issue, I reached out using the chat function on the site, and soon afterward I received an email confirming that someone was working on my concern. Within a few days, I received an email asking me to provide more details. From there, it took a few days before customer service got back to me via email with a link to ongoing appointments, which ended up being just 30 minutes. Obviously, none of this was instantaneous. However, there was consistent communication between myself and the customer service team.

While Childs Heyl didn’t report similar technical issues, she did encounter a few concerning issues around rescheduling around her no-show appointments. After it was clear that her therapist wasn’t coming to the appointment, she reached out over live chat. “I was prompted to send an email. I was still charged at the end of the session. It took a few days for Sesame to respond to me — when they did, it was a short apology, an invitation to book with someone else, and a refund. It was all impersonal and totally turned me off,” she says.

After Childs Heyl’s first no-show, she decided to try that same therapist again, since they had been the only person in her area offering the specific type of therapy she was looking for. Unfortunately, she experienced the same sequence of events with a no-show, being told to email, being charged for the session, and being offered a refund. “This leads me to believe that this person may not work for the platform anymore and that Sesame is not taking any action to rectify this situation,” she says. “The therapist that no-showed me twice is still on the platform with open availability, so I do not think they fixed that issue.”

Other Services

While I only tested Sesame Care for individual therapy, it also offers couples therapy for around $100 to $300 per session and psychiatry services for around $100 to $400 for a consult. Although high, these rates are within the national cash-pay average range for out-of-pocket rates. It’s also not all that unusual that Sesame Care only has psychiatrists who are self-pay.

Additionally, the platform offers comprehensive medical care, including urgent care, primary care, dermatology, sexual healthcare, and more. Just like with mental health services, the pricing for healthcare varies widely by provider. I saw urgent care visits as low as $50 and as high as $120, and telehealth visits for between $30 and $120. Those prices are for the appointment — I doubt they cover any testing that the provider might recommend. Psychiatrists are one of the types of specialist doctors least likely to accept health insurance.

While Sesame Care doesn’t take any form of insurance, it does accept payment from health savings accounts and flexible spending accounts.

Unlike therapy-focused companies like BetterHelp, Sesame Care offers comprehensive telemedicine services, which include mental health services. Since its focus is broader, it doesn’t offer tailored support, such as a matching service, and clinician options are limited. You simply won’t get the variety of mental health providers here that you would get on a site dedicated to therapy.

Additionally, compared with platforms like Zocdoc, Alma, or Zencare, the site was pretty bare-bones. From a purely aesthetic standpoint, Sesame Care has a much more minimal and less welcoming appearance. But more important, I didn’t get as much information about practitioners on Sesame Care’s bio pages as I did with the other companies. If knowing a therapist’s modalities and specialties is important to you, you might want to look at competitors. I tested Zocdoc and found that it was much easier to get a better sense of the therapists and their approach from that website, which made choosing a therapist much easier.

Sesame Care does offer a lot more flexibility and convenience than many companies. You don’t have to undergo a long sign-up and intake process, like you would at places like Talkspace, and unlike Psychology Today or Good Therapy, you can book quickly, right on the site. That said, you can’t use insurance at Sesame Care, while both Talkspace and many directories give you that option.

Finally, most companies that bill per session — such as Doctor on Demand and Teladoc — charge you right before or after a session, not when you book. This model helps prevent the inconvenience of having to cancel and get a refund if the therapist’s schedule isn’t accurate.

I wasn’t super impressed with my therapist at Sesame Care, but that doesn’t mean it’s not the right platform for everyone. My therapist could have been the right choice for someone else, and it is quite possible that another therapist on Sesame would have been the right match for me. However, I think that to maximize the chances of good matches, Sesame Care should provide more information about its therapists, so that you can make sure you’re picking the right one. I did appreciate how quick and convenient it was to schedule sessions. Wait times for new clients can range from two to four weeks in some places, and up to 12 to 14 months in others. But bear in mind, you might need to switch a few times to find the right therapist.

I also have a problem with how I was asked to reschedule after I paid for my therapy session because my therapist’s availability changed, and I would like to see the company resolve that issue. Most online therapy companies that have you pay per session do not bill you until the appointment is confirmed or has taken place.

I did find their customer service to be responsive, and can see how Sesame Care might appeal to someone who is uninsured, underinsured, or with a high deductible. The prices at Sesame Care could be more affordable than per-session rates in some parts of the country, where rates per hour can be $250 or more. It might also work well for someone with less severe mental health symptoms, like stress. It just wasn’t the right place for me.