Octave Online Therapy Review

Online therapy with a therapist who can accommodate your busy schedule

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Octave Online Therapy Review

Octave Review


Octave is a good choice for both individuals and couples seeking therapy. Its care team is quick to respond and match you with a therapist who can accommodate your hectic schedule, meaning you can usually have your first session within a week of signing up.

Pros & Cons

  • Accepts most insurance plans

  • Flexible appointment times

  • Session fee does not vary from therapist to therapist

  • Sign-up is quick and simple

  • Website is easy to navigate

  • Offers individual, couples, group, family, and life coaching 

  • Fast therapist matching

  • Can usually have the first session within a week of sign-up

  • Accepts HSA/FSA payment

  • No in-person therapy available

  • Evening and weekend times are in high demand so can result in a waitlist

  • Higher price point, no sliding scale options

  • Cancellation fees apply

  • No free trial offered

  • No medication management or psychiatry


Octave Online Therapy Review

Octave Review


There has been a growing demand for online therapy, not only for individuals, but also couples and families. It’s hard to make time to go to a therapist’s office for an hour, especially when you’re juggling work, family, and other demands. Online therapy eliminates the need to commute—and it opens up the option of seeing a therapist that may not even live near you, which comes in handy if you live in a rural area or a therapy desert

Octave is one of those online therapy companies that is helping make mental health care more accessible for the whole family by offering individual, couples, family, and group therapy virtually. Since I was reviewing this company for Verywell Family, I decided to try the company’s couples therapy services. In addition, we tested (separately) the company’s individual therapy sessions and we surveyed 105 users who had or are currently using Octave right now. We also evaluated the company against 54 other online therapy services; here’s how it fared.

What Is Octave?

Octave is an online therapy company that was founded in 2018 by Sandeep Acharya, the former head of strategy for One Medical, a membership-based primary care practice with a direct-to-consumer membership model. His goal with Octave is to make mental health services more accessible to everyone. 

That’s why, according to its website, Octave was named after the musical term that means a complete collection of musical notes. The founders found the name appropriate because their company offers a complete set of services that “can be tuned to each person’s unique needs.” 

Since its launch, Octave has grown from serving just California to treating clients in Connecticut, Florida, New Jersey, New York, Texas, and Washington D.C. Originally, it aimed to offer in-person and virtual therapy, but its in-person sessions have been indefinitely suspended due to the COVID-19 pandemic. There is no current timeline for when it might start offering in-person sessions again. 

What Services Does Octave Offer?

Octave offers flexible care from licensed mental health therapists. Through the intake process, couples are able to find a therapist who is best suited to their needs.

Currently, Octave offers:

  • Individual therapy
  • Couples therapy
  • Family therapy (adult family members only)
  • Group therapy (though these sessions are temporarily on hold)
  • Life coaching
  • Workshops 

Who Is Octave For?

Octave is for anyone who is interested in individual, couples, family, or group therapy. It can accommodate patients with relationship strain, anxiety and depression, substance use concerns, family conflict, anger management, and trauma.

The company is also inclusive of marginalized communities, with several therapists on staff specializing in LGBTQ+ issues, trans issues, and racial trauma. Its therapists use a wide range of therapeutic techniques, including cognitive behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR) therapy, and acceptance and commitment therapy (ACT).

However, it is not for anyone under 18 and like most online therapy companies, it is not for anyone currently in crisis. 

How Much Does Octave Cost?

When using Octave, users pay per therapy session as opposed to some other services that offer monthly subscription fee models. The session rates at Octave are basic and uncomplicated. The out-of-pocket cost for a couples therapy session is $230. Individual therapy costs can range from $170 to $250 and group sessions are $75 on average.

The average national cost of therapy ranges from $60 to $250 for a 60-minute session, so the cost ranges above put Octave on the higher end of the national averages.

In our survey of users, 89% found therapy with Octave to be at least somewhat affordable. Of that group, 19% found it to be very affordable and 8% found Octave not at all affordable. 

Does Octave Take Insurance?

Octave is currently in-network with multiple insurance plans. Within these plans, copays and deductibles range based on your individual insurance coverages. Octave is not currently working with Medicaid or Medicare insurance plans. Of the users we surveyed, 44% said that Octave was at least partially covered by their insurance companies. This is a huge perk for therapy seekers. 

After completing the patient onboarding information, Octave will contact your insurance carrier on your behalf to verify coverage and benefits. After this, the care team will provide you with the amount you will be expected to pay after each session. To pay for your portion, Octave accepts all major credit cards as well as some HSA/ FSA accounts. 

Does Octave Offer Discounts?

Octave does not currently offer discounts for students, first responders, military, etc. They also do not offer sliding scale rates. Occasionally, if you follow Octave on any of its social media platforms, it will offer a limited-time discount deal. In the past, it has participated in Black Friday by posting discount codes. 

Navigating the Octave Website

The website is laid out simply and the color scheme is calming and neutral. The first thing you read on the website is the phrase, “Mental health built around you.” 

Octave Homepage

Below that is a section called “Why Octave?” that explains the benefits of its particular services, such as “Human Connection” and “Grounded in Science.”

A “Get Started” link is noticeable, in bold lettering. Upon clicking that link, users can easily sign up for the service. 

Why Octave

In our survey, 54% of users reported that the website was easy to navigate, and 38% found it to be neither easy nor difficult. Additionally, 70% of our users found the sign-up process to be easy. 

Along the top of the page, if you would like to investigate the company further, you can explore drop-downs that include links to “Services,” “Meet the Team,” “Insurance,” “Blog,” and “Locations.” 

If you continue scrolling down the homepage, you can learn more about Octave’s therapy approach, read care team bios, and see client testimonials. 

Octave providers

In the footer of the page, you’ll find links to the company’s Instagram, Facebook, Twitter and LinkedIn profiles.

Octave has 7,742 followers on Instagram with over 235 posts, though on Facebook it has a slightly smaller following of 4,466. On these social platforms, you will find (almost weekly) posts that include: blog links, mental health tips and quotes, related news articles and updates, and company background. 

Unlike some of the other companies we reviewed, Octave does not have an app. 

How Do You Sign Up for Therapy at Octave?

There are a few short and simple steps when signing up for therapy at Octave. First, click on the “Get Started” button, which will direct you to a page that asks for some basic personal information, such as your age, race, ethnicity, gender, and sexual orientation, and you contact information. 

Octave signup

Next, you fill out a simple questionnaire that describes what type of therapy you are looking for. In my case, I chose couples therapy as our team had already tested individual therapy sessions separately. 

octave intake

Last, Octave requests that you complete a wellness survey that assesses your general mental health and levels of anxiety and depression.  

Matching With a Therapist at Octave

After you complete the intake surveys, the website promises that one of its "Care Navigators" will reach out within one to three business days. We were luckier and actually were contacted that same day. This meant we were able to schedule our first couples therapy session that same week. 

This was a huge positive for us because we were eager and excited to begin our sessions. Our tester that tried individual therapy was also pleasantly surprised to hear from her Care Navigator quickly too, though in her case it took 48 hours.

I also liked that the company did not ask for any payment information until after we were matched with a therapist and looking to schedule our first session. 

When we received our “matched” email, it included the bio for our prospective therapist. Due to the nature of our need (couples therapy), I believe matching us was simple and straightforward. Individual therapy matches are based on clinical conditions reported by the patient in the initial questionnaire, whereas couples are simply matched with a provider who is experienced dealing with couples. We did not complete a questionnaire prior to matching about the goals or issues that we wanted to address in our sessions. We were solely matched with a provider who specialized in relationships and family care.

One thing to note is that it is difficult to find evening session times, especially for couples therapy. Evenings are extremely desirable for couples therapy since many couples work. So because of this high demand, Octave offers a waitlist for anyone who is unable to match right away. If you are seeking sessions during one of the high-demand time slots, a Care Navigator may offer to place you on their waitlist until an optimal time becomes available.

Both my husband and I work and found it difficult to accommodate a time slot that was during the business day. With three kids, evenings would have also been difficult because we would have had to arrange additional childcare. In the end, we chose to sacrifice some time midday in order to preserve our evenings at home.  

How Do Therapy Sessions Work at Octave? 

Once you are matched with your therapist, you’ll schedule your first session. 

Prior to each session, we received a reminder email requesting appointment confirmation and then on the day of each appointment, we received a simple wellness survey to complete that tracked our perceived levels of anxiety and depression. 

It only took a few minutes to fill these surveys out. Each one consisted of some basic mental health questions, such as “Did the session prior offer emotional support and relief? Or did it add to stress and tension?” Our therapist explained that this survey was used to measure progress from session to session. 

Couples Therapy at Octave

Our couples sessions were each about 60 minutes in length. Our sessions were conducted virtually via Zoom. The format for each appointment was typically some Q&A, response exercises, and emotionally focused therapy (EFT).  Toward the end of each session, our therapist would summarize all that was discussed and offer some tools and exercises to do in the upcoming week. 

Each of our sessions were loosely structured by our therapist. Primarily, she fostered an environment for positive and organic conversation. This resulted in improved communication practices that created better understanding. With her guidance, we also found that we were better able to identify and address sources of conflict within our relationship. 

Initially, I was concerned that couples therapy would be full of conflict prior to finding common ground. I was pleasantly surprised to experience the opposite. Each week we found that our session was a safe place to communicate and, with the help of our therapist, we were able to use language that minimized conflict and deepened appreciation and intimacy. 

In between appointments, if we had concerns or questions, we were able to email our therapist directly. We would typically get a brief, straightforward response from her that same business day. This was extremely helpful, especially when we needed additional information or help completing our weekly exercises.  

Individual Therapy at Octave

Individual sessions at Octave are 45 minutes long and, like our couples sessions, they are held over video call. Some therapists, like the one our tester was matched with, may also extend the sessions a bit to end with mindfulness exercises if you are open to it. 

One thing that concerned our tester for individual therapy is that her therapist never performed a mental health assessment to gauge how she was feeling emotionally or coping day-to-day. This allows clinicians to screen therapy seekers for severe mental illness that might require further care than virtual therapy alone can offer.

However, our tester was pleased with the matching process and found her therapist to be well qualified, empathetic and helpful. 

Family Therapy at Octave

Octave also offers family therapy, but since the company doesn’t treat anyone under 18, these family sessions are meant for adult family members, such as adult siblings, parents and their adult children, or other family combinations. 

In order for a session to be considered family therapy, at least two adult family members must attend, though you can meet in larger groups. 

While I didn’t test this service myself, the goal of these family sessions, according to the company, is to help family members learn to communicate more effectively and gain insight into unique family dynamics in a supportive and safe environment. 

Other topics that can be explored in these sessions include family conflict, stress and burnout, addiction recovery, PTSD, grief and loss, or processing past events. 

The company also recommends that these family sessions be done alongside individual therapy with another provider.

What Happens If I Miss a Session?

Octave requires 24-hour advance notice of cancellation. In order to cancel, you must email both your therapist and the care team. If you do not give notice prior to the 24 hours, you will be charged $100 for the missed appointment. 

Switching Therapists at Octave

We did not feel the need to switch therapists, but prior to our matching, I asked our Care Navigator about the process. She informed me that in order to switch providers, we must email our therapist to cancel all upcoming sessions, and then request a switch via email with the Care Navigation Team. 

:Just like individual therapy, finding a therapist with whom you can build a therapeutic alliance is key to the therapy process," says Hannah Owens, LMSW, a subject-matter expert we consulted.

She explains that “this might mean testing out a few different providers until you and your partner find someone you feel you can trust. It's not unusual to try more than one therapist before settling on a choice.” 

Fortunately, for us, we were very pleased with our assigned therapist. However, this wasn’t the case for all the users we surveyed. Thirty-six percent of survey respondents said they switched therapists at least once at Octave. Eighteen percent said it took less than a day to get their new therapist after they switched, while 48% said they were matched again in a few days. However, 21% said it took a week and 13% said it took over a week.

Cancelling Therapy at Octave

If you would like to cancel your therapy sessions, you need to email both your therapist and the Care Navigation Team. This way the therapist is able to remove you from their schedule while the Care Navigation Team cancels your account. 

For the easily intimidated, this may not be ideal. Personally, I would rather cancel with a customer service representative and have them coordinate with the therapist. 

Quality of Care and User Satisfaction

We were very satisfied with the quality of care that our couples therapist offered. She was professional and knowledgeable, and offered a constructive command and structure to our sessions. 

Couples therapy may be intimidating to begin with your partner. Some fear it may add confrontation and tension to their relationship, or make things worse. But the truth is, couples therapy can help couples. One study by the American Association of Marriage and Family Therapists found that 93% of couples therapy patients said that they received more effective tools for dealing with the many problems that can arise in a relationship. And we found it equally beneficial. Our therapist created a safe place to discuss and work on strengthening our relationship. We found she offered us practical communication tools and goal-oriented strategies. 

One tool that we found to be most helpful was a set of weekly marriage check-in questions to be done outside of our session. Questions included: How do you feel about the split of responsibilities this past week? What have I done that has made you feel loved/ respected? Have I done anything that has hurt or frustrated you? What do you have coming up next week? Anything you need additional help and/or support with? This check-in has created a weekly time for us to have an intentional and meaningful conversation. This is a practice that we will continue long after our sessions have concluded.

Other Octave users from our survey reported an overall 71% positivity rating. Seventy-four percent found their provider to be well-qualified and 82% reported that they felt their provider met their needs. 

This aligns with how our tester felt about her individual sessions as well and how our user survey respondents felt about the quality of Octave’s therapists. Twenty-six percent considered their therapist’s qualifications excellent, 30% considered them very good, and 19% considered them good.

Octave has a high provider retention rate. On Glassdoor, Octave has an employee rating of 3.7 out of 5 stars. This review has been composed from 31 employee reviews. Furthermore, Glassdoor gave Octave 3.6 out of 5 stars for its diversity and inclusion initiatives. 

Privacy Policies at Octave

Octave takes privacy very seriously and is compliant with HIPAA (the Health Insurance Portability and Accountability Act, a federal law protecting personal health information). 

At the start of each appointment, our therapist would detail the confidentiality requirements and scenarios that would cause her to break patient confidentiality, such as if she felt one of us was a danger to ourselves or others. Octave’s privacy policy explains what personal information it gathers, how it can use this information, when it would disclose personal information, what cookies it uses, and how it handles data security. 

Octave vs. Its Competitors

Of the users we surveyed that had tried another therapy service, 86% said that the care they received from Octave was much better or better than the services they’d received before. This is likely because Octave takes a lot of care to offer an individualized approach to the therapy it provides its clients that starts right at the matching process.

Octave was not the only therapy company we reviewed that offers couples therapy, and unlike some of its competitors, such as ReGain, couples work is not the sole focus. However, we kind of like that Octave offers multiple types of therapy, allowing a user, theoretically, to get all of the care they need in one place. Our survey showed that users were pretty satisfied with both services. Eighty percent of ReGain users felt that their providers met their therapy needs, while Octave came out just slightly above with 82%. 

However, ReGain’s session rates are significantly lower than Octave’s, with weekly costs between $60 and $90 depending on demand and where you live. Sixty-one percent of our survey users found Regain to be affordable, while only 51% found Octave affordable. 

Talkspace is another online therapy service that offers couples therapy, in addition to a variety of other services. With Talkspace, couples fill out a personality survey. Upon completion of the survey, couples are offered a recommended list of therapists that has been compiled based on the couple’s unique therapy needs. This matching process is not something that Octave offers. Consequently, 88% of our survey users found Talkspace to be helpful when connecting them with a provider, as opposed to Octave’s 69%. Talkspace’s monthly rates for couples therapy begin at $396/month, making it comparable to Octave in cost. 

Queer Couples Center is an online couples therapy service that is specifically geared toward members of the LQBTQIA+ community. It offers relationship therapy to singles, those in relationships, and those in need of group sessions. Unlike Octave, it does not work with insurance companies. Our tester was also not impressed with Queer Couples Center, as the company had an exhaustive intake process that involved both a questionnaire—where she was asked insensitive questions, had to justify why they should “select” her for therapy and agree that she had $2,000 set aside to pay for care—and an interview. This made the intake akin to a job interview, where the therapy company is vetting the potential therapy seeker. These intake practices are at best unorthodox and at worst unethical, making therapy seekers prove their worth, as it were, in order to be accepted as a client. For a company aimed at already marginalized users, we found the practice unacceptable. 

While Octave is generally on the more expensive side compared to some of its competitors, I found it to be a superior service based on its customer service, ease of scheduling, and competency of providers. These factors contribute to why Octave’s services have yielded an 82% satisfaction rate with our survey users, which is higher than ReGain, Talkspace, and Queer Couples Center. 

Final Verdict

In my opinion, the company lived up to its mission. Having never participated in couples therapy, we weren't sure what to expect. The entire process was both engaging and encouraging. We were in our first session less than a week after we had decided to explore this avenue which, I believe, would dissuade anyone from having cold feet. And from sign-up to our sessions, the services were stress-free and easily accessible. 

All couples sessions are led by providers who specialize in both relationship repair and building stronger relationships and I was pleasantly surprised by the level of care and commitment to measurable progress. Each session was goal-oriented and focused on positive outcomes. This feeling of satisfaction is corroborated by our user survey, which found that a majority of respondents felt satisfied with the level of care at Octave. 

We were very encouraged by each of our sessions and found them to be extremely valuable. I would recommend couples therapy with Octave to any couple, regardless of their relationship status. These sessions made us more effective communicators and helped us focus on a common goal, instead of divisive, individualized thoughts. Our therapist was a great facilitator of conversation, and we agreed with the strategy she outlined for relationship-building. We will definitely be continuing our sessions with Octave.


To fairly and accurately review the best online therapy programs, we sent questionnaires to 55 companies and surveyed 105 current users of each. This allowed us to directly compare services offered by gathering qualitative and quantitative data about each company and its users’ experiences.

Specifically, we evaluated each company on the following factors: website usability, the sign-up and therapist matching processes, therapist qualifications, types of therapy offered, the service's quality of care, client-therapist communication options, session length, subscription offerings, client privacy protections, average cost and value for money, whether it accepts insurance, how easy it is to change therapists, overall user satisfaction, and the likelihood that clients would recommend them.

We also signed up for the companies in order to get a sense of how this process worked, how easy to use the platform is, and how therapy takes place at the company. Then, we worked with three subject matter experts to get their expert analysis on how suited this company is to provide quality care to therapy seekers. 


  • Product Name Octave Online Couples Therapy
  • Price $170 to $275 per session
  • Is Insurance Accepted? Yes
  • Types of Therapy Offered Individual, Couples, Family
  • Communication Options Audio, Video Chat
  • HIPAA Compliant Yes
  • Is There an App No
  • Accepts HSA or FSA Yes
  • Prescriptions Available No
  • Billing Cadence Pay per session
2 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Association for Marriage and Family Therapy. About marriage and family therapists.

  2. Glassdoor. Working at Octave

By Ashley Rowe
Ashley is a Verywell contributor who brings nearly 15 years of experience teaching in early childhood education.

Edited by Simone Scully
Simone Scully Headshot

Simone is the health editorial director for performance marketing at Verywell. She has over a decade of experience as a professional journalist covering pregnancy, parenting, health, medicine, science, and lifestyle topics.

Learn about our editorial process
and April McCormick
April McCormick

April is the health editor for performance marketing at Verywell, where she oversees family health, wellness, and lifestyle content. Her work has appeared in Real Simple, Martha Stewart Living, Verywell Mind, Verywell Family, Verywell, Fit, Verywell Health, Time, Parents, Parents Magazine, The Straits Times, The Huffington Post, TripSavvy, Parenting, First Time Mom and Dad, Mama Mia, All4Women, the New York Times Bestseller, A Letter To My Mom, and more.

Learn about our editorial process