Best Online Counseling for Cancer Patients

While studies suggest that nearly anyone facing cancer could benefit from counseling and other psychosocial support, limitations to in-person visits such as immunosuppression or adding yet another appointment to the calendar may seem overwhelming. Thus, the option of online therapy may be appealing.

We selected the best online counseling services for people with cancer and provide a run-down on how they work, addressing important issues such as cost, insurance, safety, and more.

Our Top Picks

Best Overall: Talkspace
Best for Physical Health: Cancer Treatment Options and Management Inc
Best for Peer Support: 7 Cups
Best for Free Support: Cancer Support Community
Best for Family: CancerCare

Our Top Picks

Best Overall: Talkspace

Key Facts

Price: $260 to $400 a month; $125 to $199 for psychiatric services
Accepts insurance? Yes
Communication options: Audio, messaging, phone, video chat

Why We Chose It

Along with providing therapy services for many different issues, including those related to cancer, Talkspace also has a blog dedicated to the problems and difficulties that arise with a cancer diagnosis. A large pool of therapists and the opportunity to be matched with a therapist by a real person rather than an algorithm helps ensure that you will get quality online counseling.

Pros and Cons

Pros

Matched with a therapist by a person, not an algorithm
Multiple subscription plans available
Blog about cancer issues

Cons

Can't browse for therapists yourself
Psychiatric services only available at additional cost

Overview

Talkspace is a large organization that provides online therapy for a wide variety of issues. When you sign up, a human being (not an algorithm) matches you with several counselors who may fit your needs. You then choose from among the offered therapists. Some counselors provide live (videoconferencing) sessions, whereas others use email, messaging, or text.

Talkspace offers multiple subscription plans, ranging from $260 to $400 a month. The basic plan includes text, video, and audio messaging, but no live video sessions. The next tier plan offers one live video session per month, and the most comprehensive plan includes four live video sessions per month. Psychiatric services are also available for an additional cost.

One valuable resource Talkspace offers is its blog, where you can find posts and articles related specifically to issues involving cancer, such as how a cancer diagnosis affects your mental health, the value of talk therapy with a cancer diagnosis, and support for family and friends of those living with cancer.

Talkspace Online Therapy Review

Best for Physical Health: Cancer Treatment Options and Management Inc. (CTOAM)

Cancer Treatment Options and Management Inc.

Key Facts

Price: $155 per session
Accepts insurance? No
Communication options: Video chat

Why We Chose It

Cancer Treatment Options and Management Inc. (CTOAM) is a helpful resource for both the physical and mental health issues that arise when living with cancer. It also offers counseling services specifically designed for people with cancer.

Pros and Cons

Pros

Online counseling designed specifically for those with cancer
Resources for both physical and mental health
Can schedule a session with a Registered Clinical Counselor anytime you need it

Cons

Mainly physical health services
No subscription packages for counseling available

Overview

Cancer Treatment Options and Management Inc. is primarily a resource for your physical health when living with cancer. It offers a Precision Second Opinion program to ensure that your course of treatment is correct for your needs, preventative measures such as genetic testing, and follow-up consultations. These services are available as package deals. It also provides training webinars for people living with cancer and their loved ones on various topics, such as new treatments for different kinds of cancer.

CTOAM also offers online counseling designed specifically for people with cancer. It has Registered Clinical Counselors on staff, with whom you can make appointments through CTOAM's Single Services option. A one-hour session with a Registered Clinical Counselor costs $155. You can schedule a session with a counselor anytime, but there are no multi-session packages available; each session must be scheduled individually.

Best for Peer Support: 7 Cups

7 Cups

Key Facts

Price: Free to $150 per month
Accepts insurance? No
Communication options: Messaging, phone, video chat

Why We Chose It

7 Cups has therapists who specialize in cancer issues, as well as a wide range of support options, such as group chats and "listener" peer support services. Additionally, it provides free resources in the form of articles and mindfulness exercises that address the everyday challenges of a cancer diagnosis.

Pros and Cons

Pros

Therapists who work specifically with those with cancer
Lots of support options available
Educational resources and exercises available for free

Cons

Can't choose your own therapist
Not all "listeners" are licensed counselors

Overview

7 cups provides a number of different options ranging from one-on-one online therapy to group chats. It has therapists who work specifically with people with cancer and are familiar with the disease's physical and emotional toll. Therapy is done via a private online chat room for a monthly fee of $150.

When you register, you are assigned a specific counselor who is matched to you based on your needs. You are also able to access a chat feature that will connect you with a "listener." Note that some listeners are licensed counselors, but not all. You can connect with a listener right on the site, and filter your options by categories such as age, gender, and whether or not the listener has lived experience.

7 Cups also provides additional resources in the form of articles about cancer, including "How to Support a Loved One with Cancer," "Mental Health Advice for Cancer Patients," and "How to Survive Anything: The Importance of Self-Advocacy." These and many more are available on the website for free. The site also offers "Cancer Paths," which are free exercises in things like mindfulness to help you cope with the everyday stresses of living with cancer.

Best for Free Support: Cancer Support Community

Cancer Support Community

Key Facts

Price: Free
Accepts insurance? N/A
Communication options: Phone, video chat, in-person

Why We Chose It

Cancer Support Community provides free support services for those living with cancer and their loved ones, including its Cancer Support Helpline. Experts on the helpline can assist with both the short-term and long-term challenges of living with cancer.

Pros and Cons

Pros

All services are free
Resources for both those living with cancer and loved ones
Cancer Support Helpline and MyLifeLine programs offer professional and peer support

Cons

No individual counseling services
Helpline is not available 24/7

Overview

Cancer Support Community offers a few different free options to support people with cancer and their loved ones. The homepage asks if you are seeking support for yourself or for a loved one, and has several different links to connect you with a community of cancer survivors and those living with cancer, either online or in person. All Cancer Support Community services are free to those living with cancer and their loved ones.

If you would like to speak to an expert, you can call the Cancer Support Helpline ( 888-793-9355 ). This helpline provides one-on-one counseling and emotional assistance on a short-term basis. Experts on the helpline can connect you to local support groups, provide short-term cancer coping assistance and short-term residential assistance, help with treatment decision-planning, and offer financial advice concerning cancer treatment and the costs of living with cancer. Operational hours are 9 am to 8 pm ET Monday through Friday, and 9 am to 5 pm ET Saturday.

Cancer Support Community also runs the My LifeLine program which lets you create your own website about your journey with cancer to share with friends and family to help facilitate communication and support. My LifeLine also hosts discussion boards moderated by licensed mental health professionals. These discussion boards can help you connect with other people living with cancer and share personal stories, coping methods, and support with others in the community, 24 hours per day, seven days a week.

Best for Family: CancerCare

CancerCare

Key Facts

Price: Free
Accepts insurance? N/A
Communication options: Phone, video chat

Why We Chose It

CancerCare offers free short-term counseling services provided by oncology social workers as well as support groups for those with cancer and their loved ones. It also has extensive cancer-related resources on its website.

Pros and Cons

Pros

All services are free
Individual counseling and support groups
Services for both those living with cancer and their loved ones

Cons

Counseling is only short term

Overview

CancerCare provides a wide range of free services to assist people and their families coping with cancer who live in New York or New Jersey. In addition to support groups for both patients and their loved ones, it provides oncology social workers who can offer both group and one-on-one cancer-focused support and counseling. According to the website, the social workers "provide short-term, strengths-based emotional support" via video chat or the phone, and services are available in both English and Spanish.

CancerCare also has extensive cancer-related resources on its website, including blogs, a video library, and a search function to find help on the site by diagnosis or topic. The services advertised on the site include counseling, support groups, case management, education workshops, community resources, and financial aid.

CancerCare is somewhat unique among cancer organizations in that services such as counseling and support groups are also provided for family members of people coping with cancer. Specifically, counseling services are offered for caregivers, the newly bereaved, and children as young as 5 years old, as well as for patients.

Final Verdict

Talkspace comes out on top for its long-term counseling services, large pool of possible therapists, and affordable subscription plans. CTOAM is the best for both physical health and mental health services, and you can find extensive cancer-related resources on 7 Cups. Cancer Support Community is the place to look for peer support, while CancerCare offers the best services for family members and loved ones.

Compare the Best Online Counseling for Cancer Patients
Company	Best for	Price	Accepts insurance?	Communication Options
Talkspace	Best Overall	$260-$400/month	Yes	Audio, messaging, phone, video chat
Cancer Treatment Options and Management Inc	Best for Physical Health	$155/session	No	Video chat
7 Cups	Best for Peer Support	Free	N/A	Messaging, phone, video chat
Cancer Support Community	Best for Free Support	Free	N/A	Phone, video chat, in-person
CancerCare	Best for Family	Free	N/A	Phone, video chat

FAQs

How Effective is Online Therapy?

Before looking at how online therapy works, it's helpful to look at the effectiveness of virtual counseling in comparison with in-person counseling.

We've known for some time that online therapy (internet therapy or cybertherapy) can be effective for people with conditions such as depression, and some earlier studies found some benefits among people with cancer. For example, a 2017 study found that online (internet-based) cognitive-behavior therapy could reduce severe fatigue in breast cancer survivors.

A 2018 study, however, was the first to directly compare online and in-person therapy specifically for people with cancer. In this study, both internet counseling and in-person counseling were found to be helpful for families with cancer. Compared to people who had no therapy (those who went on with life as usual), those who received in-person or virtual counseling experienced significantly less psychological distress.

Specific ways in which both in-person and online therapy were helpful included:

Less fear of cancer recurrence
Less repetitive thinking about cancer (rumination)
Better mental health-related quality of life
Improved mindfulness skills
Better positive mental health

While both internet and in-person counseling reduced distress, the drop-out rate (number of people who discontinued counseling) was higher in the online therapy group.

What Is Online Therapy?

Online therapy can take a number of different forms, including:

Individual therapy
Group therapy
Group chats that are moderated by a therapist
Adjunctive online therapies such as meditation, yoga, fitness classes for cancer survivors, nutritional advice, music therapy, art therapy, and much more

With cyber-therapy, virtual/remote options may include:

Video-conferencing visits
Synchronous online chat
Messaging
Email (non-synchronous)
Text messages
Internet phone visits
Apps

There are currently a number of guidelines in place put out by the American Psychological Association, the American Medical Association, The International Society of Mental Health Online, and more. In other words, concerns and issues that go along with online therapy have been considered in some depth despite the virtual option being relatively new.

Individual therapy for people with cancer is most often cognitive behavioral therapy (CBT) or talk therapy. CBT focuses on specific issues (for example, coping with cancer), fears, negative thoughts, and building coping skills.

Just as with in-person therapy, an online counselor may assign "homework" to be completed between sessions. This may include journaling and/or practicing the coping skills discussed.

Why Is It Important to Have a Therapist If You Are Battling Cancer?

Some oncologists believe that almost anyone who has been diagnosed, is living with, or has completed cancer treatment could benefit from working with a therapist. In fact, some older studies (but certainly not all) suggest that psychosocial support may even be linked to improved survival (at least with breast cancer).

In some cases, therapy can make a very significant difference. It's thought that roughly one-third of people with cancer have significant psychological distress—distress that, in turn, reduces the quality of life and can sometimes interfere with optimal treatment.

Yet, even without significant distress, there are many issues and adjustments that arise during a journey with cancer. Some of these issues that you can address with therapy (either individual or group) include:

Sorting through the multitude of emotions (as well as physical changes) associated with a cancer diagnosis
Coping with uncertainty
Anxiety and depression
Family and relationship issues that may arise or change with a diagnosis (relationship changes are almost a given)
Coping with cancer fatigue
Grieving, such as the loss of body image or the loss of freedom from schedule and limitations imposed by cancer
Coping with the fear of recurrence, progression, or death
Guilt: This may be related to your diagnosis (lifestyle factors, guilt about ignoring symptoms, etc.), guilt about not being able to be the partner, parent, or child you once were, survivor guilt if you are involved with a cancer community, etc.

There are a number of ways counseling can be beneficial even if you are not facing any specific issues. A good counselor can help you build coping skills and provide you with tools for building resiliency. They may also help you communicate optimally with your health care team to feel empowered in the choices you make.

And, even if you feel like you are coping adequately with cancer at the time, a good counselor can help you develop skills that will be valuable as you face the normal challenges of life aside from cancer. People facing cancer can experience post-traumatic growth (positive changes). Working with a counselor may not help you recognize these areas of growth (which can be a beautiful silver lining in a difficult journey) and promote these positive changes.

How Do I Choose the Right Online Therapist?

It is important to choose the right online therapist as you would an in-person therapist, but this can be somewhat more challenging. You want to find a therapist you are comfortable with and trust, but this can be more difficult without body language or tone of voice unless video conferencing is used.

To make the process a bit easier, it's often helpful to have a list of some questions you can ask. Some things to consider include:

Qualifications: Your therapist should be licensed in the state where you live. They could be a licensed social worker (LCSW), a licensed marriage and family therapist (LMFT), a psychologist (either master's degree or Ph.D.), a PsyD (doctorate in clinical psychology), or in the case of a physician, a psychiatrist.
Area of expertise: Does the therapist have experience working with people living with cancer?
Personal preferences: Do you want a therapist of the same gender? Is the age of your counselor important to you? Do you prefer a Christian counselor?
Availability: Is the counselor available at a time that works well for you? Living with cancer, it's more important than ever to have solid boundaries. Figuring out what works best for you and sticking with that is a good opportunity to practice self-care.

Is Online Therapy Safe?

Safety, privacy, and confidentiality are critical issues for online therapy. In addition to cyberspace concerns noted earlier, it's important to be aware of HIPAA regulations, which protect your personal health information. You will also be asked to "sign" a document of informed consent for treatment, just as you would with an in-person therapist.

While online therapy may feel a bit more relaxed than in-person therapy, therapists must follow a strict professional code of ethics, just as with face-to-face therapy.

Is Online Therapy Covered by Insurance?

Until recently, insurance coverage for online visits for counseling varied widely. However, since 2020, some of these kinks are being ironed out, and insurance coverage for online counseling is increasingly becoming a benefit. It's still important, however, to check with your plan to determine whether online therapy is covered. If it is not, you can request that it be covered, and your oncologist can send a letter explaining why online is preferable to in-person therapy.

For long-term counseling (over one month), a therapist is usually required to be licensed in your state, although a number of therapists are licensed in more than one state.

Some therapists provide a sliding scale based on your income if you need to self-pay for services. Since overhead costs are lower than in-person practice, online therapy may be less costly than visiting a therapist face-to-face.

When Should Online Therapy Not Be Used?

There are times when online therapy would not be appropriate, and in-person therapy is preferable despite greater infection risk and lower convenience. This may be the case for people with cancer who have very severe depression and are suicidal. In-person therapy may also be the best option for those with an underlying mental illness such as schizophrenia, bipolar disorder, or addictions. In these situations, however, online therapy may still be useful to supplement in-person therapy.

Methodology

In order to collect comprehensive data on 33 companies, we sent questionnaires to 100 current users of each. Our methodology allowed us to review the best online counseling for cancer patients fairly, impartially, and accurately. We compared companies by looking at users’ qualitative and quantitative reviews of various services offered and evaluating overall user satisfaction, therapist qualifications, types of therapy offered, website usability, cost and value for money, and client privacy protections.

A Word From Verywell

Virtual therapy can be an excellent option for people living with cancer. Working with a counselor who is well-versed in cancer-related issues can help you develop critical coping skills and resilience that may assist you with your cancer journey and the normal challenges of life. At the same time, far too few cancer survivors receive therapy due to the limitations of the disease, whether that means immunosuppression, a disability that makes traveling for visits difficult, or the inconvenience of yet another appointment.

4 Sources

Verywell Health 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.

How people with cancer can benefit from online therapy. Cancer.Net.
Abrahams HJG, Gielissen MFM, Donders RRT, et al. The efficacy of Internet‐based cognitive behavioral therapy for severely fatigued survivors of breast cancer compared with care as usual: A randomized controlled trial. Cancer. 2017. doi:10.1002/cncr.30815
Compen F Bisseling E, Schellekens M, et al. Face-to-Face and Internet-Based Mindfulness-Based Cognitive Therapy Compared With Treatment as Usual in Reducing Psychological Distress in Patients With Cancer: A Multicenter Randomized Controlled Trial. Journal of Clinical Oncology. 2018. 36(23):2413-2421. doi:10.1200/JCO.2017.76.5669
Goodwin PJ, Leszcz M, Ennis M, et al. The Effect of Group Psychosocial Support on Survival in Metastatic Breast Cancer. New England Journal of Medicine. 2001. 345:1719-1726. doi:10.1056/NEJMoa011871

Additional Reading

Abrahams HJG, Gielissen MFM, Donders RRT, et al. The efficacy of Internet‐based cognitive behavioral therapy for severely fatigued survivors of breast cancer compared with care as usual: A randomized controlled trial. Cancer. 2017. doi:10.1002/cncr.30815
American Psychological Association. Guidelines for the Practice of Telepsychology.
Compen F Bisseling E, Schellekens M, et al. Face-to-Face and Internet-Based Mindfulness-Based Cognitive Therapy Compared With Treatment as Usual in Reducing Psychological Distress in Patients With Cancer: A Multicenter Randomized Controlled Trial. Journal of Clinical Oncology. 2018;36(23):2413-2421. doi:10.1200/JCO.2017.76.5669
Dirkse D, Hadjistavropoulos HD, Alberts NA, et al. Making Internet-delivered Cognitive Behaviour Therapy Scalable for Cancer Survivors: A Randomized Non-Inferiority Trial of Self-Guided and Technician-Guided Therapy. Journal of Cancer Survivorship: Research and Practice. 2020;14(2):211-225. doi:10.1007/s11764-019-00810-9
Everts FZB, van der Lee ML, de Jager Meezenbroek E. Web-based individual mindfulness-based cognitive therapy for cancer-related fatigue—a pilot study. Internet Interventions. 2015;2:200-213. doi:10.1016/j.invent.2015.03.004
Goodwin PJ, Leszcz M, Ennis M, et al. The Effect of Group Psychosocial Support on Survival in Metastatic Breast Cancer. New England Journal of Medicine. 2001;345:1719-1726. doi:10.1056/NEJMoa011871
LeRoy AS, Shields A, Chen MA, Brown RL, Fagundes CP. Improving Breast Cancer Survivors’ Psychological Outcomes and Quality of Life: Alternatives to Traditional Psychotherapy. Current Breast Cancer Reports. 2018;10(1):28-34. doi:10.1007/s12609-018-0266-y
Murphy MJ, Newby JM, Butow P, et al. Randomised Controlled Trial of Internet-Delivered Cognitive Behaviour Therapy for Clinical Depression and/or Anxiety in Cancer Survivors (iCanADAPT Early). Psychooncology. 2020;29(1):76-85. doi:10.1002/pon.5267
Wang Y, Lin Y, Chen J, et al. Effects of Internet-based Psycho-Educational Interventions on Mental Health and Quality of Life Among Cancer Patients: A Systematic Review and Meta-Analysis. Supportive Care in Cancer. 2020;28(6):2541-2552. doi:10.1007/s00520-020-05383-3

By Lynne Eldridge, MD
Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time."

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