Tending the chair
BetterHelp sells therapy: a licensed professional, through an app, for about $280 to $400 a month. Hearth sells something older and narrower: one trained person, matched to you by hand, who stays for years. For $39 a month. This page compares the two honestly, including where BetterHelp is the better choice. BetterHelp is the example because it is the one people search for; the same comparison holds for any subscription therapy app, and the general version is at Hearth vs. therapy.
If you are in crisis right now, neither service is the right door. In the US call or text 988. In the UK, Samaritans on 116 123. More crisis resources.
you want therapy. A diagnosed condition, anxiety or depression that needs treatment, trauma work, or simply a licensed professional. BetterHelp gets you one quickly, from anywhere.
you do not need treatment. You need a consistent person for the weight that is real but not clinical: the family call, the old grief, the caregiving years, the drift of a long marriage.
you are in therapy for the root and want someone to hold the week in between. The therapist treats. The Keeper stays. Tell each one the other exists.
BetterHelp details are taken from BetterHelp’s own public FAQ as of 2026-08-22. Prices change; check their site before you decide. Hearth is our own service, so read our column with that in mind.
Licensed professionals. Every BetterHelp provider holds a relevant degree, professional credentials and at least three years of experience. That is the bar for treating a mental-health condition, and Keepers do not meet it, on purpose.
Speed and scale. A large network means you can usually start within days, in most countries, in many languages and specialisms. No waiting list for a trauma specialist in your city.
More ways to talk. Messaging, live chat, phone and video with your therapist. If you want a text-first therapy relationship, that is a real strength.
Clinical frameworks. CBT, EMDR, structured treatment plans. When the work is treatment, you want a professional trained in treatment.
Continuity, by design. A therapy app can hand you a new counsellor. Hearth will not. Your Keeper is the same person in month one and year three, so you stop re-explaining your life and start being known.
Matched by a person. Someone at Hearth reads what you wrote and chooses a Keeper for your language, your context and the themes you carry. Not an algorithm, not whoever is free.
A shape, not just sessions. A call every two weeks, a chat thread between them, and a few written lines from your Keeper every Friday about what they noticed. Small, specific, yours to keep.
Priced for years, not a crisis. $39 a month is a price you can hold for a long time. That matters, because the things Keepers hold are long.
A door to therapy when you need it. If a Keeper hears something that needs a clinician, they say so and walk you to The Bridge, our network of vetted, licensed therapists.
Most comparisons of BetterHelp and its alternatives argue about price and convenience. Those matter, but they skip the question underneath: what is the thing you are carrying, and what does it actually need?
Some weight is clinical. Depression that has settled in, anxiety that has taken over, trauma that keeps replaying. That needs treatment from someone licensed to give it, and no amount of warmth substitutes. If that is you, choose therapy. BetterHelp is a reasonable way to get it fast.
A lot of weight is not clinical. The mother who brings it up again. The grief that is four years old and still has no name. The years of parenting your parents. The loneliness of being known only in pieces. Therapy can hold this, but it was not built for it, and at $300 a month most people stop before the slow work is done.
That second kind of weight is what Hearth exists for. It used to be held by an elder, a trusted aunt, the cousin everyone called. Modern life removed those people and did not replace them. A Keeper is the replacement: trained, paid, supervised, and yours.
We are not better than therapy. We are better than no one, which is what most people have for this part of their lives.
Including the ones that beat us on something. A comparison where we win everything would not be worth your time.
Online therapy with licensed providers, and psychiatry for medication.
Where it is better: Often covered by insurance in the US, which can bring the cost down a long way. Adds psychiatry if medication is part of the picture.
Where it is limited: Still therapy, still a provider who may change. Not built for the years-long, non-clinical relationship.
Best if: You want clinical care and your insurance covers it.
Free, anonymous chat with trained volunteer listeners, plus a paid therapy option.
Where it is better: Free is free. Available right now, at any hour, with no commitment. A genuine public good.
Where it is limited: Listeners are volunteers who rotate. You start from the beginning each time, and nobody carries your story forward.
Best if: You need someone to talk to tonight and cannot spend anything.
A licensed therapist in a room with you.
Where it is better: The deepest clinical work, the widest range of approaches, and a person who can see all of you.
Where it is limited: $100 to $300 a session in the US without insurance. Waiting lists for specialists can run months.
Best if: You want treatment, and you want it in person.
Peer support: one trained Keeper, matched by hand, kept for years.
Where it is better: Continuity. The same person every call, who remembers who your mother is. A Friday note. $39 a month.
Where it is limited: Not therapy. Cannot diagnose, treat or prescribe. Not a crisis line.
Best if: You do not need treatment. You need someone who stays.
No. BetterHelp provides therapy from licensed professionals. Hearth provides peer support from a professionally trained Keeper who does not act as a clinician. If you need treatment for a mental-health condition, you need therapy, and BetterHelp is one way to get it. If what you need is a consistent, trained person for the everyday weight of your life, Hearth is built for that. Many members use both.
Yes, but they are priced for different things. BetterHelp's FAQ lists $70 to $100 per week, billed every four weeks, which works out to roughly $280 to $400 a month for licensed therapy. Hearth is $39 a month for a call every two weeks or $99 a month for a call every week, with the chat thread and Friday note included. Hearth costs less because it is not clinical care, not because it is a discounted version of it.
No. Keepers are trained peer supporters. Each completes Hearth's 120-hour training in listening, sensitivity, scope and crisis protocol, passes a background check and joins monthly supervision. They do not diagnose, treat or prescribe. When something needs a clinician, a Keeper says so and helps you find one.
Yes, and it is a common pattern. The therapist works on the clinical root. The Keeper holds the week in between: the family call, the anniversary, the quiet hour before bed. Tell each of them the other exists so nobody is working blind.
Your Keeper will tell you plainly, usually in the first few conversations, and walk you to The Bridge, Hearth's network of vetted, licensed therapists. The Keeper relationship does not have to end. Many members keep both.
The intake takes about 12 minutes
If what you describe needs a therapist, we will say so on the next screen and point you somewhere good. If it needs a Keeper, you will be matched within 72 hours.
Keep reading: Hearth vs. therapy · Peer support vs. therapy, the long read · Do I need therapy? · When you can’t afford therapy · What is a hearth keeper? · Full pricing