I have had numerous clients with mental health issues that have used services like these. There are multiple companies out there that run variations on the theme of online mental health care, both psychiatry and counseling. I do not recall who, if any, specifically used Thriveworks, but I can tell you that nobody, and I do mean nobody, has ever had good experiences with this setup. Some problems that have been pretty universal:
1. No meaningful control of who the mental health professional is that you will be seeing. (When I say "meaningful," yes, a person can ask to switch with most services, but the choices are generally slim.) This matters for obvious reasons. The providers who work with these low-cost online services are generally NOT from the top of the class, and they tend to switch practices and go in and out of working with these services pretty regularly.
2. The quality can be scary. Not all these providers are bad, but I have seen some real treats that work for these services. For instance, one of my clients was seeing a psychiatrist who was licensed here and was *allegedly* practicing in-state. However, it turned out that her in-state address was just a drop box, she was actually on the other side of the country, and this online psychiatry gig was just a sideline for extra cash. Her main business was a quack website where she sold consulting services as a vegan nutritional counselor, claiming to CURE everything from autism to every autoimmune disorder by diet alone. She kept virtually no records, and wound up sending the client into a psychotic episode that landed her patient in the hospital by prescribing a medication that was contraindicated, and then ghosted.
3. Getting records can be a nightmare. Again, not all of these services are equally problematic. But with some, it's a real problem. For example, one such service has a patient portal where the participating providers all upload records. Although it is illegal, they do not accept any requests for records from providers or attorneys. Rather, only the patients themselves can download their own records if they need them. There is no way to reach the company to deal with record requests or problems. Another such company goes the opposite route, where the individual providers keep all their own records, and requests must be made directly to them. But because of the rapid turnover pattern I was describing above, finding a doc even several months later can be a wild ride. I had to request records for a client from a doc they had been seeing about a year earlier. The request bounced, as the doc had left the practice and taken records with them. The old clinic had the doc's next forwarding address to give to patients (required by law), but it was a dead end. The provider had gone solo, and that practice had only lasted a couple months. We traced the provider through 4 more clinics they burned through in that one year before finding a valid, current contact. While finding a provider should be theoretically easy through NPI records, folks like this don't seem to bother to keep those up to date...
In most communities (obviously almost universally in large cities), there are counselors who will do a sliding scale rate, either through their own practice or through a nonprofit they work with at least to some part-time degree. There are also county mental health services in many places in the country, though these can be dicey - some are run wonderfully, and others are abysmal. Regardless, I urge my clients to find an individual counselor that they actually connect with, who does offer a sliding scale. I have had clients with great experiences with some of these counselors, where they are paying as little as $10 for Facetime visits during the pandemic, or simply out of convenience to avoid travel. It does take some effort to find these providers, but my clients' experiences with local providers like this is like night and day, compared to the docs who work with these services.
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