Every figure on this page links to the organization that produced it, and each was re-checked against that source before publishing. How U.S. therapy and counseling practices use video and market themselves, and the evidence behind it: our own read of practice homepages; how many counselors, psychologists, marriage and family therapists and social workers there are and what they earn; how many practices there are and how few are large; how many Americans see a therapist and how many do it by video; how BetterHelp, Talkspace and LifeStance compete for clients; what mental health videos on TikTok and YouTube contain and what trials say about therapy by video; the FTC, HIPAA, ethics-code, Florida and Medicare rules; and where eight popular numbers came from.
22.4% of 308 U.S. outpatient mental health practice homepages we read on November 1, 2026 showed a video player, but only 0.3% (one site) named a meet-the-therapist video, though 20.1% invited visitors to meet the therapist or team (our measurement). (Mark Studios)See details
38.0% of those homepages mentioned telehealth or online sessions, 35.1% said they accept insurance and 40.9% linked to a careers page. (Mark Studios)See details
Census counted 249,151 mental health practices with no paid employees in 2024, 62.7% more than in 2019, about 5.4 for every office with staff (our calculations). (U.S. Census Bureau; our calculation)See details
BLS counted 491,930 wage and salary mental health counselor jobs in May 2025, 73.5% more than in 2019 (our calculation), and projects 18% growth to 2035. (BLS; our calculation)See details
14.0% of U.S. adults had counseling or therapy in 2024, up from 9.5% in 2019, and 55.6% of adults who got any mental health treatment got some of it by telehealth (our calculation). (CDC NCHS; SAMHSA; our calculation)See details
BetterHelp spent $518.5 million on advertising and marketing in 2025, equal to 54.6% of its revenue (our calculation). (Teladoc Health; our calculation)See details
Clinicians rated 52% of the top 100 TikTok ADHD videos misleading; for live therapy by video, a meta-analysis of 3,564 participants found outcomes negligibly different from in person. (Canadian Journal of Psychiatry; Clinical Psychology & Psychotherapy)See details
"1 in 5 adults has a mental illness" rounds SAMHSA's 23.4% for any past-year mental illness; the "71% search for a therapist online" line credits a Statista survey we could not find. (SAMHSA; Psychotherapy Growth)See details
How many therapy practice websites show video?
About one in five. On November 1, 2026 we opened the homepages of 400 U.S. outpatient mental health practices drawn at random from OpenStreetMap, the open map database, and 22.4% of the 308 we could read showed a video player (our measurement). The frame was every U.S. psychotherapist, counselling, psychologist and outpatient psychiatry listing mapped in OpenStreetMap with a website: 1,439 distinct websites, each counted once however many offices it serves. Of the 400 sampled, 4 asked crawlers to stay away in robots.txt and were not visited, 10 showed a bot wall, and the rest failed to load or were parked, for sale or not therapy sites. With the same method on the same day, therapy homepages showed video less often than physical therapy clinics, chiropractic offices or dental practices, and a little more often than optometry practices (22.4% against 31.2%, 31.2%, 35.0% and 20.2%, our comparison).
Almost nobody shows the therapist on video. Only 0.3% of homepages (one site) named an introduction or meet-the-therapist video, although 20.1% invited visitors to meet the therapist or team in text or photos and 9.1% offered a free consultation call. The video that does appear is split between background loops and embeds: 8.4% of homepages played a muted video that starts on its own, 37.7% of the pages with any video (our calculation), 10.7% carried a video file hosted on the site and 11.4% embedded a video from YouTube, Vimeo or a similar host, 9.4% a YouTube player. Of the pages with video, 43.5% used only self-hosted files. Homepages linked to Facebook 6.0 times as often as they embedded a YouTube player (our calculation).
On the homepage (308 readable U.S. outpatient mental health practice sites, Nov 1, 2026)
Mentions telehealth, teletherapy or online sessions
38.0%
Book-online, appointment-request or consultation-request link
38.3%
Third-party scheduling tool (SimplePractice, TherapyNotes, Calendly and others)
13.6%
Client portal link
33.4%
Says it accepts insurance or names an insurer
35.1%
Mentions private pay, out-of-network billing or superbills
12.0%
Names Medicaid
10.4%
Names Medicare
6.5%
Mentions a sliding-scale fee
2.3%
Mentions a Good Faith Estimate or the No Surprises Act
7.1%
Says it is accepting new clients
4.9%
Mentions a waitlist or no openings
1.0%
Client testimonials or reviews
27.9%
Psychology Today profile link or badge
6.8%
Crisis information (988, a crisis line or 911)
15.3%
Names the 988 Suicide & Crisis Lifeline
8.4%
Mentions PSYPACT or the Counseling Compact
0.3%
Links to Headway, Alma, Grow Therapy, Rula or SonderMind
0.0%
Careers or jobs page link
40.9%
The most common scheduling tool on the homepage was SimplePractice, on 10 sites, and among sites with a client portal SimplePractice led with 24. A hand check of 30 random readable homepages agreed with the automatic video classification on 100.0% of them. The full site-level table is in homepages.csv (no business names or page text).
The professional codes discourage soliciting client testimonials (see the rules section), and 27.9% of therapy homepages showed testimonials or reviews of any kind.
How many therapists, counselors and psychologists are there, and what do they earn?
Counselors are by far the largest group. BLS counted 491,930 wage and salary jobs for substance abuse, behavioral disorder and mental health counselors in the U.S. in May 2025, at a median annual wage of $59,350 (BLS Occupational Employment and Wage Statistics). That is up 73.5% from 283,540 in May 2019 (BLS), by our calculation. Counting the self-employed, the Occupational Outlook Handbook puts counselor jobs at about 533,400 in 2025 (BLS).
Occupation (U.S., May 2025, wage and salary jobs)
Jobs
Median annual wage
Jobs in offices of mental health practitioners
Substance abuse, behavioral disorder and mental health counselors (21-1018)
Mental health and substance abuse social workers (21-1023)
132,810
$60,280
median $72,940 in these offices
Clinical and counseling psychologists (19-3033)
75,990
$100,580
31,570
Marriage and family therapists (21-1013)
66,740
$66,940
23,960
Psychiatrists (29-1223), for contrast
$281,870
Source: BLS OEWS, May 2025. Wage and salary jobs leave out the self-employed, who are a large share of private practice.
Psychologists of all kinds held about 209,400 jobs in 2025 including the self-employed, and 23% of psychologists were self-employed (BLS). Marriage and family therapists held about 76,300 jobs counting the self-employed; 33% worked in offices of other health practitioners (BLS), the Census category that holds private therapy practices. For counselors that share was 20% (BLS). The median psychiatrist earned 2.8 times the median clinical psychologist (our calculation).
BLS projects strong growth from 2025 to 2035: 18% for counselors, with about 50,500 openings a year (BLS), 14% for marriage and family therapists (BLS), 12% for clinical and counseling psychologists (BLS) and 10% for mental health social workers (BLS). In Florida, BLS counted 29,750 counselor jobs in May 2025 at a median wage of $56,790 (BLS).
Federal counts of the same workforce disagree widely. HRSA's National Center for Health Workforce Analysis counted a supply of 154,019 mental health counselors and 30,566 marriage and family therapists in 2023 (HRSA), against the BLS job counts above: BLS counted 3.2 times as many counselor jobs (our calculation; the two agencies use different definitions, sources and years). HRSA counted 104,012 doctoral-level psychologists (HRSA).
How many mental health practices are there?
Mostly one-person practices. Census counted 249,151 offices of mental health practitioners with no paid employees in 2024, most of them solo therapists, with receipts of $14.05 billion (U.S. Census Bureau, Nonemployer Statistics). That is up 62.7% from 153,109 in 2019 (our calculation). There were about 5.4 of these practices for every office with paid staff (our calculation; 2024 nonemployer count against the 2023 employer count). Florida had 19,999 of them in 2024 (Census).
Offices with employees have multiplied too. County Business Patterns counted 46,513 offices of mental health practitioners (except physicians) with paid employees in 2023 (U.S. Census Bureau), up from 28,517 in 2019 (Census), and 36,309 of them had fewer than five employees (Census). BLS's quarterly census of employers counted 54,453 private offices in 2025, against 21,504 in 2019 (BLS QCEW), a 2.5-fold rise (our calculation). They employed 295,186 people on average in 2025 at average annual pay of $50,440 (BLS). Florida had 4,349 such offices in 2025 (BLS).
Receipts more than doubled. Offices with employees took in $28.3 billion in 2024, up 10.1% from 2023 (Census Annual Integrated Economic Survey), against $12.2 billion in 2019 (Census), 2.3 times as much before inflation (our calculation). The 2022 Economic Census put receipts at $23.3 billion from 41,781 establishments (Census), up from $8.98 billion in 2017 (Census). Patient care for mental and behavioral disorders brought in $22.8 billion of the 2022 total (Census).
The field is barely consolidated. The four largest firms earned 3.6% of receipts in 2022, up from 2.9% in 2017 (Census Economic Census). 38,175 of 39,395 employer firms ran a single location (Census), 96.9% (our calculation), and only 8 firms ran 25 or more locations (Census). Telehealth is now routine: 34,759 of 41,781 offices with employees reported telemedicine revenue in 2022 (Census), 83.2% (our calculation).
Census does not publish advertising spending for therapy practices alone. Offices of all other health practitioners together (NAICS 6213, which also covers chiropractors, optometrists and physical therapists) spent $1.55 billion on purchased advertising and promotion in 2024 (Census Annual Integrated Economic Survey).
Where are the shortages?
HRSA listed 7,127 mental health shortage-area designations as of September 30, 2026, covering a population of 154,557,656 (HRSA). Those designations met 26.24% of their need for mental health providers, and HRSA put the number of practitioners needed to remove them at 7,796 (HRSA). A December 2025 HRSA brief said 137 million people, about 40% of the population, lived in a mental health shortage area (HRSA). Most designations are based on psychiatrist-to-population ratios, so they say little about the supply of therapists. HRSA projects a shortage of 99,780 full-time mental health counselors in 2038 (HRSA), 99,840 psychologists (HRSA), 33,840 marriage and family therapists (HRSA) and 17,030 mental health social workers (HRSA), and 136,350 more psychologists if all unmet need were counted (HRSA). In 2021, 45% of rural counties had no psychologist, against 16% of urban counties (HRSA).
How many Americans see a therapist, and how many do it by video?
About one adult in seven. In 2024, 14.0% of U.S. adults had counseling or therapy from a mental health professional in the past 12 months, according to the CDC's National Health Interview Survey (CDC NCHS), up from 9.5% in 2019 (CDC NCHS), a 47% relative rise (our calculation). Young adults lead: 20.2% of adults 18 to 29 had therapy in 2024 (CDC NCHS), and women were more likely than men, 16.9% against 10.9% (CDC NCHS). In nonmetropolitan areas the share was 10.6%, against 15.2% in large central metros (CDC NCHS). By family income it barely moved: 15.5% below the poverty line and 15.3% above four times it (CDC NCHS).
SAMHSA's National Survey on Drug Use and Health counts any mental health treatment, including medication. In 2024, 60.1 million adults, 22.9%, received some (SAMHSA), and 43.8 million took prescription medication for their mental health (SAMHSA). 33.4 million adults, 12.8%, received mental health treatment by telehealth (SAMHSA), up from 31.3 million in 2023 (SAMHSA). That means 55.6% of adults who got any treatment in 2024 got at least some of it remotely (our calculation). Telehealth reached 20.1 million adults with any mental illness (SAMHSA), 48.3% of adults with serious mental illness (SAMHSA) and 42.4% of adults who had a major depressive episode (SAMHSA).
Among adolescents 12 to 17, 7.4 million (28.5%) received mental health treatment in 2024 (SAMHSA) and 3.4 million (13.1%) received it by telehealth (SAMHSA), down from 3.7 million (14.2%) in 2023 (SAMHSA). 3.8 million adolescents had a major depressive episode (SAMHSA).
How much of mental health care is remote?
Mental health is the largest use of telehealth. In the first quarter of 2026, 52.1 percent of commercially insured patients with a telehealth claim were treated for a mental health condition, according to FAIR Health's national claims tracker (FAIR Health), and in the second quarter the share among patients 19 to 30 reached 70.9 percent (FAIR Health). Psychotherapy was the number two telehealth procedure category in every region (FAIR Health). An analysis of Epic Research electronic health records found telehealth made up 36% of outpatient mental health and substance use visits in 2022, up from almost none in 2019 (KFF), and mental health and substance use services were 39% of all telehealth visits from March to August 2021 (KFF). In Medicare's first pandemic year, beneficiaries used telehealth for 43 percent of behavioral health services (HHS Office of Inspector General).
Psychologists have settled on a hybrid. In the American Psychological Association's 2025 Practitioner Pulse Survey of 1,742 psychologists, 65% saw some clients in person and some remotely, 21% worked fully remotely and 14% fully in person (American Psychological Association). The fully remote share fell from 64% in 2020 (APA). Hybrid psychologists saw on average 41.3% of clients remotely (APA), and 83% planned to keep their telehealth use where it is (APA). The APA represents psychologists.
Can people get an appointment?
It is getting easier, but cost and fit still get in the way. The share of psychologists with no openings for new clients fell from 65% in 2021 to 46% in 2025 (APA); 40% had a waitlist (APA), and 61% said a new client could be seen within a month (APA). Only 62% of psychologists accepted any insurance in 2025, 33% fee-for-service Medicare and 20% fee-for-service Medicaid (APA).
Among adults with any mental illness who went untreated in 2024, 6.1 million felt they needed treatment (SAMHSA). Of adults with mental illness and an unmet need, 65.2% cited cost (SAMHSA) and 45.0% said they could not find a program or professional they wanted (SAMHSA). In a 2022 KFF/CNN survey, 27% of adults said they went without mental health care they needed in the past year (KFF), and 13% of them said they could not find a provider (KFF). In KFF's 2022 women's health survey, covering the past two years, 33% of women 18 to 64 who sought care but could not get an appointment said they could not find a provider taking new patients (KFF), and two in ten privately insured women with an appointment said the provider did not take their insurance (KFF).
Demand surveys point the same way. In an April 2025 American Psychiatric Association poll of 2,204 adults, 28% said they had talked with a mental health professional in the past year (American Psychiatric Association), and in the APA's 2025 Stress in America survey 69% said they needed more emotional support than they got (American Psychological Association). In 2022, 90% of adults told KFF and CNN the country was in a mental health crisis (KFF).
What does Medicare allow?
The Consolidated Appropriations Act of 2021 permanently removed Medicare's geographic and place-of-service limits for behavioral health telehealth (CMS). Medicare's in-person requirement, a visit within 6 months before the first mental health telehealth service, is delayed until after December 31, 2027 (CMS); after that, patients will need an in-person visit every 12 months (CMS). From 2028, audio-only behavioral health visits at home are allowed only when the practitioner could offer video and the patient declines or cannot use it (CMS).
How do BetterHelp, Talkspace and LifeStance compete with private practice?
With advertising budgets no solo practice can match. BetterHelp, the online therapy business of Teladoc Health, spent $518.5 million on advertising and marketing in 2025 (Teladoc Health 10-K), the equivalent of 54.6% of its $950.4 million revenue (Teladoc Health), by our calculation. Teladoc's company-wide advertising expense, which its filings say is mostly for BetterHelp, rose from $88.8 million in 2019 (Teladoc Health) to $545.7 million in 2025, after a 2023 peak of $613.9 million (Teladoc Health), a 6.9-fold rise to that peak (our calculation). In 2022 it was $503.9 million (Teladoc Health).
BetterHelp took in about $2,437 per average paying user in 2025 (our calculation). Teladoc says almost half of BetterHelp members had never been in therapy before (Teladoc Health), and by 2025 it was pursuing insurance coverage for BetterHelp, which had been self-pay (Teladoc Health).
Talkspace went the other way and moved its marketing to insured members. Its revenue reached $228.9 million in 2025 (Talkspace 10-K), up from $113.7 million in 2021 (Talkspace). Its clinicians completed 1,617,000 sessions for health-plan members in 2025 (Talkspace), and health-plan revenue rose 37.9% while consumer revenue fell 29.5% (Talkspace), to $17.5 million (Talkspace). Self-pay members fell from about 56,000 total active members at the end of 2021, 24,000 of them paying directly (Talkspace), to about 5,000 self-pay members at the end of 2025 (Talkspace). Sales and marketing cost $100.6 million in 2021 (Talkspace) and $53.8 million in 2025 (Talkspace), falling from 88.5% of revenue to 23.5% (our calculation); advertising alone was $30.5 million in 2025 (Talkspace). Talkspace delivers therapy by messaging, audio and video (Talkspace), lists 5,700+ licensed providers (Talkspace) and names Teladoc, Lyra Health, Amwell and Spring Health as its main competitors (Talkspace). On March 9, 2026 it agreed to be bought by Universal Health Services for $5.25 a share (Talkspace).
LifeStance hires therapists as employees and buys practices. It employed 8,040 clinicians in 33 states at the end of 2025 (LifeStance Health 10-K), up from 4,790 in 2021 (LifeStance) and 1,404 in 2019 (LifeStance). They handled about 9.0 million visits in 2025 (LifeStance), against 4.6 million in 2021 (LifeStance), roughly 1,119 visits per year-end clinician (our calculation). Revenue was $1,424.3 million in 2025 (LifeStance), against $667.5 million in 2021 (LifeStance). It ran 572 centers at the end of 2025 (LifeStance), had grown to 534 by 2021 (LifeStance) and had made 77 acquisitions of existing practices by then (LifeStance). In 2023 it began closing centers because its patients had shifted to more virtual visits (LifeStance). 87% of its 2025 patients had two or more visits (LifeStance).
Amwell's affiliated medical group listed about 1,000 behavioral health providers in its 2025 filing (Amwell), down from over 1,600 in 2021 (Amwell), and in January 2025 it sold its telepsychiatry business for $20.7 million upfront (Amwell).
Annual reports name online therapy more often than before, but it is still rare. In SEC EDGAR full-text search, the phrase "teletherapy" appears in 3 10-K documents filed in 2019 (SEC EDGAR) and 8 filed in 2025 (SEC EDGAR); "virtual mental health" in 0 and 8 (SEC EDGAR); "BetterHelp" in 1 and 4 (SEC EDGAR). Some hits are employers describing employee benefits.
What do studies find about mental health videos on TikTok and YouTube?
A large share is inaccurate, and most is not made by clinicians. Of the 100 most popular TikTok videos about ADHD, clinician raters judged 52% misleading, 27% personal experience and 21% useful, and non-clinicians posted most of the misleading ones (Canadian Journal of Psychiatry, Yeung et al. 2022). Other studies found similar or lower shares:
Only 37 of the 970 #mentalhealth videos from October 2021 cited any scientific evidence (Digital Health). In the child and adolescent study, creators did not disclose credentials in 51.6% of videos (JMIR Formative Research). By 2023, videos tagged #Autism had drawn 11.5 billion views (Drexel University). In borderline personality disorder videos, personal stories averaged 2,389 weighted likes against 222 for treatment videos (JMIR Formative Research, Evoy et al. 2026), and psychiatrists made 8.7% of them, the largest professional group (Evoy et al.). Fifty percent of 250 eating disorder recovery posts carried pro-eating-disorder elements (International Journal of Eating Disorders). A 2025 Guardian investigation had experts rate the top 100 #mentalhealthtips videos and found 52 out of 100 contained misinformation (The Guardian); it is journalism, not a peer-reviewed study. Licensed professionals appeared in fewer than 6% of 80 YouTube and Bilibili videos on college students' anxiety and depression (Frontiers in Public Health), and the first 50 agoraphobia videos averaged 113,299.5 views, with professionals' videos scoring higher on quality (Cureus). In a survey of 843 undergraduates, heavier #ADHD TikTok viewing went with higher estimates of how common ADHD is (PLOS ONE, Karasavva et al. 2025).
Who gets mental health information from video?
In fall 2024, 34% of U.S. teens 13 to 17 said they at least sometimes get mental health information on social media (Pew Research Center), and 63% of them called it an important source (Pew). Four in ten girls do, against 28% of boys (Pew), and 49% of Black teens (Pew). Only 31% of teens said they would be very comfortable talking about their mental health with a therapist (Pew), and 19% said social media hurt their mental health (Pew). In 2025, 40% of adults said they get health information from influencers or podcasts (Pew), and among those 18 to 29, 39% hear about mental health often (Pew).
In KFF's spring 2024 poll, 66% of adult TikTok users had seen mental health information or advice on the app (KFF), and 12% said they had sought treatment at least partly because of something they saw (KFF), rising to 26% among users 18 to 29 (KFF). In a 2023 survey for Common Sense Media and Hopelab, 54% of social media users 14 to 22 said the platforms are important for seeking support or advice (Common Sense Media and Hopelab), 57% among those with moderate to severe depressive symptoms (Common Sense Media and Hopelab).
The platforms have started labelling clinicians. YouTube opened its health source panels and shelves to individual U.S. healthcare professionals on October 27th, 2022 (YouTube); eligible professions include psychologists, licensed marriage and family therapists and clinical social workers (YouTube Help), but licensed professional counselors are not named, and the program runs only in US, UK, DE, BR, ID, JP, FR, KR, CA, and MX (YouTube Help). A channel needs more than 1,500 public watch hours in the last 12 months, or 1.5 million Shorts views in 90 days, to qualify (YouTube Help). YouTube says users under 18 searching depression, anxiety, ADHD or eating disorders see a shelf of videos from trusted sources (YouTube). TikTok gave $2.3 million in ad credits to 31 mental health organizations in 2025 (TikTok) and says its fund has brought them more than 173 million impressions (TikTok).
Does therapy by video work as well as in person?
For live video sessions, the trial evidence says outcomes are close. A 2021 meta-analysis of 47 between-group studies with 3,564 participants found video-delivered psychotherapy differed negligibly from in-person therapy (Clinical Psychology & Psychotherapy, Fernandez et al.); its pre-post effect fell from g = 0.99 to 0.54 after adjusting for possible publication bias (Fernandez et al.). A 2023 meta-analysis of 18 publications found no significant difference in therapeutic alliance (standardized difference -0.09, patient-rated) (Journal of Telemedicine and Telecare), where a 2018 analysis of 12 studies could not show the alliance was non-inferior (-0.30) (Clinical Psychology & Psychotherapy). A 2024 meta-analysis of 10 studies of children and adolescents found technology-assisted CBT non-inferior to face-to-face CBT for anxiety (d = 0.06) (Clinical Child Psychology and Psychiatry). A trial of trauma therapy for 126 women with PTSD found video non-inferior (Depression and Anxiety, Morland et al. 2015), and a 2007-2011 VA trial of behavioural activation for older veterans with depression found telemedicine non-inferior, with a 15% margin (Lancet Psychiatry, Egede et al.).
In VA records of 813,699 patients with at least three outpatient mental health appointments from July 2021 to October 2022, 42.2% got most of their care by video (JAMA Network Open, Connolly et al. 2026). Those patients completed 3.6 percentage points more of their appointments than patients seen mostly in person (Connolly et al.), an observational result with small effects. The same researchers say approximately half of VA mental health visits now happen remotely (Connolly et al.). In a 2022 survey of 350 VA primary care patients, 76.1% were willing to use video for a non-emergency issue (Frontiers in Digital Health, Carlson et al.).
Short videos on their own move attitudes more than behaviour. In a 2022 Portuguese trial with 626 students, a contact-based video reduced depression stigma (Psychiatry Research), but in a German trial of 1,394 people aged 14 to 29, short video interventions did not change the likelihood of seeking professional help (P = .37) (Journal of Medical Internet Research, Lemmer et al. 2024). We found no study measuring what a therapist's introduction video does for bookings.
What rules govern therapy practice advertising, testimonials and tracking?
Privacy enforcement now reaches online therapy advertising. In March 2023 the FTC ordered BetterHelp to pay $7.8 million for sharing consumers' email addresses, IP addresses and health questionnaire answers for advertising (Federal Trade Commission), with four platforms named in the complaint: Facebook, Snapchat, Criteo, and Pinterest (FTC). The FTC called it the first Commission action to return money to consumers whose health data was compromised (FTC), and voted 4-0 (FTC). Refunds covered people who paid between August 1, 2017 and December 31, 2020 (FTC); about 800,000 people began getting notices in May 2024 (FTC). Teladoc says the investigation began with a demand dated July 30, 2020 (Teladoc Health 10-K) and the order received final approval on July 14, 2023, with a $7.8 million payment (Teladoc Health). In 2024 the FTC charged that telehealth company Cerebral gave sensitive data on nearly 3.2 million people to platforms including LinkedIn, Snapchat and TikTok (FTC); the order carried a $10 million penalty, suspended after a $2 million payment (FTC), and in May 2025 refunds went to 40,249 consumers (FTC).
The FTC's amended Health Breach Notification Rule took effect on July 29, 2024 (eCFR / Federal Register). It requires notice within 60 calendar days of discovering a breach (eCFR) and media notice for breaches affecting 500 or more residents of a state (eCFR). Its first cases, both in 2023, were GoodRx, $1.5 million (FTC), and Easy Healthcare, $100,000 (FTC). Since January 2025 the maximum civil penalty for a knowing violation of an FTC rule is $53,088 per violation (eCFR).
For HIPAA-covered practices, using a client's information for marketing must obtain an authorization in writing (45 CFR 164.508(a)(3)), and almost any use of psychotherapy notes needs one too (45 CFR 164.508(a)(2)). HHS's tracking-technology guidance still says trackers on a patient portal or telehealth platform generally have access to protected health information (HHS Office for Civil Rights), although a federal court vacated part of the guidance on June 20, 2024 (HHS OCR). HHS's pandemic leniency on non-compliant video apps ran from March 17, 2020 (HHS) and ended on August 9, 2023 (HHS). The revised confidentiality rule for substance use disorder records took effect on April 16, 2024 (HHS), with compliance due by February 16, 2026 (HHS).
Can therapists use client testimonials in video?
Every major professional code limits it. APA Ethics Code Standard 5.05 says psychologists do not solicit testimonials from current therapy clients or others vulnerable to undue influence (American Psychological Association); Standard 5.01 covers advertising and directory listings (APA), 5.02 keeps psychologists responsible for promotion they hire others to make (APA), and 5.04 covers media and online advice (APA). The code was last amended effective January 1, 2017 (APA). The ACA Code of Ethics bars counselors from soliciting testimonials from current clients (American Counseling Association) and has a full Section H on distance counseling and social media (ACA). The NASW Code, Standard 4.07(b), says social workers should not solicit testimonials (National Association of Social Workers). The AAMFT Code, revised effective January 1, 2026 (AAMFT), says in Standard 9.2 that therapists do not solicit testimonials from current clients (AAMFT), and Standard 6.3 requires informed consent before therapy by technology (AAMFT).
The FTC's revised Endorsement Guides, which treat a client testimonial in an ad as an endorsement, took effect on July 26, 2023 (eCFR), and its rule banning fake testimonials and review suppression took effect on October 21, 2024 (Federal Register).
Florida rules and licensing compacts
Florida requires clinical social workers to put LCSW or the full title on all promotional materials (Florida Statutes s. 491.0149) and makes misleading advertising grounds for discipline of counselors, marriage and family therapists and social workers (Florida Statutes s. 491.009). A therapist licensed in another state can treat Florida clients by telehealth if the professional registers with the applicable board (Florida Statutes s. 456.47), but may not open an office in Florida (s. 456.47), and the registry shows a five-year disciplinary history (s. 456.47).
DEA and HHS extended pandemic telemedicine prescribing flexibilities a fourth time, through December 31, 2026 (DEA / Federal Register), after the third extension to December 31, 2025 (DEA). DEA's January 2025 special-registration proposal would keep telemedicine Schedule II prescriptions under 50 percent of a clinician's total (DEA). For Medicare, the Consolidated Appropriations Act, 2026 delays the in-person requirement for mental health telehealth until January 1, 2028 (CMS) and extends audio-only coverage to January 1, 2028 as well (CMS). The requirement has been delayed since March 15, 2022 (CMS), most recently from January 30, 2026 (CMS). Google Ads treats Health as a sensitive category that cannot be used for personalized ad targeting (Google Ads Help), and addiction-treatment advertisers in the U.S. must be certified by Google (Google Ads Help). YouTube's health-source program names licensed psychologists, marriage and family therapists and clinical social workers (Licensed Psychologist is the first mental health entry) (YouTube Help).
What the popular mental health and therapist marketing numbers really say
Therapist marketing agencies, practice software vendors and advocacy pages repeat a handful of numbers. We traced each to the organization that produced it. Pages that repeat a claim are linked only as dated evidence of how it spread, never as a source for the number.
"1 in 5 adults has a mental illness"
It is a rounding of a real federal estimate, but of a broad measure. NAMI says more than 1 in 5 U.S. adults experience mental illness each year (NAMI), and gives the figure behind it, 23.4% in 2024 (NAMI). That is SAMHSA's estimate of past-year "any mental illness" among adults 18 and older: 23.4% (61.5 million) in 2024 (SAMHSA), from a survey with 56,228 adult interviews (SAMHSA). The series barely moves: 23.0% in 2021, 23.1% in 2022, 22.8% in 2023 and 23.4% in 2024, which SAMHSA labels no change (SAMHSA). Any mental illness includes mild disorders; serious mental illness was 5.6% (SAMHSA), and 52.1% of adults with any mental illness got treatment (SAMHSA). NIMH's page still shows 2022 data, 23.1% (NIMH).
The older "one in four" has two other origins. A Maryland psychiatry foundation relays "one in four adults" (Maryland Foundation for Psychiatry); the U.S. version matches the 2001-2003 National Comorbidity Survey Replication, which found 26.2% of adults had a disorder in the past year, counting substance use disorders (Archives of General Psychiatry, Kessler et al. 2005). The global version is the WHO's 2001 statement that one in four people will be affected by a mental or neurological disorder at some point in their lives (World Health Organization), a lifetime figure.
Use instead: SAMHSA's 23.4% with its definition ("past-year any mental illness, adults, 2024"), or the WHO's 2023 estimate that 1.2 billion people, nearly 1 in 7 worldwide, live with a mental disorder (WHO).
"71% (or 77%) of people search for a therapist online"
No study measured it. A psychotherapy marketing site credits 71% to a "recent Statista survey" (Psychotherapy Growth); we found no such Statista survey. A practice software vendor's 2017 blog post says 77% of health searches begin on Google (Therasoft). The two real 77% figures measure something else. Pew Research found 77% of online health seekers began their last search at a search engine (Pew Research Center), in a survey of 3,014 adults in August and September 2012 (Pew), about any health information. Google and Compete found 77% of people researching hospitals used search engines (Google/Compete), in a 2012 survey of 533 hospital researchers (Google/Compete). The same vendor's claim that almost 80% of people decide on a therapist before calling cites nothing (Therasoft).
Use instead: SAMHSA's finding that 45.0% of adults with an unmet need could not find a program or professional they wanted, or our homepage count of how many practices let clients book online.
"A therapist intro video raises bookings"
No directory or study publishes a measured lift. The founder of a profile-video service says in an interview that a video increases trust by 89%, with no study behind it (Redd Strategy). A mental health marketing agency's 2025 page says visitors who watch a video are 64 to 85 percent more likely to act (Mental Health Marketing). The 64% is comScore's 2010 comparison of retail site visitors who did and did not view video, 64% more likely to buy (comScore), which compares people who chose to watch with people who did not. The 85% is one UK golf retailer's remark in a 2009 vendor blog post, 85% (SLI Systems). Neither involves therapy.
Use instead: nothing measures it yet. The closest trial evidence is that short mental health videos did not raise young people's likelihood of seeking professional help (P = .37).
"Half of all mental illness begins by 14, three quarters by 24"
It describes people who ever had a disorder, not everyone. NAMI says 50% of all lifetime mental illness begins by age 14 and 75% by 24 (NAMI). The source is Kessler and colleagues' 2005 analysis of the 2001-2003 survey: half of lifetime cases started by age 14 (Archives of General Psychiatry), among the 46.4% of adults who had ever had a disorder, by recall (Archives of General Psychiatry).
Use instead: a 2022 meta-analysis of 192 studies found 34.6% of people with any mental disorder had onset before 14 (Molecular Psychiatry, Solmi et al.), and only 34.5% of mood disorders began before 25 (Solmi et al.).
"It takes 11 years from symptoms to treatment"
No study prints 11 years as a single average. NAMI says the average delay is 11 years (NAMI). Wang and colleagues' 2004 study of 8,098 people aged 15 to 54, from the 1990-1992 survey, found delays averaging more than a decade (Health Services Research), with 80.1 percent of people with a lifetime disorder eventually seeking treatment (Health Services Research). Their 2005 study of the 2001-2003 survey put the median delay at 6 to 8 years for mood disorders and 9 to 23 years for anxiety disorders, among people who eventually sought care (Archives of General Psychiatry), and 88.1% or more of people with mood disorders eventually did (Archives of General Psychiatry).
Use instead: the 2005 medians, by disorder type, with their 2001-2003 date.
"160 million Americans live in mental health shortage areas"
It is a quarterly snapshot based mostly on psychiatrists. A KevinMD column says 160 million people lived in shortage areas as of March 2023 (KevinMD), and NAMI now says 120+ million (NAMI). HRSA's report for September 30, 2026 counts a population of 154,557,656 (HRSA) and an extra 7,796 providers needed to remove every designation (HRSA). The related "60% of counties have no psychiatrist" is New American Economy's 2017 figure, more than 60 percent of counties (New American Economy), counting psychiatrists only; a 2018 study found the share ranged from 6% in New England to 69% in the West North Central states (American Journal of Preventive Medicine, Andrilla et al.).
Use instead: HRSA's dated count, with the note that most designations measure psychiatrists, and its counselor projections (shortage of 99,780 in 2038).
"Viewers retain 95% of a video message" and "video lifts conversions 80%"
Therapist website vendors repeat both. One tells therapists viewers retain 95% of a video message against 10% of text (Brighter Vision). The earliest dated form is Insivia's own 2013 list, 95% (Insivia, Internet Archive copy), and Insivia now says it came from a small directional survey, 95% (Insivia). The 80% conversion figure comes from a 2010 white paper by EyeView, a landing-page video vendor, 80% (EyeView Digital). Unbounce's 2021 analysis of about 35,000 landing pages per period found video had minimal or negative effect on conversion (Unbounce).
Use instead: no general figure; test video on your own pages.
"Teletherapy is as effective as in-person therapy"
For live video sessions this holds up, with caveats; for apps and internet programs it is a different claim. Fernandez and colleagues found video psychotherapy differed negligibly from in-person therapy across 3,564 participants, though the overall effect shrank to g = 0.54 after correcting for publication bias. Batastini and colleagues' 2021 meta-analysis of 57 studies with 4,336 clients found effects largely equivalent, with few randomized trials (Clinical Psychology Review). Headlines such as BYU's "worked just as well", from a study of 5,568 counseling-center patients, are about internet-delivered programs, not live video sessions (Brigham Young University).
We started from the questions people search for about mental health practice video statistics and looked for the organization that actually produced each answer. Every figure on this page sits in an evidence ledger with its source, the exact table or paragraph it came from, the measurement period, the population measured, and the date we checked it. This edition holds 366 figures from 74 publishers.
On November 1, 2026, each sourced figure on this page was re-fetched with the fetch cache cleared and matched against the recorded wording: BLS Occupational Employment and Wage Statistics (through the BLS data API), Quarterly Census of Employment and Wages open data and the Occupational Outlook Handbook (through Internet Archive copies, because bls.gov refuses automated requests); Census County Business Patterns, Nonemployer Statistics, the 2017 and 2022 Economic Census and the Annual Integrated Economic Survey (through the Census data API); HRSA shortage-area reports and workforce projections; SAMHSA's National Survey on Drug Use and Health, CDC NCHS, CMS, the HHS Office of Inspector General, FAIR Health and KFF; the 10-K filings of Teladoc Health, Talkspace, LifeStance and Amwell and EDGAR full-text search; the FTC, HHS, DEA and CMS rules in the eCFR and Federal Register and FTC releases (through Internet Archive copies); the APA, ACA, NASW and AAMFT ethics codes, Florida statutes and the licensing compacts; Pew Research Center, Common Sense Media and Hopelab, YouTube, TikTok and Google; peer-reviewed studies through PubMed; and the pages behind each popular claim. The homepage figures are our own measurement on the same day, described in the first section. We left out the PSYPACT member count (its site refused automated requests and no current archive copy exists), Meta's health ad restrictions (its help pages would not load), the APA Practitioner Pulse methodology report (blocked) and any figure from paid or gated reports.
We only cite the producer: government agencies, regulators, company filings and official posts, and the survey owner's own report. We do not cite statistics roundups, Statista-style aggregators, or salary sites without a public method. We did not bypass paywalls or sign-up forms; where a full report was gated, we used only the figures its publisher states publicly.
Figures marked "our calculation" are arithmetic on the cited numbers, and anyone can reproduce them:
2861 Overpass elements -> minus 1093 out of scope {'hospital': 712, 'office=therapist without a mental-health tag or name': 205, 'counselling, non-mental-health speciality': 143, 'rehabilitation hospital': 29, 'other': 4} -> minus 51 on .gov/.edu/.mil hosts -> 1717 with a usable URL -> minus 68 on directory/social/platform hosts {'plannedparenthood.org': 48, 'psychologytoday.com': 9, 'naturalslim.com': 3, 'clientsecure.me': 3, 'healthgrades.com': 1, 'headway.co': 1, 'google.com': 1, 'facebook.com': 1, 'sites.google.com': 1} -> one row per registrable host = 1439
69 / 308 readable homepages with video_player = true in homepages.csv; rule: video player: a <video> element or player iframe/placeholder (YouTube, Vimeo, Wistia, Vidyard, Brightcove, Loom, Facebook video ...) at least 150x80 px, or a labelled click-to-play control or hidden player embed
33 / 308 readable homepages with video_self_hosted = true in homepages.csv; rule: video player that is a native <video> element (file served by the site or its site builder/CDN, incl. background videos)
35 / 308 readable homepages with video_embedded = true in homepages.csv; rule: video player from a third-party host (YouTube, Vimeo, Wistia, Facebook, TikTok ...)
29 / 308 readable homepages with youtube_player = true in homepages.csv; rule: a YouTube player (iframe, lite-youtube placeholder, lightbox embed link or hidden embed)
59 / 308 readable homepages with youtube_channel_link = true in homepages.csv; rule: link to a YouTube channel or handle (not a single video; template placeholders excluded)
118 / 308 readable homepages with online_booking_or_request = true in homepages.csv; rule: online booking or appointment request: a link/button labelled book/schedule (online, now, today, [a/your] [up to two words] appointment/consultation/session/intake/call), request an appointment/consultation, appointment request, make an appointment or online scheduling/booking (not "call to schedule", not tel:/mailto: links), an appointment URL path, or a third-party scheduling tool
42 / 308 readable homepages with online_booking_tool = true in homepages.csv; rule: third-party scheduling tool: a link, button or iframe to a scheduling vendor (SimplePractice/clientsecure.me, TherapyNotes/therapyportal.com, TheraNest, TherapyAppointment, Valant, IntakeQ, Jane, Headway, Alma, Grow Therapy, Zocdoc, Calendly, Acuity ...; practice-software and platform links only when the label or URL is about booking/appointments/consultations, so a plain client-portal link does not count), a SimplePractice booking-widget or Jane/Zocdoc request, or a booking-labelled link to any other third-party host
117 / 308 readable homepages with telehealth = true in homepages.csv; rule: telehealth, teletherapy, telepsychiatry, virtual/online therapy or sessions, video sessions, or in-person-and-virtual wording in the page text, a link labelled so, or a Doxy.me telehealth-room link (negated mentions and "in-person only" excluded)
108 / 308 readable homepages with insurance_accepted = true in homepages.csv; rule: insurance accepted: a named major insurer (Aetna, Cigna, UnitedHealthcare, Blue Cross/Blue Shield, Anthem, Medicare, Medicaid, Tricare, Humana ...; smaller plans only with an insurance cue), "in-network", "insurance accepted/plans/panels", or "we accept/take/bill (most) insurance" in the page text, or a link labelled Insurance; snippets that say the practice does not take insurance are excluded
37 / 308 readable homepages with private_pay_or_oon = true in homepages.csv; rule: private pay, self-pay, cash pay, out-of-network, superbill, fee-for-service or "we do not accept insurance" in the page text
22 / 308 readable homepages with good_faith_estimate = true in homepages.csv; rule: "Good Faith Estimate" or "No Surprises Act" in the page text (often a footer link) or a link labelled so
15 / 308 readable homepages with accepting_new_clients = true in homepages.csv; rule: a statement that the practice is (now/currently) accepting or taking new clients/patients, has openings or immediate availability (questions, "if" sentences and negations excluded), or a link labelled "accepting new clients"
3 / 308 readable homepages with waitlist_or_full = true in homepages.csv; rule: a practice-voice waitlist or full-caseload statement: join our/[name]'s waitlist, waitlist only, not (currently) accepting new clients, caseload/practice is full ("no waiting lists" and testimonials excluded)
1 / 308 readable homepages with intro_video_mention = true in homepages.csv; rule: an introduction/welcome/"meet the therapist"/"get to know me" video named in the page text, a play control labelled so, or a link to such a video
62 / 308 readable homepages with meet_the_team = true in homepages.csv; rule: "meet the therapist/our team/our clinicians/our providers/Dr." in the page text, or a link labelled meet the team/our team/our therapists/about me or to a /team, /our-team, /staff or /providers path
28 / 308 readable homepages with free_consultation = true in homepages.csv; rule: a free/complimentary/no-cost (N-minute) consultation, call or session offered in the page text, a booking control or a link
21 / 308 readable homepages with psychology_today_link = true in homepages.csv; rule: a link to a psychologytoday.com profile or page, or a Psychology Today verified-badge request (member.psychologytoday.com) while the page loaded
103 / 308 readable homepages with client_portal = true in homepages.csv; rule: a link to a client/patient portal: a practice-software host (SimplePractice/clientsecure.me, TherapyNotes/therapyportal.com, TheraNest, TherapyAppointment, Valant, IntakeQ, Jane, MyChart ...) or a link labelled client portal/patient portal
86 / 308 readable homepages with testimonials_reviews = true in homepages.csv; rule: testimonials or reviews shown: page text with testimonials, client/patient reviews or stories, "what our clients say", Google reviews, star ratings or review counts; a link labelled testimonials/reviews or to a /testimonials or /reviews path; or a review-widget request (Birdeye, Podium, Elfsight, Trustindex ...); "we do not solicit testimonials" statements excluded
47 / 308 readable homepages with crisis_info = true in homepages.csv; rule: crisis or emergency information: 988 (as the crisis line, not inside a phone number), a crisis line/hotline, suicide lifeline, "call 911", "if you are in crisis/an emergency", nearest emergency room or Crisis Text Line in the page text, or a link labelled crisis/crisis resources
26 / 308 readable homepages with mentions_988 = true in homepages.csv; rule: 988 named as the Suicide & Crisis Lifeline (988 not part of a phone number, with a crisis/call/text cue nearby)
1 / 308 readable homepages with psypact = true in homepages.csv; rule: PSYPACT, the Psychology Interjurisdictional Compact or the Counseling Compact named in the page text
0 / 308 readable homepages with billing_platform_named = true in homepages.csv; rule: a link to Headway, Alma, Grow Therapy, Rula or SonderMind, or Grow Therapy/SonderMind named, or Headway/Alma/Rula named with an insurance/booking cue
126 / 308 readable homepages with careers_link = true in homepages.csv; rule: link labelled careers, jobs, join our team, now hiring, employment, open positions, internships or work with us, or a link to a /careers, /jobs, /employment or /join-our-team path
This edition contains no Mark Studios customer data.
Limitations
Our homepage sample comes from a volunteer map. OpenStreetMap covers practices someone mapped with a website, so the shares describe that sample, not every U.S. practice; most solo therapists work from directories and platforms and have no mapped office.
Federal counts of therapists disagree. BLS counts wage and salary jobs, the Occupational Outlook Handbook adds the self-employed, and HRSA counts licensed clinicians with its own definitions, so the same occupation can differ by a factor of three.
Nobody measures what marketing video does for a therapy practice. The studies here measure content accuracy, stigma, help-seeking intent and treatment outcomes, not new clients or bookings.
Several figures come from parties with an interest. The American Psychological Association, ACA, NASW and AAMFT represent their professions; Teladoc, Talkspace and LifeStance sell therapy; therapist marketing agencies and software vendors sell to practices; each is named beside its figure.
Many content studies are small or from outside the U.S. TikTok and YouTube studies from Canada, Germany and elsewhere are labelled; shortage-area counts change every quarter.
Mark Studios. "Mental Health Practice Video Statistics." Last verified Nov 1, 2026. https://www.markstudios.com/research/mental-health-practice-video-statistics
APA
Mark Studios. (2026, November 1). Mental health practice video statistics. https://www.markstudios.com/research/mental-health-practice-video-statistics
MLA
“Mental Health Practice Video Statistics.” Mark Studios, 1 Nov. 2026, www.markstudios.com/research/mental-health-practice-video-statistics.
Chicago
Mark Studios. “Mental Health Practice Video Statistics.” Last modified November 1, 2026. https://www.markstudios.com/research/mental-health-practice-video-statistics.
BibTeX
@misc{markstudios_mental_health_practice_video_statistics_2026,
author = {{Mark Studios}},
title = {{Mental Health Practice Video Statistics}},
year = {2026},
month = nov,
url = {https://www.markstudios.com/research/mental-health-practice-video-statistics},
note = {Last verified 2026-11-01}
}
Our calculations and the evidence table are free to reuse with attribution and a link to this page. Each underlying figure remains the claim of its original publisher, and some publishers ask for a link when their figures are reused.
Health Resources and Services Administration (HRSA), National Center for Health Workforce Analysis, Projecting Health Workforce Supply and Demand (not stated on capture). Accessed 2026-11-01.
We re-verify every figure quarterly and when a major source publishes a new edition. The next scheduled review is February 2027. Corrections go to contact@markstudios.com.
Nov 1, 2026: First published with 366 figures from 74 publishers, each checked against its original source.
Frequently asked questions
How many therapy practice websites have video?
In our November 1, 2026 read of 308 U.S. outpatient mental health practice homepages drawn at random from OpenStreetMap, 22.4% showed a video player. 8.4% played a muted background loop, 9.4% embedded a YouTube player and only 0.3% named a meet-the-therapist video.
How many therapists are there in the U.S.?
BLS counted 491,930 wage and salary mental health counselor jobs, 132,810 mental health social worker jobs, 75,990 clinical and counseling psychologist jobs and 66,740 marriage and family therapist jobs in May 2025. These counts leave out the self-employed.
How many mental health private practices are there?
Census counted 249,151 offices of mental health practitioners with no paid employees in 2024, and County Business Patterns counted 46,513 with paid employees in 2023. 96.9% of employer firms ran a single location in 2022.
How many people get therapy by video?
SAMHSA estimates 33.4 million U.S. adults, 12.8%, received mental health treatment by telehealth in 2024. In the APA's 2025 survey, 65% of psychologists saw clients both in person and remotely.
Is online therapy as effective as in-person therapy?
For live video sessions, the evidence says outcomes are close: a 2021 meta-analysis of 47 studies with 3,564 participants found negligible differences. The effect shrank to g = 0.54 after correcting for publication bias.
Can therapists use client testimonials in videos?
The APA Ethics Code (Standard 5.05), the ACA Code, the NASW Code and the AAMFT Code (Standard 9.2) all bar soliciting testimonials from current clients. A HIPAA-covered practice also needs written authorization to use client information in marketing.
What did the FTC do to BetterHelp?
In 2023 the FTC ordered BetterHelp to pay $7.8 million for sharing consumers' health questionnaire answers and contact details with advertising platforms. About 800,000 people were notified of refunds in May 2024.
Does 1 in 5 adults have a mental illness?
Roughly: SAMHSA estimates 23.4% of U.S. adults had any mental illness in the past year in 2024, most of it mild or moderate. 5.6% had serious mental illness.
