Table of ContentsView AllTable of ContentsOur Most Recent TestingLaura’s 2023 TestingWelcome SessionHow Therapy Sessions WorkOur Other Testers' Experiences with Little OtterPros and ConsFinal Thoughts
Table of ContentsView All
View All
Table of Contents
Our Most Recent Testing
Laura’s 2023 Testing
Welcome Session
How Therapy Sessions Work
Our Other Testers' Experiences with Little Otter
Pros and Cons
Final Thoughts
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In the summer of 2024, we received insights about Little Otter from a mother and her son who have been using this company’s services for the past year. These are their personal experiences.
Why We Chose Little Otter
We’ve been using Little Otter for over a year. My son (10 at the time, now 11) was havingpanic attacksat school and experiencing generalanxiety.
We were searching for a therapist for my son, and since most NY therapists were only doing virtual appointments anyway (and are super expensive and don’t take insurance), we decided that Little Otter was a cost-effective way to find a good therapist.
Signing Up for Little Otter
There were several questionnaires to fill out throughout the process. After I did a general one, Little Otter set up a virtual appointment for my husband and me to answer a lot of questions about our son. Based on our conversation, they sent more questionnaires about our family and our son. Throughout his therapy, we have been sent more questionnaires to help monitor his progress. We did give our payment information early on, but I can’t remember whether it was before or after the initial meeting (this was more than a year ago).
We had a “kickoff session” with a care coordinator (also a licensed therapist) who then matched us with a therapist, I believe based on our needs and preferences.
We were EXTREMELY happy with their choice, and it felt like she was in sync with my son right away. It just so happened that she is also in NY, and I think that helped us connect to her in a lot of ways right away. Was it luck or was it based on their insight and our criteria? I don’t know! The whole process took just about two weeks before we had our first appointment with the therapist. This is miraculous compared to NY providers who put you on months-long waiting lists.
There is an app through which we communicate with the therapist, make and change appointments, see her post-appointment notes, and have access to a library of info. My only complaint about this app is that it does a terrible job of remembering my password and makes me log in over and over. I found that it’s much easier to log in from my computer instead. The actual sessions take place over Zoom, and they do send a regular email with the Zoom link every week.
Our Therapy Sessions
After the coordinator session, we had our first appointment with the therapist who talked to my husband and me alone and then talked to our son. We filled out more questionnaires at some point in this process, too. She then sent us a message with a diagnosis and outlined how her treatment plan would go forward. It was all very comforting to us and to our son.
She used CBT (cognitive behavioral therapy) and explained her approach in detail throughout the year. I don’t think she said it would be CBT until after our first session with her.
Our rapport with her was amazing. She’s got the demeanor of a lovely kindergarten teacher, but also clearly knew her stuff.
Our son had been reluctant to talk to a therapist at first, but loved her instantly.
Throughout the year, she intermittently invited me to join in sessions—sometimes formally set up in advance, or sometimes in the middle of a session when my son wanted to talk to both of us. I appreciated this a lot. We were also able to message with her between sessions.
I believe she was very good about getting our son to open up. As is probably typical with a child, he sometimes forgot what had been bothering him a few days before and neglected to tell her about it, even though it was fresh in my mind. I think it would have been helpful if she’d prodded him a little more to get those things out of him. But it’s ok that I was able to step in every once in a while to make sure he talked about that stuff.
My only complaint really is that a couple of times there were glitches in Zoom, or maybe we clicked an old link or something, and we didn’t connect to her right away and missed 15 minutes of the session.
This is where it would have been nice to have a phone number or something, rather than having to rely on the app to communicate. Once we knew that could be an issue, we made sure to look closely at which email link we were using and to follow up to make sure the session was underway before leaving my son in his room to talk to her.
I have no idea if we could have done sessions through anything but Zoom, but I don’t think I would have wanted to anyway. We were able to have our appointments after school on weekdays, which was perfect for our schedule.
Cost of Little Otter
It cost $400 for the first 90-minute evaluation, and then $200 a session if you just paid per time. It costs as little as $165 per session if you book a package of 8 at a time. It was all out-of-network for us.
I really, really wish this had all been in-network for insurance. We have not had any of it covered, though I think I can submit some of it for out-of-network reimbursement. Still, I would do it again—it wasn’t cheap, but also was about the same or less than what I would be paying for someone locally. And this is my son’s mental health we’re talking about. He has not had any real panic attacks since he started therapy. He still gets anxious at times, but I’ve watched him work through all the tools he’s gained to handle his feelings, and I would pay 10 times this much to see this progress.
How We Feel About Little Otter
I would recommend Little Otter to anyone having trouble finding immediate, somewhat affordable therapy for their kid. It does need to be a kid who responds well to video communication. I know some children don’t feel like they’re connecting to another human when it’s over a computer. We’re lucky that our son does.
In 2023, we asked Laura and her son to test Little Otter’s children’s therapy services to learn about the quality of care this company could provide. These are her firsthand insights.
Why I Chose Little Otter
We worked with Little Otter for just over a month, during which time we completed a welcome session, a psychiatrist assessment, and a follow-up session. The providers were professional, warm, and knowledgeable, but Little Otter does not accept insurance, and the out-of-pocket expense was quite high, so my family could ultimately not move forward with it. Read on to learn more about our experience and see if it might be worth it for you.
How I Signed Up for Little Otter
Arriving on the homepage, I immediately saw the phrase “Mental health support for the whole family,” next to a picture of a parent hugging a smiling child. A green “get started” button was beneath. Scrolling down the page, there were sections describing the company’s approach in more detail, a review from a satisfied client, a biography of founder Dr. Helen Egger, and an explanation of “How Little Otter Works” with the steps for signing up for and receiving services.
Little Otter
Buttons to “get started with your personalized care plan” and “join our care family” were peppered throughout the page.
I was immediately impressed with the user-friendly layout of the website.
It felt like all my questions were answered before I had the chance to ask them. Pricing was listed clearly on theFAQ pageand the mission of the company made me feel like I was on the right track.
At the top of the homepage is a “join now” button. I had the option to immediately sign up for my first appointment, or complete a free family health assessment, which I did. The assessment included a questionnaire for each member of my family. For my child, questions included how he feels in new situations, if he suffers from stomach aches, and if hebullies or is bullied. The assessment had over 30 questions about his behavior, and any concerns I might have, and provided some feedback as to what my family might need in terms of Little Otter’s services. This included links to its online resources and the option to book a welcome appointment to learn more.
I was not asked any questions about the type of therapist I would like for my child, including gender and age, which I found a bit odd.
After completing the family health assessment, I was prompted to provide payment information.
Out-of-Pocket Costs and Bundles
Little Offer lists its costs on its website FAQ page:
You can also purchase bundles:
Little Otter does not accepthealth insurance, but will provide a superbill for patients to submit to their insurance provider for partial reimbursement. Payment must be made in full prior to each session, and invoices and receipts are sent directly to your email. Even if a family has the option for partial or full reimbursement from their insurance, they are still required to pre-pay for their appointments. This feature excludes families who are unable to front the cost of services.
Steep PricesI felt that Little Otter’s prices—even with the discounted bundles—were inaccessible for most families. The most discounted bundle still works out to over $165 per 45-minute session, and the individual psychiatry sessions offer no discounts at all.
Steep Prices
I felt that Little Otter’s prices—even with the discounted bundles—were inaccessible for most families. The most discounted bundle still works out to over $165 per 45-minute session, and the individual psychiatry sessions offer no discounts at all.
As soon as I signed up, I had access to a private user portal that was easy to navigate and allowed me to send messages to my care team, check my appointment schedule, and view family resources like articles and blog posts. Little Otter also has an app that allows families to track their progress, with daily access to their care team when questions, concerns, or schedule changes arise.
Our Welcome Session
I was matched with a member of the Little Otter team for my welcome session, which was scheduled for the following week.
I didn’t know quite what to expect or who I would be seeing for my initial welcome session, but my spouse and I were given a 30-minute session with alicensed mental health counselorwho became our “care lead.” She walked us through what Little Otter can offer and asked us questions about our needs. At the end of the call, she scheduled a psychiatric assessment for us and our 5-year-old son. We did not choose the doctor ourselves but were assured that they would be the right fit for our family.
Founder Rebecca Egger has said, “We’re really focused on understanding each family’s unique story.” It did feel like our care team wanted to understand the needs of the entire family.
Little Otter does not list provider names or bios on its website. Instead, the “Our Team” page includes photos and blurbs about the Little Otter founder and its clinical advisors and lists its expert care team as licensedtherapists, parenting experts, andchild psychiatrists.
How Our Therapy Sessions Worked
Little Otter offers teletherapy, but all of the appointments were in the middle of my child’s school day, forcing us to make accommodations including late arrival for class. When it was time for a session we could log into our patient portal and connect to our Zoom link from there. Our initial provider as well as ourpsychiatristwere easy to see and hear.
Our providers were punctual for each session, with no issues like background noise or grainy video.
We didn’t know anything about the provider we were paired with for our initial assessment, but she immediately demonstrated that she was a good fit for our family.
She was warm and patient as we outlined our concerns and she began her conversation with our son using some personal information, asking him about his pet lizard and his younger brother.
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How Our Son’s Psychiatry Session Went
Our psychiatrist greeted us and our son for our 75-minute session with knowledge of our welcome session and the forms we had already filled out when we registered for Little Otter. This was an evaluation, not a therapy session, so the doctor had a chance to meet and interact with our son and ask me and my wife follow-up questions.
I was concerned that my young child would not be able to engage throughout our entire 75-minute assessment, but he was only needed for the first 20 minutes and then it was time for my spouse and I to speak with the psychiatrist on our own.
While my son was talking with the doctor, she was friendly but serious, and he exhibited some shy behavior when he was expected to answer questions. Overall, I think she was able to get a good sense of his personality and demeanor.
We discussed our goals and made a plan for a follow-up session—without our son—for the following week so that we could discuss a possible diagnosis.
I have personal experience talking toadolescent therapists, and, based on those experiences, I was impressed with our psychiatrist. I felt she immediately understood our situation and gave us plenty of time to talk about our concerns.
Little Otter also provides session recaps to make it easy to stay on top of your family’s “care journey.”
We also tested Little Otter two other times, from Pennsylvania and California, and our experiences were similar—excellent care with a too-expensive price tag.
Our Care Leads were welcoming and warm, explaining the Little Otter process to us in detail, and all of the therapists we worked with were incredibly professional and clearly skilled at working with families and children. We really liked one of the parent coaches we were matched with, who was well-trained and very thoughtful; however, our first 45-minute session with her ended up only being 25 minutes, and the following session—which we used to go over our treatment plan—felt a little redundant, as we could easily have read the plan ourselves without using an entire session to walk through it. Nonetheless, we appreciated her thoroughness, and we found her to be qualified, empathetic, and caring. The parent coaching she provided us felt useful and understanding.
Our second time testing Little Otter was as a BIPOC military spouse—we were specifically looking for a BIPOC person of faith as our provider, and although we weren’t able to find that (despite Little Otter stating that it is dedicated to diversity), we were still pleased with the care we received.
Our therapist, who we picked from a short list of bios we requested from the company, asked thoughtful questions and seemed genuinely interested in the answers, leading us through a thorough examination of our and our family’s mental health. Questions like “What does our experience with anxiety look like,” “How often do our challenges with anxiety occur,” “In what situations does it occur,” and “What have we done about it” made us feel as though our provider was truly dedicated to providing us the best and most tailored care possible.
Our second session, which was with our 10-year-old daughter, went equally as well—our therapist was able to immediately establish a connection with our daughter and quelled her anxiety within 10 minutes. We felt comfortable stepping away from the session, leaving our daughter alone with the therapist, and we were thrilled to hear her opening up to her provider about her feelings right away.
We especially appreciated the fact that our providers were extremely accessible between sessions. We found that we could message our therapist any time through the patient portal and we always received prompt (and thoughtful) responses. This only increased the confidence we had in our providers and Little Otter as a service. However, the hefty price tag prevented us from continuing with Little Otter, despite our happiness with the clearly professional and informed care it offered us.
Switching Providers
Additional Resources
Little Otter also offers some additional helpful resources, including a blog with articles and insights from its providers. There is a “family resources” section in each personal profile that recommends curated resources based on the child’s age and the family’s needs. I appreciated brief articles abouthyperactivity, and reader submissions aboutsugar intakeandscreen time.
While I felt like the care we received from our providers at Little Otter was excellent, the cost was prohibitive. Here are the rest of my pros and cons.
ProsWebsite is user-friendlyYou can message your care team at any timeCare team is quick and responsive to messagesClinicians listen attentively to concernsClinicians offer helpful insights right awayInvoices and receipts sent directly to your email so it’s easy to keep track of paymentsConsDoes not accept insuranceMay be prohibitively expensiveCan’t choose therapist based on web biosPsychiatrist availability is mostly during school hours
ProsWebsite is user-friendlyYou can message your care team at any timeCare team is quick and responsive to messagesClinicians listen attentively to concernsClinicians offer helpful insights right awayInvoices and receipts sent directly to your email so it’s easy to keep track of payments
Website is user-friendly
You can message your care team at any time
Care team is quick and responsive to messages
Clinicians listen attentively to concerns
Clinicians offer helpful insights right away
Invoices and receipts sent directly to your email so it’s easy to keep track of payments
ConsDoes not accept insuranceMay be prohibitively expensiveCan’t choose therapist based on web biosPsychiatrist availability is mostly during school hours
Does not accept insurance
May be prohibitively expensive
Can’t choose therapist based on web bios
Psychiatrist availability is mostly during school hours
Our Little Otter care team and the psychiatrist we met with were attentive and professional. Our psychiatrist, in particular, seemed very knowledgeable about every topic we discussed. She offered helpful insights and we felt like we were armed with useful information, even after our first appointment.
Personally, I would exhaust in-network and in-person therapy and psychiatry options for my child and family before turning to telehealth, but for a mental health company that does not offer in-person services, I believe Little Otter does a good job of connecting families with mental health experts and offering helpful resources. However, because Little Otter does not accept insurance, it would not be a viable option for many families looking for pediatric mental healthcare.
Little Otter User Survey ResultsWe surveyed 100 Little Otter users to see if their experience was similar to mine.89% said that they found Little Otter services to be affordable or very affordable93% reported that they were satisfied or very satisfied with the provider options listed on the website100% of surveyed users reported that their therapist’s qualifications were good, very good, or excellent96% found a provider who met most or all of their needsThough Little Otter does not recommend switching therapists, 60% of users switched providers once or two to three times, and 10% reported that they switched four or more times
Little Otter User Survey Results
We surveyed 100 Little Otter users to see if their experience was similar to mine.89% said that they found Little Otter services to be affordable or very affordable93% reported that they were satisfied or very satisfied with the provider options listed on the website100% of surveyed users reported that their therapist’s qualifications were good, very good, or excellent96% found a provider who met most or all of their needsThough Little Otter does not recommend switching therapists, 60% of users switched providers once or two to three times, and 10% reported that they switched four or more times
We surveyed 100 Little Otter users to see if their experience was similar to mine.
Overall, I would recommend Little Otter to families with young children who have the financial resources to receive continued care.
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Hannah Owens, LMSW
andSimone Scully
Simone Scully
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