Questions people actually ask

You answer a short questionnaire — what's going on, how you want to connect, your budget. Our care team pairs you with a licensed therapist in your state whose specialties fit, typically within 24 hours. You see their full profile before your first exchange, and you can request a different match anytime, free.

Absolutely. Browse the directory, open any profile, and request that therapist directly during signup. Matching exists for people who'd rather not choose from 300 options — not to take the choice away.

Sanctum works well for ongoing support with things like anxiety, low mood, stress, relationships, grief, and life transitions. It is not a fit for emergencies, active crisis, or conditions that need in-person or intensive care — if that's where you are, please see the crisis resources in our footer or contact your local services.

Not currently. Sanctum is a talk-therapy platform. If you and your therapist think a medication consult would help, they'll help you find the right next step outside the platform.

Messaging is asynchronous: write, voice-note, or share whenever it suits you, and your therapist responds thoughtfully five days a week. Live sessions are scheduled 45-minute conversations by video, audio, or live chat. Core is messaging-only; Plus combines both; Flex is live sessions à la carte.

Therapists respond at least once a day, five days a week — usually more. Messaging therapy isn't instant chat; it's considered, unhurried replies you can revisit anytime.

Yes — per session, on Plus and Flex. Plenty of members do audio on walking days and video otherwise. Cameras are never mandatory.

Tell us (or just tap "request new match" in the app — no awkward conversation required). Fit matters more than almost anything else in therapy, and switching is free and unlimited.

Sanctum Core (messaging therapy) is $260/month. Sanctum Plus (messaging + 4 live sessions) is $396/month. Both drop about 15% when billed quarterly. Sanctum Flex is $95 per session with no subscription. No signup fees, no cancellation fees.

We're in-network with several plans — members with covered plans often pay a $0–$35 copay per session. Enter your insurer during signup and we'll show your estimated cost before you commit. Out-of-network? We provide superbills for reimbursement claims.

Yes — therapy is an eligible expense on most HSA/FSA plans, and Sanctum accepts HSA/FSA cards directly.

Cancel in two taps from settings, effective at the end of your billing period. No calls, no retention scripts. Pause is also available if you just need a month off.

Yes. Sessions and messages are end-to-end encrypted in transit and encrypted at rest, and confidentiality follows the same professional rules as any therapist's office, with the same legally required exceptions (risk of serious harm, abuse of a minor, court order) — your therapist will walk you through these in your first exchange.

Every therapist on the platform holds an active, verified license in the state where they see you (LCSW, LMFT, LPC, LMHC, PhD/PsyD, or equivalent) and carries at least three years of post-licensure experience. We re-verify licenses on a rolling basis.

Sanctum isn't built for emergencies, and messaging isn't monitored in real time. If you're in immediate danger, call 911. If you're in crisis or thinking about suicide, call or text 988 (the Suicide & Crisis Lifeline, US) — free, confidential, 24/7. These resources live permanently in our footer.