TherapyNotes vs SimplePractice vs Valence

TherapyNotes vs SimplePractice is the fork in the road for most behavioral health practices under ten clinicians. They are the two defaults, they are priced within twenty dollars of each other, and the demos both look fine. I am going to compare them on the four things that actually change how your week goes, then show where a metered product like ours lands, since we build one and you should know that going in.

All competitor claims below come from their published pricing pages and support documentation as of July 2026. Verify before you sign anything; vendors change plans.

TherapyNotes vs SimplePractice: the short answer

Pick TherapyNotes if documentation quality and phone support are what keep you up at night. Its note templates are the most opinionated in the category, in a good way, and its support reputation is earned. Pick SimplePractice if you want the widest integration surface, the deepest template library, and the comfort of the biggest installed base. Neither one will let you automate a follow-up sequence.

Price, including the parts that do not show on the pricing page

SimplePractice advertises $49 for Starter. Per their published plan documentation, Starter does not include client email, text, or voice reminders, which begin on Essential at $79. So for practically any practice that texts its clients, the real entry price is $79, not $49. Worth knowing before you build a budget around the smaller number.

TherapyNotes lists $59 for the first clinician on their pricing page, and then charges $0.14 for each SMS or voice reminder. That is not a rounding error at volume. A clinician running 20 sessions a week with one text each pays about $11.20 a month in reminders, landing near $70. A six-clinician group sending 420 texts a month pays $58.80, roughly another seat's worth of subscription, spent entirely on text messages.

Our model is different in kind rather than degree. No monthly fee, no per-seat license, and meters on the things that cost real money to run: $0.01 per minute of video session, $0.008 per minute on top when AI notes run during video, $0.012 per minute for AI notes on an in-person session, $0.03 per SMS. Email reminders are unlimited and free. The bill can never exceed $69 per clinician in a month regardless of usage, so the ceiling is knowable even though the floor moves.

Reminders, which is where the real difference lives

Both incumbents treat the reminder as a setting rather than a workflow, and that is the constraint people feel three months in.

On SimplePractice, per their reminder documentation, you pick one offset: 24, 36, 48, or 72 hours. A client who booked five weeks ago gets exactly one contact before the session. On TherapyNotes, per their support documentation, you do not get that choice at all: the send windows are fixed by TherapyNotes, so you pick neither the timing nor the count.

Neither will text a client 90 minutes after a no-show, re-engage someone who dropped off after four sessions, or nudge a client to finish an intake packet on day 2 and again on day 5. Those are the sequences that move revenue, and they are the reason people end up trying to wire Zapier to a spreadsheet.

For contrast: our care pathways are template-based automations written as plain sentences, with a per-patient run log so you can see exactly what fired and when. Intake chasing, no-show follow-up, re-engagement, and measurement-based care ship as templates. Quiet hours, weekly message caps, and opt-outs are enforced by the system so an automation cannot embarrass you at 11pm. It is included, not a tier.

Notes and documentation

This is TherapyNotes at its strongest. The templates push you toward medical necessity language and structured content, which is exactly what you want when a payer asks for records and you have not thought about that session since March. If your practice has documentation compliance problems, TherapyNotes fixes more of them than any competitor here.

SimplePractice gives you more templates and more freedom, which cuts both ways. Experienced clinicians like the flexibility. Newer ones sometimes write themselves into an audit finding.

On our side, AI notes are opt-in per session and off by default. Transcription runs on our own servers rather than a third-party API, the audio is deleted once the note is written, and nothing gets used for AI training. If you have a client for whom recording is a nonstarter, you leave it off for that session and nothing changes. Superbill generation is free.

Groups, measurement, and the things nobody demos

If you run group therapy over video, ask both incumbents to show you a real group session with a co-facilitator before you buy. Multi-patient telehealth with roster-based rooms is not a checkbox feature, and it is native for us because the product was built after group care became normal rather than before.

On outcome measures, a dozen instruments come built in with us and auto-score with trend lines: PHQ-9, GAD-7, PCL-5, EPDS, AUDIT-C, ASRS, ASQ, and others. A suicide-risk answer flags immediately rather than sitting in a PDF until someone opens it. Ask your shortlist what happens to item 9 of a PHQ-9 at 9pm on a Friday, and listen carefully to the answer.

The money, worked out twice

Solo clinician, 20 telehealth sessions a week at 50 minutes, about 80 sessions a month, one SMS reminder each:

Six-clinician group, each seeing 70 sessions a month at 50 minutes, 40 of them by video, AI notes running on all of them, one text per session. Per clinician that is $20 of video, $16 of AI on video, $18 of in-person AI, and $2.10 of SMS, or $56.10. Across six clinicians, $336.60 a month, and that is with AI notes on every single session.

Two front desk staff, a biller, and a clinical supervisor add nothing to that number, because seats are not what we charge for. On per-seat platforms those four people are usually four more line items, and the reminder spend alone at $0.14 a message would be $58.80 for the same volume. Check the current additional-clinician rate on each vendor's pricing page rather than trusting anyone's blog post, including this one.

So which one

Choose TherapyNotes if documentation rigor and a human on the phone are your top two criteria, and you can live with reminder timing you do not control.

Choose SimplePractice if you want the largest ecosystem and the most integrations, you bill insurance heavily, and $79 a month is noise relative to your revenue.

Look at us if your volume is uneven, you have more staff than clinicians, you want follow-up automation without buying a $129 tier, or the idea of paying for software in August at January rates bothers you. Fair warning: we are newer, and if a decade of accumulated edge cases is what makes you comfortable, we do not have that yet. There is a $100 credit and no card required if you want to find out cheaply, and free migration from SimplePractice, Blueprint, Headway, and Alma.

Still triangulating? The wider list of SimplePractice alternatives covers Healthie, Zanda, and IntakeQ too, and if you are opening a practice rather than moving one, start with choosing an EHR for a new private practice. Our full rate card is on the pricing page.