Can Children Use Online Therapy?

When most people think of online therapy, they likely imagine adults talking to a therapist via their smartphone or laptop. But online therapy can be used with children too.

Before you sign your child up for online therapy, however, it’s important to understand how it works and to learn the potential risks and benefits of online therapy as compared to in-person treatment.

How Online Therapy Works

There are many licensed mental health professionals who treat children and teens online. For the most part, children can receive a similar level of treatment online that they receive at in-person appointments. 

Online therapy appointments may take place via video, live chat, phone, or messaging. Most therapy sessions can be conducted via a smartphone, tablet, or computer.

The rules about parental permission for children vary depending on the state and licensing organization. So while some states may require that parents give permission for kids to attend online therapy, other states may allow a teen to sign up without parental knowledge.

If parents are involved, the therapist may request parental input into the problem that the child is experiencing. They may also interview the parents about the child’s history and any family history of mental illness.

After an initial assessment, the therapist will discuss treatment options and recommendations as well as rules of confidentiality.

Types of Therapy Offered Online

The most popular online therapy is cognitive behavioral therapy. It’s a treatment that involves helping individuals identify and change unhelpful thoughts and destructive behavior.

Research shows online cognitive behavioral therapy can be just as effective as in-person therapy in children. It’s often used to treat anxiety and depression, but it can be used to treat a variety of other conditions as well.

Online counseling may also involve supportive counseling where the therapist provides emotional support. It might incorporate problem-solving therapy into the treatment as well, where the therapist assists a child in looking for solutions to a specific problem, such as friendship troubles.

Some forms of therapy cannot be done online. Play therapy, for example, is usually conducted with a child in person. It involves using a variety of toys (like a dollhouse) to express emotion and act out scenarios.

Sand tray therapy tends to be conducted in person as well. It involves a tray of sand with a variety of figurines available. Children (or adults) are asked to arrange the sand tray anyway they want—and the therapist may interpret the scenes or help them make sense of their creations.

Eye movement desensitization and reprocessing (EMDR) must also be done in person. It is an interactive therapy that involves talking about trauma while moving the eyes from side to side as directed by a therapist.

How Online Therapy Is Different

Children may communicate with the therapist in a variety of different ways. While some online therapy sites and plans allow for unlimited messaging, others require video chats.

Depending on your child’s age, needs, and preferences, you may be able to allow your child to communicate with the therapist in a way that best suits them.

While some people fear online therapy may be too impersonal, others report they open up more when they aren’t sitting across from a therapist in the same room. Similarly, while some children may struggle to make a connection, others might be able to connect more with an online therapist.

Online therapists with appropriate credentials can provide a diagnosis. While some parents might prefer to avoid labels, it is important for there to be an understanding of the diagnosis in order to provide the most effective treatment.

The Pros

  • Kids can meet with a therapist from the privacy of their own homes. This can be important to families who fear they might run into someone they know in the therapist’s waiting room as there is often a stigma attached to treatment. Kids may also feel more comfortable at home than in a professional’s office space.
  • Kids who are comfortable with technology will navigate online therapy with ease. Children have grown up with technology, so talking to someone online may seem like second-nature. They will likely be quite comfortable with the process.
  • There may be more flexibility around scheduling appointments. This can be helpful to busy families who have difficulty making it to appointments during regular business hours. Many online therapists offer evening or even weekend appointments.
  • Online therapy may cost less. Many therapists charge less for online appointments since they have fewer overhead costs (they don’t need to rent office space, pay staff members, etc).
  • Therapy may be more accessible. Children in rural areas may have better access to therapists when they’re able to see someone online.

The Cons

  • Technological problems can interfere with therapy. For families with slow internet, online therapy can be problematic. Technical glitches with software or issues with electronics can also interfere with therapy.
  • Parents may feel uninvolved. If a child is messaging a therapist, it may be more difficult for the parent to check-in and see how things are going or for the parent to ask questions. The child will most likely have a private room to chat with the therapist and also have their own password. Children have the right to have confidential conversations with their therapist, but, depending on age, children do not always have the right to full privacy.
  • Online therapy isn’t appropriate for every condition. Most online therapists don’t treat certain issues and conditions. A child who is suicidal or who engages in self-harm, for example, may not be eligible for online therapy.
  • Online therapists may not meet court-mandated standards. If a juvenile is court-ordered to attend therapy, substance abuse treatment, or anger management, online counseling isn’t likely to meet those requirements.
  • Online therapists may not accept insurance. Most online therapists don’t accept insurance. So if you hope to use your health insurance coverage, you may have fewer therapists to choose from.

Conditions Treated By Online Therapy

Online therapy may be an option for a variety of conditions. TeenCounseling.com, a popular online therapy site for teens, reports that they help teach coping skills, reduce anxiety, decrease stress, improve self-esteem, reduce depression, address bullying, manage anger, and treat eating disorders and other mental challenges.

Much of the research regarding online therapy for children focuses on depression and anxiety. But therapists often treat a variety of mental health issues and offer other preventative services as well.

Some online therapy sites offer psychiatry services. A psychiatrist is a physician who specializes in mental health treatment and is able to prescribe medication. This could be helpful to parents who are interested in helping a child manage their symptoms with medication.

A Word From Verywell

If you’re concerned about your child’s mental health, or you have some concerns about their mood and behavior, it may be important to consult with a professional. You might find that an online therapist meets your needs.

There are many different online therapy services that differ in terms of price and communication options. With a little research, you can find the one that is best suited to your child.

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  1. Stasiak K, Fleming T, Lucassen MF, Shepherd MJ, Whittaker R, Merry SN. Computer-Based and Online Therapy for Depression and Anxiety in Children and Adolescents. Journal of Child and Adolescent Psychopharmacology. 2016;26(3):235-245. doi:10.1089/cap.2015.0029