Therapy for children: What parents should know before starting online sessions

When to consider therapy for your child

Deciding whether your child needs therapy can be a difficult decision. While it’s normal for children to have emotional ups and downs, certain persistent signs can indicate that professional help might be beneficial. Parents should pay close attention to significant or prolonged changes in their child's behavior, mood, or overall functioning that interfere with their daily life, school, or relationships.

Clear signs that a child might benefit from professional support include:

• Frequent sadness or unexplained crying: Persistent low mood, tearfulness, or a lack of interest in activities that once brought joy.

• Withdrawal from friends and activities: A noticeable decrease in social interaction, a preference for isolation, or a loss of interest in hobbies and sports.

• Significant behavioral issues: Increased aggression, defiance, severe tantrums, or disruptive behavior at home or school.

• Regression in development: Reverting to earlier behaviors, like bedwetting after being dry, thumb-sucking, or clinging to parents, especially following a stressful event.

• Changes in appetite or sleep patterns: Major changes in eating habits, difficulty falling asleep, nightmares, or frequent waking during the night.

• Increased anxiety or worry: Persistent fears, excessive worrying about everyday things, separation anxiety, or unexplained physical complaints (e.g., stomachaches, headaches).

• Difficulty concentrating or academic decline: A sudden drop in school performance, trouble focusing, or difficulty completing tasks.

• Self-harming behaviors: Any expression of self-harm, such as cutting or other injurious actions.

• Exposure to trauma: Changes in behavior following the experience or witnessing of a traumatic event (e.g., car accidents, natural disasters, abuse, or violence).

Consider the example of a child who was typically cheerful and engaged but suddenly begins acting out at school, throwing tantrums at home, withdrawing from friends, and experiencing frequent bedwetting after a major family change, such as a move or parental separation. These shifts, especially if they persist for more than a few weeks and significantly affect the child’s daily life, are strong indicators that professional support could help them process their emotions and develop healthier coping strategies. It’s important not to wait too long to seek help; early intervention can prevent issues from becoming more ingrained and can strengthen a child's emotional resilience in the long term.

How online therapy works for kids

Online therapy for children adapts traditional therapeutic approaches to a digital format, ensuring that sessions remain engaging, effective, and developmentally appropriate. The process typically begins with a foundational intake session involving only the parent or primary caregiver. During this initial meeting, the therapist gathers crucial background information about the child's developmental history, family dynamics, presenting concerns, and goals for therapy. This also provides an opportunity for parents to ask questions and understand the therapeutic process and confidentiality guidelines.

Once the intake is complete, and if online therapy is deemed appropriate for the child's age and needs, subsequent sessions will involve the child directly. Therapists are highly skilled at adapting their techniques to maintain children's attention spans and engagement in a virtual environment. They employ a variety of creative and interactive tools, which might include:

• Play therapy with digital toys and drawings: Therapists may use virtual whiteboards, drawing apps, or even guide children in using their own toys at home during video calls to facilitate expression and communication, mirroring elements of traditional play therapy.

• Storytelling and role-play: Therapists might use digital storybooks, create collaborative narratives, or engage in virtual role-playing scenarios to help children process emotions, practice social skills, and explore different perspectives.

• Interactive digital activities: This could involve screen-sharing games designed for emotional regulation, mood tracking apps, or educational videos that help illustrate complex feelings or coping strategies.

• Puppets or stuffed animals: Therapists might encourage children to bring their own favorite toys or puppets to the session as a way to facilitate conversation and imaginative play.

• Movement-based exercises: Guiding children through simple stretches, mindfulness exercises, or breathing techniques that they can do at home, demonstrated through the screen.

While the therapeutic relationship is primarily between the child and the therapist, and confidentiality is respected, therapists will often provide updates to parents regarding the child's progress, general themes being addressed, and recommendations for parental support, while carefully upholding the child's privacy regarding specific session content unless there are safety concerns. This balance ensures parental involvement without compromising the child's trust in their confidential space.

Benefits of online therapy for children

Online therapy offers several distinct advantages that can make it an ideal choice for children and their families, addressing common barriers to traditional in-person care.

• Children feel more relaxed in familiar surroundings: Being in their own home, surrounded by their toys and comforts, can significantly reduce anxiety and help children feel more at ease during sessions. This can lead to greater openness and engagement, as they are in an environment where they already feel safe.

• Parents save time by avoiding travel: Eliminating the commute to and from a therapist's office is a huge benefit for busy parents. This saves valuable time, fuel costs, and reduces the logistical stress of scheduling.

• Easier to schedule appointments around school and activities: Online therapy offers greater flexibility in scheduling, allowing sessions to be integrated more smoothly into a child's busy school day, extracurricular activities, or family routines. Many online therapists offer evening or weekend slots.

• Increased access to specialized care: For families living in rural areas or those with specific needs (e.g., a child with a particular diagnosis like ADHD, autism, or a specific type of trauma), online therapy expands the pool of available therapists, allowing them to connect with highly specialized professionals who might not be available locally.

• Reduced stigma: For some children and families, the idea of going to a "therapist's office" might carry a perceived stigma. Online therapy can feel less intimidating and more normalized, as it blends into their everyday digital interactions.

• Continuity of care during transitions: If a family moves or goes on vacation, online therapy can often continue seamlessly with the same therapist, providing crucial consistency during times of change.

Crucially, research indicates that online therapy can be as effective as in-person care when delivered by qualified and experienced professionals. The effectiveness largely depends on the therapist's skill in engaging children virtually and the specific needs of the child.

How parents can support the process

Parents play an instrumental role in fostering a positive and effective online therapy experience for their child. Your active, understanding support can significantly enhance your child's engagement and the overall benefits derived from therapy.

Here’s practical advice for parents:

• Talk to your child before the first session: Explain what therapy is in simple, positive, and age-appropriate terms. Frame it as a place where they can talk to a kind adult about their feelings, learn new ways to manage big emotions, or work through tricky situations. You might say, "You're going to talk to a special helper online who can teach you cool ways to handle worries or tricky feelings, just like a coach teaches you sports."

• Set up a quiet, comfortable, and private space for sessions: Before each appointment, ensure your child has a designated area free from distractions where they feel safe to talk openly. This might be their bedroom, a quiet corner, or a home office. Ensure good lighting and a stable internet connection. Headphones can be very helpful for privacy and clear audio.

• Ensure their device is charged and ready: Make sure the tablet, laptop, or phone your child will use is fully charged and the therapy platform or app is easily accessible and tested.

• Avoid pressuring your child to share every detail afterward—respect their privacy: It’s natural to be curious, but bombarding your child with questions immediately after a session can make them feel interrogated and less willing to open up to their therapist in the future. Instead of "What did you talk about today?", try more open-ended, low-pressure questions like: "How are you feeling after your session?" or "Is there anything you want to share with me about how it went, or anything I can do to help?"

• Check in occasionally with empathy: Periodically, check in with your child about how they feel about therapy in general. "Do you like talking with [therapist's name]?" or "Is there anything I can do to make therapy easier for you?" Let them know you're there to support them.

• Trust the therapist's process (within safety limits): Understand that the therapist is building a unique relationship with your child. They will communicate with you regarding progress and concerns, especially safety, but will also protect the therapeutic space as confidential for your child.

• Reinforce consistency: Help your child attend sessions regularly. Consistency is key for therapeutic progress.

Your active involvement in logistics and your respectful approach to their privacy will significantly contribute to your child's comfort and willingness to engage in therapy.

Choosing the right therapist

Selecting the right online therapist is arguably the most critical step in ensuring a positive and effective outcome for your child. It’s essential to find a licensed professional who not only specializes in child therapy but also connects well with your child's unique personality and needs.

Here’s what parents should look for:

• Licensed professionals specializing in child therapy: Verify that the therapist is licensed in your state or country and has specific training and experience in treating children and adolescents. Look for credentials such as LCSW (Licensed Clinical Social Worker), LMFT (Licensed Marriage and Family Therapist), or Licensed Psychologist with a focus on child development.

• Experience with the child’s specific concerns: Seek a therapist who has a proven track record and expertise in addressing the particular issues your child is facing, whether it's anxiety, depression, trauma, ADHD, behavioral challenges, grief, or social difficulties.

• A warm, engaging, and creative approach: Children respond best to therapists who are able to connect with them on their level. Look for someone described as patient, playful, creative, and enthusiastic in their approach to virtual sessions.

• Clear communication about goals and progress: A good therapist will involve parents (appropriately, considering confidentiality) in setting realistic goals and will provide updates on the child's general progress and any recommendations for support at home.

• Parent-child-therapist dynamic: Consider if the therapist includes parents in some sessions, or offers parent coaching, which can be valuable for reinforcing skills learned in therapy.

• Platform security: Ensure the online therapy platform the therapist uses is secure, private, and compliant with all relevant health privacy regulations (like HIPAA in the U.S.).

Encourage scheduling an introductory call (often free) with a few potential therapists. This is an invaluable opportunity for parents to:

• Discuss their child's specific needs and challenges.

• Ask about the therapist's approach to online child therapy.

• Inquire how they build rapport and engage children virtually.

• Understand their philosophy on confidentiality with minors.

• Get a sense of their personality and whether their communication style aligns with what you're looking for.

If possible, let your child briefly meet the therapist on this call to see how they connect, or discuss with your child their feelings about the therapist after you've spoken to them.

Finding the right therapeutic match is paramount to your child's comfort and the success of their therapy journey.

Conclusion

In a rapidly evolving world, online therapy for children stands as a modern, flexible, and highly effective solution for supporting adolescents in navigating their mental health. Recognizing the signs that your child might benefit from professional help and taking action early can be a profoundly empowering step. Online therapy offers the comfort of home, convenience for busy families, and specialized care that meets children where they are. By choosing the right therapist and providing compassionate support throughout the process, parents can significantly strengthen their child’s emotional resilience, equip them with essential coping skills, and empower them to build a foundation for long-term well-being and confidence. Consider online therapy as a proactive and practical way to get your child the help they need to thrive.