Does Teletherapy Work for Children? What the Research Says
Online therapy became much more common during the COVID-19 pandemic, but teletherapy is no longer simply an emergency substitute for meeting with a therapist in person. It has become an established way for many children, teenagers, parents, and families to receive mental health care.
That raises an important question for parents: Does teletherapy actually work for children?
The short answer is that teletherapy can be effective for many young people. Research supports its use for several childhood mental health concerns and evidence-based treatments. However, the research does not suggest that online therapy is automatically the best option for every child, diagnosis, or situation.
A child’s age, symptoms, safety, attention, privacy, caregiver involvement, treatment goals, and relationship with the therapist all affect whether teletherapy is likely to be successful.
The main takeaway: Teletherapy is not one specific treatment. It is a way of delivering treatment. What matters is whether the treatment itself is appropriate, whether it has been adapted effectively for online use, and whether the child and family can participate successfully.
What Is Teletherapy?
Teletherapy—also called telehealth, online therapy, or virtual therapy—allows a therapist and family to meet through secure videoconferencing technology.
Depending on the child’s needs, an online appointment might include:
- Individual therapy with a child or teenager
- Parent or caregiver sessions
- Family therapy
- Live parent coaching
- Play, drawing, games, movement, or shared activities
- Psychiatric evaluation or medication follow-up
- A combination of child and caregiver participation
Teletherapy does not necessarily mean asking a young child to sit in front of a screen and talk for an hour. Effective online treatment should be adapted to the child’s age, attention, development, interests, and clinical needs.
Learn more about virtual appointments on our teletherapy services page.
What Does the Overall Research Say?
A 2025 systematic review and meta-analysis combined findings from 26 studies involving 1,558 children and adolescents receiving telepsychiatry interventions for anxiety or depression.
Across the included studies, young people experienced meaningful improvement in both depression and anxiety symptoms following treatment. When telepsychiatry was compared with a waitlist, it produced better outcomes for depression. The comparison for anxiety was less certain.
The authors concluded that telepsychiatry has potential as an effective treatment option for youth while also emphasizing that the certainty of the evidence ranged from moderate to very low. More controlled research is still needed to determine which approaches work best and for which young people.
This distinction matters. The research is encouraging, but it does not justify claiming that teletherapy is always equal to in-person therapy or appropriate for every child.
Can Trauma-Focused CBT Be Provided Through Telehealth?
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based treatment for children and adolescents who have experienced traumatic events. It includes coping skills, caregiver participation, gradual trauma processing, and work that helps the child and caregiver communicate about the experience.
Research suggests that TF-CBT can be delivered successfully through telehealth when appropriate safety, privacy, technology, and caregiver support are available.
One study examined telehealth TF-CBT provided to young people involved in foster care. Among the participants who completed treatment, average trauma-symptom scores decreased from 25.64 before treatment to 13.57 after treatment. That represents a substantial reduction in reported posttraumatic stress symptoms.
The study also identified an important limitation: only 14 of the 46 young people who began telehealth TF-CBT completed the full treatment. Challenges involving the home environment, caregiver participation, placement changes, and broader systems affected treatment completion.
This tells us two things:
- Children who complete TF-CBT through telehealth may experience meaningful improvement.
- Successful treatment requires more than access to a video platform. Stability, privacy, caregiver support, engagement, and continuity of care remain important.
For some children, receiving trauma treatment from a familiar environment may make participation easier. For others, the home environment may not provide enough privacy or emotional safety for trauma-focused work.
Learn more about trauma and PTSD treatment for children and teens.
What Does the Research Say About Online PCIT?
Parent-Child Interaction Therapy (PCIT) may be particularly well suited to telehealth. In PCIT, a therapist observes a caregiver interacting with a young child and provides immediate coaching through an earpiece.
When PCIT is provided through telehealth, the therapist can observe the family in its natural home environment. Caregivers can practice new skills in the same setting where tantrums, defiance, aggression, or difficulty following directions often occur.
A randomized clinical trial studied internet-delivered PCIT with 150 young children with developmental delays and externalizing behavior problems. Half of the families received internet-delivered PCIT, while the other half received referrals to services available in the community.
Children who received online PCIT demonstrated:
- Greater improvement in externalizing behavior problems
- Improved compliance with caregiver directions
- Increases in positive parenting skills
- Decreases in controlling or critical caregiver behavior
- Improvements that were largely maintained during follow-up
Immediately following treatment, 74% of children in the online PCIT group demonstrated clinically significant behavioral improvement, compared with 42% of children receiving referrals as usual. The difference remained at the six-month follow-up, although the groups were no longer significantly different at 12 months.
The study provides particularly strong support for telehealth interventions involving live parent coaching. It does not mean online PCIT is appropriate for every family, but it demonstrates that young children can benefit from carefully structured virtual treatment.
Can DBT Be Provided Through Telehealth?
Dialectical Behavior Therapy helps young people develop skills related to mindfulness, emotional regulation, distress tolerance, and relationships. Comprehensive DBT can include individual therapy, skills training, between-session coaching, and a clinical consultation team.
Many elements of DBT can be delivered virtually. Teens can learn skills, review homework, examine behavior patterns, and practice coping strategies during secure video appointments.
Research specifically comparing complete virtual DBT with complete in-person DBT for adolescents remains more limited than the evidence supporting DBT generally.
A study of certified DBT programs found that telehealth participants had fewer missed appointments and were less likely to leave treatment before completion than participants receiving exclusively in-person DBT. The study did not identify a significant difference in this pattern between adolescent and adult participants.
That finding supports the feasibility of providing DBT through telehealth, particularly regarding attendance and treatment engagement. However, it should not be interpreted as proving that online and in-person DBT produce identical clinical outcomes.
Virtual DBT may work well for a teenager who can maintain privacy, remain engaged, use technology reliably, and participate in safety planning. A teen experiencing significant instability, acute safety concerns, or difficulty participating virtually may need in-person treatment or a more intensive level of care.
Can Medication Management Be Provided Through Telehealth?
Telehealth can also expand access to pediatric psychiatric evaluation and medication management, especially in communities with limited access to child and adolescent mental health specialists.
One randomized study included 223 children with ADHD living in communities with limited specialty care. The telehealth intervention combined psychiatric medication management with caregiver behavior training.
Children receiving the telehealth intervention experienced greater improvement in ADHD symptoms, oppositional behavior, role performance, and impairment than children receiving enhanced treatment through primary care.
Approximately 46% of children receiving the combined telehealth intervention achieved at least a 50% reduction in ADHD symptoms, compared with 13.6% in the comparison group.
This does not mean every part of pediatric medication care can occur remotely. Depending on the child, medication, and clinical concern, a provider may still need:
- Blood-pressure or heart-rate measurements
- Height and weight information
- Laboratory testing
- A physical examination
- Information from the child’s school or other providers
- An in-person assessment
Telehealth medication management works best when virtual visits are part of a coordinated treatment and monitoring plan.
Which Children May Do Well With Teletherapy?
Teletherapy may be a good option when a child or teenager:
- Feels comfortable communicating through video
- Can participate in age-appropriate conversation, play, or activities
- Has a private or reasonably quiet place for appointments
- Has reliable access to an internet-connected device
- Has a caregiver available when participation or supervision is needed
- Would otherwise face transportation, distance, or scheduling barriers
- Needs access to a specialized treatment that is not available nearby
- Feels safer or more comfortable beginning treatment from home
Some teenagers communicate more comfortably through a screen. Some children enjoy showing their therapist their toys, pets, artwork, or home environment. Parent-coaching treatments may benefit from allowing the therapist to see what family interactions look like at home.
These can be meaningful advantages, but they do not guarantee that virtual treatment will be the right fit.
When Might In-Person Therapy Be Better?
In-person care may be preferable when:
- The child cannot remain engaged through video
- The family cannot maintain sufficient privacy
- Technology repeatedly interrupts communication
- The environment is too distracting or emotionally unsafe
- The child needs therapeutic materials or assessments that cannot be used effectively online
- The child strongly prefers meeting in person
- There are acute safety concerns or a need for closer monitoring
- The child needs a more intensive level of treatment
Families do not always have to make an all-or-nothing choice. Depending on clinical needs, provider availability, and insurance coverage, treatment may sometimes transition between virtual and in-person appointments.
What Matters More Than the Screen?
The delivery method is only one part of effective therapy. Whether treatment occurs online or in an office, several factors remain important:
- An appropriate assessment
- A treatment supported for the child’s needs
- A strong relationship with the therapist
- Developmentally appropriate activities and expectations
- Caregiver involvement when indicated
- Consistent participation
- Clear goals and progress monitoring
- Privacy and emotional safety
- A plan for emergencies or technology failures
A well-designed teletherapy appointment should still feel like individualized mental health treatment, not simply a conventional office visit moved onto a computer screen.
The Bottom Line: Does Teletherapy Work for Kids?
The available research indicates that teletherapy can help many children and teenagers. Evidence is particularly promising for youth anxiety and depression, telehealth TF-CBT, online PCIT, and coordinated psychiatric medication care.
Evidence concerning virtual DBT is encouraging, especially for feasibility and treatment engagement, but research comparing clinical outcomes across delivery formats is still developing.
The right question is not simply, “Does teletherapy work?” A more useful question is:
Is teletherapy an appropriate way to provide this treatment to this child, with this family, in their current environment?
A qualified provider can help your family consider your child’s symptoms, developmental needs, safety, privacy, preferences, and treatment goals before recommending online or in-person care.
Interested in Teletherapy?
Kalamazoo Child & Family Counseling provides secure online mental health services for eligible children, teens, parents, and families located in Michigan.
Availability depends on your family’s needs, the requested service, provider availability, clinical appropriateness, and insurance coverage.
Frequently Asked Questions
Research suggests that teletherapy can be effective for many children and adolescents, but it has not been proven to be equivalent to in-person therapy for every condition, treatment, or child. Effectiveness depends on the treatment being provided, the child’s needs, caregiver involvement, privacy, safety, technology, and the child’s ability to engage virtually.
Yes. Young children may benefit from virtual treatments that actively involve their caregivers. Research on internet-delivered PCIT demonstrates that therapists can successfully coach parents while they interact with their children at home.
TF-CBT and other trauma-focused services may be provided through telehealth when the child has sufficient privacy, emotional and physical safety, appropriate caregiver support, and the ability to participate. Some children may benefit more from in-person trauma treatment.
A provider should consider your child’s age, development, symptoms, safety, attention, comfort with technology, treatment goals, available privacy, and need for caregiver participation. The decision can be revisited if virtual treatment is not meeting your child’s needs.
Research Discussed in This Article
Clinically reviewed by Kalamazoo Child & Family Counseling. This article provides general educational information and is not a substitute for an individualized mental health or medical evaluation. Last reviewed: September 2026.
If your child is experiencing an emergency or is in immediate danger, call 911 or go to the nearest emergency department. For immediate crisis support, call or text 988 to reach the 988 Suicide & Crisis Lifeline.
