Online Therapy and Counseling for Children
Published December 2025 · Last updated · Written by Paul Paradis, Editor · Educational information – not medical or mental-health advice
What changed: Reworded link and heading text without ranking claims: “Best Online Therapy for Teens” to “Online Therapy for Teens Compared”. Earlier on October 29: Retitled the main heading to “Online Therapy and Counseling for Children” and added a pointer to the teen therapy guide for ages 13 to 17, where consent and privacy rules change.
Reviewed for educational clarity and safety language by Lisa Lewis, RN, BSN · Independent care-path guide using public clinical, insurance, and platform information
Short answer: yes, children can get therapy online, but the right service depends on age. Programs built for young children work mostly through the parent, while services for teenagers talk to the teen directly. The table below sorts the main online pediatric services by the ages they serve.
Online therapy for children can be effective for many behavioral and emotional concerns, but it works differently than adult therapy, and parents play a key role in making it successful. Telehealth has expanded access to child therapists, allowing families to connect with qualified providers from the comfort of home. This guide helps parents understand how online therapy works for children and how to determine if it might be right for your family.
Online Services by Child’s Age (Checked October 29, 2026)
Age ranges and services are taken from each company’s own site. For prices, parent access and insurance on the teen services, see the comparison in online therapy for teens; for coverage questions, does insurance cover online therapy.
| Service | Ages served | What is offered | Source | Checked |
|---|---|---|---|---|
| Little Otter | Birth to 18, grouped as 0–2, 3–7, 8–12 and 13–18, plus support for parents | Therapy and psychiatry by video after a free kickoff call | Little Otter | October 29, 2026 |
| Bend Health | Ages 1 to 25 | Coaching, therapy and psychiatry by video; neuropsychological testing for ages 2–25; virtual intensive outpatient care for ages 7–25 | Bend Health | October 29, 2026 |
| Brightline | Children and teens up to 18 | Therapy and psychiatry online in four states, with office visits in New York, New Jersey and Connecticut | Brightline | October 29, 2026 |
| Talkiatry | Ages 5 to 18 in its children’s mental health program | Psychiatric evaluation and medication management, entirely online and billed to insurance | Talkiatry | October 29, 2026 |
| Talkspace | Ages 13 to 17 with a parent’s or guardian’s consent | Therapy by text messaging, with a plan that adds monthly video sessions | Talkspace teens | October 29, 2026 |
| Teen Counseling | Ages 13 to 19 with a parent’s or guardian’s consent | Counseling by messaging, chat, phone or video | Teen Counseling | October 29, 2026 |
How to read this therapy for children guide
The therapy for children material here is for educational purposes only. It is not medical or mental health advice and does not replace consultation with qualified healthcare providers. The appropriateness of online therapy for children depends on the child's age, needs, and circumstances.
Parents should be actively involved in their child's mental health care. If your child is in crisis or danger, contact emergency services (911) or take them to the nearest emergency room.
Disclosure: No link on this site was placed by hand to pay us a commission, though a script from Sovrn Commerce (VigLink) that runs on every page may turn some ordinary links to outside stores and services into affiliate links that can earn us a commission at no extra cost to you. When it converts a link, our page code tags that link rel="sponsored" for search engines, but nothing on screen marks it as paid, so treat any outbound link as one that could earn us money. Our “best” and comparison guides do not score or rank services, and a possible commission never changes which services we list or what we say about them; see the affiliate disclosure.
Can Online Therapy Work for Children?
Research shows that telehealth can be effective for many childhood mental health concerns, though effectiveness varies by:
- Age: Older children and adolescents often adapt well; younger children may need modified approaches
- Condition: Many conditions respond well to online treatment; some may require in-person care
- Child's temperament: Some children engage better virtually; others need in-person connection
- Family involvement: Parents usually take part directly when the child is young
- Therapist expertise: Experience with both children AND telehealth matters
Good Candidates for Online Therapy
- Children with anxiety who may feel more comfortable at home
- Kids who are already comfortable with technology
- Families in areas with limited local child therapy options
- Children with physical health issues making travel difficult
- Situations requiring ongoing care during schedule constraints
- Follow-up and maintenance therapy after initial in-person treatment
May Need In-Person Care Instead
- Very young children (generally under 6) who need hands-on play therapy
- Children with severe attention difficulties
- Situations involving safety concerns
- When physical assessment is needed
- Severe behavioral disorders requiring intensive intervention
- When the child strongly resists video sessions
Common Childhood Issues Treated Online
- Anxiety: Generalized anxiety, social anxiety, separation anxiety, phobias
- Depression: Sadness, withdrawal, mood changes; learn more about online therapy for depression
- ADHD: Parent training and behavioral strategies (medication requires in-person or specialized telehealth); see our ADHD telehealth guide
- Behavioral challenges: Defiance, anger, aggression
- Trauma: PTSD, adjustment to difficult experiences: our PTSD and trauma therapy guide covers treatment approaches
- Social skills: Friendship difficulties, communication challenges
- School issues: School anxiety, academic stress, bullying
- Family transitions: Divorce, new siblings, moves
- Grief: Loss of loved ones or pets
- Autism-related support: Social skills, emotional regulation
How Child Telehealth Works
What to Expect
- Initial consultation: Usually includes parent interview to understand concerns
- Assessment: Therapist evaluates the child's needs
- Treatment plan: Developed with parent input
- Regular sessions: Usually 30-50 minutes depending on age
- Parent involvement: Ranges from attending sessions to separate parent consultations
- Homework/practice: Skills to work on between sessions
Session Format by Age
Young Children (3-6)
- Sessions typically involve high parent participation
- Parent coaching models (therapist teaches parent to implement strategies)
- Shorter attention spans require creative engagement
- May use virtual games, drawing, or interactive activities
- Some approaches may not translate well to online format
School-Age Children (6-12)
- More direct work with the child is possible
- Interactive activities, games, and worksheets
- CBT techniques adapted for children
- Parent involvement through separate check-ins
- Combination of individual and family sessions
Adolescents (13+)
- More similar to adult therapy format
- Greater independence in sessions
- Balance of teen confidentiality and parent communication
- See our online therapy for teenagers guide for more information
Finding a Child Therapist Online
Telehealth Platforms
- BetterHelp - Has therapists who specialize in children (note: their Teen Counseling platform is for ages 13+)
- Talkspace - Offers services for adolescents with parental consent
- Headway - Find insurance-covered child therapists offering telehealth
- Grow Therapy - Search for child specialists
- Little Otter: Specifically focused on children's mental health
- Brightline: Pediatric behavioral health for families
Finding Child Specialists
- Psychology Today directory: Filter by "Child or Adolescent" and "Telehealth"
- Your pediatrician may have referrals
- School counselors often know local providers offering telehealth
- Insurance provider directories (filter for child specialty)
- Ask about child-specific credentials (Registered Play Therapist, child psychology training)
Questions to Ask Potential Therapists
- What is your experience working with children my child's age?
- What conditions or issues do you specialize in?
- How do you adapt therapy for telehealth with children?
- What does parent involvement look like in your approach?
- What platform/technology do you use?
- How long are sessions for children?
- How will you engage my child virtually?
- What should we do if my child won't engage in sessions?
- How do you handle confidentiality with children?
- What training do you have in child/pediatric mental health?
Preparing Your Child for Online Therapy
Before the First Session
- Explain therapy in age-appropriate terms: "You're going to talk to someone who helps kids with their feelings and worries"
- Normalize it: Many kids see therapists and it doesn't mean something is wrong with them
- Show them the technology beforehand so it's familiar
- Let them know you'll be nearby but they'll have private time
- Ask if they have questions or concerns
- Read our guide to your first therapy session for additional preparation tips
Setting Up for Success
- Quiet space: Find a private, comfortable area
- Good lighting: Face a window or light source
- Stable internet: Test the connection beforehand
- Appropriate device: Large enough screen for engagement (tablet or computer often better than phone)
- Have supplies ready: Paper, crayons, toys the therapist may want to use
- Remove distractions: Quiet other devices, close doors
Parent Involvement
Your role is essential in your child's therapy. Our guide to support for parents and caregivers covers strategies for managing your own wellbeing during this process.
What Parents Typically Do
- Provide information about concerns and history
- Participate in sessions (especially for younger children)
- Learn strategies to implement at home
- Practice skills with your child between sessions
- Monitor progress and report back to the therapist
- Attend parent-only sessions for coaching and updates
Parent Coaching Models
For younger children especially, many effective approaches focus on teaching parents:
- PCIT (Parent-Child Interaction Therapy): Therapist coaches you in real-time during interactions with your child
- Parent Management Training: Learn behavior management strategies
- SPACE (Supportive Parenting for Anxious Childhood Emotions): Parents learn to reduce accommodation of anxiety
- These can work very well via telehealth
Signs Your Child May Need Support
Consider reaching out if your child shows:
- Persistent sadness, tearfulness, or hopelessness
- Excessive worry or fear that interferes with activities
- Significant changes in eating or sleeping
- Withdrawal from friends, family, or activities
- Frequent tantrums or behavioral outbursts
- Declining school performance
- Physical complaints with no medical cause
- Regression to younger behaviors (bedwetting, thumb-sucking)
- Talk about death, self-harm, or not wanting to exist
- Extreme difficulty separating from parents
- Difficulty adjusting to changes or transitions
If your child expresses thoughts of suicide or self-harm, seek immediate help through emergency services or crisis resources.
Insurance and Costs
Using Insurance
- Check your plan's mental health benefits for children
- Confirm telehealth coverage (most plans now cover it)
- Use Headway or Grow Therapy to find in-network child specialists
- Get referrals from your pediatrician if required by your plan
Lower-Cost Options
- Community mental health centers
- University training clinics
- Sliding scale providers
- School-based mental health services
- Medicaid often covers children's mental health
Crisis Resources
If your child is in crisis:
- 988 Suicide and Crisis Lifeline: Call or text 988
- Crisis Text Line: Text HOME to 741741
- Emergency services: Call 911
- Nearest emergency room: For immediate safety concerns
- Your child's therapist: Most have crisis protocols
Don't wait if you're concerned about safety. Trust your instincts as a parent.
Frequently asked questions
At what age can children benefit from online therapy?
Children as young as 3-6 can benefit from telehealth, though sessions typically involve high parent participation and use parent coaching models. School-age children (6-12) can engage more directly through interactive activities and games. Very young children who need hands-on play therapy may do better with in-person care.
How involved should parents be in their child's online therapy?
Parent involvement is essential, especially for younger children. Parents provide information about concerns, may participate directly in sessions, learn strategies to implement at home, practice skills with their child between sessions, and attend parent-only consultations. For many effective approaches with young children, the therapist primarily coaches parents rather than working directly with the child.
How do therapists keep children engaged during video sessions?
Child therapists adapt their techniques for telehealth using virtual games, interactive drawing activities, worksheets, and creative engagement strategies. Sessions are typically shorter for younger children to match their attention spans. Having supplies like paper and crayons ready helps, and experienced child telehealth therapists know how to make sessions fun and engaging.
What mental health issues can be treated in children through telehealth?
Many childhood concerns respond well to telehealth treatment, including anxiety, depression, behavioral challenges, ADHD (parent training and strategies), trauma, social skills difficulties, school issues like bullying, family transitions like divorce, grief, and autism-related support. Some conditions may still require in-person assessment or intensive intervention.
How do I prepare my child for their first online therapy session?
Explain therapy in age-appropriate terms like 'talking to someone who helps kids with feelings and worries.' Normalize it by noting many kids see therapists. Show them the technology beforehand so it's familiar, let them know you'll be nearby, and ask if they have questions. Set up a quiet, comfortable space with good lighting and have any supplies the therapist recommends ready.
When should I consider in-person therapy instead of online for my child?
Consider in-person care for very young children under 6 who need hands-on play therapy, children with severe attention difficulties who can't engage on video, situations involving safety concerns, severe behavioral disorders requiring intensive intervention, or when your child strongly resists video sessions. Your pediatrician or the therapist can help determine the best approach.
Related reading on therapy for children
Using this therapy for children guide safely
This overview of therapy for children is general educational information only. It is not medical or mental health advice. The appropriateness of online therapy for your child depends on their individual needs, age, and circumstances. Consult with qualified healthcare providers to determine the best treatment approach.
If your child is in danger or experiencing a mental health emergency, contact emergency services (911) or go to your nearest emergency room.
Sources
- Little Otter: age groups and services (checked October 29, 2026)
- Bend Health: ages, programs and testing (checked October 29, 2026)
- Brightline: ages and states served (checked October 29, 2026)
- Talkiatry: children's mental health ages 5-18 (checked October 29, 2026)
- Talkspace: teen therapy ages 13-17 (checked October 29, 2026)
- Teen Counseling FAQ: ages 13-19 and formats (checked October 29, 2026)
- 988 Suicide & Crisis Lifeline
- Crisis Text Line
- SAMHSA: Find help, including the National Helpline (1-800-662-4357) and FindTreatment.gov
- National Institute of Mental Health: Psychotherapies
- Company websites for the services named in this guide: BetterHelp, Talkspace, Headway, Grow Therapy.
The person behind this therapy for children guide
Paul Paradis, who founded and edits Telehealth Navigator, wrote and edited this therapy for children guide, and his background includes more than two years working inside a forensic mental health hospital setting along with a personal and family life that mental health is part of. Each guide begins with source material most readers don’t have time to read, such as SAMHSA program documents, APA and NIMH guidance, and CMS telehealth policy, and he turns that reading into plain English, linking each original so you can check his work. Since Paul is not a licensed clinician, this therapy for children guide is not medical advice, and the full account of how each guide is researched, reviewed, and updated is in our editorial standards.