Key Takeaways

• Research shows that online therapy can be just as effective as in-person therapy for many mental health conditions.

• For some people, like those with more severe symptoms or very young children, in-person therapy (or a combination of online and in-person therapy) may be a better choice.

• Most therapists now offer online therapy, but it’s still important to do your research and vet therapists before deciding to work with them.

Nearly two-thirds of Americans don’t receive mental health treatment that they need. Online therapy — although it isn’t a magic-pill solution — can make getting mental health support much more convenient and accessible for many people. The question is: does it actually work?

Online therapy is still relatively new, so many people may feel unsure about whether it can really be effective.

But research has shown that in most cases, for both children and adults, online therapy can be just as effective as in-person therapy. Online therapy can make it easier to get the support you (and your child) deserve.

Is Online Therapy Effective? What Research Says

As a whole, research has found no significant difference between in-person and online therapy when it comes to treatment outcomes.

Since online therapy is much newer than in-person therapy, we don’t have as much research on it.

But the research that has been conducted so far has overwhelmingly found that online therapy is just as effective as in-person for most people.

For Adults

Extensive studies have determined that online therapy is effective for treating mental health problems in adults. 

For example, one review found no difference between online therapy and in-person therapy for people seeking intensive support for depression.

In fact, people at the partial hospitalization level of care (where people receive outpatient therapy for several hours a day) were more likely to stick with treatment when it was virtual.

Overall, research shows that online therapy is equally effective as in-person for common mental health concerns like depression and anxiety.

But we need more evidence to determine that it can be just as helpful for people with other mental health conditions like schizophrenia and bipolar disorder.

For Children

We don’t have as much research on the effectiveness of online therapy for children. But the studies that have been conducted have had promising results. 

One of the most effective treatment methods for both children and adults is cognitive-behavioral therapy (CBT). Studies have found that online CBT is just as effective, and more affordable, than in-person CBT for pre-adolescent children with anxiety. 

Family therapy, another important treatment method for children and adolescents, is also effective when it’s delivered online. Parent involvement is a critical component of child therapy, and online therapy may make it easier for parents to check in with the therapist between sessions.

Certain therapy methods for younger children, like play therapy and sand tray therapy, may be modified to be conducted online, but could be more effective in-person. 

Does virtual therapy work for children with ADHD and behavioral issues?

Many people assume that children with neurodevelopmental conditions like attention-deficit hyperactivity disorder (ADHD) wouldn’t be able to benefit from online therapy due to their difficulties with focus and hyperactivity. But this isn’t necessarily true.

We don’t yet have enough research to be able to say definitively that virtual therapy works for children with ADHD and related behavioral issues, but emerging evidence shows that it may be helpful.

One review found that in over 50% of included studies, teletherapy options were effective for children with ADHD and autism.

Advantages of Virtual Therapy

Online therapy has many advantages, which is why so many now choose it.

Some of the main benefits of choosing virtual therapy over in-person include:

• Convenience: Most people choose online therapy because it’s more convenient. You can see your therapist from the comfort of your own home without having to commute anywhere. 

• Affordability: In some cases, online therapy may be more affordable than in-person therapy. Even if the cost per session is the same, you can save money on things like transportation.

• Accessibility: Online therapy makes mental health support more accessible for everyone. For example, if you have mobility issues or live in an area with limited therapists, online therapy can make it possible for you to get the support you need. 

• Natural: Many people, especially young people, find it more natural and comfortable to communicate online, which can help strengthen the therapeutic relationship. It also gives therapists the opportunity to observe you and your child in your natural environments — at home. It’s a way to invite the therapist into everyday situations; for example, if your child frequently has temper tantrums at dinnertime, you might schedule an online session at that time to give the therapist the chance to directly observe.

Limitations and Challenges of Virtual Therapy

Like any other treatment method, online therapy may not be the best choice for everyone.

Some limitations are important to consider.

• Technological issues: When you do anything virtually, you run into the potential for technological problems. For example, if your internet connection goes out or if your computer breaks, then you may need to miss your session.

• Potential lack of privacy: It can sometimes be more difficult to get privacy when you’re doing online therapy. For example, you might have sessions in your home where you live with other people. But all therapists must use secure software and protect your right to privacy.

• Not for all therapy types: Some therapy types — like sand tray therapy or eye movement desensitization and reprocessing (EMDR) — are better suited for in-person therapy.

• Not for all mental health conditions: We still need more research to be able to say if online therapy is just as effective for more severe mental health symptoms like those of schizophrenia or bipolar disorder.

How to Get Started with Virtual Therapy

Since the pandemic, most mental health therapists have started to offer online therapy — so there are many options available to you. But just like when you look for an in-person therapist, it’s important to choose your online therapist carefully. 

Finding a reputable online therapist or platform

Any therapist you work with, whether online or in-person, should be licensed and qualified to provide the treatment that you need.

There are many different licenses that allow someone to legally provide therapy, and they all require at least a Master's degree. 

On top of being licensed, any potential therapists should have experience and expertise in the mental health concerns that you’re living with. If you’re looking for therapy for your child, then potential therapists need to have specific expertise in working with this developmental age.

Online therapy platforms make it easy to connect with online therapists who are pre-vetted and qualified. This can take away the pressure of having to vet therapists yourself.

Questions to ask before choosing a provider

Don’t be afraid to speak to multiple therapists before making your decision. During the consultation call or your first session, you can ask potential providers questions so that you can ensure it’s the best fit.

Some relevant questions to ask online therapists include:

• What platforms or software do you use for sessions? What measures do you take to protect my privacy?

• What experience do you have working with people like me?

• What therapy methods do you use, and what is your experience delivering these methods online?

• Is it possible to come to in-person therapy sessions sometimes if I so choose?

• What are your fees? Do you offer sliding scale fees? Do you accept insurance?

Preparing children for their first virtual session

Online therapy can be an effective and convenient option for children, but it’s normal for them to feel unsure about it at first.

Let them know it's a safe place

Explain to your child that therapy is a safe space where they can talk about their thoughts and feelings, and let them know that online therapy works the same way as in-person therapy — they’ll just be talking to their therapist on a screen. 

Be honest with them

Many children and teens are already used to communicating online, so virtual therapy might feel more natural to them than it does to adults.

If they have any questions, answer them honestly, and remind them that they don’t have to share anything they’re not ready to talk about.

Allow them to have privacy

Setting up a private, comfortable space for therapy can also make a big difference. Choose a quiet spot in your home where your child won’t be interrupted, and make sure their device is working properly before the session starts.

If your child is younger, you may need to help them log in and get settled before stepping away to give them privacy. 

Know that it might take time

If your child is nervous, that’s okay — the therapist will understand and help them get more comfortable over time.

After the session, check in with your child in a supportive way, but don’t pressure them to share details. The goal is to help them build a trusting relationship with their therapist at their own pace.

Online Therapy with Emora Health

Online therapy can be a great option for both children and adults who need accessible mental health treatment for a wide variety of concerns (including depression and anxiety).

If you live in an area with a lack of mental health providers, or if you’re finding it’s difficult to physically commute to sessions, it could be time to try online therapy.

Emora Health offers 100% online therapy for children, teens, and young adults.

You can connect with a team of vetted therapists with expertise in working with children of different age groups and backgrounds. Get in touch with us and let us know how we can support you.

Sources

Bulkes, N. Z., Davis, K., Kay, B., & Riemann, B. C. (2021). Comparing efficacy of telehealth to in-person mental health care in intensive-treatment-seeking adults. Journal of Psychiatric Research, 145, 347–352. https://doi.org/10.1016/j.jpsychires.2021.11.003

Chatterjee, R. (2023, December 13). Most Americans with mental health needs don’t get treatment, report finds. NPR. https://www.npr.org/sections/health-shots/2023/12/13/1218953789/most-americans-with-mental-health-needs-dont-get-treatment-report-finds

Greenwood, H., Krzyzaniak, N., Peiris, R., Clark, J., Scott, A. M., Cardona, M., Griffith, R., & Glasziou, P. (2022). Telehealth versus face-to-face psychotherapy for less common mental health conditions: Systematic review and meta-analysis of randomized controlled trials. JMIR Mental Health, 9(3), e31780. https://doi.org/10.2196/31780

Khan, K., Hall, C. L., Davies, E. B., Hollis, C., & Glazebrook, C. (2019). The Effectiveness of Web-Based Interventions delivered to children and young people with Neurodevelopmental Disorders: Systematic Review and Meta-Analysis. Journal of Medical Internet Research, 21(11), e13478. https://doi.org/10.2196/13478

McLean, S. A., Booth, A. T., Schnabel, A., Wright, B. J., Painter, F. L., & McIntosh, J. E. (2021). Exploring the efficacy of telehealth for family therapy through systematic, meta-analytic, and qualitative evidence. Clinical Child and Family Psychology Review, 24(2), 244–266. https://doi.org/10.1007/s10567-020-00340-2

Children with anxiety problems: online therapy led by parents, supported by therapists, was effective. (2024). https://doi.org/10.3310/nihrevidence_63378