Why I Have a Telehealth/Virtual-Only Therapy Practice for Kids & Teens

It may seem strange for a board-certified child and adolescent psychologist to have a virtual-only therapy practice. Do I expect a 5-year-old to sit quietly on a Zoom call and share their feelings? Here are some reasons why a telehealth practice is ideal to me...

Child Therapy is Parent Therapy

I probably have the same story as many: I grew up regularly volunteering watching children and babysitting. There are few things more joyful than spending time with a child, learning how their brain works, and engaging in play. As a therapist, though, my top concern is the child and family having success in treatment and being able to go back to their normal (hopefully improved!) lives as soon as possible.

What I have learned doing in-person therapy with kids is that there are some kids who do not benefit much from this format. Cognitive-behavioral therapy (CBT) employs a lot of out-of-session, real life practice. Sometimes kids might really enjoy therapy, like to talk about school and friends, and even do the therapy “work” in the session, but then it does not translate to any gains at home and school.

I spend an hour a week with a child and their parent/caregiver spends at minimum another 70 hours per week with them. Parents have to understand the strategies and be able to coach them outside of the therapy space for the child to have success.

As an anxiety specialist, I use a treatment called Supportive Parenting of Anxious Childhood Emotions (SPACE) in which parents of children/teens/young adults with anxiety disorders and OCD attend therapy without the youth present at all. This is not just parent education: it is an actual treatment of their child’s disorder. For younger children with behavior problems, I use internet-based Parent-Child Interaction Therapy (iPCIT), a therapy program in which the caregiver is live-coached in behavioral skills to manage disruptive behavior such as tantrums, aggression, and not following directions. Both of these modalities are perfect for virtual therapy. I also offer parent-only group therapy.

Most Teens Do Fine in Virtual Therapy

Older teenagers generally are fine doing virtual therapy because their experience will be very similar to that of an adult, with the addition of parent involvement. Of course, some symptom presentations may not be best for virtual therapy, regardless of age (for example, a fear of driving).

I Also Work with Adult Patients

Many adults prefer virtual therapy because it eliminates drive time and makes it easier to schedule around work or school.

Sometimes the Parent Needs Their Own Therapy

In treating the child, sometimes we realize their caregiver either has the same disorder or another mental health condition that is impacting their parenting style. I am hoping to expand this area of my practice, treating parents, rather than the child, when we realize they may be the top priority for therapeutic change.

I See Patients Out of State

I have purposely chosen to treat several conditions that are relatively unknown, which makes finding a quality provider challenging. Virtual therapy allows me to work with people in many places that may not have a therapist who can treat these conditions, such as Selective Mutism and Obsessive-Compulsive Personality Disorder.

The Research is Compelling

Virtual therapy performs as well, if not better than, in-person therapy in many studies I have reviewed. Here's a sampling...

PCIT vs. iPCIT

Virtual vs. In Person Therapy for Child Anxiety

Working From Home Fits My Lifestyle

I practice what I preach. For me, taking care of my physical and mental health means less busyness, more time outside, and less time in an office or car. Virtual work is ideal for me and allows me to optimize my work time, giving more effort to patient care outside of session and being able to engage in research and learning to continually offer the best services I can provide.

Final Thoughts

Although you can see many benefits here, virtual therapy may not be the best fit for every child or family. My screening form has questions designed to assess fitness for virtual therapy and this is something we will focus on in the intake evaluation as well. If you are unsure whether this could be a good fit, I am happy to provide guidance and referrals, if needed.