Is Online Therapy for Teenagers a Good Idea?

Your teen could talk to a therapist online.
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For many teenagers, sitting in a therapist’s office talking about their feelings isn’t particularly enticing. But, talking to a therapist online might not sound so bad.

Many parents wonder, however, is online therapy for teenagers a good idea? There is some evidence that talking to a trained mental health professional over the internet could be quite beneficial for teens. But it’s important to educate yourself about the potential risks and to ensure your teen is a good candidate for online therapy before starting treatment.

What Is Online Therapy?

Online therapy may be referred to as other names, such as e-therapy, internet counseling, or telepsychology. Just as the name suggests, online therapy allows people to meet with a therapist in an online setting, as opposed to a face-to-face meeting in an office.

A therapist may communicate via text message, a mobile app, email, or a specific website. Some therapists use video chat while others use text only.

Online therapy may be used in conjunction with face-to-face therapy or it may be used as an alternative. Many people never meet their online therapist in-person.

Research Says Online Therapy Is Effective

Although computer-based therapy is relatively new, the research so far is quite positive. And studies have found that adolescents are receptive to talking to therapists over the internet.

In a study of teens in Australia, 72 percent of adolescents said they would access online therapy if they experienced a mental health problem.

Thirty two percent said they would choose online therapy over face-to-face meetings.

Other studies have found that teens prefer online therapy for sensitive issues, like sexuality. For other issues—like peer conflict, bullying, and general guidance—most prefer face-to-face treatment.

Research shows online therapy can be just as effective as traditional therapy for issues like depression and anxiety.

But it’s important to keep in mind that much of the research has focused on adults and not adolescents.

The Potential Benefits of Online Therapy for Teens

There are several reasons why you might want to consider online therapy for your teen as opposed to traditional therapy.

  • Teens are comfortable with the internet. Most teens enjoy chatting online, so therapy over the computer can feel more comfortable than talking to a therapist face-to-face.
  • Online therapy can be more convenient. Online therapy can save time because you don’t have to drive to a therapist’s office. For teens who live in rural areas or those who don’t have transportation, online appointments may provide easier access.
  • There’s less of a stigma attached to it. Many teens feel embarrassed about seeing a therapist and they may fear their peers will find out they’re in treatment. Online therapy can reduce many of those concerns.
  • It may be less expensive. Online therapy prices may be lower than in-person therapy so it may be more affordable.

The Potential Disadvantages of Online Therapy for Teens

There are some drawbacks parents should consider before enrolling a teen in online therapy. Here are some of these potential disadvantages:

  • Technology issues may be a problem. If your internet goes down, you won’t be able to contact the therapist. Special software programs aimed at keeping information confidential may be complicated.
  • Insurance may not cover online therapy. Although your insurance company may cover the cost of in-person treatment, you may not have coverage for telehealth.
  • The absence of face-to-face contact may impair treatment. Mental health professionals learn a lot of information by watching someone’s body language. If your teen is communicating over email, the therapist won’t be able to read your teen’s body language or listen to the inflection in your teen’s voice. Although video communication may be better, it isn’t a substitute for face-to-face interaction.
  • Your teen’s written expressions may be lacking. Online communication requires your teen to be able to read and retain information from the therapist. It also requires that she be able express herself effectively in text. Teens who struggle with written communication are not likely to be good candidates for online therapy.
  • Referrals to other services may be more difficult. Your therapist might not be located in your city and may not be familiar with local services in your area. That can complicate issues if the therapist is considering making referrals to other local resources, like a psychiatrist or a support group.
  • Boundaries may get blurred. Chatting online and sending text messages may cause your teen to think of a mental health professional more as a friend, rather than a service provider. Blurred boundaries may cause confusion about the therapist’s role.

Questions to Consider Before Signing Your Teen Up for Online Therapy

Just because your teen is on board with online therapy doesn’t mean it’s a good idea. You should consider the potential risks and benefits carefully.

Before seeking online therapy for your teen, ask the following questions:

  • Is the therapist licensed? Just because someone says he provides online therapy doesn’t mean that individual is a licensed mental health provider. There are many people who pose as mental health providers, but they aren’t licensed. Life coaches, online mentors, or people who give advice may lack appropriate training.
  • Is online therapy the best option? Online therapy isn’t appropriate for all conditions. If your teen is engaging in risky behavior, like substance abuse, or he’s expressing thoughts of suicide or self-harm, in-person treatment is more appropriate.
  • How will information be kept confidential? Mental health providers must keep information confidential. So it’s important to ask what methods are in place to ensure your teen’s private information can’t be breached.
  • What are the payment terms? Online therapists establish their own payment options. Some of them allow patients to pay a monthly fee for unlimited emails, while others conduct video sessions that are charged at an hourly rate. Make sure you find out how you’ll be billed and how you’ll pay before you start treatment.
  • How can I be involved in treatment? While your teen should have access to confidential conversations with the therapist without you present, it’s important for you to know how you can support your teen’s efforts. In a traditional office setting, you may be able to attend.
  • How are records kept? Find out how the therapist plans to maintain documentation. Will each therapy session be documented? Will therapy notes be sent to the primary care physician upon request? A good online therapist should be able to provide you with information about how information will be recorded and stored.
  • How does the therapist handle emergencies? Online therapy can be complicated when a crisis occurs. Find out what the therapist would do if there was a crisis, such as who would the therapist contact if your teen said she was thinking about killing herself?

Where to Start

If you’re thinking about online therapy for your teen, or you suspect your teen has a mental illness, start by talking to your teen’s doctor. You’ll want to rule out any underlying health issues that may contribute to mental health issues that may be of concern.

Your teen’s doctor can advise you about whether online therapy is a good option based on your teen's needs. If your teen has a serious mental health condition, or the doctor has concerns about safety risks, online treatment may not be the best option.

If the doctor thinks online therapy could benefit your teen, contact your health insurance company. Learn whether online therapy is covered and ask whether they have any preferred providers.

Sources:

Jakobsen H, Andersson G, Havik OE, Nordgreen T. Guided Internet-based cognitive behavioral therapy for mild and moderate depression: A benchmarking study. Internet Interventions. 2017;7:1-8.

Lattie EG, Ho J, Sargent E, et al. Teens engaged in collaborative health: The feasibility and acceptability of an online skill-building intervention for adolescents at risk for depression. Internet Interventions. 2017;8:15-26.

Sweeney GM, Donovan CL, March S, Forbes Y. Logging into therapy: Adolescent perceptions of online therapies for mental health problems. Internet Interventions. December 2016. 

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