Telehealth is more popular than ever before. By now, many of us are probably used to consulting with doctors, physical therapists, and counselors online. Given the current stresses in the world, there are many children and teens who could really benefit from having an understanding person to talk to.
However, many of the “big name” companies for online therapy primarily cater to adults. In this post I’ll go over what you need to know about online therapy for minors. This information should be helpful whether you’re a parent looking for therapy on behalf of a child, or a young person seeking therapy for yourself.
What’s Online Therapy, and Who Uses It?
Online therapy goes by a lot of names: teletherapy, telehealth, virtual therapy, video therapy…ultimately, all these terms describe the same idea. Online therapy is mental health treatment that is done over the internet, using a video conferencing platform. Sometimes when people hear “telehealth”, they think of “telephone”, but online therapy almost always includes both sound and video. Most therapy sessions take place using programs that are very similar to Zoom or Google Meet, but with more security in place to make sure the conversation stays private.
Some reasons a young person might choose online therapy are:
They have chronic health or mobility problems that make it hard to meet in person
Their family is taking precautions because of the coronavirus
They live in a rural area where it’s hard to find a local therapist
They or their parents have busy schedules that make it hard to drive to an office
They just feel more comfortable doing therapy from home
How Do I Find an Online Therapist Who Works With Kids Under 18?
Some of the large, national companies who provide online and text therapy only serve adults. The ones that do see minors typically only see teenagers ages 13 and up. In general, I think your best bet is to find a therapist who is licensed in your state and specializes in kids or teens. This is especially true if you are looking for therapy for a younger child. When you’re selecting a therapist this way, you are able to learn more about them and their approach, and ultimately have more control in choosing a therapist whom seems like a good fit for you and your family.
You can use therapist directories like Psychology Today to search for counselors in your area who work with minor clients in your city or state. TherapyDen is another great option for searches: it’s a smaller directory, but gives you lots more information about each individual therapist, including their commitment to social justice and inclusivity. If your finances are limited, Open Path Collective is an awesome resource that may be able to help you connect with a private practice therapist who can offer you a reduced fee for appointments.
Will a Minor Child’s Therapist Talk to Their Parents, Too?
Most people under the age of 18 don’t have the legal right to keep their therapy sessions 100% private, because they have a parent or guardian who is legally in charge of their care. A parent or legal guardian can access a child’s medical records at any time. On the other hand, can you imagine going to a therapist knowing that everything you say is going to be shared with your Mom or Dad? It makes it very hard to open up, and almost guarantees that therapy won’t be effective.
It can be a little bit of a balancing act to respect a minor’s need for privacy while also making sure parents feel included and have the information they need to help their child. Even though parents have a legal right to know everything, most therapists who work with minor children will ask that a parent allow treatment to remain mostly private.
When I work with young people, I usually share what I am doing with parents—for example, what coping skills I’m teaching or what our therapy goals are—but I don’t share personal things that a child has told me without permission from that child. That way, kids can feel secure in knowing that I’m not going to tattle on them to their parents, but parents can also feel secure in knowing what is happening in treatment.
How Does Confidentiality Work Online for Kids Under Age 18?
Even for therapists who keep sessions with minor children private, there are a few situations in which a parent must be told what is going on. All therapists have to follow a code of ethics which includes a promise to always inform a parent or caregiver if a child is in a very dangerous situation. This is called mandated reporting. The three major reasons that a therapist might need to break confidentiality with a minor client are:
The therapist suspects that a child is being physically or sexually abused
A child is at risk of self-harm, or of hurting someone else
The therapist hears about an elderly person or a person with a disability being abused
If a therapist has to report one of these events, only the information needed in order to keep everyone safe will be shared. For example, if a child is feeling suicidal, a therapist will share this with parents and, if needed, other professionals who can help. The therapist wouldn’t share unrelated information with those people, like how a child feels about family or friends.
Therapists can share this kind of information with parents in emergency situations, but in general, therapists can’t share information about a minor client with anyone else unless they have specific permission to do so. Teachers, employers, extended family, or other people in a child’s life won’t be told anything about therapy without written permission.
Can a Minor Seek Out Therapy Without a Parent’s Consent?
The short answer is: it depends on where you live. I wish young people never found themselves in this position, but I know that sometimes teens feel unsafe telling their parents about their need for therapy. Each state has its own rules about whether or not minors can be in therapy without a parent knowing, and in most states, the rule is that anyone under 18 needs written permission from their parent or guardian.
This article from Teen Vogue has some helpful information and advice if you are a minor looking for therapy and find yourself in this difficult situation. Another good suggestion I’ve heard is to reach out to your school’s counselor: they can help you right away, it’s confidential, and they will know about your state’s rules and resources you might have in your neighborhood.
If you are in an urgent situation and you need help right now, here are some crisis hotlines that are open to teens:
Crisis Text Line
Suicide Prevention Lifeline & Chat
The Trevor Project (LGBTQ Friendly)
Online Therapy for Minors in North Carolina, New York, and Florida
If you are looking for therapy for your minor child, or if you’re a young person doing your own research, I offer online therapy for children and preteens. Most of my clients are between the ages of 9 and 13. I’m licensed in New York, North Carolina, and Florida, so I can see kids for online therapy in any of these states. If you’d like to learn more about online counseling or make an appointment, you are welcome to contact me.
If you’re the parent of a child or tween looking for online help, my coping skills course might be a good support as you consider your therapy options. Worry-Free Tweens is an educational class for kids and parents, and teaches some of my favorite anxiety management skills for this age group.
