Teletherapy vs In-Person Therapy: When to Choose One vs the Other for Pediatric Care

Audience: pediatric

Teletherapy and in-person therapy are two ways children and teens can get mental health support. Teletherapy uses video or phone calls to connect with a therapist remotely, while in-person therapy happens face-to-face. Both methods can help with feelings like anxiety, sadness, or stress. Teletherapy offers convenience and comfort, especially for families with busy schedules or limited travel options. In-person therapy may be better for children who need hands-on activities or more direct interaction. Choosing between them depends on the child's needs, the type of therapy required, and family preferences. Sometimes, a mix of both approaches works best. It's important to watch for signs that need urgent in-person care, like severe mood changes or safety concerns. Always talk to a healthcare professional to decide the best option for your child’s mental health support.

Red flags — go in person / ER

• Child expresses thoughts of self-harm or suicide — seek emergency in-person care immediately.
• Sudden, severe changes in mood or behavior — contact a healthcare provider promptly.
• Signs of abuse or neglect — report to appropriate authorities and get urgent support.

What telemedicine can do

• Mild to moderate anxiety or depression symptoms.
• Routine counseling and talk therapy sessions.
• Follow-up visits and medication management discussions.
• Behavioral coaching and parent guidance.
• Psychoeducation and coping skills training.

What telemedicine cannot do

• Severe mental health crises requiring immediate intervention.
• Complex assessments needing physical presence.
• Situations involving abuse or neglect requiring in-person investigation.
• Therapies requiring hands-on activities or physical interaction.
• Emergency safety evaluations.

What Is Teletherapy?

Teletherapy is therapy done through video calls, phone, or online platforms. It lets children and teens talk to therapists from home or another safe place. This method can be helpful if traveling to a clinic is hard or if the child feels more comfortable in familiar surroundings.

What Is In-Person Therapy?

In-person therapy happens face-to-face with a therapist in a clinic or office. This allows for more direct interaction, including activities that may require physical presence, such as play therapy or certain assessments. It can be better for children who need hands-on support or who find it hard to focus through a screen.

When to Choose Teletherapy

Teletherapy may be a good choice when:

When to Choose In-Person Therapy

In-person therapy may be better when:

Combining Both Approaches

Sometimes, a mix of teletherapy and in-person therapy works well. Families and therapists can decide together what balance fits the child's needs. This flexibility can help maintain consistent care while addressing changing situations.

Safety and Red Flags

It's important to watch for signs that need immediate attention, such as:

If these occur, seek emergency in-person care or contact a crisis service right away.

How to prepare for your tele-visit

• Ensure a private, quiet space free from distractions.
• Test your internet connection and device camera/microphone.
• Have any necessary documents or notes ready.
• Make sure the child is comfortable with the technology.
• Confirm appointment time and platform details with the provider.

After your tele-visit

• Discuss session summary and next steps with the therapist.
• Schedule follow-up appointments as recommended.
• Monitor the child's mood and behavior after sessions.
• Reach out to the therapist if concerns arise between visits.
• Keep emergency contacts handy in case of urgent needs.

FAQs

Is teletherapy as effective as in-person therapy for children?

Teletherapy can be effective for many children, especially for mild to moderate concerns. Some studies show similar benefits to in-person therapy, but effectiveness depends on the child's comfort with technology and the type of therapy needed.

What if my child feels uncomfortable using video calls?

If your child is uncomfortable with video, talk to the therapist about alternatives like phone sessions or scheduling in-person visits. It's important that the child feels safe and engaged during therapy.

Can teletherapy handle emergencies or crises?

Teletherapy is not suitable for emergencies or crises. If your child is in immediate danger or having thoughts of self-harm, seek emergency in-person care or contact a crisis hotline right away.

How do I prepare my child for a teletherapy session?

Prepare a quiet, private space and explain what will happen during the session. Test the technology beforehand and encourage your child to express their feelings openly during the session.

Can therapy be effective if done partly online and partly in-person?

Yes, combining teletherapy and in-person therapy can provide flexibility and maintain consistent care. Many families find a blended approach meets their needs well.

Sources

1. Mental Health and Telehealth — MedlinePlus | U.S. National Library of Medicine / National Institutes of Health.
2. Telehealth: What You Need To Know — Centers for Disease Control and Prevention (CDC).
3. Pediatric Telehealth: Opportunities and Challenges — American Academy of Pediatrics (AAP).
4. Telemedicine and Mental Health: A Review — National Library of Medicine.

This information is for educational purposes and is not a substitute for professional in-person medical care. Telemedicine may not be appropriate for all situations. Always seek immediate in-person care if your child experiences a medical emergency or severe mental health crisis.