Is Online Therapy ok for Kids?

Baby in business clothes crying at a screen, highlighting limits of telehealth for kids

Picture a memory or a person you love — a special time or event. What do you actually remember? Maybe it’s the smell of sunscreen and grass on a summer afternoon, the way someone’s eyes crinkled in the light, or how their hand felt in yours.

Now notice how many of those things would not have translated through a little window on your computer screen.

Kids are not tiny adults sitting around waiting for a Wi-Fi signal. They are walking, wiggling limbic systems — pure emotion and movement wrapped in skin. Their bodies are their language. They learn through touch, sound, smell, and motion, not just words and faces in boxes.

That’s why, when it comes to telehealth for kids or online child therapy, I’m… not exactly sold.

The Grandfather Clock Effect

Here’s a fun fact: when two grandfather clocks share a room, they eventually sync their rhythms. The smaller clocks fall into step with the biggest one. It’s called entrainment — and it’s exactly what happens in therapy with kids.

When you’re in the room with a child, they unconsciously sync to your rhythm — your breathing, your posture, your energy. You become the bigger clock. That’s co-regulation in action: safety through shared presence.

But over a screen? That connection gets fuzzy. You can’t smell the crayons, hear the subtle sighs, or sense the tension in their little shoulders. Ninety percent of what kids need to feel safe and seen — the sensory, embodied, animal part of the experience — just doesn’t translate through pixels.

Why I’m (Mostly) a No on Telehealth for Kids

Adults can make telehealth work because we’ve had decades of embodied connection. Our brains fill in the blanks. We can imagine tone, warmth, presence — even through the glow of a laptop.

Kids don’t have that backlog of experience. They get their “blanks filled in” through real-world sensory input: the hum of the room, the smell of Play-Doh, the way a grown-up’s body shifts when they listen. That’s how trust and regulation form in child therapy sessions.

So yes, I’m a big ol’ “no” on teletherapy for kids as a default. Not because I’m anti-tech (Zoom is great for meetings, book clubs, and catching up with your aunt in Wisconsin), but because kids deserve the whole experience of therapy — not a cropped version.

The (Rare) Exceptions

I’m not totally black-and-white about anything. There are moments when pediatric telehealth makes sense:

• You live somewhere rural and it’s the only option.

• Your kid is older, and therapy is mostly skills work (like CBT or coaching).

• Health or safety make in-person sessions impossible for now.

If that’s your situation, great — do what works. But if it’s just about convenience, think twice. The extra drive is worth it if it means your child gets the full sensory, relational, body-based experience that helps therapy stick.

The Bottom Line

Online platforms are amazing for lots of things — but kids don’t need convenience; they need connection. They need someone whose breathing, pacing, and presence help their little nervous systems settle. They need the smell of the room, the rhythm of shared space, the safety of being mirrored in real time.

Telehealth for children gives us the illusion of closeness — but for kids, it’s missing the heartbeat.

So if you’re wondering whether online therapy for kids is “OK,” my answer is: sometimes, sure. But when in doubt? Go for the option where the therapist and your child can actually breathe the same air. That’s where the real magic happens.