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Telehealth psychotherapy…with kids?? Really?

By Marté J. Matthews, MA, MFT

Clinical Director, Child & Family Counseling Group

This Fall kids are starting Distance Learning, or homeschooling or some creative pod solution their desperate hard-working parents have come up with…and stress levels are sky high. Kids, teens, parents all need extra support and ways to manage the stress and tension. That’s what therapy is for, after all. But therapy is now available almost exclusively on teleconference platforms, known as either “telehealth” or “telemedicine.” You may be wondering: How does that work?

Child & Family Counseling Group now offers a choice of sessions on FaceTime, on Zoom or via the TherapyNotes portal. Families have a choice about the HIPAA compliant, safe & secure platform they prefer to use on their device. We use passwords and other security features to ensure NO “Zoom-bombing” in therapy sessions.

Here at Child & Family Counseling Group our staff started training on telehealth the day after the shelter in place order began and we continue training from experts in the field. We have compiled lists of on-line resources for our staff to ensure that children, tweens, teens and adults can all find engaging ways to participate in therapy.

Q. How could therapy on a computer screen possibly be helpful? What would that even look like for kids and families?

A. Good questions! Therapy on teleconference can be helpful, and it can look a lot of different ways, just like in-person therapy. We still do art projects, but the child is using their own supplies. If we plan an activity with special supplies, parents can pick them up at the store, or we can drop them off at your home if you live locally. We read stories together. We might listen to stories from a library, or #Save with Stories by Jennifer Garner or Julie Andrew’s podcast Julie’s Library. We still play, but your child might make a puppet, or use one of their own to interact with our puppet. We talk about feelings, choices, problems and ways to solve them. Our therapists are creative and find ways to “meet the client where they are” even when we are on a teleconference.

Q. But you can’t see my child’s body language if you’re only looking at his face. You won’t be able to tell that when he’s uncomfortable his knee starts to bounce and he’s fidgeting so much. Doesn’t that matter in therapy?

A. It absolutely does matter. The view we get depends on the placement of the screen in your home. For child therapy, placing the laptop or tablet on the floor, and having the child sit on a comfy cushion a few feet away works better than being seated at a table or desk. Your CFCG therapist is happy to offer suggestions about ways to address your concerns to make child therapy more helpful.

Q. My child won’t come to the screen, and even if he did, she won’t cooperate with sessions on the computer.

A. We have experience with that, too. We offer several solutions that we have found helpful with families throughout the spring & summer. Our therapists will offer engaging activities that are developmentally appropriate. We are accustomed to working with kids who are fearful or reluctant at first.

If we find that despite all of our efforts, the child will only cooperate for a few minutes, CFCG therapists offer flexible scheduling for sessions with children. For example, if your child can only tolerate 20-25 minutes with us, we can schedule two shorter sessions a week. Another option is that your child can use the first 20-25 minutes, and we can offer the rest of the time for the parent to work on solving problems in your family.

If your child won’t cooperate with even coming to the computer, we can still help your family. Our therapists are experienced with offering Parent Behavioral Training, which can be one of the most powerful ways to create change for a family. We can help you learn how to be the best parents you can be for the children you have, and make family life a little easier using this short-term therapy approach.

Your CFCG therapist will work with you to design a treatment plan that meets your needs, even if your needs change.

Q. We can’t get any privacy for a “parents only” first session.

A. We get it, and we will be creative and flexible to meet the needs of your family. Some kids won’t come to the screen, and other kids won’t be kept away from the screen. We will work with you to figure out how to make this work. If the intake visit turns into family therapy, we are prepared!

Q. How do we get started fast? We really need some help here!

A. All of our new client intake forms are on our website, with detailed instructions. You can download those to your own computer to fill them in, or print them out and fill them in by hand. Both parents complete & sign the forms, and send them back to us. Forms can be returned by scanning & emailing them, faxing them, mailing or dropping them through our mail slot at our office. Another option: You can also help us experiment with a secure online portal which allows you to sign our documents online. What is easiest for you? We can even schedule a 15 minute Zoom meeting to guide you through the process and help with trouble-shooting. Once we have the intake forms, we can schedule your first appointment.

Privacy is important! Even for children, for psychotherapy to be effective, the client needs to have privacy, not be interrupted, disturbed or overheard during their session. Anyone of any age needs to be able to express themselves freely to their therapist and feel heard. Sometimes interruptions happen. We ask for parents to help siblings respect the privacy of the session.

Sometimes parents will listen at the door, thinking their child will never know they listened to the session. We don’t recommend that. I’ll give you an example. Your child might need to blow off some steam, and say in therapy, “God, I just hate my parents!” The language could even get colorful. If you overheard this through the door, your feelings could be deeply hurt. This kind of thing happens all the time in therapy. The therapist is there to accept, reflect and explore what your child brings to the session. Therapy can help them realize “I’m mad at my parents right now,” move through the feelings, recognize problems, and accept responsibility for their role in the problem. Minutes later your child may have moved on, and their feelings and what they were thinking are “ancient history” to them. If you say something to them for what you heard, or hold a grudge, you could actually undermine the great work your child has just done in therapy.

Telehealth psychotherapy can be helpful for children and families. This form of therapy is the option we have available here and now to offer support through this very difficult time. We welcome your calls and questions about starting therapy with our therapists here at Child & Family Counseling Group.

Please contact Marté J. Matthews, Clinical Director who will call you back within one business day:

Call 408-351-1044 ext 3 and leave a voice message

Visit our website at

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