Does online therapy actually work for kids?

For anxiety, depression, and emotion regulation in children and teenagers, research consistently finds virtual cognitive behavioral therapy as effective as in-person treatment, and some studies find young people engage better online because they are in a familiar environment. That is the honest short answer. The longer answer is that virtual is not equally good at everything, and the difference between a practice that knows where the line is and one that does not is worth more to your child than any reassurance on a website.

Every virtual practice cites the same research. Here is why we can say more.

Kristin Kroll, PhD, founded Little Dove after a career in academic medicine at Children's Wisconsin and the Medical College of Wisconsin. Before the pandemic made video sessions ordinary, she was already studying them: as the attending psychologist for a cystic fibrosis clinic, where patients cannot safely share a room with one another, she was researching how to deliver group therapy over video.

Then COVID arrived, and she helped that hospital prepare its standard operating procedures and clinical measures for a rapid switch to telehealth across the board.

That sequence matters. Most practices went virtual because they had to, in a hurry, in 2020. The question of what transfers to video and what does not was one Little Dove's founder was working on before there was any commercial reason to. It is also why this practice is virtual by design rather than by leftover habit.

What virtual does genuinely well

• Structured, skills-based treatment. CBT, exposure work, and DBT-informed skills are built on practice and repetition. They travel to video with their structure intact.
• Getting the parent in the room. We teach techniques that get practiced at home, so a parent joins most sessions as a working partner. Video makes that easier, not harder. A parent can join from work without a commute.
• Appointments that do not cost a school day. The most common reason a family cannot start therapy is that the only slots offered are during school hours. Virtual delivery is what makes evenings and weekends practical.
• Continuity across distance. A college student who leaves Texas for school in another PSYPACT jurisdiction can usually keep the same psychologist rather than starting over with a stranger in October.
• Reaching families outside a metro. Access was the reason for the model. Dr. Kroll grew up in a rural part of Georgia, and a virtual practice reaches a family two hours from the nearest child psychologist exactly as well as it reaches one in central Austin.

What virtual does not do well, stated plainly

A page that only lists strengths is marketing. These are the real limits, and we raise them on the free consultation rather than after you have paid for something:

• Play therapy is less effective over video. If a young child needs play therapy as the primary treatment, we will say so and point you to a provider who offers it in person.
• A full-scale IQ score and processing speed measures require in-person administration. Our evaluations are built around what can be measured well virtually, and we are explicit on our testing page about what is and is not included.
• Some situations need a room. Acute safety concerns and higher levels of care belong with services equipped for them. Part of the consultation's job is telling you honestly when that is the case.

Being narrow about this is deliberate. A practice that claims everything works equally well on video is telling you something about its marketing, not about your child.

How you will know whether it is working

Impressions are easy to mistake for progress. Every therapy client at Little Dove completes brief validated symptom measures, the same instruments used in hospital clinics and treatment research. Scores go to your clinician automatically and get reviewed with you: what is moving, what is not, and what that means for the plan. More on that on The Little Dove Difference.

Common questions

Does online therapy work as well as in-person therapy for children?

For the concerns we treat most often, yes. Research consistently finds virtual cognitive behavioral therapy as effective as in-person treatment for anxiety, depression, and emotion regulation, and some studies find young people engage better online because they are in a familiar environment. That finding does not extend to everything, which is why we are specific below about what virtual does not do well.

Who decides whether virtual is right for my child?

Dr. Kroll does, with you, on the free consultation. She speaks with every family herself before anyone is scheduled, and the first thing she is checking is whether the virtual setting actually suits your child. If it does not, she says so. That screening is why the limits below are on this page instead of being discovered three sessions in.

What can virtual therapy not do well?

Play therapy is less effective over video, and a full-scale IQ score and processing speed measures require in-person administration. If a child needs any of those, we say so on the free consultation and point the family toward the right provider rather than starting something that will not serve them.

Who at Little Dove has actual telehealth expertise?

Kristin Kroll, PhD, the practice founder, was researching telehealth delivery before the pandemic made it routine. As the attending psychologist for a cystic fibrosis clinic at Children's Wisconsin, where patients cannot safely be in the same room as one another, she was studying how to deliver group therapy over video. When COVID arrived, she helped that hospital prepare its standard operating procedures and clinical measures for the switch to telehealth.

Are parents included in virtual sessions?

Yes, in most sessions. We teach evidence-based techniques, and those techniques get practiced at home between appointments, so the parent is a working partner rather than an observer in the waiting room. Virtual makes this easier, not harder, because a parent can join from work without a commute.

Does virtual mean my child stares at a screen alone in their room?

No. Sessions are structured and active, with goals set early and reviewed as you go. We also track progress with brief validated symptom measures rather than relying on impressions, and we tell you what the scores show.

Do we have to be in Austin?

No. We are fully virtual. Therapy is available across the 42 PSYPACT jurisdictions, Texas included, which also means a college student can usually keep the same psychologist after leaving for school. Testing and evaluations are Texas only.

Why does a virtual practice have evening and weekend hours?

Because the most common reason a family cannot start therapy is that the only appointments offered are during the school day. Virtual delivery is what makes evenings and weekends practical, so children are not pulled out of school and parents are not missing work.

Dr. Kroll discussed her telehealth research background and Little Dove's virtual-only model on the Starting a Counseling Practice Success Stories podcast, published by ZynnyMe.