Unfortunately, many kids with mental health issues don’t get the treatment they need. Indeed: More than 2 in 3 American youth with severe depression don’t receive consistent mental health care, according to the Mental Health America report. The good news: A growing number of programs offer online therapy for minors. Online therapy helps adolescents acquire the skills and resources they need to feel better and has the potential to relieve the burden of mental health needs in children and adolescents, according to an article published in the journal Child Adolescent Psychiatric Clinics of North America. Here, we’ve rounded up the best online therapy for teens.
Best online therapy with unlimited messaging for teens: Talkspace Best online therapy specifically geared toward teens: Teen CounselingBest online therapy for teens that offers medication management: Sesame
Engaged in ongoing independent researchMystery shopped each of the brandsContacted brands’ customer service teams to ask questions and gauge responsivenessBecame customers of online therapy providers ourselvesReviewed academic research into the efficacy of online therapy versus in-person therapyRead hundreds of verified customer reviews from trusted third parties such as the Better Business Bureau (BBB) and Consumer Reports
Learn more about how we researched and evaluated the best online therapy brands via the methodology page. Adolescents who have grown up with technology may find the ability to interact with their therapist via messaging more attractive than interacting in person. The ability to build a relationship with their therapist in a way that is natural and comfortable for them is important because the therapeutic relationship is one of the most important success factors in counseling, according to the National Council for Mental Wellbeing. The registration process starts with a brief assessment on the Talkspace app or online. Then you can choose from a list of therapists according to gender, days of the week they’re available, and background. Talkspace promises that its therapists return messages five days a week, but the company isn’t transparent about how frequently therapists respond or how often they respond per day. It’s worth noting that the platform receives 1.3 out of 5 stars on Trustpilot and 1.09 out of 5 stars with a B rating by the BBB. Negative reviews refer to poor customer service, questionable billing practices, and unprofessional therapists. Teens are able to communicate with counselors in four ways: asynchronously via text-based messages, or synchronously by chatting live, speaking over the phone, or videoconferencing. For synchronous sessions between your teen and their therapist, you can schedule one live chat, phone call, or video session per week. For asynchronous sessions, you and your child will each have your own dedicated messaging “room,” which is your private and secure place for communicating with the therapist. You and your teen can each send unlimited messages anytime to the therapist. You’ll be notified by email when the therapist has responded. Teen Counseling receives 3.4 out of 5 stars on Trustpilot; 6 out of 12 reviews mention poor customer service and unprofessional therapists. The platform isn’t rated by the BBB. To find a mental health professional who provides online therapy for teens in your state, simply enter your location and choose “Video mental health consult” if you’re interested in therapy, or choose “Video psychiatry consult (new patient)” if you’re looking for treatment that includes medication. Next, you’ll see a row of telehealth providers with same-day availability as well as their prices. You’ll also be able to view each provider’s profile to see whether they specialize in teen therapy before you choose. The video psychiatry consultation includes a psychiatric evaluation and treatment plan, which may include medication. If it does, Sesame may be an affordable option because most pill-based medications start at $5 for 30 pills. Sesame does not list the medications you can get for $5, requiring you to visit the Sesame website and search for the “$5 MEDS” tag to find a provider who can prescribe $5 medication. Prescriptions include free home delivery.
Major changes in behavior, such as withdrawing from family and friendsStruggling to complete daily tasks that they previously could complete relatively easily, like going to school or practicing proper hygieneBig changes in mood or emotions
Additional signs that your teen could benefit from a mental health evaluation, per the National Institute of Mental Health (NIMH), include:
Desire to spend more time alone than usualLow energy or decreased interest in things they used to likeDieting, working out excessively, or fear of gaining weightSelf-harm behaviors, like cutting or burningSmoking, drinking alcohol, or using drugsExhibiting risky or destructive behavior while alone or with friendsGoing through periods where they are highly energetic, active, and need a lot less sleep than normalBelieving someone is trying to control their mind or saying they hear things other people cannot hear
As for whether your teen specifically needs online youth counseling, Dr. Clarke suggests asking a mental health provider whether the mental health issue your teen is experiencing can be managed with virtual care. Clarke also recommends asking your teen how they’re doing, what they’re feeling, and if they’re struggling with anything. “Offering a nonjudgmental, curious stance in response to this question can help teens confide in parents or caregivers,” she explains. If your teen is acting in ways that are concerning or saying concerning things (such as having suicidal thoughts), seek mental health help for them immediately, advises Clarke. For emergency scenarios, call the National Suicide Prevention Lifeline toll-free at 800-273-TALK (8255). You also can text the Crisis Text Line (HELLO to 741741) or use the Lifeline Chat on the National Suicide Prevention Lifeline website.
Attention deficit hyperactivity disorder (ADHD)Post-traumatic stress disorder (PTSD)DepressionAnxiety
Whether online therapy is right for your teen depends on a number of factors, including your teen’s personality and the specific mental health issue they’re experiencing. A mental health provider can tell you whether online therapy is a viable option for your teen’s specific situation.
Pros
Convenience Your teen can participate in online therapy sessions without leaving your home, making it a convenient option that can save time and fit more easily into their schedule.Cost Some online therapy sessions can be more affordable than in-person therapy services.Broad Reach Online therapy can help more teens access mental health help, particularly teens in rural areas; 1 in 5 children live in a county without a child psychiatrist, according to the American Academy of Pediatrics.Fewer Hurdles For some people, mental health is a stigmatized topic, and seeking help online can be easier than seeking traditional in-person services.
Cons
Requires Reliable Technology Online therapy platforms require a reliable internet connection and either a smartphone, tablet, or laptop. This can limit who is able to participate in online therapy.Presents Privacy Concerns Online therapy can be more difficult for teens without a private space at home, as they may feel less inclined to speak freely during sessions if they think others are able to hear them. Moreover, cameras at home and the security of virtual online platforms can raise privacy concerns.Not Always Covered by Insurance The pandemic ushered in changes to insurance policies that increased access to online therapy, but it’s unclear how long these changes will last, according to the NIMH. Moreover, some insurance carriers are vague about what mental health services they cover.
Price The cost of online therapy for teens varies from program to program, so take your budget into consideration before committing.Therapist Credentials Make sure the therapy your teen will be receiving is provided by a licensed therapist, says Leslie Miller, MD, an associate professor of psychiatry and behavioral sciences and the director of the Mood Disorders in Adolescents and Young Adults Program at Johns Hopkins University School of Medicine in Baltimore. “I think it’s important to see the criteria of the person who you (or your teen) are going to be seeking treatment with to make sure that they have the training to teach the therapy and the skills,” Dr. Miller explains. Ask any potential therapist what their training has been, what their experience is, and what their areas of expertise are, adds Clarke. Their answers can help you determine if they’re a good fit for your teen.Type of Therapy Make sure the therapy you’re considering is evidence-based and that it teaches your teen skills for coping with their mental health issue, says Miller. Examples include cognitive behavioral therapy, dialectical behavioral therapy, and interpersonal psychotherapy, among others, according to the Society of Clinical Child and Adolescent Psychology. The therapy should also include ongoing assessments that track your teen’s treatment progress, as this can help you understand whether the type of therapy is working, whether medication could be helpful, and whether your teen would benefit from switching to a new therapist or form of therapy, Miller explains.Home Space It’s important to have a private space in your home where your teen can participate in their therapy session without worrying about other people listening in or distracting them. Before you commit to online therapy, think through your living situation and make sure you have the right physical space.Reliable Technology Ensure you have both a reliable internet connection and a functioning electronic device so your teen can participate in sessions without technical difficulties or interruptions.Parent or Caregiver Involvement Understand how much involvement you will have in your teen’s therapy program. Instead of opting for online therapy for minors without parental consent, both Miller and Clarke recommend some level of parent or caregiver involvement. You don’t need to know everything that your teen tells their therapist, but being looped in on some level can help you support your teen in learning new mental health coping skills and also help you stay aware of their progress (or lack of progress) over time.
It’s also important to note that each U.S. state has certain requirements regarding whether teens need parental consent to start therapy. Some providers may request your consent before consulting with your teen. Additionally, some states prohibit mental health providers from sharing information discussed during teen counseling sessions without a signed consent form. If you want to be involved in your teen’s therapy, be aware that your provider may not be legally allowed to share private information discussed during sessions with your teen. Together, we’ve researched prominent brands through the experiences of real customers collected by trusted third-party reviews sites such as the BBB and Trustpilot. We’ve also consulted with independent psychologists and other mental health professionals to better understand why people seek out online therapy, and we’ve read the latest research on the efficacy of online therapy versus in-person therapy. When evaluating each company, we consider the session types they offer, the modes of therapy they specialize in, the credentials of their therapists, their business reputation and reported customer satisfaction, as well as how easy it is to sign up for and then use the service. Price, payment options, and whether the company accepts insurance are all crucial components to consider. We always try to recommend a range for all budgets, with special consideration for lower budgets. After our experts have selected the best online therapy platforms on the market, a practicing and independent licensed therapist reviews our picks to audit each company as a whole and ensure every selection we recommend is appropriate for the users we identify. If you’re looking for adolescent therapy online that prescribes medication, you may want to consider Sesame. And if you want the best online therapy for sending messages to a therapist as issues arise throughout the day, we suggest checking out Talkspace. Another option is Teen Counseling, which offers a network of counselors who have additional experience working with teens. The Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-HELP (4357) is also a resource to consider. The SAMHSA help line is a free, confidential, 24/7, 365-days-a-year treatment referral and information service for individuals facing mental or substance abuse disorders.
