By Beth Berkowitz, PsyD and Deanne Kelly, BS, OTRL.

Teletherapy via phone and video has presented us all with opportunities to engage together in news ways. We are fortunate that for many of our kids, and particularly our teens, engaging with people in this way is not completely foreign. As a result, the transition to teletherapy has not been as daunting a task as we might have first imagined. In fact, kids are developing imaginative ways to engage in their therapy.

For example, Brenda (name changed for privacy) 7 years old, has been bringing her worries to her therapist by drawing pictures and playing out doctors’ visits with her baby dolls and stuffed animals. Her therapist, while on the other side of a screen, is able to follow along and intervene as if she were in the same room with Brenda. Other kids and therapists are reading stories together, completing worry worksheets, and practicing mindful exercises.

Below are some tips to help you guide your child through successful therapy sessions during what will likely be an extended Shelter-in-Place scenario.

1. Let your child know what to expect

If this is your child’s first experience with a therapist, have a conversation with him/her about therapy and then explain how the session will work via telehealth. Your child’s new therapist can help you with this part as well. Let your child know that teletherapy might feel a little strange at first, but then it will feel quite normal to them. At this point, you can use examples of how they have become used to seeing their teacher and friends on Zoom, Facetime, or other platforms.

2. Establish physical boundaries

Do your best to make sure your child has a private space for their sessions. In most cases this will be their bedroom, where they have access to toys, books, art and other supplies. Make sure other family members are engaged in activities, so they are not tempted to interrupt the session. If a private room isn’t available, you can provide headphones so your child’s conversation isn’t overheard. Allow your child to have a full session with their therapist (whatever amount of time has been set aside for them). Set up alternative times for you to speak with the therapist, so as not to use your child’s time.

3. Remain flexible around expectations

Remember that this might take some getting used to in the first several weeks. Some children might be able to sustain connection on a virtual platform for a full 50 minutes and others may not. Some kids do better meeting for 30 minutes twice a week. It is important to discuss this with your child’s therapist.

It is also imperative to keep your child’s strengths and needs in mind throughout this process and know that things might change depending on the day. Some days, younger children may want you to be with them for their session; other days, your child may not want to complete an anxiety worksheet, especially if they have been doing worksheets for school all week. Continue to discuss issues that arise with your child’s therapist and stay open to an ever-changing process.

4. A note about teens

As we know, sheltering in place has been exceptionally difficult for many of our teens. Allow them to set up a space that provides the most privacy for themselves during sessions right now. Maybe get them a white noise machine or, if possible, take their siblings for a walk during the session.

5. Complaints you may hear

With the change from the multi-sensory clinical environment to a screen for teletherapy, you may notice that your child complains about looking at the screen while listening to the unexpected interactions with another person. Your child may have a difficult time sitting still, may fiddle with the virtual background, or try to utilize the chat box instead of listening and talking. You may need to explore accommodations for preferred positioning including standing, sitting on a moveable object, or laying on the floor. Hand-held interactions, including paper and a writing tool for doodling, or a movable fidget, may help with attention during therapy.

The unknown can be a difficult place to be, but we have ways to provide support and comfort to one another. Adding teletherapy to your child’s week can provide the extra help they need to manage their worries and frustrations during this time.

If you need support or guidance during this time, or are facing other challenges as a parent, JFCS’ Center for Children and Youth is here for you. Our team of parenting experts and clinicians can provide online counseling to help you and your family. We can also help you establish healthy family routines, connect with other parents, plan activities at home, and receive critical assistance when you need it most. Contact us  or call 650-688-3046.


Beth Berkowitz is a licensed clinical psychologist with more than 20 years of experience providing treatment to children, adolescents, and their families in outpatient, day treatment, residential, and school-based settings. She has extensive experience serving children who struggle with anxiety, depression, attention difficulties, and family separation. Beth has spent the past eight years administering clinical training programs, supervising clinical staff, facilitating clinical seminars, and directing program development in the nonprofit sector. Beth’s commitment to mental health, strength-based services, and culturally informed treatment have been the hallmarks of her many years of clinical service and management. Beth holds a Master of Arts Degree in Clinical Psychology/Theater Arts from Cal State University and completed her Doctor of Psychology degree at California School of Professional Psychology where she focused on Adolescent Development.

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