What to Expect from Virtual Therapy Sessions for Kids and Teens with ADHD

By Dr. Mary Rooney, Ph.D.

In the months since the start of the COVID-19 pandemic, therapists have rapidly shifted from traditional office-based therapy sessions to virtual, or telehealth, appointments. This pivot has allowed patients to continue their treatments without interruption, and in many cases has made it more feasible for patients to attend their sessions consistently. Initially, virtual therapy sessions were part of a temporary solution to the current social distancing restrictions. But with improved insurance coverage for telehealth visits and high levels of patient and therapist satisfaction, telehealth therapy sessions are an option that is here to stay.

If you’re a parent considering telehealth treatment for your child or teen’s ADHD, you undoubtedly have questions about what to expect from virtual sessions. Here are answers to the top five questions I receive about telehealth therapy for ADHD.

Is telehealth treatment effective for ADHD?
Treatments that are effective during office visits are also effective via telehealth (check out this recent report from the Child Mind Institute for details about the research behind telehealth treatment). Conversely, treatments for ADHD that aren’t helpful (or aren’t evidence-based) when they are provided in-person will also not be effective via telehealth. So, before starting telehealth therapy, know how to identify evidence-based ADHD treatments and the therapists who use these approaches. If you’re not sure what to look for, take a look at earlier posts on this blog about the essential elements of evidence-based treatments for ADHD and finding therapists who use them (link to post 121 here).

How is therapy for ADHD different when it’s provided via telehealth rather than in an office?
Many aspects of treatment are the same whether the treatment is provided in person or virtually, but there may be a few positive differences. With some treatments, especially those that include parent coaching during sessions (like PCIT), the virtual format allows therapists to coach parents as they practice new skills while they are at home with their children. This might be even more effective than coaching during office visits, since the therapist can observe the child’s reaction in their usual surroundings. The same is true for things like organizational skills coaching for kids and teens. Therapists can now observe kids and teens in their actual homework space, for example, while they practice and fine-tune their organizational skills and strategies. 

Can kids and teens with ADHD really focus during virtual sessions?
This really depends on the individual child or teen. Some kids and teens with ADHD can focus quite well during telehealth sessions, but others struggle to stay engaged. Therapists use different strategies to keep kids with ADHD focused, like reducing the length of sessions, allowing frequent short breaks, using mini-behavior charts to reward on-task behavior during sessions, and incorporating fun, playful activities and conversations. Overall, parents should be highly involved in ADHD treatment for kids and teens, and parent involvement may need to be even higher during virtual sessions. Additionally, there are some kids with ADHD who simply really struggle to participate in virtual sessions. For these kids, attending office-based appointments whenever possible is usually the best solution.

Should I be concerned about security and privacy during virtual sessions?
Internet security and privacy is something to discuss with your therapist before starting virtual sessions. Therapists choose from a variety of video conferencing and telehealth platforms to provide virtual sessions, and each platform has its own security features. The most secure platforms are HIPAA-compliant. Your therapist should provide you with an informed consent document prior to starting telehealth treatment that provides details about the telehealth platform being used in their practice.

Can I choose to see a therapist from anywhere in the country?
One of the benefits of telehealth is that you are not limited to working with providers who are within driving distance of your home. However, in most cases, clinicians are only allowed to provide services to patients who live in the state in which they are licensed. While there are some exceptions to this rule, it’s generally best to keep your therapist search focused on providers in your home state.


Mary Rooney, Ph.D., is a licensed clinical psychologist in the Department of Psychiatry at the University of California San Francisco. Dr Rooney is a researcher and clinician specializing in the evaluation and treatment of ADHD and co-occurring behavioral, anxiety, and mood disorders. A strong advocate for those with attention and behavior problems, Dr. Rooney is committed to developing and providing comprehensive, cutting edge treatments tailored to meet the unique needs of each child and adolescent. Dr. Rooney's clinical interventions and research avenues emphasize working closely with parents and teachers to create supportive, structured home and school environments that enable children and adolescents to reach their full potential. In addition, Dr. Rooney serves as a consultant and ADHD expert to Huntington Learning Centers.


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This website does not provide medical advice, diagnosis, or treatment. The material on this site is provided for educational purposes only.