Children and Adolescent Interventions by Telehealth

Friday, September 22

Eight creative strategies to boost engagement with kiddos during video telehealth.

When it comes to working with children and adolescents virtually, it can be challenging to navigate the therapeutic journey together. Maintaining a high level of engagement is tough, so we’ve found some helpful tips to keep in your back pocket.

Be mindful that video telehealth is different than in-person sessions and there will be ebbs and flows in good vs. “not-so-great” days. Working through video is a whole new ballgame but once you and your clients get accustomed to video vs. in-person sessions you’ll find that great progress can be made.

Let’s start with some basics to keep in mind while treating children and adolescents and then review a few activities you can use to increase engagement  in an online setting.

Basics to keep in mind for any child or adolescent session

  • Work to establish your new relationships with both clients and their guardians as this will facilitate a better and deeper understanding of the client.
  • Therapy doesn't need all of the entertaining bells and whistles - it just needs to be dynamic, engaging and goal directed.
  • Support the guardian whenever possible; you depend on them as much as they depend on you.  Some suggested methods of communicating with a guardian:
    - While we can't always control a child's behavior we can control our reaction to it.
    - Ask questions such as “How do you think you’ll respond to (behavioral issue, or impulsivity, or whatever it is that the child is struggling with)?”
    - More often than not you will see a change in behavior just based on the response of the guardian; the change in the way that they respond to the child.

Telehealth and Online Engagement activities:


  • For adolescents, find videos, music, social media to guide the conversation. For example, if your client is adverse to talking about feelings and is a fan of the Simpsons, you can pull out a scene that demonstrates that emotion. Or, you might find a meme that conveys a particular emotion to be helpful.
  • “Go on a walk” with adolescents if they can participate in telehealth sessions with their phone. It’s especially important for adolescents to feel like they have a private space to meet with you.
  • Scavenger hunts - Play Therapy Scavenger Hunt


  • Teaching and asking children to participate in social skill activities can drive overall increased engagement and attendance.  101 Ways to Teach Children Social Skills
  • Pretend the camera is a “stage” and work together to create songs and dances. This exercise encourages communication, brainstorming, negotiation and cooperation.

Children under 10

  • Imagination and “pretend play” are great outlets for kids under ten years old to talk about feelings in an indirect way. Most kids will repeat the same theme in their play, so you may need to guide the “play” in order to get them to explore feelings that they are particularly resistant to talking about.
  • In your first telehealth session with a child find out what kinds of toys, craft supplies, and other tools they have at home that you could use in therapy. An example: have them find a container into which they could put all the toys, crafts, paper, markers, coloring supplies, etc. and call it the “therapy toy chest.” Then it’s easy for the child to grab it and have all of those supplies on hand for each session.
  • Use puppets, toys, characters, etc. as tools for children to express their feelings. The idea is for the child to project their feelings and experiences onto them.

Additional Resources:

Facebook private groups (must be a licensed counselor to access these)

Growing your Child & Family Counseling Practice

Teletherapy Training for Child Therapists: Accessing the Digital Child


Online resources:


Accessing the Digital Child Coaching Package

Sesame Street Little Kids/Big Challenges

The Best Gratitude Scavenger Hunt for Kids and Adults


Resources to Support Kids and Families during the COVID-19 Pandemic:

Conscious Discipline- e-learning resources including printables, activities, webinars, and podcasts

Cosmic Kids- free yoga and mindfulness for kids

Royally Enchanted- free bedtime stories, most include princesses

Playworks- online educational games

Go Noodle- movement, yoga, and mindfulness. A lot of elementary aged kids will already be familiar with this one from school

Yoga Ed- Yoga Ed Youtube Channel

Imagination Tree- resources and fun activities that can be done at home

Scholastic Learn at Home for Families- Scholastic Learn at Home

PBS Parents - Learn & Grow- resources for school, as well as emotional literacy that can be used in therapy

Mindful Schools- Mindfulness for Kids

National Geographic Kids- NatGeo Kids

Catch Health at Home- Health and PE at home



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