Ethical Issues with Online Teen Therapy

Written By

Ava Cheng


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Ethical Concerns With Online Teen Therapy

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Online therapy has become increasingly popular in recent years as a convenient and accessible option for mental health treatment.

However, providing therapy services virtually introduces unique ethical considerations, especially when working with vulnerable populations like teenagers.

As online teen therapy continues to grow, it is critical that clinicians and platforms prioritize client welfare.

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Confidentiality Concerns

Confidentiality is a core principle of mental healthcare. When meeting with a therapist online, teens likely assume their sessions will remain private.

However, the virtual space can make confidentiality more difficult to guarantee.

Managing Tech Issues

Technical problems likewise threaten privacy. A poor internet connection may freeze a video call at an inopportune time.

Someone entering the teen’s room mid-session could glimpse content on-screen.

Therapists must have contingency plans to handle tech glitches smoothly. That may involve following up by phone or rescheduling if confidentiality becomes compromised.

Authenticating Client Identity

Verifying who you are communicating with is also trickier remotely. When meeting a teen client for the first time via video chat, their profile picture may not match their appearance.

Photo IDClient shows therapist a photo of their ID during initial session
Security questionsTherapist establishes client identity by asking personalized questions
Multi-factor authClient must enter passwords/codes from email, phone, etc. to access therapy account
Table 1. Methods of Authenticating Clients Online

Platforms catering to teens should make identity verification standard procedure before enabling access to services. Guardians could also participate in intake procedures when appropriate.

Risk Management Challenges

Is Online Teen Therapy Ethical

Managing safety risks inherently poses difficulties in the digital space. Warning signs like self-harm may be less visible through a screen. Environmental factors like bullying may similarly be obscured.

Limited Options in Crisis Situations

If a teen conveys a desire to harm themselves or others, in-person counselors can help arrange hospitalization.

An online therapist’s crisis response options are restricted when not physically present with a client.

Erick Lazar, Licensed Psychologist

Calling emergency services from a remote location requires collecting the client’s exact address and contacts. Even then, the online therapist cannot control whether the teen receives needed intervention.

Extra diligence is warranted from virtual practitioners to preempt mental health emergencies with teens. Establishing crisis contingency plans early is vital. Checking in more frequently also helps online therapists detect emerging risks.

Jurisdictional Ambiguity

With online therapy, counselor and client may reside in different regions – potentially even different countries. This jurisdictional separation creates uncertainty around reporting obligations.

For example, definitions and thresholds related to abuse/neglect claims vary based on location.

An online therapist witnessing concerning behavior from a teen’s parent/guardian may struggle judging whether and where to file a report.

More broadly, practitioners may be unclear which guidelines and codes of ethics (state, national, international) have precedence in remote therapy. Regulatory bodies should aim to resolve such jurisdictional confusion to support ethical practice.

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Challenges Obtaining Consent

Barriers Communicating with Guardians

As minors, teens cannot legally provide full consent to treatment – guardian permission is required. But connecting with parents/guardians may be complicated online.

  • Contact information provided initially may be inaccurate or outdated.
  • Guardians referenced by the teen may not have legal decision-making capacity.
  • Such obstacles to valid consent undermine ethical practice.

Practicing Responsibly

As online platforms enable more ubiquitous access to mental healthcare, ethical challenges in areas like privacy, risk management, and jurisdiction responsibilities magnify.

Clinicians practicing teen teletherapy must recognize and adapt to these issues, prioritizing their young clients’ security and welfare through proactive planning and heightened diligence.

With conscientious efforts, telepractitioners can leverage technology to safely deliver vital support to vulnerable youth.


  1. American Psychological Association (APA) Ethics Code:
  2. TeleMental Health Institute:
  3. National Association of Social Workers (NASW) Code of Ethics:
  4. International Society for Mental Health Online (ISMHO):
  5. American Counseling Association (ACA) Code of Ethics:

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About the author

Ava Cheng

Ava Cheng

Hey there, I'm Ava Cheng—an inquisitive soul originally from Hong Kong now based in Singapore. As a physiotherapist, I have a passion for understanding women's health and the crossroads of medicine and psychology. Living in the heart of Singapore, I'm on a constant journey to explore the latest trends in these fascinating fields. The human body and mind never fail to amaze me, and I'm determined to unravel their mysteries one discovery at a time. Let's embark on this intellectual adventure together! Social

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