Does Online Therapy Help Kids and Teens? Study of 10,000 Youth

When a child is struggling with anxiety, depression, or symptoms that are hard to identify, finding effective support can feel overwhelming. Online therapy has made mental health care more accessible for many families, but convenience alone isn’t enough—parents naturally want to know whether treatment actually helps. This article summarizes peer-reviewed research examining real-world outcomes for children and teens who received care through Grow Therapy, focusing on engagement and improvement in depression and anxiety symptoms.

What does the research say about online therapy for kids and teens?

Teletherapy, telepsychiatry, and internet-based mental health treatments for young people have been studied for years, and prior research shows that remote care can be effective in controlled settings or for specific programs. The Grow Therapy study adds value by examining a large, real-world sample: nearly 10,000 children and adolescents who began care as part of routine clinical services. That scale helps parents and caregivers understand what online therapy can look like outside a research trial.

The analysis focused on young people ages 9 to 17 who started care between January 2022 and April 2024 with at least moderate symptoms of depression or anxiety. The depression cohort included 9,853 youth and the anxiety cohort included 9,996 youth; many participants appeared in both groups because the two conditions often overlapped.

More than half experienced meaningful improvement

For clinical improvement, the study used established thresholds rather than counting small score changes. To qualify as a clinically meaningful improvement, depression symptoms needed to fall by at least five points on the PHQ‑9 (Patient Health Questionnaire) and anxiety symptoms needed to fall by at least four points on the GAD‑7 (Generalized Anxiety Disorder‑7). These cutoffs represent changes clinicians consider relevant beyond typical score variability.

Among the young people who completed at least two symptom assessments, 51% of those who began treatment with elevated depression symptoms and 58% of those who began with elevated anxiety symptoms met these clinical benchmarks. Because the cohorts required at least moderate symptoms at baseline, the improvements reported are clinically meaningful for the children and teens who entered care already experiencing significant distress.

Nearly three in four attended at least three sessions

Engagement matters: therapy needs time for trust and rapport to develop. Researchers often use attendance at three sessions as an early marker that a therapeutic relationship is forming. In this study, roughly three in four youth reached that milestone—73.4% in the depression cohort and 74.3% in the anxiety cohort attended at least three visits. Many continued beyond that point, with an average of more than 12 visits per participant.

These engagement figures provide useful context for parents who worry that virtual care might make it harder to sustain a child’s attention or build a meaningful therapist relationship: in routine practice, many young people using Grow Therapy remained engaged long enough for treatment to proceed.

Gender differences and what they mean

The study observed gender-related patterns in both attendance and symptom change. Girls tended to begin care with higher depression and anxiety scores and were more likely than boys to attend at least three sessions in the depression cohort. However, girls were slightly less likely than boys to achieve the study’s benchmark for clinically meaningful improvement in both depression and anxiety.

These findings do not explain why outcomes differed by gender, and they don’t predict how any individual child will respond. They do underscore that session attendance is only one measure of progress—regularly checking symptoms, asking the child how therapy feels to them, and communicating with the provider are important ways for caregivers to understand whether care is effective.

Depression and anxiety often showed up together

A notable finding for families is how frequently anxiety and depression co‑occurred. More than 70% of youth in the depression group also had elevated anxiety symptoms, and a similar share of the anxiety group had elevated depression symptoms. That overlap highlights the value of comprehensive assessment and individualized treatment planning: a child presenting primarily with worry may also have low mood, and addressing both areas can help clarify what’s driving distress.

What parents can take away from the research

No single study can predict exactly how therapy will affect an individual child, but the results offer practical guidance for families considering online treatment:

• Focus on progress rather than perfection. More than half of young people with follow-up data achieved clinically meaningful improvement in depression or anxiety. Improvements may be gradual and individualized, so track whether symptoms are becoming more manageable over time.
• Monitor how therapy feels for your child. Attendance is only one sign of engagement. Ask your child whether they feel heard, whether they understand the work, and whether they notice any changes in mood, sleep, or daily functioning.
• Expect overlapping concerns. Depression and anxiety frequently occur together. A provider who assesses and treats both can help address the full picture rather than focusing on a single symptom label.
• Give the therapeutic relationship time to develop. Reaching three sessions is often an early marker of a developing alliance. Building trust with a therapist can be an important foundation for effective treatment.

Methodology

This research used a retrospective observational cohort design. It examined Grow Therapy clients ages 9 to 17 who began care between January 2022 and April 2024 with at least moderate symptoms of depression or anxiety. Engagement analyses included all youth who attended at least one visit. Clinical outcome analyses required at least two symptom assessments (PHQ‑9 for depression or GAD‑7 for anxiety), which reduced the sample for those analyses to 4,304 in the depression cohort and 4,318 in the anxiety cohort.

Because the study observed routine clinical practice rather than using randomized assignment, the results describe patterns seen in real-world care and cannot prove that Grow Therapy caused the improvements. The study could not control for other factors such as treatment received outside Grow, medication use, specific therapeutic modality, or provider-level differences. The authors present the results as descriptive, real-world evidence that can inform families and clinicians when choosing and evaluating online mental health care for children and adolescents.