The Ins and Outs of Virtual Care for Kids
Clinician’s Take
When virtual mental health care works for kids—and when it doesn’t
By Nicole Garber, MD, Chief Medical Officer
In this article, you will learn
- The unique benefits clinicians observe in virtual visits.
- What types of concerns and ages can be effectively supported virtually.
- Situations where in-person care may be preferable or required.
- How to prepare your child for a virtual session.
Screen time often gets a bad rap—but when it comes to pediatric mental health care, it’s opening the door to something incredibly valuable. Since the shift to online services during the COVID-19 pandemic, telehealth has proven to be more than just a temporary solution. It’s become an essential tool for delivering accessible, effective care to kids and teens
For many families, virtual care has become a flexible, effective way to access support without the stress of commuting, rearranging schedules, or navigating waitlists. But virtual care isn’t a fit for every child—or every situation.
It’s important for families to feel confident in the care they choose. That starts with understanding when virtual mental health care does work well for kids—and when it may not be the best option. In this article, we’ll walk through:
The unique benefits clinicians observe in virtual visits
What types of concerns and ages can be effectively supported virtually
When virtual intake and assessment work well—and why
Situations where in-person care may be preferable or required
How to prepare your child for a virtual session
Our philosophy around virtual and in-person care at Blackbird Health
“Telehealth also facilitates clinician ability to observe the client in their home environment and obtain a direct view into how the family functions in their naturalistic setting, which can facilitate tailoring of exposure practice.”
- Journal of the American Academy of Child & Adolescent Psychiatry
What clinicians gain from virtual visits
When virtual care is clinically appropriate, it offers an added advantage: insight into a child’s natural environment. That kind of context often strengthens the provider’s understanding and improves treatment planning.
Virtual visits give clinicians the ability to:
Observe the child in familiar surroundings, which often leads to more relaxed, genuine behavior
See sibling and caregiver interactions in real time
Pick up on environmental factors – overcrowded spaces, noise levels, sleep setup – that influence behavior and wellbeing
Gain clues about emotional regulation, attention, and executive function through at-home routines
These insights help clinicians build rapport early in the therapeutic relationship and develop more informed, personalized diagnoses and care plans.
Virtual care: What it works well for
Virtual care can offer meaningful clinical support for a range of behavioral and mental health needs—especially when those needs are mild to moderate. According to the American Academy of Pediatrics and AACAP, telehealth is effective for delivering therapy, medication management, and care coordination for children and adolescents, particularly for anxiety, depression, and ADHD.
Ongoing virtual care tends to work best when:
The child is school-aged or older, with the verbal and cognitive ability to engage on video
The child has anxiety, depression, or ADHD or a similar clinical concern
The clinical concern is mild to moderate with no immediate safety concern
The family can provide a private, quiet space where the child feels confident the conversation is confidential
When a virtual intake or assessment Is appropriate
A virtual intake is often the first step in starting care—and it can be a powerful clinical tool when used in the right context. A 2022 review in JMIR Pediatrics and Parenting found that virtual assessments are effective for gathering developmental history, observing behavior in a natural setting, and accelerating time to diagnosis.
A virtual intake can also be a helpful tool to understand if a child would benefit from virtual therapy or whether in-person therapy is recommended. A trained clinician will assess whether the child seems comfortable in their space and has the developmental and emotional readiness to engage virtually in the therapies being considered.
When in-person care is recommended
While virtual care expands access, it’s not the right format for every child or clinical concern. The American Telemedicine Association and the National Institute of Mental Health advise that certain conditions still require in-person evaluation for safety, diagnostic accuracy, or therapeutic effectiveness.
In-person care is typically preferred when:
The child is very young (typically under 5), especially for developmental or speech-related evaluations
There are safety concerns—including suicidality, self-harm, or aggression—that require risk assessment and crisis planning
The concern involves sensory, motor, or communication impairments that limit virtual engagement
The home lacks a private, consistent space or stable internet access
The clinician needs to administer certain standardized assessments (e.g., cognitive testing, ADOS, language batteries)
Getting the fit right
Virtual mental health care isn’t just a matter of convenience, it’s a proven tool that, when used intentionally, can help kids and teens access care faster, feel more comfortable, and get the support they need without unnecessary delays.
It’s not always the right fit, but when it is, families can feel confident that clinicians are equipped to build strong therapeutic relationships, make accurate recommendations, and provide care that’s just as clinically sound as in-person services.
How we use virtual care at Blackbird Health
At Blackbird Health, we believe effective care begins with a comprehensive understanding of each patient. Our virtual intake appointments allow us to observe children and adolescents in their home environments, often providing meaningful insight into how they function day to day.
Here’s how it works
Intake appointms:ents are typically 60–90 minutes
A psychiatric nurse practitioner conducts the session, often with both the caregiver and child present
The appointment includes a full developmental, psychiatric, and medical history review
The clinician identifies whether further evaluation is needed and whether virtual or in-person care is clinically appropriate
If it is determined that in-person care is necessary, whether for safety, diagnostic accuracy, or treatment effectiveness, we will make that recommendation clearly and help guide next steps.
Dr. Nicole Garber is triple board-certified in general psychiatry, child and adolescent psychiatry, and obesity medicine, bringing over 11 years of experience in pediatric mental health care.
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