When your child is struggling with anxiety, depression, or something you can’t quite put your finger on, finding the right support can feel overwhelming. Online therapy has made mental health care easier for many families to access, but convenience is only part of the equation. As a parent, you also want to know whether the care your child receives is actually making a difference.
There’s already research showing that online mental health care can help children and adolescents, but much of that evidence comes from smaller studies or controlled research settings. If you’re a parent trying to decide what’s right for your child, though, the question is usually much more personal: What happens when a kid like mine actually starts online therapy? Until recently, we’ve had less data to answer that question at scale.
That’s why we studied what happened when nearly 10,000 young people ages 9 to 17 received care through Grow Therapy. The peer-reviewed study looked at two things parents care about most: whether young people stayed engaged in care and whether their symptoms of depression and anxiety improved over time.
Here’s what they found.
Key takeaways
- Roughly 3 in 4 young people attended at least three sessions, an early milestone in establishing a therapeutic relationship.
- Young people in the study averaged more than 12 visits with a Grow provider.
- Among youth who completed follow-up symptom assessments, 51% with elevated depression symptoms and 58% with elevated anxiety symptoms experienced clinically meaningful improvement.
- Depression and anxiety frequently occurred together. More than 70% of youth in either symptom cohort also had elevated symptoms of the other condition.
- The study also identified differences by gender, including a pattern in which girls were more likely to stay engaged in the depression cohort but less likely than boys to reach the study’s threshold for clinically meaningful symptom improvement.
What does the research say about online therapy for kids and teens?
Online therapy for young people isn’t new and researchers have studied teletherapy, telepsychiatry, and internet-based treatments for years. These previous studies have given us important evidence about online therapy for young people, but they often focus on specific groups of kids or particular treatment programs.
Grow’s study offers a broader, real-world view by looking at what happened when nearly 10,000 kids and teens received care through Grow as part of their everyday lives. That makes the findings especially useful for parents wondering what online therapy can look like outside of a research setting.
The study included kids and teens ages 9 to 17 who had at least moderate symptoms of depression or anxiety when they began care. There were 9,853 young people in the depression cohort and 9,996 in the anxiety cohort, with substantial overlap between the two groups.
More than half experienced meaningful improvement
Among young people who completed at least two symptom assessments, 51% of those who began care with elevated depression symptoms and 58% of those with elevated anxiety symptoms reached an established benchmark for clinically meaningful improvement.
That benchmark is worth explaining. Researchers weren’t counting every small change in symptoms as a success. To qualify, depression scores had to decrease by at least five points on the Patient Health Questionnaire assessment (PHQ-9), while anxiety scores had to decrease by at least four points on the Generalized Anxiety Disorder-7 assessment (GAD-7). These thresholds are used to identify changes that are considered meaningful in a clinical context, rather than minor fluctuations in a questionnaire score.
These results also reflect young people who had meaningful symptoms to begin with. To be included in the depression or anxiety cohorts, they had to start care with at least moderate symptoms, making the changes measured over time clinically relevant.
Put together, the findings show that meaningful symptom improvement wasn’t an isolated result. It occurred in more than half of the young people with follow-up data who entered care already experiencing significant symptoms.
Nearly 3 in 4 young people attended at least three sessions
For therapy to have a chance to help, your child has to stay engaged long enough for a relationship with their therapist to develop. So for many parents, there’s a practical question right alongside, “Will it help?”: “Will my child actually keep going?”
In this study, roughly three-quarters did. Among young people who began care with at least moderate depression symptoms, 73.4% attended at least three visits with their provider, and 74.3% of those who began care with at least moderate anxiety symptoms did the same.
Three sessions is a useful milestone because research often uses it as an early benchmark for establishing a therapeutic relationship. Therapy depends in part on the relationship that develops between a patient and their provider, including whether they feel comfortable, understood, and able to participate honestly in the process.
Many young people in the study continued well beyond those first few appointments. On average, they attended more than 12 visits with a Grow provider. For parents who worry that virtual therapy might make it harder to hold a child’s attention or build a meaningful relationship with a therapist, these engagement numbers offer useful real-world context.
Does online therapy work differently for boys and girls?
The study found some differences in how boys and girls engaged with therapy and how their symptoms changed over time. Girls entered care with higher levels of depression and anxiety symptoms and, in the depression group, were more likely than boys to attend at least three sessions. However, girls were less likely to reach the study’s benchmark for clinically meaningful improvement in both depression and anxiety.
Of course, every child’s experience with therapy is different, and many factors can shape how someone responds to care. These findings don’t tell us why outcomes differed between boys and girls, or predict how any individual child will respond to therapy. What they do reinforce is that attendance is only one way to understand how therapy is going. Checking in on how your child is feeling, whether their symptoms are changing, and how they feel about their care can help you and their provider understand what’s working and what may need to evolve.
Depression and anxiety often showed up together
The study also reflects a reality many families experience firsthand: Mental health concerns don’t always fit neatly into a single category.
More than 7 in 10 young people in the depression cohort also had elevated anxiety symptoms. A similar proportion of those in the anxiety cohort also had elevated depression symptoms.
That overlap provides important context for parents. A child who seems anxious may also be struggling with low mood, and a teenager experiencing depression may also be dealing with persistent worry or fear. Therapy can create space to understand how those experiences interact rather than assuming there is only one thing going on.
What parents can take away from the research
No study can tell you exactly how therapy will work for your child, but these findings offer a few useful things to keep in mind if you’re considering care.
- Look for progress, not perfection. More than half of young people with follow-up assessments experienced clinically meaningful improvement in depression or anxiety symptoms. Progress can look different for every child, so consider whether the concerns that brought them to therapy are becoming more manageable over time.
- Check in on how therapy is going. Attendance is one piece of the picture, but it doesn’t tell you everything about whether care is helping. Ask your child how they feel about therapy, whether they feel understood by their provider, and whether they notice anything changing.
- Remember that more than one thing may be going on. Depression and anxiety overlapped for more than 70% of young people in the study. Your child doesn’t need to fit neatly into one category for therapy to be useful.
- Give the relationship time to develop. Nearly three in four young people in the study attended at least three sessions, a milestone researchers used to approximate the point when the therapeutic alliance, or the relationship and trust between a patient and therapist, begins to take hold. A strong connection with a therapist can be an important foundation for the work that happens in therapy.
Finding mental health support for your child with Grow Therapy
Finding the right provider can be one of the hardest parts of getting a child into therapy. Grow helps families connect with licensed mental health providers, with options to search based on factors like clinical specialty, insurance, availability, and provider characteristics.
Parents and guardians can explore providers who work with children and adolescents and find someone whose experience aligns with what their child is going through.
If you’re considering therapy for your child, you can find a therapist on Grow or check whether Grow accepts your insurance.
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Methodology
This research used a retrospective observational cohort design and 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. The study included 9,853 young people in the depression cohort and 9,996 in the anxiety cohort, with substantial overlap between the groups.
Engagement analyses included young people who attended at least one visit. Clinical outcome analyses required at least two PHQ-9 or GAD-7 assessments and therefore included fewer participants: 4,304 in the depression cohort and 4,318 in the anxiety cohort.
Because this was an observational study rather than a randomized controlled trial, the findings describe patterns observed in routine care and cannot establish that Grow Therapy caused the symptom improvements. The study also could not account for factors including treatment received outside Grow, specific treatment modality, medication use, or provider-level differences. The authors characterize the findings primarily as descriptive real-world evidence.
