During this period of isolation, change and loss, access to online counselling and support services is likely to be crucial to many children, young people and families. The profession is changing on a daily basis, adapting to new challenges and providing services that may focus more on building resilience, keeping children and young people safe and checking well-being.
While this guidance does not replace the experience and knowledge gained through appropriate, formal training, it will help you make informed choices and decisions that are in the best interests of your young clients.
Comprehensive answers to most of these questions will require additional knowledge, learning and expertise gained through your practice, training and supervision.
Replacing face-to-face contact with digital platforms may suit some children, but not others, so we need to continue to be mindful of individual assessment and choice.
We'll continue to amend and update our FAQs in line with current good practice guidance.
Please see the Security and data protection section on the Working online resources page for a checklist of information relevant to all age groups.
Can we offer online therapy for children and young people if we're qualified practitioners but have no experience of online work?
There are a number of considerations.
Read through the competences for adults, reflecting on your own levels of competence and experience. Do you feel able to meet these competences? If not, what additional training can you access?
Adopt a blended learning approach to achieving these competences that complements your experience and knowledge of working with children and young people. This includes taking into consideration the additional social, neurodevelopmental, psychological and legal knowledge required from therapists working with this age group.
Can we offer online therapy to children and young people if we're still in training?
Training providers must develop measures to ensure that appropriate training and assessment (linked to competences) is in place before trainees are signed off to practise online. Considering the present restrictions, students in training should only work with existing clients who they have an existing relationship with.
Training providers must ensure they have appropriate insurance policies to provide such services.
Reasonable adjustments should be made to enable young people to engage with online therapy, recognising that it won't be possible for everyone. Some young people may wish to opt out as online counselling may not be suitable for them.
I have asked if I can see clients online. How do I know if this is the right option?
Start by watching the videos from Onlinevents in our working online resources.
From your professional experience and knowledge of the age group that you work with, reflect upon your own levels of competence and comfort.
Providing online therapy can be similar to face-to-face therapy but it also has some very significant differences.
As the therapist, you know your client best. You have the relationship with them and can assess their needs. Continuing therapy via an online medium might not always be appropriate or what a young person wants. Ask your client – they will know.
There are some good sources of external support and information you can guide them to - see the list at the bottom of this page. If you, as their trusted therapist, provide these resources, it's likely they will take your advice and access information that they feel meets their needs.
Do we need to recontract with schools?
We recommended that school counsellors, or school counselling service providers, create a specific contract with the school if offering counselling remotely. This should have appropriate safeguards in place, including how to access the designated safe-guarding lead. It should also include checking their location at the beginning of the session, in case any safeguarding issues arise that need to be reported.
Working remotely is likely to leave a therapist feeling isolated and under pressure to do as much as possible. Working online requires greater attention to self-care and working in a managed and boundaried way, reflecting on the therapist’s own capabilities as situations arise. Any recontracting with schools needs to consider this.
What consent is required for children and young people to use an online service?
There is an exemption in the data protection act for online counselling services. A child or young person should be able to enter into online provision if they can provide valid consent.
According to the ICO, children in the UK aged 13 or over (12 in Scotland) are able to provide informed consent for their data to be processed for preventive and counselling services, if the practitioner believes the client to be competent to understand what they are agreeing to.
As with face to face work, the issue of consent for working online is complex and depends on the setting in which therapy is offered. It is advisable to read the full ICO guidance relating to children and young, key extracts are highlighted below:
- if you're relying on consent as your lawful basis for processing, when offering an online service directly to a child, in the UK only children aged 13 or over can provide their own consent
- for children under this age you need to get consent from whoever holds parental responsibility for the child - unless the online service you offer is a preventive or counselling service
- when relying on consent, make sure the child understands what they are consenting to, and that we do not exploit any imbalance of power in the relationship between us
What is the legal basis to process the child’s personal data to provide online counselling services?
With many therapists and services newly venturing into working online, it's important to be cautious as both therapists and clients may be using devices which unknowingly collect client data.
Therapists and agencies are advised to account for decisions made to either seek parental consent or to adopt the principles above of informed consent from the child or young person. Demonstrating a clear process of accountability is vital if data protection law is challenged in the future.
If you opt to seek parental consent, clear accountability includes checking with the child or young person beforehand to see if the parent or guardian can be contacted. Ethical considerations need to be taken into account if the child or young person refuses. You should document any decisions made in case this is later challenged as a data breach.
There should be no change in the way you legally process data, whether you're providing an online service or face to face counselling, as long as it's in line with current guidance on working competently and safely online.
Do we need to carry out a data protection impact assessment?
Schools and voluntary sector agencies will usually have a DPIA (data protection impact assessment) in place for how they manage data. If not, it's recommended you carry one out before agreeing to work online with children and young people:
This DPIA could consider a variety of risks including:
- whether the therapist is using a device provided by their employer or school solely for work use
- whether there is a secure platform which can be used for contacting clients by email or for online therapy sessions
- whether the school or agency is subject to any guidance from the Department for Education regarding contact with pupils while they are at home
- what the impact would be of providing or not providing therapy if the child or young person refused to seek parental consent. Would this leave them more vulnerable?
- if choosing to accept informed consent from the child or young person, explaining and documenting how this is established
This list is not exhaustive and all therapists newly working with children and young people online are advised to seek guidance from experienced online CYP practitioners or supervisors and experts in the field of GDPR and therapy, via relevant guidelines, training and CPD.
Can we offer therapy if we can't be sure the child or young person is in a confidential space? If not, do we offer check-ins, just to keep contact?
This will depend on the age of the child or young person and their understanding of what they're consenting to.
Online therapy allows a young person to make choices that they don't have when attending therapy face-to-face. For instance, they can use a mobile phone and be in contact from the best private space that they can find.
A young person may find regular check-ins supportive. They can provide a way of holding a young client emotionally between sessions or over lengthy breaks from therapy.
It's recommended that you plan check-ins thoughtfully. You should use a secure platform to check-in - texting mobile to mobile is not secure. The most secure form of contact is only via a short secure email.
It's important that you and your client adhere to any new contract agreed - if the check-in is 10 minutes, then stick to it. For a number of reasons young people often challenge boundaries online more freely. This might be in order to test the relationship or to check that they're not simply 'a number' and are still important to you. It's important that you adhere to boundaries, however much they're challenged. As with face-to-face therapy, this might be the only space where a young person feels safe and gains from the boundaries that are in place.
Would I put a child or young person at risk if I offered telephone counselling? Would texting be better so family members can’t overhear?
Texting is not appropriate for therapeutic work, only for organising session times and sharing factual information. Texting could easily turn into ‘chat’ on a therapeutic level – you could be drawn into providing a therapeutic response when the medium is not secure.
If you're not qualified to provide online therapy, we strongly recommend providing therapy via video. Video enables you to engage directly with the young person and is the closest media to working face-to-face if you're not qualified or experienced in working online.
A young person might feel that a counselling session needs to be conducted in a formal space, but you can discuss other options. Conducting therapy carries less risk to possibly rupturing the therapeutic relationship.
If a young person doesn't feel comfortable with communicating via video, you could give them the option to leave their video on while using the chat function. (This is available on platforms such as Zoom).
To prevent the young person from being overheard, encourage them to use headphones. We recommend that you encourage them to make eye contact with you at the beginning and end of a session where possible. If they feel they can't engage safely, or privately using the video function, you should assess the appropriateness of communicating via phone.
Some young people may prefer to speak by phone as they may feel video platforms invite therapists directly into their private spaces. Some may also find it easier to go outside where it's easier to talk by phone, which will not use up wi-fi data.
There are many things to consider here, all of which are part of broader cyber security measures linked to offering support via phone calls or text chat. These include:
- potential safeguarding issues and related management
- therapist competence in the use of different mediums - the knowledge and experience required to ensure safety of the young client along with the ability to ensure there are no misunderstandings
- understanding of disinhibition online, transference and countertransference specific to the online relationship
- ensuring use of end to end encrypted platforms
We recommend you only practise in this way if you're trained in delivering services via this medium. There are other options such as sharing websites offering support and information with the client – this can be managed via an encrypted email platform.
I work with under-10s. Can I work online with this client group?
Working with younger children adds a further dimension when considering assessment and contracting. This is an additional specialist area.
We don't recommend working with younger children via video as the child is likely to be within the family environment. The family dynamic, family presence and differences will bring additional therapeutic needs and insights than therapy provided within the location of a school setting.
Additional considerations must be given to consent and confidentiality. For instance:
- what are the differences between agreeing consent within a school environment and contracting with a parent, guardian or carer to seek their consent for working therapeutically online with a young child?
- are you likely to be providing therapy with an adult present? If so, are you qualified to provide family therapy? Having a third person in the ‘room’ would affect the dynamics.
I’m worried about unplanned breaks and the effect this will have on the therapeutic relationship. How easy is it to switch to online support?
Young people are used to having long breaks in therapeutic support as they tend not to have access to therapy during school and college breaks. If offered sessions to cover these times, young people often chose not to attend, probably due to a number of understandable reasons.
However, the unexpected breaks that children and young people are now facing could have a damaging effect on their mental health. You know your clients best and recontracting with all safeguards in place, including what to do if you as the counsellor becomes ill, needs to become your first point of action.
It would be appropriate to include information relating to putting together a safety plan, readily available for moments when the young person might reach a point of feeling overwhelmed or crisis. You can also include advice and links to appropriate support websites. These, along with a robust safety plan, will help a young person feel prepared to access information and support as and when they need it.
Added to this, Years 6, 11 and 13 students have had their education unexpectedly cut short. Some will be experiencing a period of loss and adjustment with multiple endings - an unsettling time during a period already full of change and transition.
It may well be that as therapists the service you provide is of a gate-keeping check-in nature, therapeutically holding the child or young person during these difficult times.
What additional safeguarding arrangements should be in place if I switch to online provision?
This is a significant issue that can only be fully understood through appropriate levels of knowledge through training and support.
You need to have sufficient knowledge, experience, supervisory support and levels of competence to ensure a young person will not become increasingly vulnerable should they share an issue that requires a safeguarding response from you.
You need to adopt remote safeguarding considerations, for example, establishing a safety boundary checklist before the start of each session as part of the recontracting process. This would include checking where the child or young person physically is - their exact locality, who else is in the room and what they can do if interrupted. Remain aware of any risks, checking out concerns as they arise.
Sessions should be scheduled in normal working hours to ensure the availability of support services.
A safeguarding lead must be contactable at any time that remote therapy is taking place and clear contracting needs to be agreed between all responsible parties.
The NSPCC has published useful advice for teachers on working safely remotely.
Further information and support
Coronavirus affecting young people’s mental health, survey reveals
More than 80% of young people who have a history of mental ill health say their conditions have worsened
Coronavirus: Helping children and teenagers cope with change, isolation and uncertainty
Our members talk about what parents can do to help young people who are struggling
Cut adrift on a sea of uncertainty, the peculiar position of our year 11 and year 13 children
Jane Darougar, executive member of our Universities and Colleges division and a sixth form college counsellor, looks at the experiences of school leavers