# Acceptance of online therapy for children and adolescents with digital media use disorders: perspectives from child and adolescent psychiatrists and psychotherapists in Germany

## TL;DR

German child and adolescent psychiatrists and psychotherapists have mixed views on using online therapy for treating digital media use disorders in young patients.

## Contribution

This study explores the acceptance, barriers, and facilitators of online therapy for digital media use disorders among German child and adolescent mental health professionals.

## Key findings

- CAPPs reported considerable experience with DMUD but limited experience with online therapy.
- Attitudes toward online therapy were generally neutral, with less favorable views for DMUD treatment.
- Key barriers included technical challenges, lack of personal contact, and data security concerns.

## Abstract

Online therapies have the potential to improve access to psychological services for individuals in need while alleviating the burden on healthcare systems. However, child and adolescent psychiatrists and psychotherapists (CAPPs) rarely integrate these services into their daily practice. This exploratory study investigates CAPPs’ acceptance of online therapy, with a focus on treating children and adolescents with digital media use disorders (DMUD). The study aimed to examine attitudes toward online therapy for DMUD treatment and to identify barriers and facilitating factors to its implementation. A cross-sectional online survey (5–10 min) was distributed to 1000 members of a German practitioner network, with 142 respondents completing it in full. Attitudes toward online therapy were assessed using adapted versions of the Attitude towards Telemedicine in Psychiatry and Psychotherapy (ATiPP) questionnaire. Barriers and facilitating factors were explored using open-ended questions. Descriptive statistics, correlations, and regressions were used to analyze the closed-ended questions, while responses to open-ended questions were categorized. CAPPs reported considerable experience with DMUD, but less experience with online therapy. Attitudes towards online therapy were generally neutral, with less favorable views on its use for DMUD treatment. Key barriers to implementation in outpatient care included technical challenges, lack of personal contact or control, and concerns about data security. Facilitators included access to adequate technical resources, user-friendly and evidence-based programs, interactive tools, and opportunities for regular face-to-face interactions. The results highlight the need to develop online therapy solutions that align practitioners’ needs and acceptance. However, further qualitative and quantitative research with more representative samples is essential for a more comprehensive understanding of this topic.

The online version contains supplementary material available at 10.1007/s00787-025-02640-w.