Some conditions and patients are more challenging to treat via video. Rachel Busman, senior director of the Anxiety Disorders Center at the Child Mind Institute in New York, treats children as young as 3 with selective mutism, a disorder where children fail to speak in social situations. The therapy is often done with groups of children and counselors to provide a lot of social interaction and opportunities for speaking, and is usually hands on: Counselors ask questions to prompt children to talk and reward them with stickers and prizes.

Now Dr. Busman’s program is running the groups on a version of Zoom for health care professionals. To make the cacophony of group online interaction with a dozen preschoolers and counselors manageable, the Child Mind therapists often break the big group into smaller twosomes or threesomes. And in lieu of physical stickers, during a recent session one counselor drew a star on an index card and held it up to the screen when a child spoke.