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Isn’t more screen time a problem?

Tele-play therapy with kiddos may at face value may seem like a daunting endeavor. However, upon closer inspection we can see how the many benefits of play therapy can translate to the virtual world, given the limitations of our new reality of Shelter in Place.


Many parents have a justified concern about screen time’s impact on their children’s development. According to the 2019 The Common Sense Census children ages 8-12 spend an average of just under 5 hours a day using screen media, with ages 12-18 using just under 7.5 hours not counting time used for homework.

Generally, medical professionals suggest Family Media Plan as there is no “one size fits all” guidelines for media use, and not all screen time is created equal. For example, a distinction is made between social media and gaming screen time and screen time for the purposes of a meaningful connection with another person.

The Importance of Maintaining Social Connections

In these unusual times it is important for children and adults to be maintaining social connections to combat feelings of isolation, loneliness and anxiety; screens can be invaluable  in times of the pandemic stay in place orders.

Even in normal circumstances, I recommend caregivers provide as much stability and predictability as possible to their children’s schedules with this increasing in importance the younger the child is.

Keeping the regular weekly appointment that the child had before the social distancing is one way to show that trusted people in their lives are still there and provide a sense of much needed structure.


Benefits of Tele-play therapy

Maintain Social Connection

Video meetings with a child’s therapist are a way to maintain social connection with a trusted other, and to provide thinking and feeling space for both children and their caregivers when space and normalcy are in short supply.


Allows for Closer Observation Face-to-Face

Given the nature of play therapy, clinician and child may be moving around the room, looking at toys or drawings together; the arrangement in video therapy is much closer to the formation adults often experience in talk therapy.

This formation in child therapy sessions can allow for more close tracking of an individual’s facial expressions than might be available meeting face-to-face.. This is not to say, however, that tele-play therapy is devoid of play, as we do still engage in play: using toys on either side of the screen, even pantomiming passing objects, real and imaginary through the screen as we play.


Comfort of Home

Tele-play therapy also usually allows the child to be in their home environment, which can be more comfortable for children than the office setting.

Meeting in the child’s space provides an opportunity for increasing therapeutic alliance and thus potential for beneficial change. It can also foster a goal of play therapy which is to increase a child’s sense of agency and confidence in the world.



Privacy Concerns

In terms of logistics for play therapy, the potentials for increased intimacy are contingent on caregivers being able to provide a safe and private space in the home for their children to use a screen to meet with their therapist.

The same concerns for children and adults can come up around privacy when having therapy sessions outside of the office. Feeling that one can be authentic in their therapy without fear of being overheard by unintended audiences is crucial to the therapy process.


Internet Privacy Issues

Internet privacy issues are, of course, also a concern on many levels when thinking about teleplay therapy. Not only may the child be concerned about their privacy being at home with maybe other children and adults moving around the home, but parents will also have concerns about the risks of having their child communicate with their therapist over a virtual platform.

Although risks are always present, precautions and best practices can be followed.

Therapists make it a point to discuss risks and limits of confidentiality and privacy in therapy, and can work with parents to figure out a system for logging onto a given tele therapy platform that allows for transparency and understanding of precautions being taken and risks. Having a working understanding of the tele therapy platform is also important as caregivers will be relied on to set up access to virtual meetings.


Caregivers Role

It is also important to make sure that children have access to tools of expression like a few art supplies (i.e. paper, colored pencils, play doe) and toys (figures, stuffed animals, legos, board games) similar to how they would within the office setting.




Making Space for Teleplay Therapy

Setting up a safe teleplay therapy space can be an opportunity for connection between caregivers and children in ways that the car ride to the office, or that post-session trip to get snacks, provided when the meetings were in person.

Setting up a ritual around the tele-play therapy session can also be a nice way to provide continuity and connection beyond the therapy time, as well as allow for both caregiver and child to feel secure about the virtual therapy space.

And lastly, it continues to be important for caregivers to have regular meetings with their child’s therapist. These meetings allow for both therapist and caregiver to have context into what is happening in the child’s world inside and outside of therapy.

It also provides parents with extra support that they will likely need while juggling their own stresses about being stuck at home, working remotely and homeschooling their children. As always, caregivers’ self-care and access to support are crucial to their children’s wellbeing.




About the Author

Courtney Hartman is a Clinical Psychologist (PSY) at Well Clinic in San Francisco. In her words, “I view the therapeutic relationship as something that is co-created over time and as the primary tool for healing.”

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