How do video sessions work? Can they really work with children?

Video sessions (telehealth) have been demonstrated to be effective in abundant clinical trials, and the research is clear that this is a useful modality. That said, until March 2020 when COVID-19 hit and I had no choice but to switch my practice to telehealth, I myself had reservations. I worried that I would feel disconnected, that it would be difficult and distracting, and most importantly, that progress would slow. I especially worried about how this would transition for children. To my delight and surprise, sessions have transitioned seamlessly to video calls, and I have found that virtual sessions offer a surprising amount of convenience, comfort, intimacy, and effective intervention–far more than I would have previously expected. Please feel free to reach out to see if this could be a good fit for you.

Why do people consider therapy?

Therapy is a partnership between an individual and a professional who is trained to help people understand their feelings, relationships, and past experiences in order to gain insight and make changes. People often consider therapy under the following circumstances:

  • They feel overwhelmed, or feel a prolonged sense of sadness or hopelessness
  • They are seeking a sense of purpose or direction, or to get ‘unsuck’ from damaging patterns
  • Their child is struggling with emotions or behaviors at home, at school, and/or within relationships
  • They are struggling with their relationships with friends, family of origin, coworkers, or partner
  • Their actions are harmful to themselves or others
  • Their difficulties make it hard for them to function in their day to day
What can I expect during a typical appointment?

Sessions are 50 minutes in length. Depending on your goals, difficulties, and strengths, we will devise a treatment program to meet your needs and promote your health and well-being. Each session will be determined by your needs. In all cases, my approach is collaborative and you will find me very engaged in sessions, providing (and receiving) feedback, offering support, connection, offering psychoeducation and skills, and working hard to help you meet your treatment goals.

For children, once out initial intake assessment is completed, it is most typical that I check-in with the guardian at the beginning of the session to understand any recent progress and new symptoms. I then will meet with the child either alone or with their guardian, depending on the treatment needs for the majority of the session. Sometimes there will be therapeutic homework, other times we will focus on progressing and healing solely within the session. As always, I invite feedback and questions throughout this process to ensure you are getting what you need.

What times do you have available appointments?

I do my best to maximize my availability to ensure that sessions are available when you need them. I offer evening appointments, however these are in high demand and tend to fill up quickly. In the event that your child needs to miss part of their school day, a ‘doctor’s note’ will be provided to excuse the absence.

How does confidentiality work?

In essence, as an adult in therapy, what you share in here, stays here. As a child (up to age 18,) your legal guardian legally has access to information about the treatment provided, however, it is important to ensure a measure of privacy in the space, so we’ll collaborate on the terms. There are times when a therapist is legally obligated to break confidentiality:

  • Harm to self or others: if a therapist believes you are in imminent danger of hurting yourself or someone else, a family member, police, or ambulance will be called to ensure safety.
  • A child, older adult, or member of a vulnerable population is in danger. In these cases, the department of social services or the police will be called
  • A file is subpoenaed by the court.
  • A client experienced a health emergency during the session: In this case, medical staff would be provided with the minimally necessary information.
  • If you choose to use health insurance, your insurance company has access to your diagnosis, what type of sessions are provided and when, and is able to access your treatment plan and psychotherapy notes under certain circumstances.
  • More information regarding privacy can be found here.
How is play therapy different than just playing?

Children learn, communicate, and grow through play. Play Therapy is the use of specific and varied techniques to help children to communicate, express feelings, heal and ‘release’ pent up emotions such as anger, anxiety, sadness, fear, worry, stress, etc. Toys are to children what words are to adults. Adults can make meaning out of words, thus talking and processing thoughts on a cognitive level. This can achieve a ‘release’ for adults and help to process feelings and resolve problems. This is not always the case for children. Research has shown that children who have not yet developed the higher executive brain functioning that adults or even older adolescents have, cannot achieve this release alone through talking, identifying feelings or being ‘taught’ how to do things-relax, breath, reframe irrational thoughts, etc.

Most importantly, many children who present in Play Therapy are struggling to regulate their nervous systems, and are unable to monitor and modify their inner states independently. Through Play Therapy and with the support of the authentic, attuned relationship, they learn to co-regulate and soothe their Limbic system and resolve difficult experiences and stored memories.  Through the therapeutic relationship a sense of safety is created, which enables the child to go toward difficult emotions and experiences and heal.

Click here  and here for more information about play therapy.

Can’t my child get the same benefits as Play Therapy from playing with their toys at home?

The answer to this question is no. While children do communicate and express themselves during their individual/solitary play at home it is far different than Play Therapy. In the Play Therapy session, the therapist is trained to elicit feelings and themes by using certain language and prompts. The Play Therapist helps the child to identify their feelings in a non verbal way and also helps them to promote independence throughout play and build self-esteem through various tasks and language. The Play Therapist is also trained to remain regulated, connected, attuned and accepting no matter what the child demonstrates or acts out in play, this way the child feels accepted and validated throughout the session, despite possibly communicating private thoughts/feelings or things which they normally are unable to communicate for various reasons. Through the relationship between the child and the therapist, co-regulation, and healing occur.

How involved will I be in my child’s treatment?

Families play an important role in children’s healing processes. The interaction between children’s problems and their families is always complex. Sometimes children develop problems as a way of signaling that there is something wrong in the family. Other times the entire family becomes distressed because the child’s problems are so disruptive. In all cases, children and families heal faster when they work together.

If a child is younger than 12 Colorado, all legal guardians must consent to treatment. If parents are divorced, written permission from both caregivers is required to provide treatment to the child. If a child is 12+, they are able to consent to their own treatment, although their parents will continue to be involved in the process. This can get a bit confusing, so I’m happy to consult with you if needed!

Will you testify in court for me or my child?

If you are or become involved in divorce or custody litigation, my role as a therapist is not to make recommendations to the court concerning custody or parenting issues. By signing the Disclosure statement, you agree not to subpoena me to court for testimony or for disclosure of treatment information in such litigation; and you agree not to request that I write any reports to the court or to your attorney, making recommendations concerning custody. The court can appoint professionals, who have no prior relationship with family members, to conduct an investigation or evaluation and to make recommendations to the court concerning parental responsibilities or parenting time in the best interests of the family’s children.

What is the difference between counseling and therapy?

Counseling and psychotherapy are often terms that are used interchangeably, and you may see that I do so throughout my practice. A licensed professional counselor (LPC) and a therapist sometimes have a comparable educational and professional background. Counseling and therapy are terms that describe the creation of a nurturing therapeutic relationship in which the client can begin to connect with themselves and their potential. Counseling can connote a shorter-term, wellness based approach and therapy can connote a longer-term in-depth process. I use both of these terms because I practice each of these forms of treatment, based on individual needs.

Regardless of how we are working together, my belief is that people are born with a natural tendency toward exploration, growth, and achievement of our full potential. My job as a professional is to help remove the barriers to realizing this potential, heal and address past trauma, and promote well-being.

Why shouldn’t I just take medication?

Medication can be effective but it alone cannot solve all issues. Sometimes medication is needed in conjunction with counseling. I will always respect your choices regarding medication, and will work in collaboration with your medication provider, if it applies, as much as needed or desired.

What qualifies you to help me and my family?

Aside from my education (I have received a bachelor’s degree and a master’s degree–see ‘about’ for more,) I have sought extensive consultation and supervision throughout my professional career. It is my absolute priority to continue learning and growing to remain current with evidence-based practices to support you and your family. There can be significant variability in education and experience within this field, and I would urge you to ask questions (of me and of other potential providers) to ensure that the approach, experience, and education is going to match well with your unique needs.

Do you take insurance?

I take a select few insurances, then I work on an out-of-networks basis for all major payers. An out of network therapist is paid by you at the time of service and you are provided with a Superbill, which you submit to your carrier for direct reimbursement to you as the insured. The extent of this coverage varies by plan. Check with your insurance company on the reimbursement given by your particular policy for out-of-network mental health services provided by a licensed professional counselor (LPC.)

Are there benefits to not using insurance?

You might elect to not use insurance for privacy reasons. Throughout treatment, your insurance company generally needs a mental health diagnosis to determine ‘medical necessity.’ Insurance companies can require additional clinical information such as a treatment summary in order to process these claims.

How can I evaluate whether therapy is working?

As we begin, we will establish clear goals. Whether we want to address difficult past experiences, manage symptoms of depression, or address persistent behavioral issues with your child, we will create specific objectives and criteria to gauge our progress, and I will check in with you about these regularly. Keep in mind that certain tasks require more time to accomplish than others. After a few sessions, my hope is that you will experience a joint effort, and comfort and connection within our relationship. I welcome feedback throughout the process, and if you ever do feel ‘stuck’, let’s work it out together!

With your child, we will be looking at several cues that therapy is progressing. As a therapist, I will be looking to ensure that they feels safe in our sessions, appear open, and are engaging well with our interventions. I will ask for feedback regarding whether symptoms and issues are improving between sessions in multiple settings–at home, at school, and in their social world. It is important to look at the whole picture when assessing progress, and if progress is lacking it can sometimes be impacted by environmental factors (new stressors, growth and development, physical changes in their world.)

How long will this take?

Unfortunately, this is not possible to say in a general FAQs page. Everyone’s circumstances are unique to them and the length of time counseling can take to allow you to accomplish your goals depends on your desire for personal development, your commitment, and the factors that are driving you to seek counseling in the first place.

I want to get the most out of therapy. What can I do to help?

I am so glad you are dedicated to getting the most out of your sessions. Your active participation and dedication will be crucial to your success. All therapy is a two-way process that works especially well when we communicate openly. I will join with you in ensuring that you are getting what you need out of our sessions.