I have a parent who’s insisting on doing virtual therapy even though her son recently left an inpatient facility and needs therapy 2-3 times weekly. Since I incorporate a lot of play/coloring/movement into therapy with young children I just don’t know if this is plausible? I’ve never done Telehealth with anyone under 18. She claims the clinic hours don’t work for her, but I find that a little hard to believe.

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I’ve done it and you’re right - it’s not great. It’s also hard to build a safe environment and dialogue when the kid can just tune you out or look at other things on the screen. I’ve done some small play activities over Zoom but it was a hassle.

There will be some issues for sure, but how I look at it is, incorporate the parent(s) with the understanding that I as a mental health provider I will not be around all the times and this allows me to assist the client and the parent with the necessary tools needed for life.

I don’t feel this particular client would be one to try to figure out how to manage Telehealth with 18y and below. If this client had not just come out of inpatient. Maybe with other clients, for sure. Lay firm boundaries as to why…your recommendations as a professional especially after the client’s inpatient stay you recommend 2-3 day of intensive in office therapy. In the same sentence, offer recommendations to at least 3 other therapists that may be available if they are not accepting. :)

You may want to consider discussing the potential risks and benefits of virtual therapy with the child's primary care physician or the inpatient facility where the child recently received treatment. They may have specific recommendations based on the child's needs and medical history.

I love doing teletherapy. I dislike doing teletherapy with adolescents and I don’t do teletherapy with children unless it is part of family therapy with one or both parents present onscreen at the same time.

That being said, you are the professional with the experience. If you in your clinical experience feel teletherapy would not be recommended for this child for any reason, why allow yourself to be pressured by the parent? Don’t you have the option to say that you only recommend in person live therapy and then allow the mother to decide whether she will agree? If a patient said they were only available for therapy on Sunday evenings at 9:00 PM for in person therapy would you consider that and agree?

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