You Want Me To Do What? The L.O.V.E Response To Virtual Therapy With Children

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Dr. Latrice Love, PhD, LPC is a licensed professional counselor and Motivo Supervisor. In light of COVID-19, Dr. Love gathered resources to illustrate how her personal, guiding model, L.O.V.E. (L.O.V.E. stands for learning, observing, visualizing and evolving), as well as virtual tools and at-home toys, can be utilized to conduct effective, connective therapy with children virtually. Through a case study and rubric of client goals, Dr. Love offers a new perspective on how to keep our important work with children alive online. 

What happens when play is removed from therapeutic play or play therapy? 

As a helping professional, frankly, it sucks not to be able to sit on the floor with a child and use therapeutic, creative play. In fact, I wouldn’t be surprised if you may be suffering more than the children due to the limitations our new normal has imposed on us. 

Navigating this chaos is not only tough, but it’s rapidly changing the way many people are able to perform their jobs. As we deal with this together, it’s natural to wonder: Are we still effective clinicians during our time together with kids in cyberspace or on the phone? 

One way forward is to name the thing we’re all feeling. We can spend 20 minutes of our virtual session embracing the “suck” and validating how strange, awkward, and uncomfortable things are while we practice social distancing. There are benefits to embracing the “suck” and validating the normal emotions that people are having in response to the world around us. However, what is the plan for the next session… and the next one? At what point are you able to continue the work that was being done prior to COVID-19? That’s where L.O.V.E. can come in. 

Where is the creativity? 

Using play and other creative forms of therapy have proven to be beneficial for people of all ages while working on a variety of mental health concerns. Having the modality change in how we are able to offer services is an opportunity to truly think outside of the box. A quick internet search can pull up a variety of virtual activities and games that you can use with your clients. If we refuse to allow our clients to admit unwarranted defeat, why is it ok for us to do so?

Ok, I’m listening… now what?

Here is where I insert a little L.O.V.E… (drumroll)

LEARNING
1. Learn/Identify client’s strengths
2. Learn/Identify client’s strengths
3. Learn/Identify activities that can meet the needs of your client’s strengths and interests 

OBSERVING
1. Observe the tools and resources that your client has access to when developing ideas
2. Observe client’s interest in participating in alternative activities through discussion
3. Observe what is needed to remain organized, professional, and intentional 

VISUALIZING
1. Visualize potential barriers and limitations for ideas
2. Visualize how the alternative activities fit within your treatment plan
3. Visualize the goals and expectations that can stem from implementing the new activities

EVOLVING
1. Implement new activity with clear objectives and milestones to track progress
2. Record observations related to what is working about the alternative activity
3. Make appropriate revisions based on findings and proceed with activity, implement new activities when needed and revise current activity to meet the client’s needs as you learn more

Sounds easy enough, tell me more!

Scenario: Jane, 6 y.o. female with anxiety concerns. She has been in therapy for 2 months and has recently started to open up. Her current concerns are related to social anxiety and not fitting in with other children.

Learning: Jane loves watching cartoons, playing with dolls, puppets, and drawing. Jane opens up really well when she draws in therapy and uses dolls for role playing activities. Learning activities identified: cartoon clips, drawing virtually or picture sharing, and storytelling ideas.

Observing: Jane has computer access and the ability to connect face to face. While working with her, she mentioned that she loved watching a specific cartoon. Activity link: https://youtu.be/jil0WCh_UoQ This clip from one of her favorite cartoons highlights an example of one of her favorite characters. In the clip, the character is feeling as though she is unable to do something that others seem to be able to do well. 

Visualizing: Technical issues can create a barrier or limitation if the plan is to share the video clip during session. Thinking through this in advance can create an opportunity to have a back-up plan using the same tool/resource. The clip is less than 2 minutes. It can be watched in advance and used as a story instead. While helping Jane with her social anxiety, one of her treatment goals is to help her overcome her fear and change anxious patterns. One of the interventions is to help her navigate how her thoughts interfere with her trying new things. The goal of using the video clip is to have her recreate the clip in her own words as she shares her thoughts about what either of the characters could have done differently; identify things that may be familiar; and ultimately see that the main character did not try the activity before admitting defeat in an effort to promote a mindset change. 

Evolving: After watching the video, Jane did not initially reach the end goal, but she was able to recognize that the character did not try to do something that she felt was difficult. This opened up the opportunity to talk about her reasons for not trying new things which had not been discussed before. During the next session, the client drew a picture to describe a situation that occurred at school which took the new topic further. Using the information uncovered from the cartoon clip and the drawing, the conversation continued and meeting virtually was the least of the concerns. 

Okay, I’m convinced, but my client’s goals are tough to address online.

As a mental health professional, you are still reading because you genuinely want to help the people you work with and are looking for creativity, motivation and ideas/suggestions, like how to continue toy and object play techniques including ball play in a group setting. In a virtual setting, groups can still be held. Instead of throwing an actual ball to someone for them to speak on a topic or share something, you can simply call their name and mimic passing the ball to keep it fun. Medical, baby doll, baby bottle, and block play techniques can be done with the items the person has available to them. It may add more value if the item belongs to them in some settings. Storytelling can become more exciting in a virtual environment and free Poll software and create a change of pace for your tech savvy clients when posing direct questions and for role-playing. Puppets, dance, and music are also still an option in a virtual setting. To get your creative juices flowing, here are a few ideas to help you embrace change through L.O.V.E.

For more ideas or inquiries about the L.O.V.E. model, you can reach out to Dr. Latrice Love at drlove@latricelove.com or latricelove.com

Are you a tele-health provider with expert tips or tools for virtual therapy or supervision? Let us know! Email emily@wearemotivo.com to share your ideas.

Emily Donahue

Emily Donahue

Emily Donahue holds a Master's in Mental Health Counseling from Northwestern University. She works as a limited permit therapist at a private practice in Brooklyn, earning her clinical and supervision hours for full licensure. She has a special interest in women and alcohol use and her dream is to meet Irvin Yalom one day.

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