Remote psychotherapy with children and adolescents

What is it about?

This study reveals that therapists who had to shift to remote sessions with children and adolescents to some extent have faced similar challenges and difficulties as has been previously described for therapists working with adult patients. The therapists described both positive and negative aspects of this transition. In accordance with prior research, therapists reported that video-mediated psychotherapy could have many advantages for those patients and their families who otherwise might find it difficult to come to the clinic. Meanwhile, ethical dilemmas linked to patient safety and risk assessments were frequently brought up as a downside of the format, and the perception of delivering treatment of poorer quality had a significant impact on the therapists’ mood, which led to increased feelings of stress, inadequacy, and loss of skills. Factors such as disturbances from the patient's home environment, technical difficulties, loss of body language and other communicative tools, also affected the therapists negatively and might have contributed to concentration problems, frustration, fatigue, and reduced job satisfaction. All this reflects the therapists’ long-term process of digesting the new therapy format that could be summarized as a journey from a necessary evil to an opportunity – for some young people.

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Why is it important?

One lesson from this journey is that therapists who work with children and adolescents remotely need to address specific issues that are associated with the specific characteristics of each individual patient. Difficulties with protecting the patient's integrity become more pronounced, as does the lack of communicative tools. The greater involvement of parents is common in remote sessions in regard not only to technical assistance but also becoming a spokesperson for the child. Unique to the present study is the therapists’ experience of transferring the risk assessment for the children to the parents, who could become responsible for determining the child’s mood and suicidal ideation. Such issues should be addressed in an age-appropriate way with the patient, and when applicable, also with the parent. Above all, our study reveals the need for professional support and preparation time for forced transitions to new forms of treatment and new patient groups in times of crisis.