Telehealth Adds Insight Into Children’s Therapy Sessions

So why was the boy falling asleep during his school’s online and in-person classes?

The mystery soon unraveled, the answer in plain sight to Kevin Green. During a video telehealth session that took the SBH social worker into the bedroom of his young patient, Green noticed the electronics the child had access to. It was an obvious non-verbal cue in determining why the child had been sleepwalking through his classes.

“It led to important discussions with both the child and parent,” says Green, who treats patients from the ages of five to 21. “The child admitted to me that he was using the game system during the school day and even in the middle of the night. We agreed to discuss this further with the parent in session as the child was struggling with staying up during the day. The parent admitted she ‘felt bad’ in restricting electronics, but the video session led to a healthy discussion of the importance of limit setting and structure to keep the child on point during the school day.”

This is an example of how the telehealth program, which added video to its telephonic capabilities this summer, has supported the observation skills of SBH behavioral health therapists. Green has held all of his individual therapy sessions this way since August. He said he will revisit running group therapy sessions by video conference at a later date.

“I am finding that I am able to have the same impact working with children, teens and their parents through video sessions as I did with in-person sessions. It feels no different than if they are in the same room with me,” he says. “Parents are able to meet with me during video sessions if needed for collateral sessions, which have been helpful with keeping children and teens on proper sleep schedules and offering strategies to reduce distractions in order to complete school work when working from home.”

Behavioral health has, without question, been the medical specialty at SBH that has most seamlessly adjusted to telehealth, and young patients have been the most compliant in using the video technology.

Back in the spring, as a result of the pandemic, many institutions and providers began to transition to telehealth services for routine doctors’ visits. Patients generally liked the chance to avoid any possible health risks coming to the hospital, cut down on travel time to and from their provider’s office and continue with their medical appointments while never leaving home. However, admittedly, some were intimidated by the technology that enables these video visits.

“What I have seen is that children and adolescents have had a much easier time transitioning to video calls than adults,” says Dr. Pablo Ibanez, medical director, behavioral health services at SBH. “They are tech savvy and it comes natural to them. Meanwhile, a lot of the [adult] patients I see in my practice have been struggling to adjust to telehealth.”

Personally, Green sees telehealth as a boon to both him and his young patients.

“My patients are already comfortable with the technology and with the pandemic and traveling uncertainties or if the weather is bad or a parent is not feeling well, we can still have a session. Video has allowed us to have more connectedness and, as a therapist, it gives me greater insight. Compliance has improved. We haven’t missed a beat.”

During video therapy sessions he says certain hurdles need to be overcome. It is imperative, he says, for children to have a private area to talk to their therapist and family boundaries need to be established during what are generally 30-minute sessions.

“Kids need a place to talk,” he says. “Even before we get started, we look at challenges and hurdles. For the most part, I’m finding that parents and siblings give them privacy. I can still work with my patients through depression, anxiety, PTSD. I can’t hand them a tissue, but I can demonstrate active listening and empathy.”

He says he can still employ mindfulness, visualization and deep breathing techniques as he did with in-person therapy. He can observe them while they play board games or draw.

“You might have a cat jump out on a table or a dog bark. But you see the dynamics, communications and relationships unfiltered, how the siblings or parents talk to the patient when they’re at home,” he says. “You can see them working through issues right there as they are happening, when they may have tears running down their faces, all in real time,” he says. “It gives us a better perspective of the household dynamics. There are things you see that you wouldn’t see in your office. It makes it all more personal, which is why it’s so helpful.”