Fun, Games & Telehealth
In the early 2000’s I took one of my first courses on ethics and counseling and I wrote a paper about “e-counseling.” At the time I had a hard time finding research articles and the concept seemed almost outlandish. I remember imagining The Jetsons as I wrote the paper and struggled to find resources on e-counseling. Fast-forward to 2020 and I am actually doing “e-counseling” or tele-health. I never thought I would be doing this, but here I am!
I work from a relational perspective, and believe building and sustaining relationships is one of the primary mechanisms for healing and growth in therapy. I wasn’t sure if that could be accomplished or maintained via a screen, but I am happy to report that it is going a lot better than I anticipated. Trust me, it is not always perfect! Sometimes there are frozen screens or lag times but I am pleasantly surprised at how well this is working out.
I am an expressive arts therapist, so in “real life” sessions I use a lot of creative modalities, but a lot of this is limited on tele-health because my clients might not have access to the same art supplies at home. So, I wanted to share with you some of the resources and strategies I’ve used so far to help keep kids engaged in tele-health sessions.
I use a LOT of play therapy in my everyday practice. In fact, this is one of the modalities I use most often in my work with younger clients. When I work with children with special needs on social skills, we also play a lot of games. So I figured out this way to play board games online with clients via zoom! This could be accomplished with other video platforms that allow screen sharing and allow you to log on multiple users as well.
How I Play Board Games on Zoom
Step 1: I log into Zoom on my laptop and put my laptop Zoom session on mute and turn my laptop sound down (this reduces the feedback.)
Step 2: I send myself an invite of the zoom link to my phone and also log into Zoom on my phone.
Step 4: I point the phone towards my board game and turn up the sound on my phone (sometimes I plug in headphones into my phone.)
That’s it! It sounds more complicated than it is. I recommend giving it a try first with a friend or family member before you try it out with a client to work out any tech issues. So far, I have used Candyland and Chutes and Ladders. Believe it or not these are both games that have so much therapeutic value! I am always surprised by how much the older kids love Candyland, because it’s not my favorite. However this game is continually picked by kids of all ages and so I need to remember to meet them where they are at!
Before playing any game, we always review the expectations for games to ensure everyone is a good sport. Some of our usual expectations don’t apply to telehealth – like only touch your own piece and hands away from the board unless it’s your turn!
I have the kids take turns discussing a prompt or role play scenario related to their treatment plan goals before each turn. I’ll create a future blog post about creating SMART treatment plan and IEP goals and how I progress monitor and collect data.
You can also turn just about any non-therapeutic games into a therapeutic game with a little bit of creativity! The book Therapy Games: Creative ways to turn popular games into activities that build self-esteem, teamwork, communication skills, anger management, self-discovery and coping skills by Alyssa Jones is a great resource for getting started on that.
In my office I also always keep a copy of The Responsive Counselor's Any Game Counseling Prompts for 26 Different Topics and Kylie the Creative Social Worker's Counseling Questions for Games handy, as these are resources that you can use as prompts to open up discussion about a variety of topics, while having fun playing a game!
There are also some really great therapeutic games you can also use. I have some great therapeutic card games but I haven't figured out how to use them in tele-health quite yet! Let me know if you have some creative ideas. In the mean time, here are some cool board games you can consider. These are more expensive but are worth the investment as you can use them for years.
Jeopardy Labs is a very cool website where you can make a free jeopardy online game and then you can use screen-share to play it live with others. In the past I have used this to introduce myself and my role to a whole classroom and I have also used this as a final group exercise as a way to collect data with my 10-week self-regulation group that is based on the fabulous book Hunter and His Amazing Remote Control. I haven't made my own tele-health Jeopardy games quite yet (I'll be sure to post them when I do!) but I have used some that others have made. You can search on the website but here are a few that you might find useful to get started:
Spinning Wheel Games
If you have a tabletop spinning wheel, this is always super fun to use in sessions! Normally, I just put cards or prompts on different colored sheets of paper that match the colors on the wheel or you can also write on the wheel with dry erase markers. The kids love to spin it and then they pick the card that matches the color. This can also be done on Zoom with the counselor doing the spinning. You could just have the kid tell you where to put your hands to start, so they have some sense of control in the spin.
There is also an online spinner that you can customize (although the number of characters you can use is relatively short.) Here is a great example of a feelings spinner that someone customized. I had some extra time in a session so I did a screen-share and we spun the feelings spinner and then discussed different prompts like:
What might make someone feel this way?
When was the last time you felt this way?
How do you know if someone else feels this way?
Use your body/face to make a sculpture to represent this feeling.
If this feeling were the weather/a color/an animal/a sound, what would it be?
You can also have the child brainstorm a list of animals and type them in to make an animal spinner. Then toggle between 2 screens with the feelings spinner and the animal spinner and you can practice embodying what the different animals are feeling. It's pretty fun to pretend to be a silly zebra, a scared fish or an angry snail!
I have also been using the whiteboard feature on Zoom to play Pictionary. I find it is helpful to use a theme such as "guess the emotion I am drawing" or "guess the coping skill I am drawing." You might need to adjust your permissions for this to work.
Coping Skills Scavenger Hunt
It's great to get people up and moving during a tele-health session so I love using a scavenger hunt! There are many variations but here are some examples to get you started:
Find something to share that helps you calm down.
Find something to share that you have created.
Find something to share that feels good to touch.
Find something to share that you like the taste of.
Find something to share that you like the smell of.
Find something to share that you like to look at.
Find something to share that you like the sound of.
Find something to share that reminds you of a good memory.
Find something to share that reminds you of a special person.
Find something to share that reminds you of a special place.
Find something to share that reminds you of nature.
Find something to share that helps keep you healthy.
Mirroring Game with Drawing or Legos
You can work on communication, listening and frustration tolerance skills by having the first person draw a simple picture, out of sight, such as a snowman, a house, a tree, a person etc. Then, without giving away what the final outcome will be, the first person will give step-by-step directions to the second person (or other people if in a group) on how to draw the picture, without looking at it. When they are done, everyone holds up their drawings and discuss what the process was like. This is a great exercise to practice positive self-talk and having a growth mindset.
If both the counselor and the child have legos, you can do a similar exercise by building with legos.
Tier-1 School-wide Social-Emotional Learning Interventions Online
In addition to doing live sessions with students, I also created a website as a Tier-1 whole school social-emotional learning intervention. I know many districts are using Google Classroom, but my school is using Clever (via Microsoft) because this is the program our students were already logging into academic programs with. Some counselors may be using Google Sites, or Weebly sites etc. Just do what works for you and is within the guideline for your district.
On my Sharepoint website I have a ton of resources for both parents and students and I also post weekly lessons. I was getting a lot of phone calls from parents about kids with sleep disturbances, so I was able to collect a bunch of resources and put them into one area on my website. That way when a parent calls and asks me about sleep tips at the end of my phone call I can refer them to the website!
One of the recent lessons I posted was teaching students how to Create Their Own Coping Skills Plan. You can watch the video below and download your own fillable free coping skills plan to use with your students by subscribing my free resource library (scroll down to the bottom of this page to subscribe.)
You can read more about another lesson I did with the book When My Worries Get Too Big. Just like with the Coping Skills Plan, I also created a fillable form for worrying that I'm sharing with you as well in my free resource library. Many people don't have access to printers, so I think providing clients with fillable forms is helpful.
On my Sharepoint site as part of my weekly lesson, I am also using Zoom to record myself narrating one of these awesome Coping and Mindfulness Videos from The Responsive Counselor.
To do this, follow these steps: Step 1: Start a Zoom session by yourself and hit record.
Step 2: Start doing a screen-share and navigate towards the purchased resource.
Step 3: Record yourself narrating with the provided relaxation script.
Step 4: When done, stop screen-share, then hit stop recording, and close out zoom
Step 5: Once you exit out, the recorded file will be converted into an Mp4, which you can then upload as an unlisted video on Youtube, and then embed or link it onto your Google Classroom or Sharepoint site!
Helpful Tips for Navigating Telehealth
Set up a free Google Voice Number so you can send texts on it and make and receive phone calls without giving out your private phone number. When you set up voicemail, make sure to leave important emergency contact information (like a local crisis team if someone is having a mental health emergency.) Here are some scripts to consider from Simple Practice.
I have found it helpful to keep appointment times consistent so they are always at the same time and day each week.
Send out invites at same time each week. For example, I send out all my invites on the Friday for the following week and I change the links and passwords each week to keep them secure. Here is some info on how you can keep a Zoom session secure.
Consider using some type of a reminder app for appointments (you may need to obtain consent before using.)
Before meeting on Zoom, Teams, Google Hangout or whatever platform you are using, set up norms and expectations and plan time to review them. It would be helpful to have these on a visual that you can screen-share. Some ideas to consider are:
Arrive on time
Whole body listening (review what this means, if needed)
Distraction free (no playing other games, or watching TV etc.) while meeting
Try to keep computer/phone/device in one spot during meeting
Try to find a quiet spot to be (if possible)
Dress like you are out in public or at school
Don't take the device into places that you don't want people to see (like the bathroom)
Don't take any pictures or video of the meeetings
A lot of people seem to be using Boom cards but I haven't tried them yet! Are you using Boom Cards? What are your thoughts? What else are you using to make tele-health sessions engaging and productive for children and teens? I'll keep adding to this blog post as I try new resources so please share with me what you have found to be useful!