The Challenge of Online Work with Children

The Challenge of Online Work with Children

Working with children and families requires flexibility and plans can change in ways that test the most competent practitioner. With restrictions on face-to-face work and unpredictable requirements for isolation due to the pandemic, a well-planned session in the clinic may suddenly be moved on-line. This is particularly challenging with groups of siblings and significant family conflict, and requires a different skill set in the practitioner. Family court disputes and the requirement that children ‘take sides’ adds another level of complexity.

This was the situation with a client and her four young children who had been booked in the clinic for a first visit. A half an hour before they were due to arrive, the mother called to say that she was unable to attend and requested an appointment on-line. The practitioners proceeded with the first visit process with the mother alone who was regularly interrupted by the children. Despite this and the shortened time, a request for her to have greater authority with her children was established and the beginnings of an ecogram created. At the conclusion of the session, she agreed to attend with the children in person the following week to complete the ecogram, timeline, and first visit protocol.

However, an hour before the session the mother called to say that one of the children had been a close contact of a COVID sufferer and again requested an on-line session. This proved challenging with children ranging from ten to three years who were tired, hungry, and anxious. The extent and reason for the anxiety only became apparent when we learned that, while the parents were separated, the father continued to live in the house and was listening to the consultation outside the door. Despite everything, the practitioner did engage the children and laid the foundations for future meetings.

This is what we learned:

1. Where possible, take charge of the wider environment by establishing who is in the home, who can hear or see, and who is actively participating. A statement about the children’s requirement for a private conversation should be established and, if this cannot be agreed, the session stopped. Of course, people are not always honest about this and in their anxiety may continue to secretly listen leaving children vulnerable to consequences of their honesty.
2. Before the parent leaves check if anyone needs to use the toilet or get a snack or a favorite toy. Ask the parent to help the child and then agree not to interrupt unless the child is sent to get them.
3. Ask parents to supply children with drawing material.
4. Take charge of the session with the children by clearly stating your expectations and requirements in order to achieve a good outcome. This should be done with important adults in the room so they can support the process and agree to requirements for privacy and minimal intrusions. Children should have the process of the session, limits to confidentiality, reasons for their involvement and the protocol of Bower(note) explained to them. The practitioner should direct where people sit in order to be seen and heard.
5. Ask that all technology, devices, and other distractions be turned off/removed.
6. Once the parent leaves, evoke the hierarchy of the sibling subsystem, joining with older children to support younger one’s participation.
7. Turn up your volume in terms of noticing, rewarding, and encouraging participation.
8. Give clear direction as soon as a problem arises. For example, intervene early if conflict erupts or rearrange seating if this is indicated.
9. Choose those matters you will address and those you will ignore. Some things don’t matter in terms of success of the session, and some are crucial.
10. Visual enquiry and drawing an ecogram and a timeline are still possible and engaging for children on-line. Be sure to explain, demonstrate, and hold up the picture at regular intervals ensuring all can see and understand. You may also ask older children to construct an ecogram in timeline at their end or pick the colours for your other notes.
11. Keep the session short in order to ensure engagement and stop or call a break if you sense children have lost interest.
12. Be sure to ask for feedback.
13. Complete the session by asking all adults into the session. Praise the efforts of the children and reinforce the right and need for confidentiality. Directly instruct parents not to question children about the conversation and ask children not to use material in the session against one another.
14. Establish how, with whom, and where the next session will occur.