I’ve decided to do a series of blog posts about different interventions I’ve been doing with kids over telemental health. Telehealth was a growing field before COVID-19, and in my work with rural populations, it’s a service I have been offering for more than three years. If someone physically can’t make the trip to my office, my office comes to them! Now that I am working from home, this is the case with every single person who meets with me, and as someone who primarily works with kids and teens, this proved to be challenging at first.
Although there is research showing the effectiveness of online therapy with many populations, the general consensus a year ago was that kids do better with in-person sessions. If a child is below a certain developmental level, my recommendation was to make in-person appointments happen, even if it meant driving hours round-trip.
When I determined that the safest thing I could do for myself and my clients was to work from home, I couldn’t say to 80% of my caseload, “Sorry, I can’t see you right now. I’ll call you when I’m back in the office!” So I consumed what educational materials I could find on telemental health with kids and developed some interventions of my own, and now I’m creating a blog series to pass my knowledge on to other professionals. I’m in the process of creating my own training for TMH with kids, so stay tuned for that as well.
The first telemental health intervention I want to talk about is chess.
My first practicum supervisor told me that, to be a good therapist, I had to learn to play chess. He recommended chess as an intervention for clients of all ages, especially kids, and since then I have always kept a chess board in my office. It’s really popular with many of my clients, so when I moved to telehealth full-time, I wanted to see if I could bring this intervention with me. Chess takes focus, planning, patience, frustration tolerance, and executive functioning – all things that can be part of a child’s treatment plan!
Fortunately, you can create a special link to play chess with a friend online. My husband and I used lichess when we were living apart while I completed graduate school, so I was already familiar with it. You can choose whether games will be timed (kids who have high anxiety might struggle with a time limit, but kids who have trouble remembering it’s their turn can benefit from the added structure), and there are several variations you can choose from if the client wants to mix it up.
Now, I am not a chess master by any means, but compared to most 8-year-olds, I am quite good. Different therapists will have different approaches to this, but when I play chess with a client, I might change my “difficulty level,” but I don’t let them win. Kids have told me they appreciate this because they know, when they win a game, they truly beat me.
That being said, lichess has an option when you create a game with a friend to have custom setup (on the website, this option is called From Position). If a child wants, they can have me start the game with fewer pieces or give themselves extra pieces to make the game easier or more interesting.
Compared to playing chess in-person, I’d say lichess has some definite pros:
- Kids can add extra pieces that you might not have on hand.
- You can choose whether or not turns are timed.
- When you select a piece, the game automatically shows you where you can move that piece – less time is spent teaching the child the game.
- You can “take back” moves, but only if the other person approves it, so the therapist can use this as part of their interventions if they choose.
- You can “take back” as many moves as you want because the computer remembers all the moves you’ve done.
- The game tracks whether or not someone is in check, so that frees up the therapist to focus more fully on the child.
- The child can’t flip the board out of anger if they lose. 🙂
Cons of chess online are:
- If you are taking a non-directive approach, you can’t let the child change how different pieces move or add their own rules. Computers don’t really understand child-centered play therapy.
- Kids have to ask every time they want to “take back” a move – you can’t set it to just let them do this if they want to. (Of course, this can be a great way to work on impulse control!)
- You can choose your next move before your opponent takes their turn, which has proven tricky with highly impulsive children who are trying to stay in the moment with me.
There you have it – chess can be part of your online therapy session. Honestly in a lot of ways, I’ve found I actually prefer lichess to using the actual chess board in my office.
Tell me what other games you’d like to see converted for telemental health!