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Why Teletherapy?

By | Nesca Notes 2023

By: Carly Edelstein, MSW, LCSW
Licensed Clinical Social Worker and Executive Function Coach

During the pandemic, providers all over the world implemented virtual services. While some therapy clients preferred and/or needed to shift back to in-person once deemed safe, others grew fond of meeting with their therapist virtually. Given the effectiveness, convenience, and flexibility, teletherapy is here to stay. Unlike medical doctors, most therapists don’t need to check your temperature or blood pressure when they see you. Rather, therapists aim to create a physical space where their clients feel safe and comfortable. That said, what if you feel the most comfortable being vulnerable in your home? While not everyone sees the appeal in teletherapy, having the option increases accessibility, and studies show clients attend teletherapy more consistently than in-person, yielding more desired outcomes.

Feeling emotionally and physically comfortable at home during teletherapy is just as important as its convenience. Perhaps you’re a college student or working parent with limited free time in your busy schedule. Teletherapy offers flexibility by removing transportation and wait times. With rates of anxiety, depression, and other mental health conditions rapidly rising, teletherapy is an option to consider if you’re seeking support.

Tips for preparing for your first teletherapy session:

  1. Consider privacy; place yourself in a room or space where you can discuss confidential information without others overhearing your conversation. Sound machines that make white noise can help to prevent sound waves from escaping the room.
  2. Limit any distractions; sign into the teletherapy platform in a brand new window versus a tab, so you’re not tempted to browse the web or check emails during your session. You want to set yourself up for success when it comes to being focused and staying present.
  3. Notice what’s in your background; in order to feel as comfortable as possible, make note of what your therapist may see behind you while on video.
  4. Sit back, relax, and trust the process!

Sources:

https://www.forbes.com/health/mind/teletherapy-for-mental-health-treatment/

How well is telepsychology working? (apa.org)

 

About the Author

Carly Edelstein is a Licensed Clinical Social Worker practicing in Massachusetts and Rhode Island. Having worked both in private practice and schools, she has extensive experience supporting students, families and educational teams to make positive changes. Ms. Edelstein provides executive function coaching and psychotherapy to clients ranging from middle school through adulthood. She also offers consultation to schools and families in order to support her clients across home and community environments.

To schedule an appointment with one of NESCA’s counselors, coaches, or other experts, please complete our online intake form

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and the greater Burlington, Vermont region, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

A Social Life – What is it Exactly?

By | NESCA Notes 2021

By Dot Lucci, M.Ed., CAGS
Director of Consultation and Psychoeducational Services, NESCA

Many parents want their children to have friends and a social life, yet are concerned about the quality of their child’s social life. They often describe their child’s afterschool hours as being occupied with screen time, which may actually include others. Other children may be engaged in structured activities, such as scouts, sports, school-based clubs (i.e., robotics), music lessons, gaming clubs, and more. Then there are the children that tire easily when around many people and prefer alone time or being around one or two friends. When children are asked if they have friends, they often say yes and that they are online friends. These children who are engaged in structured social activities, online gaming, and other online activities say they have satisfying social lives. So, who’s to judge? A person’s definition of a satisfying social life is for each of us to decide (so long as they are doing so safely and responsibly).

When it comes to defining friends and a social life, there is often a disconnect between a child or teen’s definition and that of their parents. Today, there are so many more ways to have friends, a social life and socialize than there were “when we were kids.” Having a social life is now defined more broadly, such as online friends, gaming friends, the number of followers on Instagram/Twitter, and so much more.

A “virtual friend” or “online friend” is someone who one connects with online. These virtual friends are often very connected to others and can even become BFVs (best friends virtually). In the “old days” before the internet, these friends would have been called “pen pals,” whereby letters were written and exchanged. These pen pals of old sometimes heard all the trials and tribulations of one’s life. Virtual friends (VF) may stay as that – you may or may not ever meet them, which doesn’t diminish the relationship or make it less important and meaningful. IRLs (in real life friends) are people who one connects with in-person or in real-time. Many times, children and teens have better and stronger VFs than IRL friends. And sometimes they do meet up at different events, such as: E3 Expo, PAX, gaming clubs, Comic-Con and many more.

Socializing is different for each of us. How do we respect our children’s personalities and choices regarding socializing while encouraging them to explore more and different friendships and experiences? There are “introverts” and “extroverts” amongst us. Many extroverts love socializing both in real life and virtually and have many friends. They get energized by being around others. They’ll text a friend(s) and invite them over with no plan on what to do other than hang out. They care little about planning, predictability, and are okay going with the flow, handling ambiguity and uncertainty. Introverts are more comfortable with alone time, structure, predictability, clear boundaries, and rules/guidelines when engaging with others. Often times these kids are more comfortable with VFs and the online world with its structured platforms, anonymity, and being able to participate/not participate on their terms. Many of these kids are often the leaders and moderators on virtual platforms – something you may not suspect given their presentation in real-time/real life.

In this new world of online social connection, it is best to not try to force your child into being an “in real life socializer,” and involved in many social activities but instead make sure they have the social skills and knowledge to be successful in the real world of school, work, and community. Be aware of what and whom your children are connecting with online and accept who they are as a person. Trying to force them to be someone they are not may lead to more mental health challenges than them only having VFs or only engaging with IRL friends occasionally or on their terms. A satisfying social life is a personal choice and one that can’t be forced. There are many adults who are happy with one or two IRL friends and have structured activities they participate in (i.e., book club, trivia night, etc.); yet have many more VFs in their online platforms.

There has been much written about introverts in an extroverted world and how trying to force them to be someone they are not can backfire. Being happy with one’s social experiences and friends – whether virtual or in real life – is what it’s all about.

References

https://www.parents.com/kids/development/shy/raising-an-introvert-in-an-extrovert-world/

https://www.pewresearch.org/internet/2015/08/06/chapter-4-social-media-and-friendships/

https://www.pewresearch.org/internet/2018/11/28/teens-friendships-and-online-groups/

 

 

About the Author

NESCA’s Director of Consultation and Psychoeducational Services Dot Lucci has been active in the fields of education, psychology, research and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.

Ms. Lucci directs NESCA’s consultation services to public and private schools, colleges and universities, businesses and community agencies. She also provides psychoeducational counseling directly to students and parents. Ms. Lucci’s clinical interests include mind-body practices, positive psychology, and the use of technology and biofeedback devices in the instruction of social and emotional learning, especially as they apply to neurodiverse individuals.

 

To book a consultation with Ms. Lucci or one of our many expert neuropsychologists, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician/consultant in the referral line.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

Getting Through Thanksgiving Day

By | NESCA Notes 2020

By: Madelyn (Maddie) Girardi, OTD, OTR/L

Occupational Therapist, NESCA

Setting Expectations

Thanksgiving may be different this year, but it can still be a long day full of sensory stimulation, new social interactions and possibly unfamiliar faces and experiences. By providing clear expectations, this can help prepare the child for upcoming events, minimize surprises and set the child up for success. Talk openly about events, review pictures of anticipated people/events, and/or watch a video describing an experience beforehand. Use a calendar or visual schedule at home to display the sequence of upcoming holiday events. A social story is a great tool to prep the child for the day (Lewis, 2016).

Open CommunicationBeing transparent with family members/friends can allow for greater understanding and a more positive experience for those involved. Help those present understand if there are certain obstacles/triggers that can be avoided, or if there are particular tools/language that can be incorporated throughout the day (Lewis, 2016).

Devotion of TimeFor parents, we know that much of Thanksgiving is devoted to cooking and meal preparation. Make sure to communicate with family members beforehand about the plan for the day. Will there be other children or adults around to play with the child, or should my child be expected to play independently if I am occupied? If so, have a few preferred toys/activities accessible. Or involve the child in the meal preparation process as appropriate.

Consider the Environment

How will your family be celebrating Thanksgiving or other holidays this year – in-person or virtually?

In-personFestivities this year may take place with modifications. Will it be less crowded this year? Will events be taking place in a different set-up this year (outside, in the garage, socially distanced)? If so, prepare your child by communicating expected changes beforehand.

  • Is my child expected to wear a mask or keep a distance from others? If so, use a social story or designate a “code word” to act as a reminder for proper mask/social distancing etiquette. Allow the child to practice wearing a mask beforehand. Model expected behavior (Lewis, 2016). Provide mask breaks as appropriate.

VirtuallyWith current social distancing guidelines, Thanksgiving interactions may instead take place virtually. If possible, it can be helpful to make children aware of this change beforehand. Many children may experience difficulty attending to a Zoom call. Here are some tips to help:

  • Provide a tool to help with heightened arousal: fidget toy, squeeze ball, putty, fidget band (at feet), chewing gum/oral tool, etc.
  • Consider the environment: Eliminate distractions as much as possible (visual plus auditory), ensure adequate lighting and proper seating, etc.
  • Rehearse events beforehand, identifying potential “rough spots” and positive coping strategies (Lewis, 2016). Proactively establish talking points if helpful.
  • Establish guidelines for both the beginning and end of a videocall. Use a timer if necessary.

Sensory EnvironmentThanksgiving Day will likely be full of stimulation for the senses: sight, smell, touch, sound and taste.

  • Food sensitivity: Many children may experience sensitivities to food textures, tastes or smells. Ensure access to “safe,” or preferred foods beyond traditional Thanksgiving dishes. If attending a celebration outside of the home, make sure to pack a few options for meals/snacks. For children who experience sensitivity to smell, consider bringing a comfortable nose plug.
  • Sensory overload: Ensure access to calming tools in the case that overstimulation, or sensory overload, occurs. Some options include a weighted or compression vest/blanket, chewy, squeeze ball, pushing/pulling activities, noise canceling headphones or a mini trampoline for a movement break. Create a calming jar with the child beforehand. Ensure that the child has a safe space they can go to, such as a dark, quiet room, when feeling overwhelmed. For children who may experience challenges self-regulating, help to guide the child in identifying states of arousal before a meltdown occurs. Use visuals as needed.

 

References

Lewis, K. S. (2016). Full Inclusion Holidays: An SLP offers tips to prepare clients for a season full of social and sensory stimuli—and people who may not understand their communication and behavioral challenges. The ASHA Leader21(12), 52-56.

 

About the Author

Madelyn (Maddie) Girardi is a Licensed Occupational Therapist in Massachusetts with experience in both school-based and outpatient pediatric settings. Maddie received her undergraduate degree in Exercise Science/Kinesiology at The College of Charleston in South Carolina and  earned her Doctorate degree in Occupational Therapy from The MGH Institute of Health Professions in Boston.

Maddie is a passionate therapist with professional interest in working with young children with neurodevelopmental disorders, fine and gross motor delays and Autism Spectrum Disorder (ASD).

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

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