Join Us for Our Special Event – Thursday 13 June, 7-9pm UK
As practitioners in counselling and therapy, we are all well aware of the challenges facing us:
● The difficulty in securing referrals for private practice ● Working below our financial means with platforms that do not align with our practice ● Incorporating new tools and technologies for online practice ● Feeling disempowered in a technological age with a broken business model
These are the hurdles we face, but how do we overcome them?
At ACTO, we believe that the key lies in empowering our members with knowledge, tools, connections, and confidence. We’re dedicated to partnering with organisations that share our values and can provide support to both us and our clients.
If you’re looking for innovative ways to transform your practice, come along to our next exciting event!
Join us as we work towards empowering you to build your own practise “toolbox”, leveraging the latest in technology.
We have invited our industry partner, PlaySpace, to present how they’ve been working with practitioners in Canada and USA to unlock potential with their sessions using technology. We will cover the following topics as well as a Q&A discussion afterwards:
● The main challenges facing practitioners with private practice ● The current online therapy landscape and the pivotal role that practitioners play in shaping its near future ● How PlaySpace is taking a new approach to developing technological solutions by putting practitioners in the driver’s seat ● How ACTO members can access these technological solutions such as VR, virtual playroom tools such as Dollhouse and Sandtray, and more
Our goal is to create an open forum where members can come together, discuss these challenges, learn and get more involved.
But we need your input, your views and your involvement: whether you are a practitioner working with CYP or adults. All are welcome! It’s free to attend, however you do need to reserve your spot:
By the end of this event, we’re confident you’ll join us in our excitement for the future, brimming with new tools at your disposal, opportunities for involvement, and exclusive access to solutions you can put into practice.
Together, we can turn challenges into opportunities and pave the way for a brighter future in counselling and therapy.
New ACTO Chair and accredited integrative CYP therapist Basi Amodu shares the motivations behind her career choices and priorities for the organisation
Basi Amodu did not initially set out to be a therapist.
During the early stages of her career, Basi had a number of differing jobs before becoming a mother, ranging from location and reportage work in Cuba and South Africa to working in the property management industry. Then when she became a mother and decided to work within her local community in a local library, she successfully applied for a role at a school as a Home School Coordinator – a bridge between, home, school and Children’s Services. This proved to be a seminal moment. Assigned to working with families impacted by alcohol, substance misuse, mental health and domestic abuse, Basi could see how positive changes in the family environment were less significant for the smallest children in those families. Basi’s sole mission became how to make systemic changes using the statutory bodies that would benefit the children, young people, and their families to help them have the best possible start in life. In conjunction with this, Basi also became the Project Coordinator for the Young Carer’s Service in area of West London. This fostered Basi’ ambition to work garner more support from the statutory bodies that had the resources to effect real change in the lives of young people and their families.
Building the foundations for a career in counselling and therapy
Much of Basi’s work involved working with families impacted by mental health, substance/alcohol, and domestic abuse – often referred to as the ‘toxic trio.’ Although Basi enjoyed the work, she realised that to help get the families more financial and practical support, she needed a new form of language and additional skills to advocate on behalf of her clients.
A chance conversation with a colleague pointed Basi in the direction of a new foundation course in counselling children which encouraged her to apply. In due course, Basi not only completed the foundation course but went on to study for a postgraduate diploma in counselling and immediately after the master’s degree in counselling at the University of East London.
Basi explained:
“Domestic violence funding was being stopped and I realised that I wanted to focus more on children and young people. By developing my therapy work, therapeutic skills and drawing on my experience and background, I could assist more disenfranchised children and families, ensuring that they received the crucial early intervention they required.”
“Children are not as afraid of change as adults are.”
Developing strategies for coping with change in our lives can be a challenge for all age groups. One of the reasons why Basi finds it rewarding to work with younger age groups is her belief that children and young people are more willing to take positive risks – and are arguably not as afraid of change as adults are.
Basi said:
“Children and young people know that when we meet for a therapeutic counselling session, they are coming into a space to talk about difficult things. I use my creative and listening skills, to provide a safe space that allows young people to challenge their lived experiences, offers them the opportunity to explore and express themselves without judging them. These methods help children to find the answers to the questions they are struggling with themselves.
“I find it incredibly rewarding to accompany young people on their journey – even if I may not see the eventual positive changes in their lives in the future.”
It is not only working with children and young people that Basi finds fulfilling professionally. Helping parents to deal with challenges in their lives is equally satisfying, for example working with parents to understand their parental struggles often stem from a space of fear (not wanting to repeat mistakes) and love for their child. Supporting parents to explore their role not just as parents but also as people in their own right. One way of doing this is to offer space for parents to understand their own school and childhood experiences. For Basi, it is important that this process is a collaborative one without personal judgement.
The transition to working online.
The advent of the COVID-19 pandemic resulted in therapists and counsellors moving their practices online as lockdown restrictions were enforced during 2020/1. For some therapists this represented a major challenge, getting to grips with technology and seeking to offer clients a comparable experience to that of a face-to-face session. Yet not for Basi.
Basi had already gained online experience using Skype to work with younger clients who had were now at university and wished to continue their sessions virtually without having to find another therapist.
This experience encouraged Basi to further research the benefits of working online, for example in countries like South Africa, Ethiopia and Canada had been using ‘Telehealth’ before the pandemic as a lifeline for many in remote communities. Many of Basi’s clients viewed online working as a backup; not perfect or a long-term solution, but one which could work for some of her clients.
In March 2020 the pandemic hit whilst Basi was working privately and within a digital school. Due to having family in Europe Basi was able to prepare her private clients for the transition to online working, sharing creative resources, coaching families with using Zoom and other platforms, and re contracting the work. The clients were practising using the video and live chat platforms in the months leading up to the first UK restrictions. The transition to working online was rapid but Basi was prepared as were her clients. Once the UK government shut the country down the new service launched within 24 hours.
Basi said:
“This period was incredibly intense. I was working with a full cohort of students, and we knew that restrictions to face-to-face contacts were imminent.
“We were thoroughly prepared though, providing briefings for parents, and explaining how it would work. The result was that it was a seamless experience for our young clients. That’s not to say that it did not have its own challenges; and like many thousands of therapists and counsellors, we were training as we were delivering!”
Working online has therefore been an extremely positive experience for Basi, so much so that although she continues to work in person in school, her private practice and clinical supervision work is online only.
Addressing the concerns of practitioners on working online
Basi understands the unease that some practitioners feel about working online. She explained:
“I appreciate that some therapists and counsellors are uncomfortable about working online. They have concerns about their abilities to pick up non-verbal clues from their clients, they feel that it is difficult to maintain the same connections – and perhaps believe that online is not appropriate for dealing with specific issues. I am aware too that some professional bodies have a view that it is not possible to work with certain cohorts, for example clients under 11 years of age. Furthermore, some individuals are not confident about working with the technology and feel limited by it.
“These are all legitimate concerns – which as an organisation supporting online practitioners we need to be fully understanding of. Nonetheless, there are many reasons to be excited about the benefits of working online.”
In Basi’s opinion demonstrating how practitioners can work with different traumas and issues is key to convincing those who are either sceptical or have yet to try working online:
“Working online is not an emergency system; it is another way of working which can offer many different ways, and tools, for you to work with clients.
“There are several therapists who are using technology in innovative and exciting ways to work with children and young people, such as Lesley Simpson-Gray,Jessica Stone and Ellie Finch.
“By working online, we do not only expand our reach, but we also expand our skills and our competencies – ultimately offering more choice to our clients.”
These experiences convince Basi that online working has increased her creativity, boosted her confidence, expanded her contacts – and helped her to work with clients who find the in-person sessions daunting due to concerns about body image or for reasons of disability or accessibility. Where appropriate, Basi can work without a camera and use Live Chat to communicate.
Working online internationally does though have other important considerations.
Basi is an Associate Member of the Barbados Society of Psychology and understands how legal systems can differ in countries across the world. This makes it crucial to be mindful of client safety, as the laws and regulations governing a territory could be very different to the UK. In addition, it is essential to undertake the necessary training and groundwork to ensure that as a therapist or counsellor, we have the appropriate set of competencies to help a client overseas.
The future of ACTO
This year saw Basi elected as the new Chair of ACTO in succession to Adrian Rhodes.
Basi explained that it although she did not put herself forward to do it, it is a role that she is now relishing – and is keen to make sure that ACTO focuses on delivering more benefits to its members. She explained:
“When I agreed to be Chair, I was clear that I was not just a director but a member, too. This means that it is important that we increase the services and benefits we provide to our members, whether they are students, professionally qualified or in supervisory roles.
“That is why I have a number of priorities for the coming year and beyond.
“Firstly, we need to incorporate our training providers more closely within ACTO, helping members and potential members to access the professional training they need.
“Secondly, we want to grow our membership – and this requires us to be seen as the leading body in the UK for online digital working; driving up standards and showcasing innovation which benefits our clients. This also necessitates that we understand that as newer members qualify, they may have different needs from those who have worked online for many years. We must change and adapt.
“And finally, we must be ambitious. I feel that one of ACTO’s long-term aims should be to be regulated by the Professional Standards Authority. This would give both members and clients greater protection and more confidence about our status. It is likely to involve significant work – but for me, it represents a real opportunity to grow and professionalise the organisation.”
Basi Amodu was talking to Simon Frost
————————————————-
About Basi Amodu
Basi is a MBACP (Accred) of the BACP and an Associate Member of the BSP (Barbados Society of Psychology) and Chair of ACTO. She is an integrative creative therapist in schools and private practice working with children, young people (CYP) and adults. Basi also works as a clinical supervisor working with therapists and other experts in the helping professions. For further information about Basi please click here.
ACTO conference 2023
ACTO is hosting its next annual conference on 4 November 2023. More information will be available on the news and events pages soon.
Therapeutic groups in schools can be a fantastic way for children to develop empathy, find peer support, and process feelings and experiences. The recent pandemic has not only disrupted children’s usual support network and school experience, but also created the need for developing new ways of enabling social connection and group experiences. When physical distancing is imperative the online therapeutic school group can become a means of providing much needed social support, space for processing of feelings and experiences, and an outlet for children and young people to express themselves facilitated by the supportive presence of attuned adults.
Hybrid models of working, specifically where the therapist is online, and participants are together in person can enable groups placed in ‘bubbles’ access to expanded resources and experiences using digital technology. This blog post will give a taste of how a group intervention with an online therapist can provide a therapeutic opportunity and support children and young people with their wellbeing. This blog post is adapted from a longer and more detailed article A moveable Feast: Logistic and therapeutic considerations for the online school therapy group.
Aims of the intervention
To provide a 6 session block of weekly therapeutic group sessions for primary age children with the aim of supporting emotional regulation, peer support and processing of emotions and experiences. A hybrid model where the therapist is attending online with a group of children together, can allow for children and young people to access an interactive and attuned therapist through digital means. Additionally, in line with their digital rights, and involvement and empowerment with their developing digital skills, a wellbeing intervention experienced digitally has the potential to enhance children and young peoples’ understanding of how online interventions can support them.
The premise
The online therapist develops a therapeutic group with up to ten children and an ‘in person’ learning assistant with the aim of supporting group members with emotional regulation, peer support and a safe space to share experiences and feelings.
In this situation the therapist collaborates with the school to facilitate the group remotely during the school day. Key considerations for this include the quality of internet connection and appropriate technology, the expertise of the therapist in online working, suitable referrals and aims, the use of a consistent private space, and the suitability of the supporting adult who will be present with the children.
Communication
Before starting, communication between the school and the therapist is very important to make sure a thorough assessment is conducted. An agreement must be in place to meet the requirements necessary for the work to be a success, and any adaptations needed voiced and established before starting. A working alliance and understanding of the aims of the group must be developed between the therapist and the learning assistant before starting, to agree approaches in response to specific situations, such as if a child becomes dysregulated. Safeguarding procedures must be established and suitability of referrals assessed in line with group aims.
Connection
Connection of both technology, and of the felt experience of the group ‘connection’, is of great importance if the group is to be effective in achieving its aims. For this reason, tests of the equipment and internet must be carried about before starting. In order to foster connection in the group, the therapist, attending remotely and as such relying more heavily on tone of voice, screen presence and facial expression must make additional adaptations to their delivery style and structure of their intervention.
Outcomes
If assessed properly and set up with core conditions met, this type of group can very successfully support young people with their mental health and wellbeing. This is partly because consultation shows children and young people don’t tend to separate the online world, and in person world as ‘real’ and ‘not-real’. In this way, the online therapist is not interpreted as less impactful as an in person one. Key factors in the therapist being impactful while attending remotely is in their modification of their practice to compensate for factors which come to play online. These factors include understanding and mitigating for dissociation or the disinhibition effect, knowing how to amplify screen presence, and being able to design the intervention appropriately. The therapist who successfully undertakes this work will dedicate time to communicating and collaborating with the school to set the work up properly, and will also dedicate time to preparing the learning assistant who will be in the room recognising their importance in supporting the children in the space.
Conclusion
I hope I have given you a flavour of how a remote therapeutic group can be fantastic opportunity for additional support to children and young people. Those who are already working online, or with a hybrid approach blending in person and online therapy may be interested in learning more about this iteration of the hybrid model. Those who are currently not working digitally, or with groups, however are curious to find out more about possibilities may also have found some content of interest in this post or inspiration for further research and training.
Biography
Elle Gilbertson is an art therapist working with adults, young people and children in private practice and in the third sector. In her private practice she is also a clinical supervisor working with other therapists. She holds an MSc in Art Psychotherapy, and a diploma in online therapy. She has a special interest in mind/body interventions, and when appropriate integrates her training in embodied practices into her art therapy practice to support clients regulate, process feelings and foster healing. She is excited about the combined potential for art therapy and online therapy to facilitate therapeutic change.
You can find out more at www.ellegilbertson.com, or contact her directly at ellegilbertson@proton.me
Qualified Counsellor Ellie Finch explores the benefits & key considerations when using video games for working with younger clients.
Perhaps, like me, you’ve experienced the children and young people you work with talk with enthusiasm about games like Minecraft or Fortnite – and could see how much using a video game therapeutically could engage them in counselling?
I’ve been using video games in my private practice with children and young people for the past 2 years and have found it to be a great way to engage children and young people. Sometimes I simply talk about a child’s favourite video game with them; I might ask them what character they like to play, and this can lead to an exploration of their identity. Sometimes I watch a child play and might reflect back to them what I observe. For example, a child with low self-esteem might do something kind for another character in a game and I reflect back to them what I’ve seen of them in the game. Often, I will play the game with the child and together we might play hide and seek, battle monsters, build a castle among many other things.
Games I’ve played with clients include Roblox, Fortnite, Among Us and Animal Crossing. But the game I’ve found most safe, accessible and useful therapeutically is Minecraft.
Before starting to use video games in your practice, there’s a number of important points to consider. I shall map these considerations to the ACTO CYP competences:
ACTO CYP Competency: Psychological Processes relevant to Online Therapy
Ever since I started using Minecraft in my practice I’ve been bombarded with enquiries from parents who can instantly see how it would engage their child in counselling. Often the parents have children who would otherwise not have engaged in counselling if it hadn’t been for Minecraft. However, it’s important to recognise that using a particular video game in sessions might not be suitable for all children. For example, if the child has been struggling with coming off a game to take part in other activities at home, they may struggle with the end of counselling sessions. This can actually be a great opportunity to explore the reasons why they find it hard to come off the game but you may also need to work on setting boundaries around use of games in sessions. In addition, if a client is struggling with not feeling contained in their life, then you will want to consider the landscape of the game you play. For example, Minecraft worlds are enormous and in order to create a more contained space, almost like a sandtray, I provide a physical boundary such as an island or a wall around the space we work in.
I always ask my clients to create a safe place in the game in their first session. This is a place they can come back to at any time if they need to. A safe place can be anything, a cave, a house, a castle…
It also helps to understand the culture of video games and the video game you chose to play itself. For example, terms like ‘griefing’ are useful to know; griefing is a type of online bullying. In Minecraft griefers are players that destroy other players creations. When using Minecraft therapeutically however you can create a private world just for your clients so this can’t happen. In addition, the social side to gaming can be really important to players and the relationships they have through the game are just as significant as their in-person relationships.
ACTO CYP Competency: Assessment of clients for online therapy
Factors to consider when working online using a video game are:
Does the place where the child will be having their counselling have good enough internet connection to run the game as well as a video platform such as Zoom?
Is the child already playing the game online with other people? If not, you need to work with the parent/carer and child to educate them on online gaming safety, playing on servers with strangers etc. Minecraft Education has an in-built game called ‘Cybersafe: Home Sweet Hmm’ that takes the player through some internet safety challenges and helps the player to come up with strategies to keep safe online: https://education.minecraft.net/en-us/lessons/cybersafe-home-sweet-hmm (This game is available on Minecraft Education and Bedrock editions)
ACTO CYP Competency: Contracting and Boundaries
Having an agreement with the client around the use of a video game (or any digital therapy tool or resource) is essential.
My contract, for example, contains the following:
Information about the potential benefits of using Minecraft therapeutically as well as the potential challenges.
What they can expect a session using Minecraft to be like.
Boundaries such as the way we will communicate, how I will ‘unfriend’ them after each session and that I won’t be inviting anyone else into their private Minecraft world.
What we will do if we can’t connect in the game or lose connection.
I’m also clear about my level of competency in the game (please don’t feel you need to be an expert player – you need to be familiar with game controls, but most important is that you know how to keep your clients safe in the game).
ACTO CYP Competency: Data Protection
It’s essential to clearly explain any potential data protection risks of each game you play to a client.
I provide a clear, age-appropriate explanation of what ‘data protection’ and ‘GDPR’ mean, along with information about security standards (i.e. does the game have an ISO27001 certificate), where the location data is stored (i.e. outside of the UK, outside of EU, or in the US, for example, where they have different data protection laws).
It’s also important to clearly state how you will take steps to protect your client’s data in relation to the game and the limitations of this.
For example, I save a copy of the world after each session which is saved locally on my computer (and backed up to an external, encrypted hard-drive). My computer is password protected and I have installed anti-virus and firewall. I run updates on my computer regularly to ensure the security measures are up to date.
ACTO CYP Competency: Communication in online therapy
I do not advise using the communication channels within a video game. Instead, I use my usual video platform or the telephone (you may find using the telephone helps with internet connection issues).
I ask my clients not to use the chat function in the game. I also ask my clients to not write anything on signs or boards etc in the game that discloses personal information such as names, locations etc.
You will also need to get used to the idea that if you are embodying a character in a game alongside your client then your movements and body language as that character will be forming part of your communication with your client – much in the same way as our body language in real life forms part of our communication.
ACTO CYP Competency: Creativity in Online Therapy
Video games provide a great online resource for adapting in-person therapeutic resources.
For example, I use Minecraft much like a sandtray by asking clients to create scenes using items and characters in the game which they can select from a vast inventory (a bit like having rows of miniatures on shelves in your therapy room).
I also have a family tree activity where I ask clients to select different coloured and textured blocks to represent themselves and their family and place them in a tree.
Here are some links to resources and publications about my work:
I have made a 10-minute video for parents introducing them to how I use Minecraft therapeutically by taking them on a journey around my Minecraft island that can be viewed on my website here: https://www.elliefinch.co.uk/counselling-using-minecraft
I have a free webinar also available on my website where I introduce how I use Minecraft therapeutically: https://www.elliefinch.co.uk/events
ACTO CYP Competency: Managing Risk and Safeguarding Issues
Top tip: There are three main editions of Minecraft: Java Edition (available on Mac and Windows), Bedrock/Windows Edition (available of PC, iPhone and iPad, Android, and a range of games consoles including Switch, PlayStation and Xbox) and Education Edition (available on Windows, Mac, iPad, and Chromebook)
Just like working online creates more issues around safeguarding and risk; video games can add a few more to consider. You want to be sure that you are familiar with the video game’s security and privacy settings and have them enabled for yourself and have also advised the client and their parent about how to enable these settings. For example, many video games, including Minecraft (excluding Minecraft Education Edition) are part of social media networks like the Xbox Network. This means that unless you have enabled certain privacy settings your clients may be able to see your friends list, see when you are online, what games you are playing and with who etc. I have written two extensive blog posts for parents about keeping their child safe in Minecraft which is also useful for practitioners using Minecraft Bedrock and Java editions: https://www.elliefinch.co.uk/post/essential-steps-for-keeping-your-child-safe-when-they-are-playing-minecraft-bedrock-edition
Last year Minecraft Education Edition became more widely available to purchase and this is exciting news for therapists as, due to it being designed for use in school settings, it is a lot safer to use with clients than Java and Bedrock Editions. I’ve also written a blog post about the pros and cons of using Minecraft Education Edition: https://www.elliefinch.co.uk/post/why-i-m-using-minecraft-education-from-now-on
Playing video games with clients, can provide a great opportunity to talk about online safety and check in with them about their online life. It is essential you do some training in online safety if you haven’t done so already.
ACTO CYP Competency: Endings and Supervision
Endings in video games can be incredibly poignant and meaningful – whether it be taking a screenshot of your characters together one last time or planting a tree together in the client’s world. I ask permission to take screenshots of the client’s work in the game, you can create a document together and use it to review the work at any time, including in the final sessions. It’s also something they can keep.
I’d advise practitioners looking to start using video games therapeutically to seek consultancy and training before starting to work using video games and connect with professional peers already working in this area.
It’s also important that you have a supervisor that either uses video games in their own practice or is open to learning about using video games alongside you.
As you can see, there’s a lot to consider when incorporating video games into your practice. There’s also additional factors to consider that sit outside the ACTO CYP competences such as making sure you are working within the terms and conditions of the video game license terms and conditions.
I’ve been inundated with enquiries from parents telling me their children are actually excited about the idea of counselling using Minecraft. And, seeing the huge amount of interest there is amongst counsellors and other professionals in using video games like Minecraft therapeutically, I have been training other professionals and organisations in how to use video games therapeutically and safely with their clients.
You don’t need to be a gamer to use video games therapeutically, but you do need to have some confidence using technology so that you can troubleshoot any technical issues that arise. My Getting Tech-Savvy in Minecraft webinar can help you get to grips with the technical side of using Minecraft therapeutically: https://www.elliefinch.co.uk/shop
I also provide 1-to-1 and small group consultations, bespoke training to organisations as well as an upcoming training course on using Minecraft therapeutically.
Ellie is also part of the team of ACTO CYP therapists who have just updated the ACTO competences for CYP online therapists which were used throughout this blog post
All images used are taken by the author. Ellie Finch’s services are NOT AN OFFICIAL MINECRAFT PRODUCT. NOT APPROVED BY OR ASSOCIATED WITH MOJANG OR MICROSOFT.
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