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Guest: Tim Schuettge, LICSW, MPH
Link to Show: Episode 6
Saul: Welcome to episode six of Life in the Time of Corona, a podcast exploring the many ways to stay healthy and sane in these strange times. I am Dr. Saul Rosenthal, a developmental and clinical health psychologist. According to Education Week, at the end of April schools are closed for 55.1 million students in the United States. That is 97% of children who attend school. For most youth in this country schools educate and provide guidance during the longest period of rapid development in our lifetimes. What does it mean when that structure suddenly disappears? How do parents and families make up for the loss when their day-to-day lives are also upended.
Today, we are joined by Tim Schuettge, who has master’s degrees in social work and public health. He is a licensed clinical social worker with expertise in child, adolescent and adult psychotherapy, and cognitive behavioral therapy. Tim was one of the first social workers to be embedded in a pediatric primary care practice which is where I first met him. He consults with Boston Children’s Hospital psychiatry outpatient service and maintains a private practice in Canton and Newton, Massachusetts. Tim, thanks so much for joining us today.
Tim: Thank you.
Saul: So one thing I am asking everybody who comes onto the show here is – What are some of the biggest changes that you are going through both in your work and in your private life?
Tim: Well one of the most difficult parts of this is I do not know what I am going to see my adult children again. I mean, we do Zoom calls but to see them face-to-face, and I have a toddler grandson and I really miss him. Although I am learning to play with him through FaceTime which is interesting, he’s actually adapting the FaceTime. While we’re not real sure that is a great idea, but… so I am actually interacting but not quite nearly the same. So I think those are the things that are most difficult… and learning new technology. I had not ever done any Zoom sessions in my therapy practice prior to this, so this is all sort of new… the technology has been a learning curve of sorts.
Saul: And what are you hearing from your clients about the biggest challenges that they are facing, dealing with the coronavirus?
Tim: Well, I think part of this is that the kids aren’t able to go out and play with other kids. There is like… the families are pretty… they’re at home, and they have their siblings, and they have an opportunity to have Zoom calls or FaceTime with friends and also in video games and things, but they really do not have those… the play dates. So I think those are the some of the biggest difficulties. I think the other thing… as I was thinking about this… is that I will be we live very fast-paced lives. A lot of… there is a lot of criticism out there about families being overscheduled and this has actually been interestingly an opportunity to slow down, and the families have more time with their kids. Sometimes this can drive the parents a little bit crazier than the kids. The kids have both parents at home.
I mean, it’s like for them that can be a really positive thing. But also, families have more time to be reflective. The parents that I have been meeting with are more reflective. They are also easier to access. A lot of times in my private practice getting parents together for a session is problematic because everybody has got lives and schedules, and this way it is very easy to schedule parents so they are more accessible. And I think other thing is learning to take parents working at home and taking turns with the kids and then the older siblings watching the younger siblings. And the last thing I think is the opportunity to be creative in terms of activities or games, things with the family.
Saul: So lots of challenges but also opportunities.
Saul: Now some kids are homeschooled typically, but mostly kids are going to school outside of the home.
Saul: Could you talk just a little bit about what the importance of school for kids at that age might be?
Tim: Yeah, I think that one of the things is that this is occurring in the spring, so there has been a big chunk of the school year that has already occurred which I think has been very helpful and I think kids do learn differently through technology rather than in the classroom. They do not have their peers in the classroom. So I think that is another one of the challenges and the other part is that kids… young adults as well… are saying that they are not retaining as much from the lessons and from the homework. Although I honestly think that that whatever’s happening now you can be pick and catch up very easily, because the truth is this is not that long a period of time in the larger educational year.
Saul: So you think the kids will catch up, assuming schools open in the fall of this year.
Saul: You talked about the social issues for these kids and how technology is allowing for some social interactions but that one of the big issues is the lack of play dates… lack of that face-to-face… and also how that peer interaction might help in school. Could you talk a little bit more about the importance of that social interaction for kids of the sort of 6 to 12 years of age?
Tim: One of the things that children at this age process information through play, so their ability to play with others… it’s just that the opportunities aren’t there.
Saul: So that play particularly for the younger kids is important in any kind of learning, any kind of development… for the older kids may not be as much play as more sort of one-to-one or one-to-many social interactions is sort of that give-and-take that is different, I think, with the technology… with FaceTime or with Zoom… It seems like you lose a lot of the body language. We were talking about this a little bit before we started recording… just how body language is really important in any kind of this interaction. So it seems like you are saying that that is true with kids of this age, even learning it is important to do that.
Saul: What are some of the unique issues for the school-age children given the restrictions that we are all experiencing?
Tim: Well, one is that the parents are taking a larger role in their children’s education. It is not exactly homeschooling but they are definitely taking a much larger role. The other part is that experts say that you have about a 20 minute attention span, tops. So for younger kids, that is even shorter, and I think part of this is having shorter periods of learning and then making sure that there are breaks that are sort of built into this. One of the things that has happened in my private practice is I have much more difficult time with younger children… school-age children… especially the younger grades on zoom. They just… we can draw a little but you really cannot do play therapy. The other part is that their attention span is a lot shorter. Often what happens is that I will spend about 10 minutes tops with the child, and then they’re off somewhere, and I end up with parents in consultation. So we do a lot of parenting work which is very helpful but the kids are sort of all over the place, and the parents… every session the parents are saying well, hopefully we’ll be able to do this in the office sometime.
Saul: It’s funny. I’ve noticed the same issue with my kids that I work with and I have heard that from other child therapists, that when we’re doing these sessions online through Zoom, particularly for kids although I also find this with adults… it seems like for many people, not everybody but for many people, those sessions feel a lot shorter. They end up being shorter, almost as if the attention span is even shorter with this technology than it is face-to-face.
Tim: Yes. It is, and it’s also in a different context because you’re not in the milieu, and the thing about school-age kids is the predictability… I was going to comment on that, in fact in terms of the family as well… being able to anticipate, this is where I am going to be learning… I’m in the classroom, there’s the teacher, and how all of that really has meaning for children and their ability to be able to learn to just acquire knowledge and if that is not there, and they’re adapting to a new environment with the limitations that are built in.
Saul: So predictability is really important for these kids. And there is obviously a lot less of it.
Saul: Do you have any advice for parents to maybe help increase the predictability for the kids?
Tim: Yeah, I was thinking about that, as I think that one of the things for parents is it is important to continue the daily routines that are familiar to the children, being consistent, especially in routines and in discipline, and just continuing the consistency and the routine that the kids know, and giving them the ability to be able to anticipate and to plan ahead. I think having some kind of weekly schedule using a whiteboard or something like that where the family can put what is happening during the week, what are the school times, what are the activities, what are the chores. What kind of household responsibilities does everybody have so that kids can anticipate what is going to be happening next… because there is so much beyond the house that is really unpredictable. I also think the other pieces and it’s probably pretty obvious… is to really keep the news down or completely off. If there is a way not to have access to the news that can be very helpful I think to all of us, but especially to kids, and also using… thinking creatively about board games, singing, dancing, family activities… there is a lot of creative possibilities here for the families.
I think the other thing is for parents to understand that the children really do process information through their play so their play may be different and their emotions may change. What they will be doing is acting out their emotions and feelings through their play… so their play may very well be different from the way it was before.
Saul: So they’re using play as a way to process those emotions to understand what is going on.
Tim: Uh-huh, their emotions may be different and they may have some meltdowns because of this and so for parents to understand that there are going to be some changes because of this.
Saul: So some of your advice for parents seems to be to try to maintain that consistency, or even build up more predictability and consistency, to watch for the different ways that children may be expressing their emotions, also to use this time as an opportunity for creativity and for reflection. Are there other ways that parents can be helping out there school-age children right now, particularly given that the parents themselves are now juggling multiple roles and all these changes.
Tim: Right. Well, I think being honest, being aware of where the kids…of how the kids are feeling and what they are thinking and also being as honest as possible about what is going to happen now. If a parent doesn’t know and they probably don’t know what the next step is or when this is going to end or is being open and transparent with children around that… and also being reassuring at the same time, basically. The parents’ job is to keep their children safe and letting their children know what they are doing to provide for that safety, which is all of the things that we’re doing with pandemic quite frankly, but also just reassuring children in that context, which will also help, I think, reduce anxiety.
Saul: So trying to maintain some sense of normalcy even if we don’t know what is going on. Or at least, if not normalcy, at least the sense that things will be better, things are okay, everyone is safe and they will be getting better. We mentioned a couple times the role that technology is now playing in education and in socializing. Do you have anything to say about screen time? It is sort of an interesting topic. I work with a lot of people who overuse technology, but at this point everyone is using technology more for school, it’s for work, it’s for socializing. Do you have any thoughts about screen time for kids of this age… sort of that 6 to 12-year-old?
Tim: I think that we can kind of throw out some of the… American Academy of Pediatrics set out certain guidelines but all of that is pre-pandemic. So the amount of time that children spend on the screen time is definitely going to go up and I think part of that depends on what it is that they are doing on the screen, although one of the things that I… in the kids that I have been working with, one of the contacts that they have is through games and their friends are all on the games and so they are able to interact and so it is hard to say, “Well you can’t play Fortnite… well, it’s a little hard… I mean now… this is… or what is it mine…
Tim: Minecraft, thank you, which under ordinary circumstances drive parents crazy, but this is how they’re connecting with their friends. This is a blip… it doesn’t feel like it, but this really is a blip in all of our lives and so if there is more screen time right now, we’ll work it out later, is my thinking.
Saul: When we’re in the middle of it, we don’t realize it, but it is useful to realize that this is just a moment in time.
Tim: One of the things that I was thinking about when I was anticipating coming in and talking today is the Chinese have two characters for the word crisis. One is “danger” and the other is “opportunity”. I think it is important to think about that in the context of where we are right now, is that there is the danger aspect of the pandemic and also the opportunity we have to get to know each other. to slow down our activities, to find new ways of interacting and reflecting within families and that has always helped me at times to look at the whole context of this as the Chinese are looking at it.
Saul: I think that’s a really great way to think about it, to think about crisis both as a moment of danger which it is, a moment of risk, and a moment of potential growth, opportunity for change. As we finish up with the conversation there are a few “one thing” questions that I like to ask if that’s okay. So what is one thing that people should take away from our discussion?
Tim: I think the opportunity to spend time with their children and to be creative with them, having this opportunity to really slow down and spend time together in different and positive ways.
Saul: And what is one thing that you’re doing to take care of yourself?
Tim: Well, let me give two things. One is… and I think this is true for families too, is that I’m trying to get outside every day, I’m trying to exercise, I run. On days that are halfway decent I try to bike and the other part is some form of yoga every day, even if it is only 15 minutes but just trying to get in one of those, you know, of the millions of yoga classes that are all over the place but just trying to do some yoga every day and I found that to be really helpful.
Saul: And finally, what is one thing that you think this experience, this coronavirus experience, has changed about us forever?
Tim: Wow. I wonder if the fast-paced life may not be quite as fast. We may find ways of reevaluating how we’re building our activities and our schedules in the larger picture after this, maybe it’s changed our thinking. But we in New England are known for our fast-paced lives. You start in the morning and you just go, go, go until it’s time for bed and everybody’s passing each other… maybe this is going to be helpful in evaluating that as we move forward and just being a little bit more reflective.
Saul: Well, that would be both interesting and actually quite nice if we are able to do that. So lots of good thoughts and advice for parents of school-age children and I would say actually any of us, things like maintaining predictability, maybe using schedules, certainly checking in with your kids, paying attention to how the child is playing, what the child is saying, even their dreams, what are they communicating to you about how they’re feeling? But in particular, this time of crisis really is also a time of opportunity to connect with each other differently, to engage in creative activities and maybe to do more together as a family.
Now I want to thank you all for joining me during Life the Time of Corona. You can subscribe to the show at iTunes or wherever you get podcasts. Please rate the show and definitely leave comments. Find out more at my website, saulrosenthalphd.com, and follow me on Twitter and Instagram at drSaulRosenthal. Tim Schuettge is a licensed clinical social worker who works with children, adolescents and adults in a private practice outside of Boston. He was one of the first behavioral health clinicians fully embedded in a pediatric primary care service and he continues consult with Boston Children’s Hospital. Tim, thanks so much for joining us.
Tim: And thank you for having me on.
Saul: Absolutely and thank you, listeners. I look forward to continuing the conversation on Life in the Time of Corona.
Saul Rosenthal, PhD May 19th, 2020