The COVID-19 pandemic forced therapists and patients to physically separate and conduct sessions from afar. This created particular challenges for child and adolescent work, which tends to center around movement and embodiment. As therapists navigated the constraints of their new reality, early skepticism quickly gave way to creative, on-the-spot solutions. Born out of necessity, therapist’s flexibility and accommodations brought about changes to the analytic frame that were unprecedented in scope. Common themes include the therapist’s loss of control over the structure of psychotherapy, a renegotiation of therapist and patient roles, placing the parent at the center of treatment, findings new ways to play, and virtual treatment as a new mechanism for modulating closeness and intimacy in the therapeutic dyad. Rooted in clinical vignettes of clinicians from the early weeks of the pandemic, this paper will illustrate these themes and consider their implications for the future of psychotherapy with children and adolescents.