Wednesday, March 25, 2020

Ideas for Kids on Virtual Visits

See also: Therapeutic Activities Master List
Feelings by Pokemon Type

What was thumbs up and thumbs down this week?

Online UNO!
20 Questions
 Draw Me a Tree
Would you rather?
Mindfulness Scavenger Hunt
Simon Says
The Oyster & The Butterfly
Mother May I?Grandmother's Trunk
What's Better?
Hangman or Petals

Simon Says- can integrate showing feelings, giving self hug, deep breaths

 Mother may I... see directions

+ story books I  read and then have kids draw in response.  I like" ish"   and" the dot"

Older kids like hangman- again can choose a word that has relevance to the kids or a theme as opener for discussion

create bingo cards

scavenger hunt

Kelso's Choices

"Name Ten
Name 10 is a classic conversation game in which one person declares a category such as Fruit and the other players must come up with 10 examples of that category. The person who came up with the category gets to determine whether the examples fit.
This is similar to the game Scattergories – where teams or individuals come up with answers that fit the letter rolled on a die and the categories listed on their card. Scattergories was a hit in our household when I was growing up – a great game for any family who loves word play.
Traditionally a clapping rhythm keeps up the pace so players won’t take forever to come up with a response. 

A my name is Alice

In this conversation game each person takes turns adding a name and a thing in alphabetical order. The first person might say: A my name is Alice and I like apples, and the next person could say A my name is Alice and I like Apples, B my name is Bobby and I like bears and so the game goes with each person reciting and adding to the chain.
    • If you have young kids you can drop the recitation of what others have said and just have them do the next letter so it could be the first person says A my name is Ann and I like airplanes and the next person says B my name is Ben and I like balls.
    • If you have older kids try having each person add to each letter as they recite. The first person could say A my name is Abigail and I like aliens, the next person must not only do their own letter but add to the previous letters A my name is Abigail and I like aliens and atoms, B my name is Betty and I like bananas.

Fact or Fiction

In this game each person takes turns telling two things that are true about themselves and one thing that is not, the other players must then guess what is fact and what is fiction. Younger kids may not quite ‘get’ this conversation game, but often their additions to the conversation are hilarious anyhow.
For a science based version of this game, check out Educational Insights Sci or Fi game – your family can try to determine science fact from fiction, while learning interesting facts along the way.

I Spy

This game traditionally starts with the phrase I spy with my little eye something… and then one descriptor is added such as red, smaller than a mouse, made out of wood. The other people take turns trying to guess what the item is. The person who guesses then gets to be the “spy”. Perfect conversation game for a car trip. You can find more road trip games ideas here.

Questions Only

Everything anyone says must be stated in the form of a question. This conversation game is incredibly simple, has no real winner or concrete ending, it will keep you giggling and like it or not it may just crop back up hours after you thought it was finished.
And speaking of questions – the simple conversation game of asking interesting questions to answer never gets old. A couple recommended resources: Table Topics cards have a great selection of question packs from family dinners to questions for teens.
Another popular set of questions comes from The Kids Book of Questions – great way to keep the conversation flowing.

 20 Questions

One player thinks of an object, letting the others know only whether it is animal, vegetable, or mineral. Then the other players ask questions that can be answered only with yes or no.
For instance, if the object is a car (mostly mineral), the players will ask, “Is it bigger than a laptop computer?” or “Can it move?” The object: Guess the answer in fewer than 20 questions.


Each player takes on the persona of a well-known person and offers only that person’s initials as a clue. The questioners try to guess the identity of the person by asking specific questions that can be answered only with yes or no.
The first questions may be general, such as “Are you alive today?” The player, answering in character as George Washington, for instance, may say, “No, I’m not alive today” without offering any other information. The next questions continue to zero in on the identity until a player correctly guesses the mystery person.
Botticelli is a great game for older kids who are familiar with people in the news and historic figures. It can be made more difficult by using just a last or first initial.


Each player comes up with a place name (town, state, country, etc.) that begins with the same letter as the last letter of the place the previous player mentioned.
Example: Player 1 says Spain. Player 2 has to name a place that begins with an N, such as New York, which ends in K. Player 3 then mentions Kansas. Keep going for as long as you can name a new place.


One player names a letter of the alphabet. Each player takes a turn adding a letter that contributes to the spelling of a word each has in mind. A player can be challenged if another player suspects the letter just added isn’t part of a real word.
The catch: Players have to avoid completing a word. Each time a player completes a word, he gets another of the letters in the word ghost. Once a player has all five letters, he’s out of the game. But that person can then help, or haunt, other players.
Example: Player 1 starts with the letter B. Player 2 adds A. Player 3 adds L, having in mind the word balance. Player 4, thinking about the word balloon, adds another L, forgetting that it completes the word ball. The fourth player, having inadvertently spelled a word, would get a G for ghost, but stay in the game.
I Packed My Grandmother’s Trunk
Each player starts off with the same sentence: “I packed my grandmother’s trunk and in it I put ___.” The player completes the sentence with a word that begins with the letter A. For instance, “I packed my grandmother’s trunk and in it I put an alligator.”
The next player repeats the previous sentence and must add a B word. “I packed my grandmother’s trunk and in it I put an alligator and a banana.” In turn, each player has to remember what the past players have said and add an item that starts with the next letter of the alphabet.

How many?

This simple game started when JImmy was about three years of age and fascinated by animals but it can easily be adapted to other themes. I would start by asking a question about a specific attribute (see some examples below) and she would call out as many responses as she could think of;
    • How many animals can you name that hatch from eggs as babies?
    • How many animals can you name that have patterns on their bodies?
    • How many animals can you name that eat leaves?
    • How many insects can you name that have six legs?
    • How many vehicles can you name with four wheels?
    • How many things can you name that are cone shaped?

I’m thinking of…

A simplified version of 20 questions, and somewhat easier than I Spy when on the move in the car, we start this game with a single object in mind and the phrase, “I am thinking of something ….,” and then name a feature or attribute of the object or thing. So it might begin, “I am thinking of something that is blue.” The other players are welcome to make a guess or ask for another clue and we go back and forth between clues and guesses until they work out the correct answer.

What’s Better?

This fast paced game simply asks kids about their preferences between two things –
    • “What’s better – banana or apple?”
    • “Banana”
    • “What’s better – banana or cheese?”
    • “Cheese”
    • “What’s better – cheese or chocolate?”
    • “Chocolate”
    • “What’s better – chocolate or ice cream?”
Of course, you don’t have to choose food – books, prizes, games, sports – anything is fair game. Debates about different choices that children make provide lots of insight into their individual personalities and preferences.

Odd One Out

Begin by naming three items – two that are connected in some way and one that is not (you can make this as easy or as hard as you wish, depending upon the age and interests of your children) and ask your children to choose the odd one out. For example with “train, bus, hair” it is easy to identify the odd one out. “Platypus, cobra, horse” is more challenging. “Chop, chicken, ship” focuses the game on identifying different sounds. “21, 63, 78” turns it into a math challenge.

Silly Songs

Younger children love to listen to silly nursery rhymes created by altering the rhyming words of familiar nursery rhymes. For example,
“Twinkle twinkle little bat,
How I wonder where you’re at”
“Baa baa black sheep, have you any eggs?
No sir, no sir, But I have some pegs.”
Spotting the funny rhyme is fun for little ones whilst older children (5 years+) will enjoy making the rhymes with you.


Make up your own funny tongue twisters by choosing a letter or sound and working together to make a sentence with as many words beginning with the chosen sound as possible.
Rhyming Tennis
Players agree on a rhyming family – say ‘at’ as in hat – and take turns, back and forth, each saying a new word that fits the family.

Sound Tennis

Players agree on an initial sound or blend, say ‘P,’ and then take turns back and forth, each saying a new word that begins with that sound, until the round comes to a finish when one player cannot think of a new word beginning with the nominated sound. We allow the other player, the ‘winner,’ to choose the new sound for the next round.

Alphabet Chain

Choose a category and take turns naming an item that fits the category following the sequence of letters of the alphabet. So the first person chooses a word starting with a, the second person a word beginning with b, the third person with c, etc. The category can be anything at all – animals, countries, names, superpowers, etc

Telehealth Play Therapy Activities

Paper Plate Activity
Materials: Paper Plate, Styrofoam Plate, or Plastic Plate 
Purpose: Psychoeducation about Anxiety and Worry 
Have the client collect toys or item around their house and have them place them on the plate. Have the client hold the plate up with their hand. If several minutes go by without the client getting tired and putting the plate down have them add more to the plate until they are tired of holding up the plate. 


Process with the client the metaphor of the items on the plate representing anxiety, worries and stressors that the client is carrying and how carrying these emotions can wear us out. Discuss with client coping skills, problem-solving skills, and supports that can help the client take some of the client’s anxieties off  of their plate. 

Me Tree- Sueann Kenny- Noziska (2018) 

Purpose: Engagement and Assessment 
Materials: Drawing Materials 
Have a client draw a tree that includes roots, a trunk, a hole, branches, leaves falling off the tree, and a top of the tree. Then have the client answer the following questions, the answers correspond with each part of the tree.
Roots: What are my roots? What grounds me?
Trunk: What helps me stand tall and strong?
Branches: What am I reaching for?
Falling Leaves: What can I let go of?
Top of the Tree: What am I growing into?
Process the clients answers with them after the activity. 

Benevolent Experiences Ecomap- Sueann Kenny-Noziska (2018) 

Purpose: Identify Protective Factors and influences 
Materials: Art Supplies or Toys that the client can use as symbols to answer the questions (animals, action figures, cars, army men, food, etc.) 
Have the client answer each question either by writing the answers for each question, drawing a symbol to represent the answer of each question, or picking a toy or symbol to represent each answer. 
    1) Did you have at least one caregiver with whom you felt safe?
    2) Did you have at least one good friend?
    3) Did you have beliefs that gave you comfort?
    4) Do you like school?
    5) Have you had at least one teacher who cared about you?
    6) Have you or do you have good neighbors?
    7) Has there been an adult (not a parent/caregiver or person from #1) who could provide you with support or advice?
    8) Do you have a predictable home routine, like regular mealtimes and a regular bedtime?
Discuss and process with client after the activity. 

Family Map- Sueann Kenny-Noziska (2018) 

Purpose: Assess family system 
Materials: Paper and Drawing materials 
Have the client draw a picture with each family member represented as a symbol. Therapist can also have the client pick a toy or an item around there house to represent each family member. Client can also create a symbol for each family member out of play-doh. 
Process with Client after. 

Simone Says

Purpose: Regulation 
Play Simone Says with the client. If the client is hypoactive you can have the client do active things such as jumping, jumping jacks, push-ups ect. If the client is hyperactive you can have the client do calming things such a sitting still, laying down, standing on one foot etc. 

Bubble/Calm Breathing-

Materials: Bubbles for both the therapist and the client 
Purpose: Calm breathing is a technique that teaches your child to slow down his or her breathing when feeling stressed or anxious.
When your child is feeling anxious, his or her breathing will change. When we are anxious, we tend to take short, quick, shallow breaths or even hyperventilate. This type of anxious breathing can actually make the feeling of anxiety worse! Doing calm breathing can help lower your child’s anxiety and give him or her a sense of control. Calm breathing is a great portable tool that your child can use when feeling anxious, especially in situations when you are not there to help him or her through it.

Calm Breathing:

Have the client take a slow breath in through the nose (for about 4 seconds). 
Hold your breath for 1 or 2 seconds. 
Exhale slowly through the mouth (over about 4 seconds) 
Wait 2-3 seconds before taking another breath (5-7 seconds for teenagers) 
Repeat for at least 5 to 10 breaths
A good way to practice calm breathing it is to do some bubble blowing, because you have to take a slow, deep breath to make a big bubble, and you have to blow the bubble really slowly or it will pop! ... Take a slow, deep breath in, hold it for a second, and then slowly blow some bubbles.

Story Telling- Terry Kottman and Kristin Meany-Walen (2018)

Make up a story about…
Story can be used to explore just about anything. Story telling can be used with both individuals and families. Using a metaphor in a make-believe story can give the client the distance needed that a real story cannot do. 
You can have clients use their toys (stuffed animals, plastic animals, action figures, Legos and Lego people, etc.) to tell you a story or you can have they can tell you a story without any toys. 
Pictures can be downloaded to help spark stories. You can show the client a picture and have them make up a story about what happen before, during and after the photo was taken.
Client can tell you a story using favorite characters from a book, movie, video game etc.
Speed Drawing- Creator unknown 
Material- Paper and drawing materials
Have the client fold a piece of paper in half vertically (hotdog style) and then horizontally (hamburger style) giving the client 4 boxes on each side of the paper. Determine an amount of time that the client has to draw each picture (i.e. 30 seconds, 45 seconds, 1 minute, etc.). Give the client a prompt one of the squares, then give the client the allotted amount of time to draw then move on to the next square.
Examples of prompts:
Draw something that makes you happy
Draw something that makes you angry
Draw something that makes you feel safe
Draw someone that you are thinking about
    • Anything can be used as a prompt and the activity can fit each client’s needs, goals, and what you known about them as a client. 
After all the drawings are complete, have the client tell you about each picture. Discuss and process the drawings with the client. 

Speed Lego Building

Materials- Legos
Same premises as the above activity, but use Legos instead of drawing and give clients time limits to make things (a superhero, a robot, a house, a safe space, a care, something that makes them happy, etc.)

Speed Play-Doh Building

Materials- Play-doh
Same premises as the above activities, but use Play-doh instead of drawing and give clients time limits to make things (a superhero, a robot, a house, a safe space, a care, something that makes them happy, etc.)

If I Were a Superhero- Susan Kelsey 

Goals: Assess the clients coping mechanisms and improve the client’s ability to conquer fears.
Materials- drawing paper and drawing materials 
Explain the activity as follows:
“Lest pretend that you are a Superhero who has never been invented before. Imagine what you look like, what your superpowers are, and how you use them. After you invent your superhero, draw your superhero in action on the paper.”
After the client finishes his/her drawing, explore in depth who she/he has invited and what the superpowers are and how they are used. It is also helpful to explore how the superhero may be like the client and the qualities that the client possesses.
Discussion: The client’s superhero can provide valuable information about his/her coping strategies. Children who are traumatized or feel hopeless may have trouble inventing a superhero. 
Postcard Activity (2017)-
Material- post card PDF found on or a piece of paper in place of the post card PDF. Drawing materials
Most people would probably agree that it’s easier to express or recognize hurts and regrets when there’s distance between yourself and the problem. This is why the postcard activity can be a good self-discovery exercise that helps answer the question, “what would I say to someone if I didn’t have to do it face-to-face?”
    • Have clients write a message to someone they’re frustrated with or to someone with whom they have something to share;
    • One the blank side, have the client express their feelings with art;
    • Use this as a way to start a conversation about what’s being expressed with the postcard (Post Card Activity, 2017).

What Anxiety Looks Like-

Materials- Paper and drawing materials
Understanding and visualizing anxiety can be a pivotal first step in controlling and treating it. Representing anxiety as an abstract concept, a human, or even a monster could help the artist develop strategies to recognize it when they feel it coming on and to deal with it appropriately.
Here’s how to do the activity:
    • Draw, paint, or create a collage considering these suggestions as a template: If anxiety had a body (and personality) what would it look like? How would it talk? What does it care about? What does your body look like with anxiety? What would it look like if anxiety was no longer present?;
    • Discuss the appearance and personality of the anxiety, or journal about what you’ve discovered (Tartakovsky, M., 2015).

What Feelings are in your Heart-

Materials: Heart worksheet that can be printed by clicking on the picture in the link, or have a client draw a heart on a piece of paper. Drawing/coloring materials 
The objective of this intervention is to allow children to develop vocabulary and identification of feelings to promote healthy expression of emotion. This exercise also serves as an open-ended question about how the child views their world at the moment.
This exercise is used to explain that everyone has feelings or emotions, and this is normal. Explain that there is no right or wrong way to do this exercise. Help the child brainstorm and list the emotions they can think of and suggest some that may be missing from their lexicon.
Using crayons, colored pencils, or markers, have the child choose what colors match each emotion for them. For example, angry might be red or sad might be blue. Then the child colors in how much of their heart is feeling that emotion right now.
*Activity can also be modified to have clients draw pictures of the things in their heart that are important to them. Goodie “what’s in your heart activity” into google images for ideas. 
Emotions Drawing- Creator unknown.
Materials- Paper and drawing/coloring materials
Have the client pick 5-10 crayons, markers, colored pencils etc. Have the client assign a feeling or emotion to each color. Have the client draw a picture using the colors and discuss and process the picture with the client. 

Safe Place Drawing- Terry Kottman and Kristin Meany-Walen (2018)

Materials- Paper and drawing/coloring supplies
Objective: Helps us to have a sense of what is important for the client’s sense of safety
Tell the client to draw “a safe space.” After the client is down with the drawing (if the client feels safe and willing) guide the client in verbally processing how the space they created establishes and contributes to a sense of safety for them. This can also be done in a family session with each member drawing a safe space. 

Pokémon Character Creation- Terry Kottman and Kristin Meany-Walen (2018)

Materials: Paper and Drawing/Coloring Supplies
Can be used to explore interpersonal dynamics (self-image, recognition of personal strengths, and weaknesses, and willingness to assess and take personal risks)  
Ask client to create and draw a Pokémon character if their own. After the character is created, have the client make a list of 3 attacks and 3 defenses the character can use to keep himself/herself safe. 
*Activity can be modified to have clients create characters from their favorite show or video game such as Minecraft. 

Self Portraits- Terry Kottman and Kristin Meany-Walen (2018)

Materials: Drawing/Coloring Supplies and Paper
Have the client create a Self Portrait: 
Can be representational or nonrepresentational.  
Client can draw pictures of their whole body or just their face
Clients can be asked to draw shapes and patterns that show how they feel about themselves
They can draw a picture of themselves as an animal, car building, plant, etc. (think of the client’s interests) 
You can also have clients create portraits of there real self and their ideal self. 

Music-Terry Kottman and Kristin Meany-Walen (2018)

Have clients (especially teens and adolescents) play you their favorite songs or songs they dislike. Music can tell you a lot about the client. You can have clients play you songs that they listen to when happy, sad, to get energized etc. 
Here are some questions you can ask about the songs:
What do you like/dislike about the song? Music? What do you like/dislike about the musical group/singer? What do you like/dislike about the type of music? 
What makes this song/music special to you?
What was going on when you first heard this song?
What does this song tell us about what’s important to you?
What impact does this song have on you or your life?
What is going on with you when you listen to this song?
How do you feel when you listen to this song?
What feelings does this song evoke in you? How do you feel after you listen to it? 

  • Simon Says: Rules are simple. One person is designated as Simon, provides instructions to others, which they must obey. The other player/s lose if they follow a command that does not have the phrase "Simon Says" in the beginning. Both the therapist and the client take turns to be Simon. They can give directives like "Simon says stand up. Simon says, sit down. Stand up. Gotch-ya. “ Simon didn't say." Simon Says is a tremendous therapeutic game to integrate the shifts of high-low arousal during higher brain functioning processing (paying attention and decision making when excited). Process with your client, or family, feelings of frustration around losing, and the excitement around "telling a grown-up what to do." 
  • Charades: A mimicry game where the intention is to guess the word or phrase that someone is acting out. The therapist can choose to take turns with the client or choose either themselves or the client as the person acting out or guessing. Categories can be animals, sports, videogames, things in the sky, or professions. A therapist can send topics to the family beforehand, so the client has time to come up with some ideas. Use this game to process communication styles, interpretations of how something was acted out, and the concept of shorthand communication (including the shorthand they may unknowingly use with friends and family).
  • I-Spy: Individuals take turns trying to guess which nearby object was selected in secret, through description queues given by the selecting player. The therapist and client can choose a theme for the round (like colors, soft or hard objects, shapes, etc.). The game starts with a selected theme. The person who is "it" will  spy something in that theme, saying, "I spy with my little eye (insert themed object)." The therapist must establish the rule that the object must be visible by the camera and that neither the therapist or the client can use themselves to block the object. This is a great game to improve language development as it reinforces vocabulary, and pro-social engagement, as the point is to help the other person guessing.
  • Going on a Picnic: This game is perfect for communication building and sequential cognitive connection. Though it can be played with the therapist and the client, it has better therapeutic results with families. Using the ABC's as the framework, someone will begin the game with "I am going on a picnic, and I'm bringing (choose a food item that starts with an “A”, like apple, artichokes, avocados, or a silly thing, like an astronaut or an airplane). The next person repeats what the first person said, and then adds another item (that starts with a “B”). Repeat this until the entire alphabet has been used. If someone forgets an item, then the round starts over. You can even create their picnic story into an digital book, with My Storybook. Discuss ways for the family to remember details (teaching supportive communication). Process frustrations when something was forgotten, and the game must start over, or potential sibling rivalry regarding the speed of memorization and gameplay.
  • Reading: Any book can be read out loud. The therapist can let the family know before the session, so that the client can choose a book to read. The therapist can also choose to read books they have. Remember to show the page and images to the camera. If the therapist has a library card, they can also reserve a digital book online, screen share with the client (if their HIPAA compliant software allows this), and read together. Protip, practice reading the book before meeting with the client so you can do voices for different characters. I have an LA Public Library Card and use the online website Hoopla, which allows me to download 15 titles a month. They have a variety of books, even comic books, and Disney books. Great books to read and process that is available on Hoopla include:

  • Coloring: There are a variety of free coloring pages found online. Simply type "free coloring page" in Google. Choose some and send them to the family before the session so that they can download, print, and get the necessary coloring tools available. This is a good option for families that have crayons or other coloring media in the household. As an art therapist, there are a variety of ways I utilize coloring. Use this intervention to discuss with the client their choice of colors, decision making around what to color when, and their judgments or self-critic of their coloring work.
  • Worksheets: There are a variety of free worksheets found online. Simply type "free therapy worksheets for kids" in Google. Choose some and send them to the family before the session so that they can download, print, and get the necessary materials to fill it out ready. This is a good option for families that have crayons and writing utensils at home. These items can be assigned as homework to bring into the next session. Focus on processing with the client the prompts and responses on their worksheets.
  • Videos: If your software allows for screen sharing, share a mindfulness YouTube video, or other appropriate psychoeducation videos, in session. To maintain some control, I screen share and play the video, instead of the client. I allow the client to send me a list of topics they want to learn more about, and I research age-appropriate videos to play during the session. Sometimes, depending on the sensitive information in a video, I will send it to a parent/guardian for approval. I will have the video cued up, with the ads already skipped, and any unnecessary intros already jumped. I then mute the client, so there is no feedback, and they hear the video through their speakers and watch it on the shared screen. If a client needs to ask a question or tell me something, they communicate a pause. We use a gesture we agreed upon for unmuting (I often teach them the ASL sign for “comment”). Additionally, they can message me inside the video software, if they don't want to stop the video. At the end of each video, we process the client's reactions around the content. Videos I have used in a session include: 
  • Show and Tell: Show and tell is the practice of showing something of significance to someone and discussing it. Children love to show you their wold. With online therapy, you have the chance to see their home, and particularly their room (if you were not doing home-based treatment). If the child's computer isn't directly plugged into the modem, have the child give you a tour of their room explaining what the different items are and their importance. Have the child show off an essential comfort/self-soothing item (like a teddy bear or blanket) and explain why it is comforting. Have them take you to various rooms in the house that are of importance. Have them share culturally significant items or rooms, like family heirlooms, religious items, or alters, and talk about what they mean to the family and the child. Some children even show me urns that contain loved-ones and share stories about them (this is great for grief processing work). This entire exercise is fantastic for rapport building.
  • Board Games At Home: If the youth have board games, such as Sorry or Candyland, you can have them set up the game and play the pieces for you. It's an excellent opportunity to discuss "being a helper" and diversity. Process what it is like to assist someone who isn't able to touch or interact with the objects physically. This opens the conversation around experience with individuals with disabilities, and now social distancing to help prevent the spread of the COVID-19 (coronavirus). This also allows the therapist to challenge the temptation to cheat. A therapist can choose to use their own gameboards, and have the client describe which pieces to move. I choose not to do this, only because youth can get distracted when they aren’t engaging with the pieces.

  • Feeling Faces: Discuss feelings using feelings flashcards that have faces on them (I created some with emojis, which the youth love). Show a face on the screen and have the youth label the feeling. Then try to have the youth make the same face. This creates emotional recognition and mirroring emotional states, which increases empathy. Try to include somewhat goofy faces that are hard to replicate or animal faces (like a pig), as this makes it more challenging and fun for children. You can even send the flashcards to the family to print out, so the youth can choose feeling faces for you to identify and imitate. There are also free printable flashcards with question prompts around emoji feeling faces that can also be used.
  • Whiteboard or Jamboard: In in-person therapy, therapists often use a whiteboard or a dry-erase board for psychoeducation, or interventions such as tandem drawing. I use GSuite, which allows me to have an interactive whiteboard, through a program called Jamboard. Some HIPAA compliant videoconferencing software includes the use of a whiteboard, such as Zoom Healthcare and TheraPlatform. I create a Jamboard session, share the private link with the client, and we work on the board together, or they work on it by themselves. For art therapy, I will use the bridge assessment/intervention, along with motivational interviewing, to help address challenges the youth faces. Sometimes I will draw a line down the middle of the board, or create circles around the board, to represent boundaries that the youth and I have to honor. There is also a cognitive processing exercise I use with a child where we take turns drawing a line until we have created an entire picture. Lastly, with Jamboard specifically, I can import a coloring image page, and we can color it together using the pen tool.
  • Puppets: One advantage to not being in-front of the client, and instead online, is that puppetry is easier! Young children especially love seeing puppets on screen. Puppets can add humor and levity to a session. Inform the parent/guardian before session that you’ll be puppeteering, so they can be in the room to help the young client, depending on their age. If they aren’t participating in the session, they can sit in the room with headphones and stream something. For slightly older clients (6 to 7), the parent doesn’t have to be in the room. Have a story prepared to tell the client, tell jokes, or discuss feelings and where they are felt in the body. Keeping the experience non-directive can also be used to encourage imaginative thinking, autonomy, and free expression.
  • Podcasts: If your software allows for screen sharing, share topics from Podcasts that are age-appropriate. Share a clip or the entire Podcast, depending on the length of the session. Depending on the sensitive information in a Podcast, I’ll send it to a parent/guardian for approval. I’ll have the clip cued up, with the ads already skipped, and any unnecessary intros already jumped. I then mute the client from my end, so there is no feedback, and they hear the Podcast through their speakers. If they need me to pause want to ask a question, they use a gesture we agreed upon for unmuting. They can also message me inside the video software if they don’t want to pause. In the end, we process the client's reactions around the content. The Podcasts can be useful resources for the clients to utilize as coping skills. Often I assign a Podcast to listen to as homework, with a worksheet to complete and process their reactions in the next session. These are good for family therapy as the whole family can process their responses to the information and discuss it in family therapy. Podcasts I have used in a session include:
  • Online Gaming: There are plenty of ways to play games online with children. Avoid any games that involve substantial multiplayer, or online community experience, that need to be downloaded, or that require a screen name. If you have to create a log-in, make sure it is with your HIPAA compliant email and something nondescript like "person85." Play Uno or play checkers, chess, or connect four with Skill Games Board. Play card games like Go Fish or Match with You can even get a free Minecraft Serve through Aternos. Minecraft is a great game to discuss home life. For art therapists, it is a digital way to do the House portion of the House-Tree-Person Assessment. Even nonart therapists can discuss home life without doing it as an assessment. Work with the youth to build a home. It isn't difficult for someone who hasn't played before, to learn. The goal is to have the child do most of the work themselves, anyways. Talk about what makes a home safe. Have them focus on "comfort zones," "safety measures," and "areas to avoid without supervision." These will take parent consent, consenting to opt-in to use online gameplay for therapeutic means, and discussing the benefits and risks.


Transitioning therapy online with youth, family, and children may seem daunting. Fear not. A lot of these interventions mentioned, you are probably using in in-person therapy already. We rarely have interventions where we need to "touch" a client. Think about your common intervention go-to's, add a screen, and visualize the barriers you need to overcome to make that intervention possible. There are still a whole host of common interventions that can be used in online therapy. Some include mindfulness meditation, journaling, empty chair technique, or therapeutic role play. With some solution-focused thinking, you'll see it wasn't as difficult as you made it out to be.

Anyone seeking advice on where to get started transitioning your practice online in response to COVID-19 (coronavirus), I created a blog post you can read.

"20 Free, Low Prep, and Minimal Supply Activities for Telmental Health With Children:
  1. Bibliotherapy: Giraffes Can’t Dance.  Check out my blog HERE for how I use this book for growth mindset, self esteem, regulation, and social skills. If you don’t have this book there is a link to you YouTube video of the book.  You can send the client the link through the chat feature and they can pull it up on their computer – OR if your program has a screen share it can be co-viewed this way too! This blog has a download packet of three printable worksheets to use BUT if a client does not have a printer you can ask the parents to have markers and paper ready and the client can create the worksheets themselves! Supplies: Giraffes Can’t Dance (or video), printed handouts (or computer paper), markers, crayons, pencils, or pens.
  2. Guided Imagery: Safe Calm Space. Have kids watch Peace Out Guided Relaxation For Kids – Balloon by Cosmic Kids Yoga. Explore where their balloon took them and have them draw a picture of their safe, peaceful, calm space. Supplies: Paper, crayons, markers, or colored pencils.
  3. Pick a Miniature: I LOVE miniatures. And here’s a secret – your client’s likely have a giant collection of their own miniatures in their home.  You could have clients pick a miniature for a wide variety of feelings and ask them to explain how each miniature is like that feeling.  You could have them pick miniatures to represent their strengths, their goals, or what they are like when they are with each member of their family.  The sky is really the limit here. Supplies: Have the client gather a collection of their own miniature objects.
  4. Mindfulness Scavenger Hunt: Have the child do a scavenger hunt finding and collecting five things they see, four things that make noise, three things with texture, two things that smell, and one thing they taste.  For other ideas check out this link hereSupplies: Printer OR have the therapist read off each item one by one.
  5. Gratitude Scavenger Hunt: Okay and speaking of scavenger hunts, here is a link to an amazing gratitude scavenger hunt with a free printable. I also found another example and free printable hereSupplies: Printer OR have the therapist read off each item one by one.
  6. Mindfulness: Get a free printable download of 12 “Mini Mindfulness” activities for kids here and 8 free printable breathing exercises here.  Supplies: Printer (therapist only) OR read a copy of the exercises on your screen or alternative screen.
  7. Bibliotherapy: Last Stop on Market Street. Check out my blog HERE for how I use this book for gratitude.  Don’t have the book? No worries – there is a version HERE that the author reads on YouTube. If you worry your client isn’t old enough to click the link the parent can sit in and the child and parent can watch the book together. Supplies: Last Stop on Market Street (or the video), a thank you card OR paper and markers, crayons, or colored pencils.
  8. Emotional Hedbandz: Get these free printable feeling cards here and hold it up to the camera without looking (or disable/cover the part of the program where you can see yourself). Explore emotions by taking turns asking one question each about the emotion until both emotions (or all with family) have been identified.  The low budget version? Have the family write feeling words on small slips of paper.  BONUS if you can find elastic, string, or a headband to hold the feeling card up.  Supplies: Printer OR slips of paper to write emotion words on.
  9. Emotional Regulation: Grab your emotional Regulation free download here, free anger dice game printable here, free anxiety coping skills mini card deck here, and free “anger buttons” printable worksheet hereSupplies: Printer (or read activities off the computer) and dice.  Don’t have dice? Cut out slips of paper and draw from a cup!  
  10. Quick Draw: This is a Terry Kottman technique and can be found in her book Doing Play Therapy.  For this activity you agree on a fairly short time limit.  The limit doesn’t actually matter and it can be altered and flexible.  I usually go between 30 seconds and 2 minutes. Have the child get several pieces of printer paper and fold them into quarters. Each section is a new drawing. Using the time limit you instruct a child to make a new drawing in each section.  Prompts can be anything you think would fit the child and can include things like drawing their proudest accomplishment, what mad looks like, what they worry about the most, the place they are the happiest, their favorite subject in school, the last time someone was angry with them, the last time they felt guilty about something, etc.  After you go through 4-8 rapid drawings you circle back and use each drawing as a jumping off point for a discussion. Supplies: Paper and crayons, markers, or colored pencils.   
  11. Mandalas: Use this amazing resource and this one to help children use mandalas to help express their inner world.  Supplies: Paper and crayons, markers, or colored pencils.   
  12. Feeling Heart: Help young people understand and articulate all the complex and complicated feelings that are in their heart.  Unsure of what a feeling heart is?  Check out an example and free printable worksheet hereSupplies: Printer and crayons, markers, or colored pencils.  No printer? Have the client or their parent draw out a heart on plain paper.
  13. Music Body Outlines: I talk about these amazing feeling faces here BUT they also have body outlines included in the free printables!  You can encourage the child to do a body feeling map OR one of my personal favorites play three songs of varying nervous system activation (ie soothing, happy and upbeat, angry and aggression) and have them listen to each song through.  After each song have them map out what feelings they felt, where they felt it in their body, and compare the three.  Supplies: Printer and crayons, markers, or colored pencils. Don’t have a printer?  Coach their parent to make three sheets “ginger bread man style” body outlines.
  14. Recipe for a Good Friend: Use the book This Moose Belongs to Me to process what it means to be a “good friend”.  Process what expectations Marcel has for his moose and if they are realistic.  Don’t have the book – watch the video here! Develop your own recipe for a good friend with this free download.  Be creative and check in with parents ahead of time about what snack objects may be on hand at home.  Brainstorm what ingredients are used to make up a “good friend” and include a recipe of how to put it all together.  The sky is the limit!  For fun you can use trail mix to identify each trait (ie. raisins = fun, M&Ms = loyalty, etc.).  You can also alter this for what it means to be a good family member and enjoy the snack as a family!  Lastly – if there is no way to have the actual trail mix – brainstorm what would be in the mix and you can use this as a bridging activity and make the actual trail mix when you are back in the office! Supplies: Printer and crayons, markers, or colored pencils. Snack food to make a “trail mix”.  Don’t have a printer?  Use a blank sheet of paper to create a recipe or snag a parent’s blank recipe card.
  15. Big Feeling Eaters: Check out my blog post here about Big Feeling Eaters complete with how to make this emotional containment activity out of a Kleenex box.  This is a great strategy for emotional regulation!  Are you worried the family you work with won’t have a Kleenex box?  You can make this activity out of an envelope (because almost EVERYONE has those) or to be honest with some thoughtfully folded and taped paper.  Check out some examples here and hereSupplies: Kleenex box, craft paper/wrapping paper, and art supplies OR envelope and art supplies.
  16. YogaCosmic Kids Yoga has an amazing YouTube channel with a TON of exciting yoga practices (Frozen, Harry Potter, or Pokémon anyone?) OR download these FREE kids animal yoga pose cardsSupplies: Yoga mat OR a towel works just fine!
  17. UNO: You can play UNO online with clients using sites such as this one. Use the same “therapy rules” you have in office.  My favorites are identifying feeling triggers, warning signs, and coping skills for every color switch.  For me green = anxious, blue = sad, yellow = happy, and red = mad.  Don’t have a screen share option?  You can use what is called a “Tab Resize Extention” for Google Chrome to allow the screen to split.  Supplies: None!
  18. Sand Tray: Okay – now most of our clients do not have a sand tray on hand at home.  BUT most of them have miniature toys and computer paper.  For this activity have the client or parent tape together four sheets of computer paper in a rectangle.  Have the child or parent gather up the typical “categories” including people, animals, fantasy figures, plant life, minerals, environments, transportation, miscellaneous objects.  You can have the client start out by drawing what kind of ground the “tray” will have on the paper. Then, do your sand tray work as usual! Supplies: Miniatures, art supplies, paper.  
  19. New Tune, New Mood: Identify with the child what mood they would like to have in the moment.  This could be happy, excited, calm or anything else.  Create a playlist with the child of their favorite songs that get them in this mood.  They could design an album cover and list the songs out.  You can play the songs together and encourage the child to move their body in what ever way feels comfortable for them.  Supplies: Paper and crayons, markers, or colored pencils
  20. Holding on and Letting Go: Have the child trace each one of their hands.  In one hand (or just use the fingers if you want less prompts) write what the child has control over.  You can write a list draw pictures, or a combination of both.  In the other hand write what the child doesn’t have control over and needs to “let go”.  Again - use words, pictures, or a combination.  For further deepening you could have the child separate the page and “destroy” what needs to be let go.  That could be ripping it up, crumpling it, throwing it in the garbage, etc.  Supplies: Paper and crayons, markers, or colored pencils."

Even before the COVID-19 outbreak, games have long had a social component for players who weren't in the same room together. Apps like online game site Pogo allow your kids to play some of their favorite board games, like Monopoly and Yahtzee, with friends without sitting around the same table. It's also possible to game with friends using Xbox Live and Nintendo Online (both of which require paid subscriptions) — kids can share their usernames and play video games like Minecraft and Roblox against each other. For something lower-tech, Let’s Play Uno allows kids to play this timeless card game with friends for free. And Pokemon Go lets kids to interact with friends and even track their activity in the game. Since the COVID-19 outbreak, the game’s manufacturers have made adjustments to the game that bring the Pokemon closer to home.


Jane Leu Rekas


Jane Rekas is a Licsensed Clinical Social Worker at Western Psychological and Counseling Services, in Gladstone, and Certified Hypnotist, Reiki Master, and Astrologer.


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