Using Games in Therapy

Games are an engaging way to build the therapeutic relationship while assessing a child’s strengths and areas where there is room for growth.  Playing games as they were intended to be played can teach you a lot about a child’s functioning in multiple areas, and adding a therapeutic twist can make games highly adaptable to many clinical issues (ex. feelings, CBT, social skills, etc.).  Below are some suggestions for how you can use games in your own practice.

Purpose of Playing Games in Therapy:

• Rapport Building: Games are a fun way to begin building rapport with clients.  How the child plays can tell you a lot about their functioning and engaging in an activity can take some of the perceived pressure off and help increase comfort and disclosure.  You can also see how they are at multi-tasking/holding a conversation while playing.
• Frustration Tolerance: How often does the client become frustrated and how do they react and regulate their emotions when they do?  How do they respond to falling behind or losing?  Do they give up or push through?  Are they able to verbalize their emotions?  Do they become aggressive?
• Decision-Making: Are they able to quickly make decisions and adapt their strategy as needed? Did they demonstrate impulsivity? Are they confident in their choices or appear insecure?  How much reassurance from you do they seek?  Are they able to look at the whole picture or do they think of moves one at a time?
• Problem-Solving: Can they identify what their options are?  Are they quick to ask for help or able to use their problem-solving skills without much direction?  Do they show flexibility when things don’t go their way and easily move onto other strategies?  How effective was their problem-solving?
• Response to Rules: At the start of therapy, I usually let the client dictate the rules and do not interfere if they change them.  Do they follow the set game rules or make up their own?  How often do they change them?  Do they ever permit you to win?  Later on in therapy I may state that we will play by the game’s rules, which I enforce, to see how they react or teach appropriate social skills/sportsmanship.
• Provides Opportunities For Positive Reinforcement, Redirection and Limit-Setting:  How do they respond?  Does behavior improve?  How much redirection do they need?
• Social Skills: Games are perfect for teaching social skills, conflict resolution, and good sports-personship.  They are highly effective when played in group therapy and give the therapist tons of opportunities to model, reinforce good behavior, facilitate positive interactions, etc.

Creating a Therapeutic Twist:

• Create a Color Code: This is a simple way to modify games to fit specific therapeutic issues.  Many games already have colorful pieces, and if they don’t you can easily add multi colored stickers.  Then write out a code in list form (ex. every time you land on red describe a time you were angry).
• Write up Cards: You could also use a color code with multi-colored stacks of cards.  Having more questions allows you to address more specific issues.  You could forget the color code and just play the game normally and have a client answer a question before each turn.
• Alter the Board/Pieces:  You could also write questions or tasks directly onto the game board or pieces.

Create Your Own Games:

• Bare Books has inexpensive blank game boards, books, puzzles, etc. that you can use to create your own therapeutic games.  A professional looking blank board game is just $3.95.  They have flat rate shipping so I suggest getting together with a couple people to place your orders.

Buying Therapeutic Games:

• Games made specifically for therapy can be great, though are often expensive.