Listening activities to promote cognitive flexibility and communication

Reader Emily Clifton sent in this very useful assortment of interventions. Ms. Clifton earned a gift certificate to for her submission. Learn how you can do the same!

Game: Puppets

Ideal for: group or in family sessions

Instructions: In this game you assign one group the role of puppet, and another group serves as the puppet masters. You will have the group act out a situation. The puppets are doing the actions, but each have a puppet master that will be their voices, so the puppets’ actions have to be guided by what the puppet masters are having them say.


Game: Sculpting

Ideal for: group or family session, must be done in pairs

Need: Play-Doh, Legos or another building material

Instructions: The therapist gives each member equal amounts/sizes of play-doh or Legos. The therapist has one person make a sculpture that the other person cannot see. Then they have the builder describe to the other person how to recreate their sculpture. At the end they compare to see if their sculptures are the same. Then you have the participants switch roles. The therapist should ask questions such as: What was difficult about being a listener? What was difficult about instructing others?


Game: One-Liners

Ideal for: group or family session

Instructions: The therapist chooses three people to create a scene. Two people are given one generic line. Throughout the scene, they can only say this line. The other person may say whatever they want. You give the participants a general character and scene, such as: two customers and an employee at McDonald’s. During the scene, you can say freeze to help characters that are stuck. Afterwards, you can talk to members about how it felt to have their control limited or to be the one in charge of moving the scene forward, etc.


Game: Storytelling

Ideal for: individual, group or family sessions

Need: Deck of Apples to Apples cards, In a Pickle Cards, Story Cubes or other cards with nouns on them,

Instructions: Each person during their turn chooses a card at random. They must use the noun on this card to start, continue, or end a story. They must not negate anything the person before them has said. In a larger group, it is also good to include the parameters around the story getting violent or lewd.


Game: 5-2-1

Ideal for: group or family in sets of two or three

Instructions: Group people into twos or threes. Ask each of them to think of a story concerning something that has happened to them that is about five minutes long. Then you assign each person in the group a role: listener or teller (and if there’s a third person–observer). The Teller will have five minutes to tell their story. During this time, the listener can’t talk, but has to show they are actively listening to the story. After the five minutes, the listener has two minutes to summarize the story they just heard, and the teller has to show active listening skills. Then, during the last minute, the teller has to summarize the listener’s summary. Afterwards, the facilitator can ask questions such as: How did you know the listener was listening? How was it to listen without being able to talk? How did you show you were a good listener? How was it to tell a story without being interrupted? What was it like to be an observer and what did you notice? Then each person can take turns taking on the different roles in rotation.


Communication/Feeling Identification Activity:

Ideal for: clients needing to identify different cues regarding how people are feeling or the environment around them.

Need: Pictures from magazine or photos of people interacting with one another in natural settings: library, trick-or-treating, cooking dinner, etc.

Instructions: Show kid(s) one picture at a time. You can ask them to identify the who, what, why, when and how of the picture, asking them to point out which contact clue led them to know something about the people in the picture. For example: drinking orange juice could signal breakfast time, or the color of leaves on a tree could signal season. You can also ask about what emotion each person is feeling and how you know this from their body language, facial expression, proximity to one another, etc.

Using ‘Taboo: The Game of Unspeakable Fun’ to Teach Impulse Control

Taboo isn’t just for dinner parties! Here’s a fun intervention idea submitted by reader Charity Armbruster that uses the game to treat impulse control. Ms. Armbruster earned a gift certificate to for her submission. Learn how you can do the same!

Taboo is a word guessing game by published by Hasbro. In the Taboo game, you need to get the other participant(s) to guess the secret word, but the obvious clues are strictly off-limits. To get someone to say pinball, you might say arcade, game, flippers, tilt, or roll. In this game you can’t because all of those words are strictly forbidden. There is an additional challenge in racing against a clock.

The Taboo Game can be difficult for children with impulse control issues and anger issues. However, as the game is played children are able to develop cooperation skills, persistence, impulse control, and learn how to delay gratification. I play the game with students in our schools who have anger issues. Many of these children can be rather explosive. As an angry child becomes more emotional, they may refuse or be unable to say why they are upset or what happened to cause their distress. Before starting the Taboo game I explain how difficult it can be to communicate when angry, and I state that when someone becomes so angry they cannot express their feelings, it’s like a game of Taboo. The teachers and aides are trying to figure out what the problem is, but the child is not saying anything. I explain that even a simple “I don’t know” can be more beneficial than not saying anything.

Playing the Taboo game is usually combined with other lessons related to anger control, such as identifying what makes me angry, strategies to control my anger, and techniques to regulate and/or healthily redirect my anger.

Example 1: In this example the game was played one-on-one with a student. I began by explaining the rules of the game to a student, and then I went first. The child’s task was to guess what the word on the card was. Within minutes the student became very upset  because he could not guess the word. As we played the game, we would stop and take breaks, and process the frustration and ways to handle it.

Example 2: During another game a student became frustrated and threw the cards across the room, stating this game is “stupid”. Again, I processed and discussed the frustration with the student. He sat in the chair and stared at me. He then said “it’s really hard.” I asked him if instead of throwing the cards could he “ask me for help from me.” Often I would stop and use humor to defuse his frustration before it became to explosive.

For children with impulse and anger issues, Taboo: The Game can be difficult because they may have a hard time finding the right word. However, playing the game over time gives the child and counselor ample opportunity to develop anger management strategies, frustration tolerance, and better communication skills.


The Social and Emotional Competence Game

The Social and Emotional Competence Game is more focused on specific aspects of functioning and behavior. The game is a useful introduction for children just starting in therapy, and can be played multiple times at different stages in therapy. The game can also be played in small groups and with siblings. The design of The Social and Emotional Competence Game is premised on the assumption that children who are able to initiate and maintain relationships, cooperate with others, empathize, and communicate effectively are are more likely to experience success at home, at school, and with their peers. Social and emotional competence refers to the capacity to recognize and manage emotions, solve problems effectively, and establish and maintain relationships with others. It is these skills that serve to protect our children from a host of difficulties including behavior problems, increased emotional distress, academic failure, delinquency, and substance abuse. The Social and Emotional Competence Game is designed to give counselors and teachers another tool to teach social and emotional skills. The Social and Emotional Competence Game is a fun way to teach empathy, communication skills, self-awareness, social awareness, relationship skills, self-management, and responsible decision-making.

Like The Talking, Feeling, and Doing Game, The Social and Emotional Competence Game consists of elements that are familiar to most children: a board, dice, pawns, chips, and a spinner. The object of the game is to have the most chips when time is up. Cards can be pre-arranged prior to a session to focus on specific issues. A separate set of cards is available to cover Asperger’s Disorder, Bipolar Disorder, Anxiety, and ADHD. Play is essentially the same as The Talking, Feeling, and Doing Game. Players roll a die, count out spaces and respond to a card that matches the color of the space they landed on. There are also spin spaces and detour spaces. When a player lands on a detour they go down a path that consists of squares that are all the same color.

The cards in The Social and Emotional Competence Game are labeled as follows: Sharing Feelings, Getting Along, Caring, Communication, and Cooperating. As the game progresses players become increasingly familiar with what these concepts are and the importance and advantages of engaging in these kinds of behaviors. The categories are broadly defined and overlap with each other. For example, Caring can involve such behaviors as being kind, sharing, and expressing a feeling appropriately.

Examples of Sharing Feelings cards

• Anthony doesn’t understand why his friend doesn’t invite him over anymore. How does Anthony feel? Should he discuss his feelings with his friend? Two chips.
• How might a child feel when their parent tells them that a grandparent has died? One chip.
• Name up to five things that make you feel sad. Earn one chip for each thing you can name.

Examples of Getting Along cards

• Barry’s brother always wants to play with his friends when they are over. Sometimes Barry doesn’t want him to. What can Barry do? Two chips.
• Rachel’s parents just told her they are going to have a new baby. She is not sure she wants a new baby in the family. Do you think she should talk to her parents? What should she say? Three chips.
• What is a nice thing to say to a parent? One chip.

Examples of Caring cards

• A new student joined Nancy’s class. What can Nancy do to make friends with her? Two chips.
• How can you show your friends that you care about them? One chip.
• Marcie is going to an amusement park with her friend. Her friend is afraid of a lot of the rides. What are some kind and helpful things Marcie can do for her friend? Two chips.

Examples of Communication cards

• Bill thinks all he ever does is chores and homework. He would like to talk to his parents. What are some things he can say? Three chips.
• Who is your favorite relative? Why? Two chips.
• Ted is five years older than his brother. Ted thinks his brother is treated differently. Should Ted talk about this? Explain your answer and get three chips.

Examples of Cooperation Cards

• Does your family have good cooperation skills? Explain your answer for two chips.
• Penny’s parents told her that she needed to cooperate next time she played a board game with her brother. Name three ways to cooperate when you play a game. Earn up to three
chips, one for each thing you can think of.
• Why do children want to have friends? One chip.

Don’t Break the Ice!

“Don’t Break the Ice” is a popular children’s game that has been around since the sixties. The game can be used as an “ice breaker” and included as an activity in the playroom. Children ages 3 and older will enjoy this game. The game includes 32 small “ice blocks” and one large “ice block.” The blocks fit tightly into a frame. Players take turns knocking the blocks out with a mallet, trying to avoid letting the Polar Bear fall through.

Just like checker play, the child’s approach to playing this competitive game can provide useful diagnostic information. Children with low self-esteem may be hesitant to play, or sore losers. Children with low frustration or anxiety may demonstrate increased agitation as more blocks are knocked out and it gets closer to the skater falling. Just as when playing Checkers, playing Don’t Break the Ice can also serve as a vehicle to communicate interest, concern and affection to a client.

“Don’t Break the Ice” can be played in a session, following the rules of the game. Just like ther types of game play, this facilitates engagement and building rapport with a client. Kenney-Noziska (Kenney-Noziska, Sueanne, 2008; Techniques-Techniques-Techniques: Play-Based Activities for Children, Adolescents, & Families. West Coshohocken, PA; Infinity Publishing) adds a strategy that facilitates engagement, helps establish the therapeutic relationship, and assists client and therapist getting acquainted. Colored stickers are attached to the underside of the blocks. Each color corresponds to a question:

• Blue – Talk about something I like
• Red – Talk about something I don’t like
• Green – Say something about myself, family, or friends
• Yellow– Ask another player a question
• Smiley Face – Choice (or therapist may provide a treat or prize)

There is also the object of playing the “Large Block” version of the game. Game may end when this block drops, four stickers may be placed inside, or if you have extra small cubes the large cube can be replaced.

A third way of using “Don’t Break the Ice” involves adding feelings words to each of the stickers. When one or more of the blocks falls, participants can talk about when they’ve had the feeling identified on the sticker in one of the blocks.

Dr. Gary’s Therapeutic Cootie Game

Over 50 million copies of the Cootie game have been sold since it was introduced in 1949. It is a great preschool game. The game consists of a picture board that depicts all the game parts, Cootie body parts (body, head, antenna, proboscis, eyes, 6 legs), and a die.

This modified version of the Cootie game introduces a therapeutic element. The versions described below focus on social skills and depression, but any story can be written to work on any number of issues and challenges.

First, here are the basics of the game. The object of the game is for each of the players to construct their own Cootie. The first player to do so wins the game. In the therapeutic version, it is not necessary to have a winner. The goal is to complete the story.

Game Play: Each part of the body is identified by a number as follows: 1-Body, 2-Head, 3-Antenna, 4-Eye 5-Probobcis, and 6-Legs. There are two ways to begin the game. Each player rolls the Die once and the high score starts the game, or the youngest (visitor) may go first.

Each player tries to get the body of the Cootie by rolling a “one” spot. If he succeeds, he gets a free roll of the Die, to try for the head. The body and the head must be obtained in the order named, before any other parts of the Cootie can be attached. The legs, eyes, antenna, and eyes can be acquired in any order; all are eligible after the body and head are obtained. The player loses the Die when he fails to roll the number for an eligible part that they have not yet acquired. For example, if the player rolls a 4 and already has the eyes, then the die gets passed to the next player. If they roll a 4 and don’t yet have the eyes, they pick them up and roll again.

One body, one head, eyes, two antenna, one proboscis, and six legs are required to make a complete Cootie.

Once the body and head are acquired all the other body parts can be acquired in any order. In the therapeutic version, parts are acquired but must be added to the Cootie in order, so that a story can be told that makes sense. If a part is acquired out of order, for example a leg before Cootie has a proboscis, the part is picked up and set aside until it can be added.

Social Skills Story
When a one is rolled and the body is acquired each player says: “Cootie wants to play.” When a two is rolled and the head is acquired each play says: “Cootie wants to play with
____________ (choose the fellow player, a peer, or a sibling).

Players are now eligible to acquire body parts in any order, but they are added to Cootie in the order listed below.

When the eyes are acquired each player says: “Cootie is going to look at __________when Cootie speaks. Cootie is going to look at _________ when ___________ talks” and the player attaches the eyes to Cootie. If the player has already acquired the antenna, then that can now be added.

When the antenna is acquired and added each player says: “Cootie is going to listen carefully when __________ talks” as they attach the antenna to the head.

When the proboscis is acquired each player says: “Cootie is going to keep his/her tongue, feet, and hands to herself when she plays” as they add the proboscis to Cootie.

• Each leg represents a skill or affirmation, depending on the child’s needs. Here are some examples:

• Leg 1: Cootie says, “Do you want to play with me.”

• Leg 2: Cootie tells himself: “I won’t get mad is someone says no, I’ll find someone else to play with.”

• Leg 3: Cootie says: “You’re the guest. What do you want to play?”

• Leg 4: Cootie tells himself: “Make sure your friend is having fun.”

• Leg 5: Cootie says: “Thanks for playing with me. I had fun!”

• Leg 6: Cooties tells himself: “I did a good job taking turns and sharing today.”

After each Cootie is completed, the story is retold, repeating each statement as the appropriate body part is pointed to.

Here’s an alternative version for a depressed child:
When a one is rolled and the body is acquired each player says: “Cootie doesn’t want to be sad and bored today.”

When a two is rolled and the head is acquired each play says: “Cootie is going to think of three things he can do today.” The therapist can prompt the child, or make suggestions.

When the eyes are acquired each player says: “Cootie looks for Mom (Dad, teacher, sibling) and gives them a hug” and the player attaches the eyes to Cootie. If the player has already acquired the antenna, then that can now be added.

When the antenna is acquired and added each player says: “Cootie tells himself one thing he likes about his life” as they attach the antenna to the head (the therapist can ask the child to identify that one thing, or make a suggestion).

When the proboscis is acquired each player says: “Cootie enjoys tasty food. The tastiest food I had this week is __________” as they add the proboscis to Cootie.

Again each leg represents a skill or affirmation, depending on the child’s needs. Here are some examples:

• Leg 1: Cootie says, “I don’t have to be bored. I can find something to do.”

• Leg 2: Cootie tells himself: “I don’t have to be sad all the time. I can be happy when _____________.”

• Leg 3: Cootie says: “Two things I like about my life are __________ and __________.”

• Leg 4: Cootie tells himself: “The person who can help me when I’m sad is ___________.”

• Leg 5: Cootie says: “I am beautiful. And then Cootie says it again really loud, I AM BEAUTIFUL.”

• Leg 6: Cooties tells himself: “I am good at ________________.”

Again, after each Cootie is completed, the story is retold, repeating each statement as the appropriate body part is pointed to.

Here’s a story for non-compliance, with a focus on “listening the first time.”
When a one is rolled and the body is acquired each player says: “Cootie listens the first time.”

When a two is rolled and the head is acquired each play says: “Cootie is guessing what his Mom and Dad are going to tell him to do today.” The therapist asks the child to guess.

When the eyes are acquired each player says: “Cootie looks at his Mom’s (or Dad’s or Teacher’s) face when she tells him what to do.” If the player has already acquired the antenna than that can be added now.

When the antenna is acquired and added each player says: “Cootie listens very carefully so that he/she can repeat what she heard” as they attach the antenna to the head.

When the proboscis is acquired each player says: “Cootie tells his/her Mom (Dad, Teacher) what they are going to listen to today” as they add the proboscis to Cootie. The therapist can encourage the child to guess what that might be.

As noted above, each leg represents a skill or affirmation, depending on the child’s needs. Here are some examples:

• Leg 1: Cootie says, “I don’t want to brush my teeth but I will.”

• Leg 2: Cootie tells himself: “I wish I didn’t have to go to bed, but I will.”

• Leg 3: Cootie says: “I am going to listen the first time again!”

• Leg 4: Cootie tells himself: “Listening the first time is easy today.”

• Leg 5: Cootie says: “I had a good day. I listened the first time.”

• Leg 6: Cooties tells himself: “I am good at listening the first time.”

Again, after each Cootie is completed, the story is retold, repeating each statement as the appropriate body part is pointed to.

Family Card Game

We are thrilled to post this therapeutic technique submitted to us by close friend of ChildTherapyToys Liana Lowenstein. Ms. Lowenstein is a therapist and author whose books include three volumes of Assessment and Treatment Activities for Children, Adolescents, and Families; Creative Interventions for Troubled Children & Youth; and Creative Interventions for Children of Divorce. (You’ll also find her articles and techniques peppered throughout this blog.)

The great thing about the innovative techniques presented here is that they require no more than a standard deck of playing cards. However, if you’re interested in using other fun therapeutic card games in your practice, be sure to check out the wide variety offered at ChildTherapyToys!

Therapeutic techniques that involve children or the entire family can be challenging, particularly if the therapist relies on the usual modus operandi of therapy—talk. The First Session Family Card Game (from Creative Family Therapy Techniques Edited by Lowenstein, 2010) provides a means by which talk is integrated into an engaging game. A standard 52-card deck is used for this activity. Introduce the activity by stating, “We are going to play a game that will help me get to know your family.” The rules are explained as follows:

Take turns picking the top card from the deck of cards. If you get a card with an even number, pick a card from the question card pile and answer the question. If you get a card with an odd number, pick a card from the question card pile and ask someone in your family to answer the question. If you pick an ace, ask someone in your family for a hug. If you pick a Jack, Queen or King, you get to pick something from the surprise bag. At the end of the game, everyone who played gets to pick something from the surprise bag.

The question cards have been specifically designed to facilitate joining and to help the family identify treatment goals. Examples of questions for the First Session Family Card Game include:

1. True or False: When families seek therapy they often feel nervous, embarrassed, and/or overwhelmed.
2. Fill in the blank: A good therapist is someone who…
3. What would need to happen in the session today to make you feel like it was worthwhile coming?
4. What do you think needs to change in your family?
5. True or False: Everyone in our family plays a part in making it better.
6. How will you feel if your family gets the help you need?

During the game, there is ample opportunity to observe family dynamics, which further assists in treatment planning. Added elements of the game include hugs to encourage nurturing interactions in the family, and a surprise bag filled with small treats to further engage the clients.

The game can be repeated in the last session (thereby called the Last Session Family Card Game, Lowenstein, 2010) with questions focused on reviewing therapeutic gains. Examples of questions for the Last Session Family Card Game include:

1. What is a positive change someone in your family has made during your time in therapy?
2. What is your family able to do better now?
3. Tell about something you have learned about someone in your family during your time in therapy.
4. Tell about a skill you learned in therapy that you can use to deal with problems that arise in the future.
5. What advice would you give to another family who are experiencing a similar problem that brought you to therapy?
6. Families often teach therapists valuable lessons. Ask your therapist to tell something your family has taught him/her.

Additional questions for the two above versions of the game can be found in Creative Family Therapy Techniques (Lowenstein, 2010). The game can be modified for specific target populations. For example, below are some sample questions from the bereavement version (found in Creative Interventions for Bereaved Children, Lowenstein, 2006):

1. Tell three feelings you have had since your loved one died.
2. Describe a grieving ritual or custom your family followed when your loved one died.
3. Share a favorite memory of the person who died.
4. In what ways has your family changed since the person died?
5. What has helped you the most since your loved one died?

The game is used as a “stimulus for expression of otherwise unattainable information” (Schaefer & Reid, 2001). The therapist provides supportive feedback and validates feelings that emerge during the course of the activity.

About the Author:
Liana Lowenstein, MSW, RSW, CPT-S, is a child and family therapist in Toronto, Canada. She is internationally recognized for her innovative work including numerous books on child and family therapy.

Welcome to the Autism Store!

Play therapy’s greatest virtue is perhaps in its breadth of application. The process of allowing children (and adults!) to express themselves through the language of play can be tremendously useful in a variety of situations. It can be used to teach discipline and good behavior, lift spirits and mend the emotional wounds caused by trauma or grief, and help a patient work through anxiety and depression. Play therapy’s ability to foster expression and improve social and emotional competence is particularly beneficial to children with autism. Many therapists use play-based treatments for Autism and other Pervasive Developmental Disorders and research suggests a high level of success.

Keeping in mind that every specific situation requires it’s own very specific tools, has created The Autism Store–a one-stop shop with the most valuable and fun tools available for play therapy with autistic children. The store boasts a huge variety of books and games, sensory toys, creative materials, and more, all designed to help a child connect and engage through the power of play. The products offered have been expertly curated and are available at affordable prices. Stop by and discover what your therapy room might be missing!   

Feelings Uno

Here’s an easy and useful intervention idea submitted by reader Emily Clifton, LISW. Ms. Clifton earned a gift certificate to for her submission. Learn how you can do the same!

Purpose: To help identify triggers and start conversations in family/individual session.

Target Population: Can be used in individual, family, or group sessions that include children/adolescents.

Materials Needed: One deck of Uno cards.

Rules: Give each color in the Uno deck a feeling (example: yellow-happy, blue-sad, red-angry, green-jealous). Then whenever someone changes the color, they have to state a time when they felt the emotion that corresponds with the new color.

Bubble Tag

Here’s another great intervention idea submitted by reader Emily Clifton, LISW. Ms. Clifton earned a gift certificate to for her submission. Learn how you can do the same!

I teach a group for children with autism and impulse control issues.The children were having trouble with boundaries with one another and out curtains and blinds.  This game helped a lot.You can usually play 3-4 rounds in about 5 minutes, so it’s also a good way to get out extra energy if students become restless during activities that require more focus, and it can provide something for kids to do if your setting up a new activity.

Purpose: To help set physical boundaries in group sessions.

Rules: First talk about how everyone has different sized personal bubbles and then ask them to practice different sizes of bubbles.Say that during the game, all the players will be bubbles, and can choose how big their personal bubbles will be during the game.Then talk about real bubbles, explaining that real bubbles pop if they accidentally rub up against anything, such as a wall or other people, therefore if the students touch anything, they have to pop and fall onto the ground.Also, there are 1-2 students or teachers in the room that are “needles.”If they say pop around the student’s personal bubbles, that student is popped.   The last one or two people standing get to be the new needles. 

The Alphabet Game

This great technique comes from Christy Harris, LPCA. Christy received a gift certificate to for her submission. (And so can you!)

Print the letters of the alphabet, in varying sizes & fonts, and glue each letter onto a different color construction paper. Each matted letter is then glued to a poster board. Lay the poster board on the floor and have children drop buttons (coins or tokens will work as well) on the letters. Whatever letter the button lands on, the child is asked to talk about something they like to do that starts with that letter. This is great as an ice breaker for beginning stages of therapy. During later sessions participants can be asked to identify a “coping skill,” “kind word,” or “action” that starts with the letter. I have used this technique during individual therapy, as well as groups of children ages 5-12. This technique is especially helpful for children who are resistant to talk or participate. Another feature of the letter board is that the letters spelling “control” are the largest letters on the board and all have the same color background, reinforcing the concept of control in a fun and subtle way. I chose control because I work with many children on anger management skills. Additional boards can be made that feature another keyword or skill.