Therapeutic Games

Therapeutic games are great but usually pretty expensive.  Children and teens disclose and express a lot more during games than if I were to just ask them questions.  One way I keep the cost down is by buying low cost regular games and give them a therapeutic twist (see jenga and feelings tic-tac-toe posts).  

Bare Books has really cheap blank game boards, books, puzzles, etc.  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.  Click here to check it out.

FREE Play Therapy Activity Book

Here is a link to a great 120 page play therapy activity book compiled by Liana Lowenstein.  My mentor also contributed :)

Feelings Tic-Tac-Toe

Tic-tac-toe is a very quick and smile game that can easily be made therapeutic.  I made these three activity sheets in “Pages."  

Feelings Tic-Tac-Toe

1. Goal: To help children correctly identify/convey and express feelings
2. Supplies: Tic-tac-toe activity sheet (I created the ones above in Pages), space markers (ex. 2 kinds of animal miniatures, skittles, etc)
3. Each time a marker is placed on a square, the child is asked to act out the feeling with their face.
4. After a couple games, I change the rules (ex. “Each time you put your marker down, tell me about a time when you felt that way”).
5. Play-do face activity sheets (a few posts below) can also be integrated into this activity.
6. Feelings skittles/fruit snacks is a nice compliment to this game (see above post of group 2 outline)

Tic-Tac-Toe Variations

1. Goal: To increase disclosure/expression/comfort and what ever you want (highly adaptable game).
2. Supplies: Tic-tac-toe activity sheet (I created the ones above in Pages), space markers (ex. 2 kinds of animal miniatures, skittles, etc)
3. This game is easily adaptable to your client’s specific needs if you simply use blank/colored squares.
4. Create a key so that every time they place their marker on a certain color X happens.

• Ex. Every time you land on blue share a time when you were angry, when you land on green name a coping skill you could use. 
• Answer a question on a blue card when you land on blue and a green card when you land on green)
• Write a different question, role-play scenario, task etc. that corresponds with each colored square.

Feelings Tic-Tac-Toe was originally developed by Liana Lowestein:  You can buy the book here

Free Play in Child Development and Psychotherapy PDF

Here is another FREE book.  This one is Play in Child Development and Psychotherapy by Sandra Russ.  Send me an E-mail if you would like me to send you a PDF version (uclasocialworker@gmail.com)

Common Sand Tray Symbols

Here are a list of possible symbolism that certain miniatures may hold for children.  I feel that my themes post is extremely helpful when looking at sand trays, but I don’t use this list as much.  It is interesting to look at, especially if certain figures are used repeatedly, but I take these with a grain of salt.  I was taught not to give my interpretations too much weight because it could possibly make me miss something the child is communicating.  It’s not important to know what every piece represents so don’t obsess over this list too much, or ask the child to tell you what every figure means/represents in their lives (they probably wouldnt be able to tell you anyway)

• AMERICAN FLAG: Symbol of identity and belonging. May be used as symbol of ego.
• BABY: Frequently used as symbol of the young self (and fledgling ego)
• BEAR: May symbolize instinctual wisdom or strength. Bears are fiercely protective of their young. May represent positive side of mother love.
• BIRDS: Fly and often seen as carrying spirits
• BRIDGE: Symbol of connection and integration. May indicate attempt to make connections between polarities or opposing aspects of individual.
• BUTTERFLY: Symbol of rebirth and transformation
• CASTLE: Often represents a place of safety
• CAVE: Can suggest place of safety or unknown. May indicate digging into depths of unconscious. Considered a feminine symbol, often symbolizing Good Mother.
• DINOSAUR: May symbolize unconscious rage
• DIVER: Suggests venturing into depths of unconscious
• DOLPHIN: Represents instinctual and guiding intelligence. Appears in myths and legends as saviors.
• DOVE: Symbol of purity and innocence. White dove may also symbolize awakening spirit.
• DRAGON: In fairy tales, is something overpowering to be overcome. Is often guardian of some treasure. May also be symbol of devouring feminine (Terrible Mother archetype).
• EGG: May symbolize new beginnings
• FENCES: Use may indicate efforts to bring some structure to life. May provide either protection or limits. Presence in trays may suggest either increasing ability to set boundaries or a felt need for control and restrictions in connection with instincts.
• FIRE: May symbolize either destruction or cleansing. Often a symbol of sexual energies.
• FLOWER: Often symbolizes transformation and rebirth
• FROG: Is the ultimate animal of transformation. Changes from tadpole to frog to prince.
• GIRAFFE: May symbolize attempt to “stay above it all” to avoid the turmoil going on below.
• HOLY GRAIL: Quest for healing and spiritual nurturing.  Feminine container of spirit.
• HORSE: May represent helpful, guiding instincts. Bridging sea and sky, instinct and spirit, feminine and masculine.
• JUNGLE ANIMAL: Expresses relationship to instincts and aggression (especially large predators).
• KEY: Symbolizes unlocking something (hopeful future?/ traumas of past?).
• LAMP: May signify new illumination of consciousness
• MILITARY FIGURE: Common symbol of authority and conformity
• MIRROR: Mirror provides reflection. May symbolize self-realization, truth or wisdom. May also represent impulse toward consciousness, reflecting back to individual what she/he has not yet seen.
• MONSTER: Often symbolizes fears or out-of-control feelings and impulses.
• OWL: May represent wisdom, protection or sometimes death. 
• PEACOCKS: Its glorious tail feathers may symbolize flowering of the personality. May represent all-inclusive kind of wisdom (because of many eyes on tail feathers).
• PEGASUS: Winged horse born of severed snake-covered head of Medusa. May symbolize bringing unconscious to light or converting evil to good.
• RAINBOW: Often represents transformation or bridge between spiritual and temporal.
• ROAD (OR PATH): Suggests journey in progress
• SEEDS: Universal feminine symbols of fertility and creative life
• SHELLS: Frequently express relationship to feminine.
• SIGNS: May indicate either containment or need for guidance and direction.
• SPIDER: May represent Great Creator (who spins thread of life). May, also be symbol of devouring Terrible Mother (especially black widow).
• STAR: Often connected with hope (since it shines in darkness).
• SUN: Often symbolizes nurturing aspect of father.
• TREES: Symbolize presence of growth and life.
• TUNNEL: Can signify avenue to unconscious.
• TURTLE: Is often symbol of abandonment. Mother turtle leaves and babies must make perilous journey back to sea alone. May also symbolize survival in hostile environment.
• VEHICLES: Are most often symbols of mobility. May represent control power or escape. May symbolize energy available for movement and growth.
• WATER: Is feminine symbol, signifying the unconscious or unknown.
• WELL: May symbolize access to nourishment or energy being gathered from unconscious (water/depths)
• WITCH: May symbolize Terrible Mother archetype

Rainbow Rice Tray

Sand trays are a great asset to any playroom, but can be messy and difficult to clean up at times.  Sand is definitely preferable, but this is a cool alternative if you are sharing an office and don’t want to have to deal with cleaning up sand.

Click here for more info on how to color your own rice.

Sand Tray Themes

I created this chart in Pages.  You just check off what themes you see in each sand tray your client does.  This chart helps you to create a great visual of your client’s progress in therapy.  Initially, check-marks are usually all clustered on the left, but as time goes one more and more drift over to the right.  It is great to see.

Themes That Suggest Wounding

• Chaotic: Haphazard, fragmented, or formless arrangement; e.g., objects’ flung into the tray; boundaries of outer reality disregarded; items carefully placed but overall appearance is jumbled or disconnected.
• Empty: Reticence to use figures or lifeless feeling with lack of energy and curiosity; e.g., a nearly empty tray with only a dead tree placed in a corner.
• Split: Parts of tray appear separated or detached; e.g., river, fence, or elephants placed from bottom to top of tray seem to divide tray
• Confined: Figure or groups normally free are entrapped or caged; e.g. an agonized figure is placed in a cage; a sand wall is built around an old woman.
• Neglected: Figure is isolated from possible support; e.g., a baby in a high chair while mother is sleeping in the nextroom.
• Hidden: Figures buried or hidden from view; e.g., a gun hidden behind a house; a witch buried in the sand under a tree.
• Prone: Figures normally upright are intentionally placed in a reclining, fallen position; e.g., a standing pregnant woman placed face down in the sand.
• Injured: Figures with injuries or in the process of being injured; e.g., a bandaged man lying on a stretcher; a cowboy placed in the mouth of a dinosaur.
• Threatened: Menacing or frightening events and the inability of the endangered figure(s) to escape the experience; e.g., aggressive animals surrounding small child.
• Hindered: Possibility of new growth and development is impeded or hindered; e.g. a boat moving into new waters, while under siege by an army.

Themes That Suggest Movement Towards Healing, Wholeness, and Transformation.

• Bridging: Connection between elements, joining of opposites; e.g., a ladder joins earth and tall trees; a bridge links an angel and devil.
• Journeying: Movement along a path or around a center; e.g., a knight follows a trail, someone paddles a canoe down a stream.
• Energy: Alive, vital, intense energy is visible; e.g., organic growth present, construction machines work on a task, airplanes take off from a runway.
• Going Deeper: Discovery of a deeper dimension; e.g, a clearing is made, a treasure unearthed, a well dug, a lake explored.
• Birthing: Emergence of new development; e.g., a baby is born, a flower opens, a bird lays eggs.         
• Nurturing: Nourishment or help are provided to support growth and development; e.g, a mother feeding babies, supportive family groups, nurse helps a patient, presence of food.
• Changed: Sand and/or objects are creatively changed or used; e.g., sand is contoured to build a land bridge; sand is moved/stacked as an essential part of a lunar compound; a house is built from twigs picked up on walk to school.
• Spiritual: Religious & spiritual symbols present, such as supernatural beings, worshiping figures or numinous items; e.g., Buddha overlooking a couple.
• Centered: In center of tray, elements are aesthetically balanced or a union of opposites occurs; e.g., a man and woman married; mandala centered in the tray.
• Integrated: Congruent organized idea encompasses entire tray; unity of expression; e.g., day at the zoo, baseball game, abstract construction unifying whole tray.j

Suggested Sand Tray Activities

• "Create your own world" or “Tell me a story in this tray"
• Client constructs representation of real-life experience, interaction or problem situation.
• Can provide reassuring distancing for client by keeping in third person.  For example, suggest a scene about "a girl who feels betrayed by her best friend"instead of the client.
• Client builds tray portraying particular issue requiring solution.  Client then selects miniature to act as a Helper or Wise One to answer questions or aid in needed actions.
• Client builds tray illustrating particular feeling and circumstances (or miniatures) that evoke that feeling.
• Client constructs a scene representing own family.
• Therapist selects clinically significant group of miniatures (to focus upon particular situation) and then asks client to create a world for the miniatures.
• Client may play out situation in tray
• Client and therapist do a Joint Tray (similar to Oaklander’s joint picture technique).
• Therapist and client create story in tray together where client selects miniature and supplies first sentence. Therapist follows suit for next sentence and miniature, etc.
• Therapist suggests that client build an Amplification Tray for certain part of constructed world that is confusing or difficult to experience.
• Miniatures involved are moved to second empty tray where they dialogue or play out situation.
• Client adopts physical stance of particular figure in constructed tray, (Therapist may mirror client’s stance.) Client focuses on feelings/thoughts the stance evokes.
• For small group: Members construct individual trays, then select figures symbolizing their own journey to form a group tray.

Sand Tray 101

1.  Direct a child to create a scene (can be general or specific)

• Allow client to work unhindered in tray until they tell you they are finished.
• Pay attention to what the child picks, discards, does with the sand, etc.
• Take not of themes and the energy in the tray that may occur to you as you think about this client’s, particular presenting problem, early years, family situation, etc

2.  Look for themes and comment on what you see (relating to the selection and placement of figures).

• I notice that…. (ex. this one is all alone in the corner)

3.  Make gentle interpretations, but do not share them.

4.  Invite the child to describe their scene (examples below)

• Tell me about your world

• Does your tray have a name?

• Does it have a story to go with it? Will you tell me the story?


5.  Ask relevant questions (examples below)

• What was difficult about doing this?  What was easy?

• What do you dislike about the scene? What do you like?

• Is there anything you would like to change?  (Have them change it) How did that feel?

• I’m wondering about _____________
• If you had to choose one of these figures to be you, which one would it be?
 (Don’t go farther than this and ask them to tell you what each figure represents, the probably wouldn’t even be able to tell you)
• Does this world remind you of anything in your own life?

7.  Invite parts of the scene to talk to each other

• Does anyone (referring to the figures) have anything to say?

Free Mental Health Powerpoint Presentations

Many School-Based Mental Health practitioners do presentations or in-service trainings for teachers and parents surrounding mental health issues.  This website provides free powerpoint presentations that may be helpful.  Many topics apply to practitioners working in non-school settings as well.

Subjects include adolescent development, anxiety disorders, disruptive behaviors, the IEP process, depression, anger management, and more.

Click here

Click here to access collection of 17 free, online series and over 150 on-demand presentations related to child and adolescent trauma. 

The topics covered include: Assesment and treatment of complex trauma, culture and trauma, theory and research findings of about trauma, creating trauma-informed child-serving systems, the impact of terrorism and disaster on children, child traumatic grief, and child sexual abuse. 

Each 1.5 hour presentation is worth 1.5 CEUs.

FREE Cognitive Behavioral Therapy Books

FREE Cognitive Behavioral Therapy books.

Just send me an e-mail at uclasocialworker@gmail.com if you want Pdf versions of any of these.

Therapeutic Toys

Here is a list of therapeutic toys that are used in play therapy.

1. Nurturing/Family Toys

• Purpose: Build and explore relationships
• Dolls, baby bottles, blankets, diapers, doll house (furniture and doll family), puppet family (people and/or animals), miniatures, kitchen set (food, dishes, etc.), doctor’s kit.

2.  Fantasy/Pretend Toys

• Purpose: Express feelings, and play out roles/scenarios
• Dress-up clothes/hats, costume jewelry, puppets, miniatures, mirror, masks, play money, magic wand, vehicles (cars, trucks, rescue vehicles, planes), doctor’s kit, communication toys (phone, microphone, mailbox, etc.)

3.  Expressive and Construction Toys

• Purpose: Express feelings, mastery, problem solving and creativity
• Arts supplies (markers, crayons, paint, paper, etc.), craft supplies (stickers, pipe cleaners, beads, popsicle sticks, tape), water, play dough, clay, building blocks, legos, cardboard bricks.

4.  Acting Out/Aggressive Release Toys

• Purpose: Expression, processing and mastery of fear and anger; Control
• Monsters and villains, heroes, plastic soldiers, dinosaurs, spiders, snakes, aggressive looking puppets and miniatures (ex. dragons, animals with teeth showing, etc.), rope, handcuffs, bop bag, toy guns/knives, dart gun.

5. Movement and Motion Toys

• Purpose: Mastery, emotional outlet, and self-regulation.
• Balls, basketball/hoop, bubbles, ring toss, bean bags, target games, jump rope, hula hoop, music.

Van Fleet et. al (2012). Child Centered Play Therapy.

‎"Inocente"

‎"Inocente" won the Oscar for best documentary short. The film follows a homeless, undocumented immigrant teenage girl in San Diego as she relentlessly pursues her dream of becoming an artist. With heart and wit, the film explores the issue of homelessness among youth while also capturing the power of art and ambition.

Click here to watch Inocente for free! 

FREE books on using Cognitive Behavioral Therapy with children and adolescents

Just send me an e-mail at uclasocialworker@gmail.com with the title of any books you want and I’ll send out a Pdf version.