Category Archive Play in Therapy

ByStacy Garcia, MA, LPC, NCC

The Worry Worm Game

Children with anxiety sometimes have a hard time opening up about what they’re worried or anxious about. Enter the worry worms. Worry worms are simply construction (or cardstock) paper worms that look like… well, little worms. I use them in play therapy, but you can easily make your own worms at home and play the worry worm game.

The Game

Worry worms are pretty easy to make. Simply draw or trace a worm onto brown construction paper (or cardstock paper works well too). Make several worms, and cut each of them out. Wa-la! Worry worms! I laminate my worms, simply because this allows me to keep them durable for multiple children to play with.

Next I hide these little guys (the worms) around the room for the child to find. For each worry worm the child finds, they are asked to tell one worried thought they have or have had.

Simple right?

It looks like a game of hide-and-seek to them, but let me tell you what really happens when you play the worry worm game:

  • The child is identifying their worried feelings. This is a huge thing. The mastery of this skill is a major foundation to helping children learn how to cope and regulate their emotions.
  • The child is able to begin tolerating the idea and practice of sharing uncomfortable thoughts out loud because they are motivated by the challenge, reward, and fun of finding the hidden worms.
  • The game itself offers a titrated set of exposures to anxiety producing content that is completed while remaining grounded in the safety of the worm prop.
Have fun playing the worry worm game! Do you have ideas or strategies that you use to help kids talk about their feelings? Please feel free to share in the comments. I’m always looking for new ideas to use in the playroom!


ByStacy Garcia, MA, LPC, NCC

“The Real Game of Life:” A Printable Life Skills Game for Teens

Life skills don’t come particularly easily to everyone. Some teens and young adults, especially those with special needs, have quite a bit of difficulty learning some of the skills they need as they transition into adulthood.

I created the following game – “The Real Game of Life” – for teens to help teach some of the basic life skills that many people take for granted, all the while reinforcing good decision making skills (because, hey, in the real game of life, we’re all forced to make decisions). The game is meant for at least two players, though a couple others may join to play the game too. It is helpful for at least one player to be someone who knows the basic life skills that the cards address, or at least have someone close by on the sidelines in case there are any questions, as well as to judge whether the answers given are adequate or correct.

Photo courtesy of Pixabay

The Real Game of Life


Materials needed to make “The Real Game of Life” include:
  • Printable “The Real Game of Life” cards, laminated for durability and cut apart
  • Twister game mat
  • 1-2 beanbags
  • Masking tape, optional
Here’s how to prepare and play the game:
Print “The Real Game of Life” cards and laminate and cut each of the cards apart. Then find a Twister game mat. You may have an old game of Twister at home somewhere that no one has played for several years; if not, you can still find the game affordably priced at most department stores. After attaining the Twister game mat, lay the mat out flat on the floor.
Next you will need to place one card on each circle of the game mat, face down. The extra game cards should be placed in a separate pile, easily accessible but away from the game mat. Then assign each column of circles with a point value; if you wish, you can label the columns with their point values on index cards. For instance, column one of the game mat might be worth one point; column two can be worth two points; and so on. Another option is to assign each colored circle with a different point value, with a range of possible scores from one to five. (Obviously, if you choose this option, you’ll want to somehow label the various circles with the points a player can earn if they land on that circle.)
Next, designate a line away from the mat from which to throw the beanbag from. One beanbag is sufficient for the game, though if you happen to have more beanbags, you can give each player his own to use. Designating the line with a line of masking tape could prove beneficial.

Game Play

Decide which player will go first. Each player then takes turns throwing a beanbag onto the mat, aiming for a color circle with a card placed on top of it. If the player lands on a circle with a card, he reads and answers the question card aloud. If the beanbag lands on a white area, the player loses his opportunity to answer a question and earn points until his next turn.
If the player’s answer is adequate or correct, based on the therapist’s opinion (or the opinion of another person knowledgable about the life skills addressed), and requires little or no help, he earns the number of points designated to tht column (or circle) in which his beanbag landed. Then the card is subsequently removed from the game mat. If the player’s answer is not thought to be correct, he is to turn the game card back over so it can be answered later when someone lands on that circle.
If a beanbag lands on a circle that has already had its card removed, no question is asked nor any points earned for that turn, and it then becomes the next player’s turn.
If a player reads the question he draws from the mat aloud and decides that he cannot answer it adequately, he has three opportunities per game to lay the card back onto its designated circle and instead choose from the separate deck of game cards. If that question is answered correctly, the player earns the same number of points for which he would have earned had he answered the original question he landed on from the game mat.
The game ends once all the questions from the mat have been answered. The player with the most points at the end is declared the winner.
For a printable pdf version of “The Real Game of Life’s” instructions, as well as for the printable game questions, look and click below.
Hope you enjoy the game!

Photo courtesy of Pixabay

ByStacy Garcia, MA, LPC, NCC

What is Play Therapy?

“Play therapy is based on the fact that play is the child’s natural medium of self expression. It is an opportunity which is given to the child to ‘play out’ his feelings and problems just as, in certain types of adult therapy, an individual ‘talks out’ his difficulties.”  – Virginia Axline, “Play Therapy”

Sigmund Freud believed he could understand children by watching them play. He was right. According to the Association for Play Therapy’s website, play is the child’s language. Play:
  • Is fun; it’s enjoyable.
  • Elevates our spirits; it brightens our outlook on life.
  • Expands self-expression, self-knowledge, self-actualization, and self-efficacy.
  • Relieves stress and boredom.
  • Helps us connect to people in a positive way.
  • Stimulates creative thinking and exploration.
  • Regulates our emotions.
  • Boosts our ego.
  • Allows us to practice skills and roles needed for survival.
  • Fosters learning and development.

Photo courtesy of

Play therapy is the child’s mode of communication, for sharing his world, his inner thoughts and feelings, and the meanings that he makes of his experiences of the world. It’s the child’s opportunity to communicate what he can’t as easily put into words. It is child-to-self communication, similar to the way that many adults go over and over a topic that’s bothering them when working with a therapist – in ways that they won’t when thinking about it alone, even if they’re doing it “all the time.” Specially trained mental health professionals use play therapy to help kids express what’s troubling them when they may not have the verbal language to express their thoughts and how they’re feeling. It builds on the natural way that kids learn about themselves and their relationships with the world around them.
The Association for Play Therapy defines play therapy as “the systematic use of a theoretical model to establish an interpersonal process wherein trained play therapists use the therapeutic powers of play to help clients prevent or resolve psychological difficulties and achieve optimal growth and development.”
In adult therapy, the counselor’s listening and empathic responses help the client work through their problems and gain insight. In play therapy (particularly Child-Centered Play Therapy, or CCPT), with the counselor’s attentive tracking and empathic responses, kids work all the way through their own repetitive, unproductive loops to reach new understandings of their experience, and new decisions of who they want to be and how they want to behave.
Play therapy is used to help kids cope with different emotions and find solutions to problems. By confronting their problems in this setting, kids are able to find healthier solutions.

Who Benefits from Play Therapy?

Everyone can benefit from play therapy, including teenagers and adults! It is especially appropriate for children between the ages of 3 and 12. Play therapy is identified as the treatment of choice in mental health, school, agency, developmental, hospital, residential, and recreational settings with clients of all ages, according to the Association for Play Therapy. As is the case with most therapy modalities used in treating children, it is most effective when a parent/caregiver is also actively involved in the child’s treatment; kids and families heal faster when they work together. The therapist will decide how and when to involve some or all of the child’s family members. At minimum, the therapist will want to communicate regularly with the child’s caregivers to develop an appropriate treatment plan, as well as to identify and monitor progress.

Photo courtesy of

What Issues and Concerns Does Play Therapy Help?

Play therapy is often utilized as the primary intervention or as an adjunctive therapy for multiple social, emotional, and behavioral disorders, including (but not limited to):
  • Anxiety disorders
  • Obsessive-Compulsive Disorder (OCD)
  • Depressive disorders
  • Attention-Deficit/Hyperactivity Disorder (ADHD)
  • Autism Spectrum Disorder
  • Oppositional Defiant and Conduct Disorders
  • Anger management
  • Trauma
  • Grief and loss
  • Divorce and family dissolution
  • Academic and/or learning difficulties
  • Social developmental difficulties

How Long is a Play Therapy Session?

Play therapy sessions generally last for 30-50 minutes. For most school-aged children, I frequently allow for 45 minutes per session, once a week. The length of a session is dependent, however, not only on the age of the child, but additional factors as well, such as the child’s attention span and developmental level.
On average, it may take approximately 20 sessions of play therapy before treatment is deemed to be complete. However, this also varies from child to child. Some children require fewer sessions, while more serious or ongoing issues may require more. I ask parents and caregivers to be patient; it may seem sometimes as though all we’re doing is “playing,” but in reality, the child is hard at work.

Photo courtesy of

Who Can Provide Play Therapy?

While many trained clinicians sometimes utilize play techniques in their sessions, the practice of true play therapy requires extensive specialized education, training, and experience. A licensed mental health professional with a Master’s or Doctorate degree must receive advanced, specialized training, experience, and supervision in order to be credentialed by the Association for Play Therapy as a Registered Play Therapist (RPT), Registered Play Therapist-Supervisor (RPT-S), or School-Based Registered Play Therapist (SB-RPT).
I am currently in the process of becoming a Registered Play Therapist (and have been for some time now). This means that I am permitted to practice play therapy while completing my training and required hours of experience while under the supervision of a RPT-S. If you’re interested in play therapy for your child (or even for yourself!), please contact Creative Resilience Counseling at 304-292-4050 or by contacting me on the website’s Contact page. I look forward to working with you and your child!
For more information about play therapy, check out the Association for Play Therapy’s website!
ByStacy Garcia, MA, LPC, NCC

Batman in the Playroom: Using Superheroes to Heal

What if I told you that Batman is my security guard, my protector, my hero?  My superhero?  Would you think I was crazy?  Or perhaps that maybe I was joking? I’m speaking only truth.  He helps me learn new ways of looking at things.  He helps me solve the problems I face.  And he shields me from the villains that might be lurking around in the shadows.

Villains?  Yes.  Villains.  You know, the ones outside of my cozy little therapy room?  The villains.  The bully who picks on me.  The man who lives down the street and scares me and gives me goosebumps every time I pass by on my bike in front of his house.  My mom, who hits me until she blacks out.   Those villains.  The villains we all encounter in some way at different points in our lives in the real world.  The ones who frighten us.  The ones who seem a lot more powerful than us.  The villains. 

But don’t worry about me because I’ve got Batman to protect me.  And Superman, the Incredible Hulk, and Wonder Woman too.  They get me through it all.  To you, they might look like just toys, but to me, they’re like my best friends, and best of all, they teach me how I can be a superhero too…

Superhero Child

Play and Children

I don’t think that there’s any question that children love to play.  Spend fifteen minutes with a child, and you will likely catch a glimpse into an entirely different world, one that is magical and, truthfully, a lot more fun.  What could a child possibly love more than play?!  Well, there actually is something…. They really love it when a grown-up joins in and plays with them!

It turns out that play has even more benefits than just being fun. It actually has a purpose!

“In their play, children repeat everything that has made a great impression on them in real life, and that in doing so, they abstract the strength of the impression and make themselves a master of the situation.” -Sigmund Freud.

Play, especially fantasy play, is a safe way for children to express their emotions, to figure out the confusing things that they’re experiencing, and sometimes to even distance themselves from what are otherwise very painful situations. Lev Vygotsky, a Russian psychologist who contributed a great deal in the field of developmental psychology, regarded fantasy play as a window into a child’s under’s understanding of their current reality, of which they’re able to “experiment with competencies and understandings beyond the constraints of their intellect and experience.”

Maybe this will help: As grown-ups, we often use metaphors to help us understand things (concepts) more completely and to help us gain insight into the many situations we encounter in our day to day lives.  A metaphor is simply a figure of speech containing an implied comparison, one in which a word or phrase is applied to an object (or action) to which it isn’t literally applicable. “All the world’s a stage” is likely a metaphor that you have heard.

What metaphors do for us, fantasy does for a child.  Most of us have probably watched a young child as she transforms her building blocks into a fast and exciting train. Or perhaps you’ve seen the family cat magically imagined to become a terrifying tiger in the jungle! Metaphors help us, as humans, generate various possible solutions to the problems we face.  They help to provide those “light bulb” moments of insight.  This is what play does for children!

Calling All Superheroes!

Enter Batman.  Superman and the Incredible Hulk too.  Invite all the superheroes.  And don’t forget the villains!

The Joker

Yep. They’re all invited to my play therapy room.  They come so they can help teach children how to their own superhero and how to identify the superheroes in their own lives.  (Not all heroes wear capes, after all.)  They teach kids how to use their superpowers to defeat the villains they may encounter. They help kids work through their own adversity, and they do it all in a safe, non-threatening, and playful way.

You see, within each of us (children included) lies a number of superpowers that we often don’t know are even there.  One such superpower is strength.  Inner strength.  Superheroes are able to help teach children that.  Superheroes have the power to heal the hearts that have been broken and the spirits that have shattered.  Superheroes help the child being bullied in the school hallways.  They help teach children how to solve problems and look for solutions. They teach courage to the child who has to go to court to testify against his abuser.  They give children the opportunity to learn that they too can fight any villain they encounter throughout life – that good really can overcome evil.

Why Superheroes?

Calling All Superheroes!There’s something about superheroes that many kids can relate to, whether they’re in therapy or not.  Here are some things about superheroes that I myself never realized until I started exploring using superhero therapy:

  • The superhero has often experienced some type of early childhood traumatization.
    • Superman was separated from his parents and sent to a completely different planet.
    • Spiderman was adopted and raised by his aunt and uncle.
    • Batman was orphaned after his parents were brutally murdered.
  • Most superheroes grow up without his or her biological parents.
  • The classic American superhero generally comes from outside of the community he or she is called to serve, though he may reside therein.
  • The superhero is outcasted from society in some way.
  • Every superhero was faced with with adversities and failures in their childhood that only continued as they aged on their road to super heroism.  Yet, somehow and in some way, they were able to survive and ultimately rise.
  • The superhero’s motivation is a selfless zeal for justice.
  • When faced with adversities, the superhero finds answers in vigilantism and restoring justice.
  • The superhero, though on a mission of personal vengeance, unites this vengeance with a consuming love of impartial injustice.
  • To do what he (or she) does requires superhuman powers and the inability to suffer fatal injury.

Can you see why some children feel such great connection with superheroes?  Simply put, they can relate to these super figures.  The children I see in therapy are frequently those who, just like their superhero friends, have also faced significant adversities and challenges in their young lives. Some  have faced traumatic events; some have trouble coping with anxiety or have been beaten down with depression.  There are kids who have been outcasted by their peers at school and others who have suffered at the hands (or hurtful, hateful words) of a bully.  And there are children who feel invisible to the world around them and may even be behaving in ways in attempt to find someone who cares enough to pay attention.

Regardless of the challenge, regardless of the adversities these children have endured, it can be guaranteed that there’s a superhero out there who has faced something similar.

When superheroes and children “meet,” kids are suddenly given an ally in the world; they find a friend.  They realize that they’re not alone. There’s finally someone to validate how they feel.  Children become empowered by the new knowledge that they too can overcome, that even they have superpowers. And most importantly, they learn that they can be a superhero too.  And isn’t that something we hope all children have the opportunity to realize?

ByStacy Garcia, MA, LPC, NCC

My Favorite “Non-Therapeutic” Games… Perfection

Perfection game photoPlaying games in therapy is one of my most favorite things to do in my profession as a therapist.  Children especially enjoy game play, as they also like having a willing opponent in which to play games.  In my practice, I use specialty therapeutic games, which are games that are specifically created and designed to address particular mental health issues and challenges (e.g., impulse control, positive thinking, etc.), as well as traditional board and card games that you can purchase at a department store (e.g., UNO, CandyLand, etc.).  I call this latter group of games “non-therapeutic” because they were not specifically designed to be used as therapeutic techniques in mental health.  The truth is that regardless of whether a game is specifically designed with a therapeutic purpose in mind or not, ANY game can be made to have therapeutic value in my playroom.

I’ve explored various techniques that I use with the games Jenga, Find It, and Sorry! in previous posts.  In this post I’m going to show you the therapeutic value of the classic game Perfection with children who have difficulty with focus, attention, and concentration and those who need to develop more effective problem-solving skills and appropriate coping strategies.  Perfection is an excellent game to help with all these things!

How to Play Perfection

The object of the game Perfection is to fit all the shapes into their matching holes in the game tray.  Pictured in this post is the travel edition of Perfection, which includes 16 shapes, but the original game actually has 25 shapes that you have to fit.

To set the game up, the player spreads the shape pieces next to the game tray so that he or she can easily access the pieces.  It helps if all of the handles are facing up, though if you’re looking for the added challenge, leave the shapes as they are.  Then the player sets the timer (on the game tray) so that they have 60 seconds of time to complete their task (for the travel edition of this game, the timer will be set to 30 seconds as there are fewer shape pieces).

Next the player simply presses down on the game unit’s pop-up tray and starts the timer.  The player then has to quickly fit the shapes into their matching holes.  If he or she finishes before the timer runs out, they should quickly turn the timer off; their turn is over and they have successfully completed their task (they win!).  If he or she DOES NOT finish before the timer runs out, the tray will pop up and scatter the shapes all over (and nearly scare you both to death in the process!).

How to  Make Perfection Therapeutic

Perfection is played no differently in therapy than how it is played regularly.  When I first introduce the game to a child, I teach them how to play and let them play two or three times without any intervention from me.  During this independent game play, I observe the child’s behaviors:  Does the child become easily frustrated?  How does the child handle the stress and frustration of trying to beat the timer?  Is this method effective for them?  How well are they able to concentrate and focus?  Are they easily distracted?  More likely than not, you will find that most kids get in such a hurry to beat the timer that they actually decrease their efficiency of successfully completing the task due to their inability to remain calm and focus on the task itself.

After the observation phase, I discuss my observations with the child.  I then prompt him or her to brainstorm ways to improve, offering suggestions such as slowing down, remaining calm, using deep breathing techniques, and staying focused.  I then role play these new techniques with the child while they play the game again (and sometimes, again and again).

Soon you (and the child) will see visible improvement in their efficiency in completing the game’s task.  The goal, whether achieved that day or a few sessions down the road, is for the child to be able to utilize effective and appropriate coping and problem solving skills during game play, as well as in real life situations that he or she may encounter.  For this reason, it is important to process and even role play these new skills and how they can be utilized in various life situations, such as when taking a test in school.  It’s remarkable how easily kids will remember their new skills all because they played the game Perfection!


ByStacy Garcia, MA, LPC, NCC

My Favorite “Non-Therapeutic” Games… Find It

Find It GameI love using games in therapy, and kids love playing games in therapy!  Last week I posted about the use of the Jenga game as a therapeutic intervention during counseling sessions.  It’s an excellent resource for just about any topic or skill that you’re trying to teach to kids, adolescents, and adults alike.  I use a number of games in therapy sessions, both therapeutic and “non-therapeutic.”  The difference between the two is what their intent and purpose was when the game makers created them.  “Non-therapeutic” games are simply those that you can find at your local department store in the game aisle, like Candy Land, Jenga, and Operation, but in my experience, ANY game, regardless of its intent during creation, can be made therapeutic.  Today’s game can be found in both therapy resource catalogs AND the game aisle.

Find It as a Therapeutic Intervention

Find It, like Jenga, is another one of my favorite “non-therapeutic” games to use as a therapeutic intervention with children and adolescents.  Find It is a classic I Spy game that comes in a nice sturdy cylindrical container filled with miscellaneous small objects to find (e.g., a rubber band, an eraser, a feather, etc.) that are hidden in a colorful array of beads, pebbles, or dried rice (depending on which version of Find It that you choose).  I primarily use the game with children and teens that I’m treating for Attention-Deficit/Hyperactivity Disorder (ADHD) or who have other issues in which they have difficulty with focus and attention.  I use the game to help improve their concentration and focus, as well as to informally assess their distress tolerance.  The object of the game is simple:  Find as many objects from an included list as you can.  You can do this activity timed or take as long as you need.

The first time I give a child the Find It game during session, I collect baseline data by setting a time limit (for example, 10 or 15 minutes) and assess how many objects they can find within that given time frame.  The game itself includes a small notepad checklist, so we mark each item off as it is found.  I write down the time limit I give the child (whether it was 10 or 15 minutes) and the number of objects found, and then I put the information in the child’s file so I can access it in future sessions.

How Often to Use Find It in Session

We play the game intermittently; the next time we play the game is generally a few sessions after I’ve collected the initial baseline data.  The sessions in between are spent doing other focus improving activities in order to help the child develop his or her skills.  When we play the game again, I give the child the same time limit as before.  Again the child is asked to perform the same task:  Find as many objects as possible before time is up.  The objects are never in the same place as they were initially, as each movement of the container shakes and jumbles the objects around.  I record the data afterward, just as I did the first time the child played.  This time I’m looking to assess whether the child’s scores (number of objects found in a given time) have improved as a result of our working on their focus, concentration, and attention span.

Find It as a Tool to Improve Distress Tolerance

Find It also allows me to see how a child tolerates the distress and frustration that comes with sometimes having difficulty finding the small objects.  During game play, if a child is becoming noticeably distressed, I teach coping and self-regulation methods that they can use to slow down and bring their focus back to the game again.  Between sessions, we will work on improving the child’s distress tolerance and learning effective coping skills to help handle frustration.

How Long to Use the Find It Game

I generally give the child the Find It game and assess their focus once every few sessions until I see that their scores have significantly improved and/or their distress tolerance is handled appropriately on a consistent basis.  Once I see that the child has improved, we put the game away, though the child usually ends up getting it out at the beginning or end of future sessions as a transition activity.


ByStacy Garcia, MA, LPC, NCC

My Favorite “Non-Therapeutic” Games… Jenga

Jenga photoGames are wonderful to use in therapy, especially with kids!  I utilize a number of games in therapy sessions, both therapeutic and “non-therapeutic,” the difference being what their intent and purpose was when the game makers created them.  “Non-therapeutic” games are those that you can find at your local department store and find in the game aisle, like Scrabble, Monopoly, and Battleship.  In my experience, ANY game, regardless of its intent during creation, can be therapeutic.  I’ve taken many, many “non-therapeutic” games and turned them into awesome therapeutic interventions in therapy.  The results are always amazing.  Kids love that they’re playing a game, and they don’t even mind that I may have changed it up a little.  My next few posts will be about some of my most favorite “non-therapeutic” games to play in therapy.

Therapeutic Jenga

Jenga is a gem!  I have used Jenga hundreds of times as a therapeutic intervention.  The game can be used in so many ways and with practically any topic you think of.  Additionally, I’ve found that I can use Jenga with any age group:  children, adolescents, and even adults!

When I first started using Jenga, I would write various tasks and questions based on the skill I was trying to teach on the individual wooden blocks.  This isn’t necessarily a bad idea, but it didn’t take long before I had spent a small fortune on Jenga games.  If you walk into my office, you’ll find several Jenga games, each covering different topics and for different age groups, all created before I eventually realized that it was significantly more cost effective to just purchase one Jenga game, color code the blocks with stickers or markers, and create prompt and task cards to use instead.  You can create your own Therapeutic Jenga any way you wish, but if you plan to use the game for several different skill teachings, I’d advise the latter method.

Therapeutic Jenga is played by following the game’s original game instructions, regardless of what topic or skill is being taught.  Simply color code your individual blocks with various colored stickers or by using different colored markers prior to play.  Have color coded task/prompt and/or question cards prepared as well.  During game play, a task card is drawn according to the color code on the block that is plucked from the tower.  The person who picks the block is the one who answers or completes the question/prompt.  Just for fun, I intentionally leave a few of the blocks blank (with no color code), which are used as free passes, meaning there’s no question/prompt to complete – the kids and teens especially love when they choose one of these!

What therapeutic skills can be taught using Therapeutic Jenga?

Among other topics, I’ve used Therapeutic Jenga for rapport building, reinforcing positive relationship skills, social skills, teaching emotion identification and expression, communication techniques, anxiety reduction, impulse control, and even to teach all ages how to dispute irrational self-talk.  I’m yet to witness even one person complain about not wanting to play Therapeutic Jenga.  It’s a game that is always met with an excited and receptive attitude!

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