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.
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.
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:
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.
Playing 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!
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!).
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!
I 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.
Games 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.
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!