10 Telehealth Therapy Games for Teens: Screen Share, Chat and Voice

Telehealth therapy games for teens can use shared-screen clues, chat choices, short role-plays and collaborative puzzles to practise a specific skill. You do not need a separate gaming platform for the ten games below. The therapist can manage the materials while the teen directs choices by voice, chat or pointing.

This guide is for therapists and counsellors running adolescent video sessions. Each game includes the actual materials, words to use, rules, an example and a phone or low-bandwidth adaptation. These are facilitated activities, not browser games with built-in multiplayer. The examples are available to use from this article; there is no separate download required.

Choose a telehealth game for your session

Set up the session before starting

Choose one skill and explain it: “We are practising how to check what we know before choosing a response.” Offer a fictional example, a different scene or the option to pass. Agree how the teen can stop or change the game.

Check whether the teen can see shared material on their device and whether speaking or typing is comfortable and private. Share only the prepared window, with unrelated notifications and client material out of view. A blank document or paper held to the camera is enough; remote control and a new account are unnecessary.

Use your usual consent, confidentiality, location and emergency arrangements for telehealth. Explain limits of confidentiality rather than promising complete secrecy. If someone may overhear, agree what can safely be discussed; headphones alone do not make the teen’s spoken replies private. Do not ask for a room tour, private messages or a view of personal belongings as a condition of playing.

These games are illustrative skills-practice formats, not individually validated treatments. Choose them within the teen’s assessment and care plan. A camera turned off, a delayed reply or a wish to stop is something to understand, not a score for engagement.

10 games you can run over a video call

1. Emoji Director

Skill: Emotional vocabulary and asking before assuming.
Suggested time and players: 5–8 minutes; one teen and therapist.

Prepare: Show or read this fictional scene: “A character arrives at a club meeting and sees that everyone has started.” Have three symbols ready: a cloud, a spark and a question mark. You can draw them on paper instead of using emoji.

Say: “You are the director. Choose a symbol for how this character might feel, then give me one clue. I will try to understand your version.”

1. Offer the three symbols and let the teen pick, replace them or pass. Ask for one clue about a possible thought, body feeling or urge.
2. The therapist proposes an emotion and explains the clue used: “I wondered about uncertainty because they do not know where to sit.” The teen can correct the interpretation.
3. Reverse roles with a second scene: “The character is invited to show something they made.” Keep more than one plausible feeling in play.
4. Finish after two rounds by writing one useful question someone could ask the character instead of assuming what they feel.

Example round: A teen chooses the spark and says, “Their face feels hot.” The therapist guesses embarrassment; the teen says frustration fits their story better. Together they write, “What was it like arriving after everyone started?”

Remote adaptations: The teen can type the symbol or say its number. On a phone, show one symbol at a time. If visuals fail, read “cloud, spark, question mark” aloud. Do not infer a real teen’s emotion from their camera expression.

Debrief: “Which clue helped?” “What would we still need to ask?”

2. Clue Unlock

Skill: Separating observations from conclusions while new information arrives.
Suggested time and players: 8–12 minutes; one teen or a small group.

Prepare: Prepare a blank page with “Known”, “Possible” and “Still missing”. Keep three clues off screen: 1—“Jo’s team changes the practice time”; 2—“Jo did not see the update”; 3—“The coach asks whether Jo can attend the new time”.

Say: “You can unlock one clue at a time. Our challenge is to build a conclusion that fits the information, including what we do not know.”

1. Read the starting case: “Jo arrives and finds the practice space empty. Jo thinks, ‘They decided to leave me out.’” Ask where the statement belongs on the page.
2. Reveal clue 1 only. Let the teen tell you what to move or add. Before unlocking clue 2, ask what question they would want answered.
3. Reveal the remaining clues separately. After each, revise the page rather than keeping the first conclusion as the answer to defend.
4. Close the case when the teen offers one observation, one uncertainty and one possible next step.

Example round: “Practice moved” is an observation. “They dislike Jo” remains an interpretation. Jo might ask where updates are posted and how to receive them. The coach’s invitation adds information without proving every relationship is fine.

Remote adaptations: The therapist controls the document, so remote-control access is unnecessary. The teen directs moves by voice or chat. On a phone or voice-only call, number the categories and read back a short summary after each clue. In groups, rotate clue-reader and question-builder roles.

Debrief: “Which clue changed our conclusion?” “What does it fail to prove?”

3. Choice Route

Skill: Considering consequences and revising a response when context changes.
Suggested time and players: 8–10 minutes; one teen or 2–4 participants.

Prepare: Write three choices: A—reply immediately; B—pause and clarify later; C—ask a trusted adult for support. Use the fictional scene: “A classmate posts a sarcastic comment about a character’s project.”

Say: “Choose a route for the character. Then I will add information, and you can change your choice.”

1. Read the scene and let the teen choose A, B, C or another option. Ask what goal the route serves and what might happen next.
2. Describe a plausible consequence collaboratively; do not make every therapist-preferred choice magically succeed.
3. Add this context: “The same classmate has posted several targeted comments this week.” Ask whether a different route or combination now fits better.
4. Let the teen write or say the opening line for their revised response. End when they can explain the goal and what further support might be needed.

Example round: A teen initially chooses to ignore one comment. After hearing that it is repeated, they suggest saving relevant information through an appropriate school process and asking a trusted adult for help. The useful shift is responding to context, not finding a universal correct answer.

Remote adaptations: Put only the current scene and three choices on screen. Voice or a single chat letter works on small devices. If screen sharing drops, read the choices. Groups can choose independently before discussion; do not treat majority vote as clinical advice.

Debrief: “What changed your choice?” “Which consequence can we predict, and which is uncertain?”

4. Coping Trade-Off

Skill: Matching a coping option to its setting and limits.
Suggested time and players: 8–10 minutes; one teen or a small group.

Prepare: Prepare four options: take a brief quiet break; write down the next question; ask for practical help; talk to a safe person. Prepare two setting cards: “five minutes before a lesson” and “at home after a difficult day”.

Say: “Pick a tool, then test whether it fits the setting. You can keep it, adapt it or trade it for another.”

1. Reveal the first setting and invite the teen to choose one option. Ask what it might help with and what it would not solve.
2. Add a constraint: “There is no quiet room available.” Invite a trade or a smaller version of the same option.
3. Reveal the second setting and repeat. A strategy may be helpful in one setting and unsuitable in another.
4. End by choosing one realistic option for a fictional character and describing exactly how they would use it.

Example round: “Take a quiet break” becomes “sit at the available desk and write one question to ask after the lesson”. At home, talking with a safe person may be more accessible. The teen does not have to claim either option makes them calm.

Remote adaptations: Display four large numbered options or read them aloud. The teen says “keep”, “trade” or “adapt”; you do the moving. With low bandwidth, use two options per round. In groups, invite differing choices without ranking whose coping is best.

Debrief: “What does this tool help with?” “What support or problem-solving is still needed?”

5. Repair the Chain

Skill: Understanding the interaction of thoughts, emotions, body sensations and actions.
Suggested time and players: 8–12 minutes; one teen and therapist.

Prepare: Make four numbered tiles: 1—“The teacher will think I am stupid”; 2—“worried”; 3—“tight stomach”; 4—“does not ask the question”. Keep a fifth tile ready: “asks for help with the first step”.

Say: “I have mixed up the character’s sequence. Tell me where the tiles belong, then we will test one change.”

1. Read the situation: “A character cannot understand the first part of an assignment.” Show the tiles in a mixed order and invite the teen to sort them into thought, emotion, body and action.
2. Let the teen direct the sorting by tile number. Keep an unsure space for ambiguous wording.
3. Replace the action tile with tile 5. Ask what might happen next and which parts of the sequence could remain uncomfortable.
4. Invite the teen to edit the thought into something believable, such as “I do not understand this step yet; I can ask about it.” End by comparing the two sequences.

Example round: Asking for help does not guarantee the tight stomach disappears. It may give the character useful information while worry remains. The teen notices that a different action can be possible without perfect confidence.

Remote adaptations: Use one large tile at a time on a phone. With voice only, read each tile and repeat the category labels. The therapist moves tiles; annotation is optional. This is skills practice, not a test of how quickly the teen can sort.

Debrief: “Which change could give the character new information?” “What might stay the same?”

6. Caption Editor

Skill: Developing fair self-talk while acknowledging a difficult event.
Suggested time and players: 7–10 minutes; one teen or pairs.

Prepare: Type this fictional caption: “I made a mistake in practice. I ruin everything.” Under it, leave spaces for “What happened”, “What the caption adds” and “A fairer version”.

Say: “You are the editor. Keep the true part and change anything the evidence does not support.”

1. Read the caption aloud and ask the teen to identify the specific event. The therapist highlights only the words the teen chooses.
2. Ask what “everything” implies. Add two facts: “The character completed the first section” and “The coach showed how to practise the difficult part”.
3. Invite a revised caption that acknowledges the mistake and includes relevant information. The teen can dictate, type or choose between two drafts.
4. Now act as the character and say, “But I still made a mistake.” Let the teen revise the caption so it does not dismiss that fact.

Example round: “I struggled with one section. I finished another part and now know what to practise” is more precise than “I am brilliant”. The character can still feel disappointed.

Remote adaptations: Use a blank document containing only fictional text. On a phone, send one short line at a time through approved session chat. If chat is unavailable, make the edit orally and read it back. No real social account or private post needs to be opened.

Debrief: “Which words became more accurate?” “Would the character actually believe this version?”

7. Response Replay

Skill: Rehearsing a boundary and responding to mild pushback.
Suggested time and players: 8–12 minutes; one teen and therapist.

Prepare: Use the fictional scene: “A friend wants to copy your homework.” Write or read three buttons: pause, edit, replay. Agree a mild pushback line in advance: “It will only take a minute.”

Say: “We can pause at any point and edit the line. This is practice, not a test of how tough you can be.”

1. Let the teen choose a first response or offer two to edit: “I can explain the question, but you cannot copy mine” and “No, I am not sharing my answers”.
2. Rehearse the exchange once. The teen can say “pause” or type P to stop.
3. Only with agreement, use the mild pushback line. Invite the teen to hold the boundary, offer a suitable alternative or end the exchange.
4. Replay their chosen version and discuss where this rehearsal fits real situations. Stop before pressure becomes an endurance contest.

Example round: The teen edits an overlong explanation into, “I can help you understand it, but I am not sending my work.” If the friend persists, the character ends the conversation rather than producing ever more reasons.

Remote adaptations: Keep the agreed scene on screen so the teen does not have to remember it. Camera-off participation can be an option if it fits the clinical arrangements. Voice-only rehearsal works without buttons. In groups, use voluntary roles; never cast a member as an actual bully.

Debrief: “Which line sounds like something the character could say?” “When would outside support be more appropriate than another reply?”

8. Constraint Mission

Skill: Turning a valued intention into an accessible next action.
Suggested time and players: 7–10 minutes; one teen and therapist.

Prepare: Prepare a mission: “Morgan wants more creativity in the week.” Make three constraints: no extra money; only five minutes available; materials must already be at home.

Say: “Design a version of the mission that works within these conditions. We can change the plan instead of demanding more effort.”

1. Invite an initial idea, then reveal one constraint at a time. After each, revise the action so it still connects with creativity.
2. Ask the teen to describe the first visible step, needed materials and a realistic cue.
3. Test the plan with a final question: “What if energy is lower than expected?” Build a smaller version or choose another appropriate response.
4. End when the teen can describe the action and how they would review whether it was worth repeating. Personal application is optional.

Example round: “Start a big painting” becomes “open an existing notebook and draw one shape after putting the school bag down”. A smaller version is putting the notebook where it will be easy to find. This does not require buying supplies or reporting an instant mood lift.

Remote adaptations: The therapist reveals constraints in large text or reads them. On a phone, keep only the current constraint visible. With voice only, summarise the revised plan before adding another condition. Avoid assigning actions that conflict with medical limits or necessary rest.

Debrief: “Does the new version still connect with the goal?” “What needs support rather than more willpower?”

9. Support Network Puzzle

Skill: Identifying different kinds of help and practising a specific request.
Suggested time and players: 8–10 minutes; one teen or a small group.

Prepare: Draw a fictional character in the centre of a page. Prepare three needs: understand an assignment; have company during a lonely lunch; get help with repeated hurtful messages. Use roles rather than real names: teacher, trusted friend, school wellbeing staff or appropriate caregiver.

Say: “Build a support map for this character. Different people may help with different needs.”

1. Offer the first need and ask the teen to connect it with a possible support role. Ask why that role might fit and what information is missing.
2. Repeat for the other needs. Allow more than one route and remove any role that is unsafe or unavailable in the fictional scenario.
3. Choose one route and rehearse a concrete request: “Could you show me the first step?” rather than “Fix everything”.
4. Add an unavailable-response card: “They cannot help today.” Build a second route instead of assuming the first person must solve it.

Example round: For repeated hurtful messages, the character asks school wellbeing staff, “Can we talk about messages that keep happening?” A friend may provide company but cannot be expected to manage safeguarding alone.

Remote adaptations: Use numbered roles with large lines between them; the teen directs the drawing. On a phone, discuss one need and two roles at a time. Voice-only play uses a spoken map. Groups keep examples fictional and do not collect private contact details.

Debrief: “Which kind of help are we asking for?” “What is a reasonable backup?”

10. Teach-Back Challenge

Skill: Consolidating a skill and checking whether it transfers to a new example.
Suggested time and players: 5–8 minutes; one teen and therapist.

Prepare: Choose one skill practised earlier. Prepare a new scene: “A character’s friend says they cannot meet this weekend.” The therapist will offer an incomplete response for the teen to edit.

Say: “You can coach me. I will deliberately leave something out, and you can tell me what to change.”

1. If the skill was evidence checking, say: “That proves the friend does not like them.” Ask the teen to name what the sentence assumes.
2. Let the teen request one missing detail. Reveal: “The friend has not explained why yet.” Invite a conclusion that leaves room for uncertainty.
3. If the skill was boundary or coping practice, use an incomplete example from that game instead. Ask the teen to improve it and explain one reason.
4. End with the teen choosing whether to apply the skill to their own week, practise another fictional round or keep it as today’s learning.

Example round: The teen coaches, “We know they cannot meet, but we do not know why. The character could ask about another day.” Acknowledging disappointment belongs alongside checking the assumption.

Remote adaptations: This round needs no visual materials or extra website, making it a useful fallback when screen sharing stops. Accept a spoken edit, a short chat line or a choice between two responses. Avoid making the teen responsible for reassuring or caring for the therapist.

Debrief: “What did you want me to notice?” “Where might this skill help, and where would it not be enough?”

A 30-minute telehealth session example

1. Minutes 0–5: Check privacy, capacity and the session goal. Explain the pause option and test whether the teen can read one shared line.
2. Minutes 5–15: Run Clue Unlock with the fictional practice-time case. Reveal one clue at a time while the teen directs changes to Known, Possible and Still missing.
3. Minutes 15–22: Try Choice Route with one fictional scene. Compare the goal and consequences of two options. Keep the amount of material suited to the teen’s capacity.
4. Minutes 22–27: Use Teach-Back Challenge to check what was learned. Let the teen correct an assumption in a fresh example.
5. Minutes 27–30: Ask what was useful, uncomfortable or unnecessary. If wanted, agree one small practice task and how it will be reviewed.

Switch to an ordinary conversation, a single short round or another appropriate approach when that better fits the session. Completing every planned game is not the goal.

What to do when the technology gets in the way

• Small phone screen: show one scene or choice at a time, use large text and read it aloud. Keep the teen from having to switch repeatedly between the call and another app.
• Annotation unavailable: the teen names a tile or option and the therapist moves it. Joint editing is optional.
• Screen sharing fails: read the fictional scene, offer two labelled options and summarise changes aloud. Teach-Back Challenge works without visuals.
• Chat unavailable or unsuitable: use voice, pointing or paper as appropriate. Do not imply that session chat is necessarily private or temporary; check the platform and service arrangements.
• The call disconnects: use the reconnection plan already agreed for the session. An audio-only continuation needs to fit the clinical and service arrangements rather than being assumed suitable for everyone.

Adapting the games for online teen groups

Use shared fictional scenes, give turns by invitation and allow observation or passing. Rotate roles such as clue reader, option chooser and summary checker. Avoid requiring disclosure, speed-based scores or visible ratings of how calm participants feel. Use smaller groups or pairs only where the platform, supervision and group plan support them.

Explain who can see typed replies and whether they may remain in chat. Agree that participants will not record or screenshot the session. Personal disclosure remains optional even when the group has already agreed confidentiality expectations.

Frequently asked questions

What are good telehealth therapy games for teenagers?

Choose the skill first. Clue Unlock practises checking information; Coping Trade-Off practises matching tools to context; Response Replay practises boundary language; and Teach-Back Challenge reviews learning. Each can be facilitated without a separate gaming platform.

Can I run these games without printing?

Yes. The therapist can type the fictional materials into a blank document, read them aloud or draw them on ordinary paper. The article supplies the examples needed. Prepared printables are an optional purchase, not a requirement.

Can a teen participate from a phone?

Use one large scene or choice at a time, read the material and accept short spoken or typed responses. Avoid tiny boards and multiple open apps. Check what is actually readable on the teen’s device before starting.

What if a teen does not want to talk?

Offer a numbered choice, a written edit, observing one round or a fictional character. Ask what format they prefer and whether privacy, fatigue or the activity itself is getting in the way. Participation should not depend on telling a personal story.

Are these online multiplayer games?

No. They are therapist-facilitated games played during an existing telehealth session. The therapist hosts the clues, document or conversation. If choosing a separate browser game, assess its accessibility, privacy arrangements and clinical fit before introducing it.

Can printable therapy games be used in telehealth?

Some products allow or describe telehealth use, but a PDF download does not automatically permit public uploads or redistribution. Check the specific product’s format and licence. The ABC(D) Explorers description lists telehealth sessions and prohibits public uploading, sharing and redistribution.

Choose your next session resource

Try a round using the examples above. For prepared materials to practise the CBT model, explore ABC(D) Explorers. Keep any use within its licence and your usual clinical arrangements.

• For broader thought-work games, see CBT games for teens.
• For other clinical goals and formats, browse the teen therapy games and activities guide.
• For face-to-face group options, see no-prep teen group therapy activities.
• For wider individual-session ideas, see therapy activities for adolescent clients.

Telehealth practice resources

For preparation and privacy considerations, see the Australian Psychological Society’s videoconferencing principles and HHS guidance on telebehavioural health privacy. These inform practical preparation; they do not validate the individual games or certify a platform or product. Use guidance appropriate to your location and service.