CBT activities for children turn thoughts, feelings and actions into something a child can see, sort, draw or practise. Start with one fictional example and one skill: use a thought–feeling–action map to teach the model, a card sort to separate thoughts from body clues, or a comic to practise a different response.
These activities are for therapist-led sessions. Pick one based on the child’s language, interests and goals. Let them point, draw, speak, watch or pass. A believable thought can acknowledge that something is hard, unfair or unsafe; address real problems rather than asking children to think them away.
Choose by the skill you want to practise
- Learn the CBT model: start with activities 1 or 4.
- Notice feelings and clues: choose 3 or 10.
- Check a thought without debating it: try 2, 5, 6 or 7.
- Choose or practise a response: try 8, 9, 11, 12, 13 or 15.
- Finish by naming what helped: use 14.
1. Draw a thought–feeling–action map
You need: Paper and three coloured pencils.
- Draw three circles labelled Think, Feel and Do. Say, “Imagine Jo wasn’t picked first for a game. What might Jo tell themself?” Write the child’s idea in Think.
- Ask, “If Jo thought that, how might they feel? What might they do?” Put the answers in the other circles and connect them with arrows.
- Ask for one other possible thought and see whether the feeling or action might change. Let both maps stand; don’t ask the child to choose the happiest one.
What it looks like: Jo thinks ‘Nobody wants me’ and steps away. With ‘I might get picked next,’ Jo may still feel disappointed and choose to wait nearby.
Make it easier: Draw symbols or offer two possible responses to point to.
2. Fill in a character’s thought bubbles
You need: A stick-figure drawing and two blank thought bubbles.
- Draw a child waving at someone who keeps walking. Say, “We can see what happened. We can’t see what the character is thinking. What could go in this bubble?”
- Have the child fill in two different possibilities. Ask them to match each bubble with a feeling the character might have.
- Read both versions back. Ask, “What could we find out before deciding which story fits?” Write one question the character could ask.
What it looks like: ‘They’re angry with me’ might go with worry; ‘They didn’t see me’ might go with surprise. The character could ask later whether the friend saw them.
Make it easier: Give the child two prewritten bubbles to move rather than asking them to generate ideas.
3. Act out a feeling and check your guess
You need: Four slips labelled happy, worried, disappointed and excited.
- Pick one slip and act it out without saying the word. Say, “What might I be feeling? What clue did you notice?”
- Confirm what you intended and ask for another possible interpretation of the same clue. Swap roles if the child wants a turn.
- End by practising a question to check a guess: “You got quiet. What’s happening for you?”
What it looks like: The therapist looks down. The child guesses sad; the therapist says they were acting worried. Together they practise asking instead of assuming.
Make it easier: Draw poses or point to picture choices. Don’t require eye contact or facial acting.
4. Sort thoughts, feelings, body clues and actions
You need: Four labels and four slips.
- Lay out Thought, Feeling, Body clue and Action. Write ‘I might get it wrong,’ ‘worried,’ ‘fluttery belly’ and ‘hide behind Dad’ on separate slips.
- Say, “Where would you put each one? Tell me what made you choose.” Let the child move the slips and explain any ambiguous choice.
- Put the slips in one possible sequence. Ask the child to swap the action for another option and tell you what changes.
What it looks like: The child sorts fluttery belly under Body clue and replaces hiding with asking Dad to stay nearby while they try one step.
Make it easier: Start with only Thought and Action, then add the other labels.
BONUS: FLIP THAT THOUGHT - A CBT GAME FOR KIDS
Get our ready to use CBT game for kids
5. Play a five-step thought flip
You need: Paper and pencil or a set of CBT cards.
- Write a fictional scene: a friend plays with someone else. Say, “What tricky thought might pop up, and what feeling might come with it?” Write both.
- Ask, “What do we know from the scene? What are we guessing?” Help the child write a believable alternative that still makes room for disappointment.
- Say, “What might you do if you kept that new thought in mind?” Act out one small action and ask if the thought felt believable.
What it looks like: ‘They don’t like me’ becomes ‘They’re playing together now; I don’t know what that means.’ The child rehearses asking to join.
Make it easier: Model all five moves once before inviting the child to choose the final action.
6. Choose a thought that helps with the next step
You need: Two thought cards and one counter.
- Write ‘If my drawing isn’t perfect, I should stop’ and ‘I can ask how to draw the tricky part.’ Say, “Which thought gives the character something they can do?”
- Let the child place a counter on either card or between them. Ask, “What might each thought lead them to do?”
- Have the child edit one card until it sounds like something the character might actually say. Read it aloud and pick a next action.
What it looks like: The child writes ‘I can try the wheel first’ and starts with one circle.
Make it easier: Skip the counter and read each choice aloud. Avoid timing the response or rewarding the most positive answer.
7. Put a worry in front of a toy judge
You need: Three figures and two slips marked Clues and Still unknown.
- Assign one figure to voice a worry, one to gather clues and one to sum up. Say, “The worry says nobody will play with Kai tomorrow. What could the clue finder tell the judge?”
- Write concrete observations on Clues and unanswered questions on Still unknown. Let the child move the figures and give each a turn.
- Ask the judge to give a fair summary without promising what will happen. Pick a safe action Kai can try.
What it looks like: One child played with Kai yesterday; tomorrow’s plan isn’t known. The judge says Kai can ask one person to play and have another activity ready.
Make it easier: Use two figures and let the therapist play both while the child chooses the slips. Address real exclusion directly.
8. Build a coping toolbox for two situations
You need: Paper, pencil and a small envelope.
- Write two situations, such as noisy lunch and waiting for a turn. Say, “What could make each one a little easier? Let’s draw one option per slip.”
- Help the child match each tool to a situation. Ask what makes it available there and who can help. Add one backup if the first option isn’t possible.
- Put the slips in the envelope. Pick one to practise now and agree where the child can use it.
What it looks like: A quieter table needs an adult’s help; counting objects while waiting can be done independently. The child practises asking where they can sit.
Make it easier: Offer a picture menu. Include changes adults can make, not only things the child has to do.
9. Try two easy breaths and check how they feel
You need: No materials; practise at rest.
- Say, “Want to try two gentle breaths or watch me first? Breathe normally in, then let the air out comfortably. No need to make a big breath.”
- Model two easy breaths without breath holding. If the child opts in, do the two breaths together and stop if they feel uncomfortable or dizzy.
- Ask, “Same, easier or less comfortable?” If they dislike it, offer a different way to pause, such as looking around the room.
What it looks like: The child tries twice, says focusing on breathing feels odd and chooses to name three things they can see instead.
Make it easier: Offer observation only. Avoid making a breathing exercise a condition for continuing the session.
10. Mark an early clue on a body outline
You need: A simple body outline and a pencil.
- Say, “Think of a pretend character waiting to speak in class. What might they notice in their body?” Ask the child to mark one spot or choose ‘not sure.’
- Ask, “If they noticed that clue, what could they do next?” Write one option beside it. Note that the same clue can happen with different feelings.
- Rehearse that response once with a fictional character and ask the child to change it if needed.
What it looks like: Tight hands might mean worry or excitement. The character puts their notes on the desk and asks for a moment.
Make it easier: Use a visible clue like stepping back if body sensations are hard to name.
11. Draw a ladder for an agreed practice goal
You need: Paper and pencil.
- Draw three rungs. Say, “What’s a safe thing you want to be able to do more easily? What would a tiny first step look like?” Agree on a goal the child wants.
- Write three increasingly challenging versions together. Ask which is manageable and what support the child needs. Don’t pick an unsafe task or push ahead without agreement.
- If appropriate to the treatment plan, practise the chosen step once. Ask, “What did you learn, and what would you change?” End by recording the agreed next step.
What it looks like: A child who wants to ask a librarian a question starts by rehearsing with the therapist, then plans a supported visit. They don’t have to complete every rung today.
Make it easier: Use three movable cards. For clinical exposure, follow the agreed treatment plan and consent process; the ladder alone is just planning.
12. Pick and test a solution to a small problem
You need: Three slips and a pen.
- Say, “Two children want the same marker. Let’s write three safe things they could do.” Give the child a slip for each idea.
- Ask, “What might happen if we tried each one?” Have the child choose an option and act it out with you.
- Ask, “Did that solve the problem? If not, what could we try instead?” Write the backup on the back of the chosen slip.
What it looks like: They try taking turns. If both need the marker immediately, they can find a second marker or ask an adult to help organise supplies.
Make it easier: Start with two picture choices and act out both before deciding.
13. Swap two puppets’ points of view
You need: Two puppets or folded paper figures.
- Show one puppet joining a game late. Say, “This puppet thinks everyone left it out. What might the other puppet know that we don’t?”
- Let the child voice the second puppet. Then swap roles and ask each puppet one genuine question about what happened.
- Ask the child to choose one reply that acknowledges both perspectives. End by acting out the next line, without assuming the characters must agree.
What it looks like: One puppet says the game started early because it began to rain. The other says it still felt left out. They agree to check the start time next time.
Make it easier: Let the child direct you from the side or write the two lines instead of performing.
14. Record something the child actually tried
You need: A slip of paper and a pencil.
- Near the end, say, “What’s one thing you tried today that you want to remember? It can be asking for help, taking a pause or telling me this didn’t fit.”
- Ask what made the action possible. Write the action and the support in the child’s words. Check they agree with what you wrote.
- Ask if they want to keep the slip or leave it with you. Invite them to name one place the same support might help again.
What it looks like: The child asked to see an example before starting. The slip reads ‘I asked for a demo; seeing it first helped.’
Make it easier: Offer an observation they can accept, edit or decline. No points, praise quota or comparison with others.
15. Draw a comic with two possible endings
You need: Paper divided into four boxes and a pencil.
- Say, “Let’s draw what happens, what the character thinks or feels, and two things they could do next.” Use the first two boxes for the event and reaction.
- Use the last two boxes for different actions. Ask, “What might happen after each one?” Write or draw the likely consequences below each box.
- Have the child pick an ending to rehearse. Ask what would help the character try that response in real life.
What it looks like: A board game ends unexpectedly. One ending shows the character walking away without saying why; the other shows them asking if the game can be saved for next time.
Make it easier: Use stick figures or let the therapist draw as the child dictates. Include a safe pause as a valid ending.
Put it together in one session
Spend five minutes choosing a fictional scene and finding out how the child wants to take part. Use the card sort to teach the four categories, then draw two comic endings and act out one. Close with one slip about what helped. If time is short, do only the card sort and practise one action aloud. For more practice with pausing and turn-taking, see impulse-control games for kids. When anger and adult support are the main focus, see anger management activities for kids.
Optional printable CBT game
If you’d prefer prepared cards for activity 5, Flip That Thought! Kids Edition is a printable game for ages 7–11 with situation, tricky thought, helpful flip and action cards. The blank-paper version above is complete on its own.
Common questions
What if the child can’t name a thought?
Start with what they saw or did. Offer two thought bubbles and a blank one for ‘something else’ or ‘not sure.’ You don’t need to insist on a thought before helping with a practical problem.
Can I run these in a group?
Use the same fictional example for everyone. Offer quiet writing, pointing or passing before a round of optional sharing. Don’t ask children to disclose personal worries to take a turn.
Are these a full CBT treatment plan?
No. They are original ways to teach and rehearse skills. The NHS overview of CBT describes the broader work of exploring thoughts, feelings and actions with a therapist. Use assessment and a suitable care plan to decide which activities fit.