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Rapport building activities in therapy — techniques for children

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rapport building activities in therapy give clinicians ready-to-run, evidence-informed tools to connect quickly with children, reduce drop-out, and increase treatment engagement. This guide provides 30+ session-ready activities, exact therapist scripts, age adaptations, teletherapy options, trauma-informed notes, and simple measurement tools you can use in the first session.

Why rapport matters in child therapy (definition and outcomes)

Therapeutic rapport (also called the therapeutic alliance) is the collaborative, trust-based relationship between therapist and child that predicts engagement, attendance, and treatment outcomes. Good rapport increases disclosure, cooperation with tasks, and willingness to try therapeutic strategies.

Brief stat block:

  • According to a 2022 peer-reviewed study, a stronger therapeutic alliance predicts better symptom reduction across pediatric psychotherapy trials.
  • According to a 2021 industry report, early-session rapport is associated with lower drop-out in school-based counseling programs.

Understanding the definition of play helps clarify why play-based rapport activities work—see our definition of play guide for context. A brief history explains roots of rapport-building through play—see our founder of play therapy for background.

Core principles of rapport building with children

  1. Attunement — match affect and energy; therapist behavior: mirror tone, slow breathing when child is dysregulated. (Therapist script: “I notice you look a little quiet—want to show me how your body feels?”)
  2. Pacing — follow the child’s lead before introducing structure; therapist behavior: wait, observe, offer small invitations.
  3. Child-led play — prioritize autonomy; therapist behavior: offer choices and reflect play themes. (See child-centered play therapy guide.)
  4. Unconditional positive regard — accept without judging; therapist behavior: reinforce strengths and normalize feelings.
  5. Playfulness — use humor and curiosity appropriately; therapist behavior: create surprise and delight at the child’s pace.
  6. Nonverbal attunement — mirroring posture, facial affect, and movement; therapist behavior: subtle mirroring to increase safety.
  7. Clear boundaries — set safe limits with warm firmness; therapist behavior: state rules plainly and compassionately. (Therapist script: “We keep toys on the table so everyone stays safe.”)
  8. Trauma-informed stance — prioritize safety and choice; therapist behavior: offer opt-out and grounding tools. (See the trauma informed play therapy guide.)

For clinicians integrating cognitive techniques, consult the CBT play guide to align rapport tactics with intervention goals.

Preparing the room, materials, and caregivers for rapport-focused sessions

Preparation reduces friction in the first session. Arrange a predictable, child-friendly space with a few well-chosen materials that invite choice and play.

  1. Room setup: low table, soft seating, open floor area, visual schedule at child level.
  2. Toy selection: 6–8 curated items (sensory bin, blocks, puppets, art supplies, small figures, sand tray) rotated weekly.
  3. Safety checklist: no small choking items for toddlers; sanitize sensory materials between clients; check for allergies.
  4. Caregiver prep: pre-session email with intake form and brief consent language; invite caregiver to join first 10 minutes and leave if child prefers one-on-one.
  5. Confidentiality script: brief caregiver wording and child-friendly version to say at the start of the session.
  • Checklist: visible schedule, consent forms, clinician emergency contacts, toy cleaning supplies, observation mirror/window (if used), hand sanitizer.

play psychologist guide offers clinician tips on toy use and engagement strategies.

Age- and developmentally-tailored rapport strategies (toddlers, preschool, school-age, tweens)

Match activities to developmental milestones—attention span, symbolic play, fine motor skills, and emerging autonomy determine what will build rapport successfully. See CDC and AAP milestones for specifics when planning.

CDC child development milestones

Toddlers / 1–3 years

  • Development: object permanence, sensory exploration, parallel play. Use sensory, short-turn activities and caregiver presence for safety.
  • Activity ideas:
    • Bubble pop (goal: shared delight). Therapist script: “Boom! Pop—your turn!” Tele-adapt: caregiver blows bubbles on camera.
    • Sensory tray with rice/cups (goal: tactile attunement). Therapist script: “What does it feel like—soft or loud?” Stop cues: freezing, averted gaze, crying—pause and offer caregiver comfort.
  • play therapy for 2 year olds guide

Preschool / 3–5 years

  • Development: symbolic play, dramatic play, emerging rules, 5–15 minute attention spans.
  • Activity ideas:
    • Puppet introductions (goal: reduce social pressure). Therapist script: “This is Danny Puppet—he’s a little shy. Can he ask you a question?” Variation: child uses puppet to talk about feelings.
    • Feelings charades with picture cards (goal: emotion labeling). Therapist script: “Show me how ‘surprised’ looks!” Tele-adapt: screen-share pictures and have child act on camera.
    • Mini-dramatic play kitchen (goal: shared narrative). Therapist script: “Would you like to be the chef or the customer?”
  • play behavior guide

School-age / 6–11 years

  • Development: cooperative play, problem solving, rules-based games, longer attention (15–30 minutes), improved verbal capacity.
  • Activity ideas:
    • Collaborative building (LEGOs, blocks) with a shared challenge (goal: teamwork & communication). Therapist script: “Let’s build a bridge that won’t fall—what should we try?” Variation: assign roles like architect and builder.
    • Feelings timeline (draw simple events) (goal: narrative & trust). Therapist script: “Can you show me a time you felt brave on this line?” Trauma note: avoid pressing for details; offer choices to skip.
    • Board or card games with therapeutic prompts (goal: rule-following and turn-taking). Therapist script: “When it’s your turn, you can also tell me one thing that made you smile this week.”
  • Clinician vignette: “In a first session with an 8-year-old who hated talking, collaborative LEGO building led to a 12-minute uninterrupted play and two spontaneous sentences about school.” (Composite clinician vignette)

Tweens / 10–13 years

  • Development: identity work, increased autonomy, abstract thinking, sensitivity to peer evaluation.
  • Activity ideas:
    • Choice-based project (zine, playlist creation) (goal: autonomy & self-expression). Therapist script: “Which of these project ideas feels more like you—music or comic-making?”
    • Structured role-play with options (goal: perspective-taking). Therapist script: “You choose whether to play the leader, the challenger, or the observer.” See therapy games for teens guide for older adaptations.
    • Goal-setting board with stickers (goal: collaborative planning). Therapist script: “What’s one tiny thing you’d like to try this week?”
  • play therapy for teens guide and therapy activities for teens guide offer group and individual ideas.

For each age group, consult the play behavior guide to verify play types are developmentally typical.

Categories of rapport-building activities (overview + selection guidance)

Use categories to select activities based on goal: nonverbal attunement, creative expression, games, storytelling, or structured tasks. For a broader overview of play therapy types and when to use different play techniques, see our therapeutic play guide. Some techniques translate across ages—see our therapy games for adults guide for adapted exercises.

Activity category Primary goals Best age
Nonverbal attunement Safety, co-regulation Toddlers–school-age
Creative expression Self-expression, narrative Preschool–tweens
Games Turn-taking, rules, rapport School-age–tweens
Storytelling & puppets Projection, disclosure Preschool–school-age
Structured tasks Goal-setting, problem-solving School-age–tweens

30+ session-ready rapport activities with scripts, materials, goals, and variations

This section lists concise, copy/paste-ready activities organized by category. Each entry includes Goal, Materials, Steps (numbered), Therapist prompts in quotes, Variations, Trauma/Cultural note, and Teletherapy adaptation or low-resource alternative.

  1. Bubble greet (Nonverbal attunement)

    • Goal: Gentle approach and shared delight.
    • Materials: Bubble bottle, wand.
    • Steps:
      1. Invite child to pop bubbles together.
      2. Mirror child’s pace and enthusiasm.
      3. Transition to sitting task after 3–5 pops.
    • Therapist prompts: “Ready? I’ll blow and you pop—pop!”
    • Variations: Use finger bubbles for toddlers; count pops for school-age.
    • Trauma/Cultural note: Avoid sudden loud pops for sensory-sensitive children; check for cultural norms around physical proximity.
    • Teletherapy adaptation: Caregiver blows bubbles on camera or use a short bubble video to pop together.
  2. Name-and-motion (Nonverbal attunement)

    • Goal: Build recognition and mimicry.
    • Materials: None.
    • Steps:
      1. Say your name with a small motion; invite child to copy.
      2. Take turns creating simple motions.
    • Therapist prompts: “I’m Sam—this is my wiggle. Can you do my wiggle?”
    • Variations: Use props for preschoolers; add sound effects.
    • Trauma/Cultural note: Offer alternative if child refuses touch or movement.
    • Teletherapy adaptation: Show motions on screen; ask child to show theirs.
  3. Puppet introductions (Storytelling)

    • Goal: Reduce social pressure; promote projection.
    • Materials: 2–3 simple puppets.
    • Steps:
      1. Introduce puppet as shy/curious.
      2. Have puppet ask a non-threatening question.
      3. Invite child to answer through puppet or directly.
    • Therapist prompts: “This is Mira the puppet—she’s a little nervous. Mira asks: ‘What’s your favorite game?'”
    • Variations: Child uses puppet to talk about feelings.
    • Trauma/Cultural note: Allow child full choice; don’t pressure disclosure.
    • Teletherapy adaptation: Use on-screen puppet or stuffed toy held up to camera.
  4. Sensory bin exploration (Sensory play)

    • Goal: Regulation and tactile engagement.
    • Materials: Rice/beans, scoops, cups, small figures.
    • Steps:
      1. Invite child to explore for 2–5 minutes.
      2. Mirror descriptors (soft, crunchy).
    • Therapist prompts: “What does this feel like—smooth or bumpy?”
    • Variations: Themed bins (ocean, farm).
    • Trauma/Cultural note: Screen for sensory aversion; provide opt-out.
    • Teletherapy adaptation: Use household items (beans in cup) and ask caregiver to set up; or use an interactive sand app for older kids.
  5. Feelings charades (Creative expression)

    • Goal: Emotion labeling and nonverbal expression.
    • Materials: Feelings cards or simple picture cards.
    • Steps:
      1. Draw or select a feeling card.
      2. Act it out; partner guesses.
    • Therapist prompts: “Show me ‘excited’ with your face and body—go!”
    • Variations: Use animal feelings for younger kids.
    • Trauma/Cultural note: Avoid cards that may trigger; offer an ‘I pass’ card.
    • Teletherapy adaptation: Share screen or hold cards to camera.
  6. Two-minute free draw (Creative expression)

    • Goal: Quick self-expression and low-pressure sharing.
    • Materials: Paper, crayons.
    • Steps:
      1. Set a 2-minute timer and invite free drawing.
      2. Invite child to name one thing about their drawing.
    • Therapist prompts: “You have two minutes—draw anything. Ready, go!”
    • Variations: Use drawing prompts (happy place).
    • Trauma/Cultural note: Respect refusal to share details.
    • Teletherapy adaptation: Use digital whiteboard or have child hold drawing to camera.
  7. Co-build challenge (block/LEGO) (Games/structured tasks)

    • Goal: Cooperation, communication.
    • Materials: Blocks/LEGO.
    • Steps:
      1. Propose a shared building challenge.
      2. Assign roles or take turns.
    • Therapist prompts: “Let’s make a bridge for Teddy—what should we do first?”
    • Variations: Timed builds, team challenges.
    • Trauma/Cultural note: Check for frustration tolerance; pause if overwhelmed.
    • Teletherapy adaptation: Use online building apps (screen-share) or have child build and describe steps.
  8. Emotion sorting with toys (Creative expression)

    • Goal: Identify and categorize emotions.
    • Materials: Small figures, emotion labels.
    • Steps:
      1. Ask child to place figures into ‘happy/sad/angry/safe’ zones.
      2. Discuss selections.
    • Therapist prompts: “Where does this dinosaur go—happy or angry?”
    • Variations: Use photos or drawings.
    • Trauma/Cultural note: Avoid labeling child’s caregivers; keep content general.
    • Teletherapy adaptation: Use slide with drag-and-drop zones or have child show placement on a tray.
  9. Co-regulation breathing with pinwheel (Nonverbal attunement)

    • Goal: Grounding and physiological regulation.
    • Materials: Pinwheel or bubble wand.
    • Steps:
      1. Model slow inhale/exhale while blowing pinwheel.
      2. Invite child to copy for 3 rounds.
    • Therapist prompts: “Breathe in with me—make the pinwheel go slow.”
    • Variations: Use hand-on-heart for discreet regulation.
    • Trauma/Cultural note: Offer sitting quietly option if breathing feels intrusive.
    • Teletherapy adaptation: Use on-screen timer and model breathing on camera.
  10. Mood meter check-in (Measurement & brief check-in)

    • Goal: Quick emotional baseline and normalization.
    • Materials: Mood meter poster or digital version.
    • Steps:
      1. Child points to current mood color/face.
      2. Therapist validates and asks one follow-up question.
    • Therapist prompts: “Can you point to how you’re feeling right now?”
    • Variations: Use thermometers or emoji cards.
    • Trauma/Cultural note: Allow nonverbal pointing or caregiver assistance if needed.
    • Teletherapy adaptation: Share screen or have child hold up a paper emoji.
  11. Story-building stones (Storytelling)

    • Goal: Narrative development and projection.
    • Materials: Small stones or picture cards.
    • Steps:
      1. Child picks 3 stones/cards to create a story.
      2. Therapist adds a sentence and passes back.
    • Therapist prompts: “Tell a little story about the red stone.”
    • Variations: Co-create comic strips.
    • Trauma/Cultural note: Avoid prompting details about traumatic events; keep fiction-based.
    • Teletherapy adaptation: Use slide images or have child show objects on camera.
  12. Safe place visualization with drawing (Creative expression)

    • Goal: Build internal safety resource.
    • Materials: Paper, crayons.
    • Steps:
      1. Guide a short visualization of a safe place (2–3 minutes).
      2. Invite child to draw it.
    • Therapist prompts: “Imagine a place that makes you feel calm—what do you see?”
    • Variations: Create a mini “safety box” of items.
    • Trauma/Cultural note: Use grounding and offer options to skip; follow SAMHSA trauma-informed guidance if triggered. SAMHSA trauma resources
    • Teletherapy adaptation: Use screen meditation or ask caregiver to assist with drawing materials.
  13. Mirror game (Nonverbal attunement)

    • Goal: Build connection through subtle mirroring.
    • Materials: None.
    • Steps:
      1. Stand or sit facing the child and mirror small movements slowly.
      2. Switch roles after a minute.
    • Therapist prompts: “I’ll do this and you copy—ready?”
    • Variations: Use faces only for shy children.
    • Trauma/Cultural note: Offer permission before mirroring closely; respect personal space.
    • Teletherapy adaptation: Mirror gestures on camera; ask child to copy.
  14. Choice board (Autonomy & engagement)

    • Goal: Empowerment through options.
    • Materials: Visual choice board with 4–6 activities.
    • Steps:
      1. Present the board and invite child to pick one.
      2. Proceed with chosen activity.
    • Therapist prompts: “You can pick one of these—what looks fun?”
    • Variations: Use digital choice menus for teletherapy.
    • Trauma/Cultural note: Ensure culturally relevant options; avoid forcing choice.
    • Teletherapy adaptation: Use shared slide or chat-based selection.
  15. Emotion faces with playdough (Sensory & emotion labeling)

    • Goal: Tactile expression of feelings.
    • Materials: Playdough, tools.
    • Steps:
      1. Ask child to make a face that shows how they feel.
      2. Discuss choices gently.
    • Therapist prompts: “Can you make a face for ‘surprised’?”
    • Variations: Use clay tools to create symbols.
    • Trauma/Cultural note: Sanitize materials between sessions; check for allergies.
    • Teletherapy adaptation: Child shows creation to camera; caregiver facilitates materials.
  16. Two-truths, one-favorite (Conversation starter for older kids)

    • Goal: Low-stakes disclosure and rapport.
    • Materials: None.
    • Steps:
      1. Therapist models two neutral facts and one favorite thing.
      2. Invite child to share theirs.
    • Therapist prompts: “I’ll say two facts and my favorite snack—your turn!”
    • Variations: Make it about hobbies or games.
    • Trauma/Cultural note: Keep prompts non-intrusive; avoid family history queries.
    • Teletherapy adaptation: Use chat or whiteboard to list items.
  17. Emotion dice roll (Games)

    • Goal: Randomized emotion talk to reduce pressure.
    • Materials: Emotion dice or cube with faces.
    • Steps:
      1. Roll dice and discuss the landed emotion for 1–2 minutes.
    • Therapist prompts: “You rolled ‘surprised’—tell me a small surprising thing.”
    • Variations: Use feelings cards or spinner.
    • Trauma/Cultural note: Offer pass option; respect cultural emotion norms.
    • Teletherapy adaptation: Use online dice or a randomizer on screen.
  18. Mini sandtray play (Symbolic play)

    • Goal: Projection and narrative exploration.
    • Materials: Small tray, sand, 6–10 miniatures.
    • Steps:
      1. Invite child to build a scene representing ‘today’ or ‘home.’
      2. Ask one reflective question.
    • Therapist prompts: “What part of this scene is most important to you?”
    • Variations: Use felt board for low-resource settings.
    • Trauma/Cultural note: Do not interpret immediately; ask child for meaning.
    • Teletherapy adaptation: Virtual sandtray platforms or child shows small figures on tray to camera.
  19. Letter to a helper (Narrative and projection)

    • Goal: Externalize problems and identify supports.
    • Materials: Paper, stickers.
    • Steps:
      1. Invite child to write/draw a note to a trusted helper (real or imaginary).
      2. Discuss what they’d ask for.
    • Therapist prompts: “Who helps you feel safe? What would you tell them?”
    • Variations: Create a “helper postcard” craft.
    • Trauma/Cultural note: Avoid directing child to identify unavailable adults.
    • Teletherapy adaptation: Use digital drawing tools or email a postcard template to caregiver.
  20. Board game with check-in tokens (Games)

    • Goal: Turn-taking and brief emotional check-ins.
    • Materials: Simple board game and tokens labeled ‘pause/skip/share’.
    • Steps:
      1. Play turns; when landing on a token, child chooses to pause, skip, or share a feeling.
    • Therapist prompts: “You landed on a token—would you like to pause or share?”
    • Variations: Use cooperative games for teamwork focus.
    • Trauma/Cultural note: Normalize opting out of sharing.
    • Teletherapy adaptation: Use online board apps or agree on digital rules.
  21. Compliment jar (Strengths-focused)

    • Goal: Highlight strengths and change focus to positives.
    • Materials: Jar, slips of paper, pen.
    • Steps:
      1. Write or draw something positive about child; invite them to add one item.
      2. Review when morale is low.
    • Therapist prompts: “I’ll add one: ‘You tried something new today.’ Want to add yours?”
    • Variations: Family jar for caregiver involvement.
    • Trauma/Cultural note: Avoid minimizing difficulties; balance validation with strengths.
    • Teletherapy adaptation: Use a digital note board shared with caregiver consent.
  22. Emotion scavenger hunt (Active)

    • Goal: Movement-based emotion recognition.
    • Materials: Emotion cards hidden around the room.
    • Steps:
      1. Child finds cards and acts out the emotion.
    • Therapist prompts: “Find the card that shows ‘surprised’—show me how you act it out!”
    • Variations: Use photos or items representing emotions.
    • Trauma/Cultural note: Monitor overstimulation; offer seated alternatives.
    • Teletherapy adaptation: Use a home scavenger hunt with caregiver help.
  23. Sound guessing box (Sensory & attention)

    • Goal: Attention and shared curiosity.
    • Materials: Small box with objects making distinct sounds.
    • Steps:
      1. Shake box and invite child to guess the item.
    • Therapist prompts: “What do you think is making that sound?”
    • Variations: Rhythm clapping for older kids.
    • Trauma/Cultural note: Avoid startling sounds for trauma-exposed children.
    • Teletherapy adaptation: Use household objects and caregiver assistance on camera.
  24. Role reversal (Role-play)

    • Goal: Perspective-taking and empowerment.
    • Materials: Props or hats.
    • Steps:
      1. Invite child to ‘be the therapist’ and ask you two questions.
      2. Debrief feelings about the role.
    • Therapist prompts: “If you were the helper, what would you ask me?”
    • Variations: Use story roles for younger children. See role playing therapy guide for deeper techniques.
    • Trauma/Cultural note: Avoid re-enactment of traumatic events.
    • Teletherapy adaptation: Swap roles via camera; child asks therapist questions remotely.
  25. Emotion thermometer (Measurement & psychoeducation)

    • Goal: Teach graded emotion intensity and give quick data point.
    • Materials: Thermometer visual (0–10) or slider.
    • Steps:
      1. Child indicates current intensity and explains one reason.
    • Therapist prompts: “On a scale of 0–10, how big is your worry today?”
    • Variations: Use colors for younger kids.
    • Trauma/Cultural note: Respect nonverbal responses and offer alternative ways to show intensity.
    • Teletherapy adaptation: Use chat slider or shared screen tool.
  26. Guided choice stories (Narrative & autonomy)

    • Goal: Engage through collaborative storytelling with choices.
    • Materials: Story prompt cards.
    • Steps:
      1. Offer a beginning and two choices for how the story continues; child picks and you narrate.
    • Therapist prompts: “Should the hero go into the forest or the cave?”
    • Variations: Make it about the child’s school or home to increase relevance.
    • Trauma/Cultural note: Avoid choices that mirror real-life dangerous situations.
    • Teletherapy adaptation: Use shared slides or interactive story apps.
  27. Treasure map task (Problem-solving)

    • Goal: Cooperative planning and sequencing.
    • Materials: Paper map, stickers.
    • Steps:
      1. Create a simple map and plan route to treasure together.
    • Therapist prompts: “If the river is here, how do we get across?”
    • Variations: Add obstacles for older kids.
    • Trauma/Cultural note: Use culturally neutral scenarios and be sensitive to escape imagery.
    • Teletherapy adaptation: Use shared whiteboard to draw the map together.
  28. Emotion matching memory game (Cognitive & fun)

    • Goal: Memory, emotion recognition.
    • Materials: Pairs of emotion cards.
    • Steps:
      1. Play memory matching with emotion pairs; discuss matched cards.
    • Therapist prompts: “You found ‘brave’—when did you feel brave?”
    • Variations: Use photos of faces from different cultures to increase inclusivity.
    • Trauma/Cultural note: Avoid photos that could trigger personal trauma.
    • Teletherapy adaptation: Use digital memory apps or screen-shared images.
  29. Music choice & movement (Nonverbal attunement)

    • Goal: Regulation through rhythm and shared preference.
    • Materials: Short music clips, speaker.
    • Steps:
      1. Offer two music choices; move or sway to chosen track together.
    • Therapist prompts: “Do you want calm music or bouncy music? Pick one!”
    • Variations: Create a ‘feelings playlist’ over multiple sessions.
    • Trauma/Cultural note: Check music appropriateness and sensory limits.
    • Teletherapy adaptation: Share audio or ask caregiver to play track at child’s location.
  30. Sticker story timeline (Narrative & low pressure)

    • Goal: Sequence a few events with minimal verbal demand.
    • Materials: Stickers, paper timeline.
    • Steps:
      1. Child places 3–5 stickers along a line to show ‘a day’ or ‘week’.
      2. Ask one neutral question about a sticker.
    • Therapist prompts: “Show me a sticker for something fun that happened this week.”
    • Variations: Use icons for emotions or activities.
    • Trauma/Cultural note: Avoid asking about specific upsetting events; offer choices to skip.
    • Teletherapy adaptation: Use digital stickers on a shared document.
  31. Slow-motion replay (Nonverbal regulation & humor)

    • Goal: Build safety and playfulness through controlled silliness.
    • Materials: None.
    • Steps:
      1. Do a short action together (e.g., wave) then replay it in exaggerated slow motion.
    • Therapist prompts: “Let’s all move like we are underwater—slow!”
    • Variations: Use sounds or props.
    • Trauma/Cultural note: Check that play is culturally appropriate and not humiliating.
    • Teletherapy adaptation: Use camera slow-motion filter if available or model slowly on screen.
  32. Quick gratitude toss (Strengths-focused)

    • Goal: Foster positive attention and reciprocity.
    • Materials: Soft ball or beanbag.
    • Steps:
      1. Toss ball; the catcher names one thing they are glad for.
    • Therapist prompts: “When you catch, tell one small thing you liked this week.”
    • Variations: Use a countdown to keep it brief.
    • Trauma/Cultural note: Avoid pressuring children who are in crisis to find positives; offer a neutral question instead.
    • Teletherapy adaptation: Use virtual passing (name game) or have caregiver toss with child off-camera.
  33. Magic question box (Curiosity & transition)

    • Goal: Lower anxiety about unknown questions and offer control.
    • Materials: Box with question slips (fun, neutral, and therapeutic options).
    • Steps:
      1. Child draws a question and chooses whether to answer, pass, or answer with a drawing.
    • Therapist prompts: “Pick one—answer, pass, or draw it out.”
    • Variations: Use themed boxes (school, feelings).
    • Trauma/Cultural note: Ensure questions are non-intrusive and culturally sensitive.
    • Teletherapy adaptation: Use chat or shared doc with hidden prompts.
  34. Finish-the-story cards (Narrative)

    • Goal: Encourage imagination and brief sharing.
    • Materials: Prompt cards with story starts.
    • Steps:
      1. Read beginning and invite child to continue for 1–2 sentences.
    • Therapist prompts: “The dragon found a door—what happens next?”
    • Variations: Use collaborative round-robin for older groups.
    • Trauma/Cultural note: Keep scenarios neutral and non-threatening.
    • Teletherapy adaptation: Share slide with prompt.
  35. Quick check-out ritual (Closure & consistency)

    • Goal: Predictability and safety at session end.
    • Materials: One-minute ritual (song, high-five, sticker).
    • Steps:
      1. Use the same brief ritual each session to build predictability.
    • Therapist prompts: “Two thumbs if you liked something today—one thumb if you want to tell me more next time.”
    • Variations: Use a special goodbye phrase or hand signal.
    • Trauma/Cultural note: Allow alternative if child rejects physical contact or rituals.
    • Teletherapy adaptation: Use a wave or screen high-five.
  36. Emotion journaling (older kids) (Reflection)

    • Goal: Increase introspection with low pressure.
    • Materials: Notebook, pens.
    • Steps:
      1. Invite a 3-minute free-write or drawing about one feeling.
      2. Offer choice to share.
    • Therapist prompts: “Write or draw one thing that felt hard this week—no need to show if you don’t want to.”
    • Variations: Use prompts like ‘one win’ or ‘one worry’.
    • Trauma/Cultural note: Respect privacy; decide together about sharing content.
    • Teletherapy adaptation: Use shared doc or ask child to hold journal to camera.
  37. Emotion matching with photos (Cultural humility)

    • Goal: Increase emotion recognition using diverse faces.
    • Materials: Photo set of diverse expressions.
    • Steps:
      1. Match photos to emotion words and discuss cultural differences in expressions.
    • Therapist prompts: “Do people show ‘happy’ the same way everywhere?”
    • Variations: Use family photos if appropriate and with consent.
    • Trauma/Cultural note: Be sensitive to cultural display rules and family norms.
    • Teletherapy adaptation: Share image slide or screen.
  38. Make-a-plan token (Goal-setting)

    • Goal: Small, achievable task planning to build efficacy.
    • Materials: Token or sticker to represent plan.
    • Steps:
      1. Help child pick a tiny goal for the week and give a token as reminder.
    • Therapist prompts: “What’s one tiny thing you could try before our next session?”
    • Variations: Use a digital calendar for older kids.
    • Trauma/Cultural note: Ensure goals are realistic and not coercive.
    • Teletherapy adaptation: Send a reminder email to caregiver with child’s permission.
  39. Quick check-in Likert (older kids) (Measurement)

    • Goal: Fast self-report of mood (0–4).
    • Materials: Visual Likert scale.
    • Steps:
      1. Ask child to rate mood quickly and note one reason if willing.
    • Therapist prompts: “On a scale from 0 to 4, how was your week?”
    • Variations: Use emojis for younger clients.
    • Trauma/Cultural note: Respect nonresponse; combine with behavioral indicators.
    • Teletherapy adaptation: Use chat poll or shared slide.

Note: Not all activities are appropriate for children with complex trauma—use clinical judgment and the trauma-informed adaptations in the next section. For downloadable worksheets, printables, and more game-based ideas, see our therapy activities guide and therapeutic games guide. For themes that may emerge after rapport is built, consult the play themes in therapy guide.

Trauma-informed and culturally responsive adaptations

Follow trauma-informed principles to keep children safe during rapport activities. Use cultural humility to adapt materials and prompts.

  • Rule 1 — Prioritize safety: always offer opt-out and provide grounding options. (Follow SAMHSA trauma-informed guidance: SAMHSA trauma resources.)
  • Rule 2 — Use clear, developmentally appropriate consent language: “You can say stop at any time and that’s okay.”
  • Rule 3 — Watch for physiological cues of dysregulation: shallow breathing, freezing, dissociation; if seen, slow down and offer grounding.
  • Rule 4 — Avoid forced disclosure or reenactments of traumatic events; instead invite metaphorical play or drawing.
  • Rule 5 — Check cultural relevance of toys, images, and names; ask caregivers about culturally meaningful or triggering content.
  • Rule 6 — Pacing adjustments: shorter activities, more frequent check-ins, and caregiver presence when appropriate.
  • Rule 7 — Safety planning: have a brief, documented plan if a child becomes distressed (grounding, caregiver contact, crisis resources).
  • Rule 8 — Document triggers and successful adaptations in session notes to inform continuity of care. See the trauma informed play therapy guide for training and deeper principles.

Rapport-building in teletherapy (tools, activities, tech tips)

Teletherapy requires intentional adjustments to maintain the therapeutic alliance. Prepare caregiver logistics, test cameras, and plan short engaging activities that fit a screen.

How-to steps:

  1. Pre-session: Send a 5-minute tech orientation to caregivers explaining camera placement, materials, and privacy.
  2. Start: Conduct a 1–2 minute caregiver check and a 30-second visual safety sweep of the room.
  3. Engage: Use screen-share slides, digital whiteboards, and brief on-camera activities (2–10 minutes each).
  4. Check-in often: Pause every 3–5 minutes to assess engagement and offer opt-outs.
  5. Close: End with a predictable ritual and brief parent debrief (1–3 minutes).

For platform considerations, see our Grow Therapy reviews guide when selecting teletherapy platforms.

Six tele-activities with scripts (stepwise):

  1. Virtual puppet show: Therapist uses a puppet on camera; invites child to use a stuffed animal. Therapist script: “This puppet wants to know your favorite color—can you show me?” Suggest screenshot: capture child’s puppet holding moment. Outcome note: “Child engaged for 10 minutes and named two emotions.”
  2. Screen-share co-draw: Open a whiteboard and draw together for 3–5 minutes. Therapist script: “Add one thing to our picture—I’ll add the sun.” Screenshot suggestion: the final co-created image.
  3. Virtual mood meter: Share a mood slide and ask child to click or point. Therapist script: “Point to the face that matches your mood right now.” Outcome note: quick baseline for progress notes.
  4. Household scavenger hunt: Child finds an item representing ‘calm’ and returns on camera. Therapist script: “Find something that helps you feel calm and show me.” Screenshot suggestion: child’s item on camera.
  5. Guided story with slides: Therapist advances slides as child chooses plot. Therapist script: “Do you want the hero to go left or right?”
  6. Breathing with an on-screen timer: Use visual countdown and model breathing. Therapist script: “Breathe in for four—hold for two—out for six.” Outcome note: measurable calming during hyper-arousal.

Teletherapy screenshot guidance: capture non-identifying images (e.g., puppet hands, co-drawing without faces) only with consent and follow agency policy. Clinician vignette: “A 9-year-old engaged for 12 minutes using the virtual mood meter and provided two emotion words, improving session pace and trust.” (Composite vignette)

Measuring rapport and documenting progress (indicators, brief tools, session note templates)

Measure rapport through behavioral observations, brief self-report tools, and caregiver feedback. Trade-offs: shorter measures reduce burden but may miss nuance; observational markers require clinician time but are sensitive.

Observational indicators (examples to note in session):

  • Eye contact (age-appropriate)
  • Latency to engage in play
  • Duration of shared activity (minutes)
  • Voluntary disclosure or offering of material
  • Compliance with simple requests

Sample 1-page checklist (copyable):

First-Session Rapport Checklist

1. Greeting warmth & name use: Y/N

2. Child chose at least one activity: Y/N

3. Observed co-regulation within session: Y/N

4. Child shared >1 verbal or nonverbal sign: Y/N

5. Caregiver debrief completed: Y/N
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