5 creative tools for working with children and teens in therapy
If your original training was focused on talking therapies, stepping into work with children and teenagers can feel like learning a new language. The core values of connection, empathy, and curiosity still apply, but the route to building trust and emotional safety often looks very different.
For many young people, especially those who are socially anxious or more avoidant in their relational style, the intensity of face-to-face talking therapy can be overwhelming. Creative techniques not only help reduce anxiety, but also give children and young people the means to explore and make sense of their unconscious, often complex emotions more deeply. This can become central to the work, offering them ways to express themselves that feel safer and more natural, while helping therapists tune into what is being communicated beyond words.
Here are five creative techniques that can support therapists who are making the transition from adult to child and adolescent work.
1. The Tree of Life
This narrative-based therapeutic intervention invites young people to explore their identity and experiences through the metaphor of a tree. The tree can be drawn, created using collage, represented in a sandtray (see below for more on this technique), or you could print out a pre-made template.
Once the outline of the tree has been created, you can invite the young person to write on different parts, each representing aspects of their life:
Roots – Where they come from, family, community, culture
Trunk – Strengths, values, skills
Branches – Hopes, dreams, goals for the future
Leaves – Supportive or influential people
Storm or rain clouds – Difficult or painful experiences or challenges they face
This tool helps build a shared narrative that honours both resilience and struggle. It’s especially helpful in early sessions or when trying to understand more about a young person's inner world. It can also support their own self-awareness in a balanced way by inviting hopefulness without ignoring difficulties or pain.
2. The Poisoned Parrot
This technique helps externalise patterns of critical self-thoughts in a playful way. Ask the young person to imagine a parrot. Explain that this isn’t just any parrot — it’s a poisoned and poisonous parrot that constantly says unkind or critical things, like "You always mess things up!" or "You're not good enough."
Ask the young person how long they would put up with that kind of talk before throwing a towel over the cage or getting rid of the parrot. Draw the comparison between the poisoned parrot and how many of us speak to ourselves internally. When that critical voice comes up, can they just notice it and think, "There’s that parrot again. I don’t have to listen to it — it’s just a parrot."
You can invite them to draw the parrot, describe it, or give it a name. You can also draw speech bubbles around the parrot showing the kinds of things it says.
Helpful prompts include:
What does the parrot say the most often?
Are there any particular situations where the parrot shows up a lot?
Where do you think it learned to speak like that?
What would you like to say back?
This metaphor helps young people step back from their thoughts and begin to challenge them without feeling blamed or exposed.
3. Playing games with therapeutic intention
Games in therapy can do more than build rapport or reduce the pressure of direct conversation or eye contact. They also support emotional awareness and can reveal relational dynamics, patterns of self-perception, and internal narratives.
Pay attention to how your client engages with a game:
Do they make up the rules or try to control the game? Perhaps reflecting a need to create safety within the relationship?
Do they ask you how to play and want you to lead the game?
How do they respond when things don’t go their way? Do they get angry with themselves, with you, or withdraw?
Games bring out a whole range of emotions. Do you notice any emotional shifts during the play?
What might their approach to the game reveal about how they see themselves or how they relate to family members?
You might comment gently on the shifts and changes you’re noticing in your client, in a way that feels safe and appropriate without disrupting the flow of the game. You can put their feelings into words for them, helping to expand their emotional awareness and vocabulary.
Noticing your own emotional responses can provide valuable information. Do you feel an urge to rescue, protect, or let them win? These countertransference responses can be meaningful. Rather than stepping straight into a rescuing role, try to stay curious. You might say, “I notice you're really hard on yourself in this game. I wonder if you feel like that in other places too, like school or with friends.”
Games can create safety and connection, while giving you a valuable window into the young person's emotional world.
4. Expressing emotions using art
Children and teenagers often struggle to describe how they feel, especially if emotional literacy was missing earlier in life. Art can allow feelings to take form and be explored at a safe distance.
Here are some ideas to try:
When discussing a feeling, ask them what size, shape, colour, or texture it has. Then invite them to draw or paint the feeling.
Use emotion cards, emojis, post cards or images to help them connect with what’s going on inside.
Use digital tools like a Zoom whiteboard or a drawing app if working remotely. There is even an online sandtray you could use.
You could ask open questions like:
Would you like to show me how that feels, or what that’s like, using the paints or pencils etc?
I notice you’ve drawn yourself far away from the rest of your family. I wonder what that might be about.
If these characters could speak, what would they say to each other?
What title would you give your drawing?
It’s important to remain curious and collaborative, rather than interpreting what you see. Let your client tell you what it means to them, and help them make sense of it through your shared dialogue.
5. Sandtray
Sandtray therapy, originally developed by Margaret Lowenfeld, is not just for younger children. It can be powerful with teenagers and even adults when introduced respectfully and with care.
You might invite the young person to show you:
Their family
Their life
An emotion they’ve been experiencing
A current problem
Their hoped-for future versus their feared future
Observe what they place where, the dynamics that emerge, and how people, animals, or objects interact. Gently reflect on what you see to support emotional awareness:
“I notice you’ve buried that locked box in the sand. I wonder what that might mean to you?”
This approach supports storytelling, emotional processing, and symbolic expression in a safe and contained way.
Finding support to build your skills
If you are new to creative or play-based work, or if you want to deepen your skills, you don’t have to figure it all out alone. Finding a supervisor who specialises in creative or play therapies can be incredibly helpful.
A supervisor with this background can guide you in how to introduce tools, manage boundaries while using playful methods, and stay grounded in therapeutic thinking — even when the work looks very different from traditional talking therapy. They can help you reflect on your use of metaphor, play, and symbolism, and also support you in noticing how your own emotional responses shape the work.
Over time, this kind of support can help you grow in confidence, creativity, and authenticity.
Closing thoughts
You don’t need to become an art therapist or play therapist to use creative tools in a meaningful way. The most important ingredients are your presence, curiosity, playfulness, and willingness to meet young people where they are.
These approaches aren’t just ways to fill time while doing talking therapy. They are often the very place where relationship builds and emotional work happens. When used with sensitivity, they open the door to connection in safety, deeper exploration, and more impactful therapy.
If your training was focused on adults, stepping into this world may take time. But with guidance, supervision, and a sense of play, your practice can evolve in ways that support young people more fully — and also enrich your own experience as a therapist.
