Clinical support
12 telehealth therapy activities for adults
Combat screen fatigue and enhance engagement with these virtual techniques.
November 12, 2025
6 min read
Online therapy is a great way to reduce barriers to mental health treatment, as it can make therapy more convenient and accessible to many clients. But meeting virtually may also pose unique challenges to you as a therapist. From managing technology to adapting in-person activities to telehealth, you’re responsible for making online sessions feel safe, supportive, and engaging for each client.
With a bit of creativity, you can foster a strong therapeutic relationship with your clients — and help them meet their treatment goals — even through a screen. Below, find 12 telehealth activities for adults, plus tips for strengthening engagement with your online clients.
The unique challenges of building connection in virtual therapy
Working with adult clients virtually often calls for extra intentionality. In-person sessions naturally build connection through shared presence, eye contact, and nonverbal cues — but those subtleties can be harder to recreate through a screen. You might notice clients becoming distracted, fatigued, or less expressive in an online setting, making it more challenging to sustain momentum and deliver interventions that feel equally effective.
Even so, engagement is key to therapeutic success and long-term progress. Incorporating interactive, telehealth-friendly approaches helps adults stay focused, involved, and emotionally connected. These strategies foster collaboration, deepen trust, and strengthen commitment, supporting meaningful outcomes between and beyond sessions.
Setting the foundation for successful telehealth sessions
Before meaningful work can happen in telehealth, it’s important to create a virtual space that supports focus, comfort, and connection. A few small adjustments can make a big difference in how present and engaged both you and your clients feel, such as:
- Check your tech: Test your video platform, audio, and internet connection before each session.
- Use the right lighting: Use natural light or a soft front-facing lamp so your face is clearly visible.
- Find your angle: Keep your camera at eye level to simulate natural eye contact.
- Cut distractions: Silence notifications, close other tabs, and work in a quiet, private spot.
- Set expectations: Talk with clients about privacy, readiness, and session etiquette to establish clear virtual boundaries.
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Telehealth therapy activities that foster connection
Bringing variety into your online sessions helps keep therapy dynamic and personalized. Mixing in activities like collaborative games, mindfulness or grounding techniques, and even simple interactive tools can make sessions more engaging. These approaches give adults new ways to process emotions, stay focused, and connect to the therapeutic work in a format that feels fresh and relevant to their individual goals.
Interactive mindfulness activities that deepen presence
Mindfulness activities can help your clients stay grounded in a distracting environment and support clients who may be struggling to stay regulated in-session. At the same time, these techniques teach clients helpful tools to manage stress, anxiety, and other mental health symptoms in their everyday lives.
1. Five senses check-in: Guide clients to pause and notice five things they can see, four they can touch, three they can hear, two they can smell, and one they can taste. This grounding technique helps them reconnect with the present moment and reduces anxiety during or between sessions.
2. Breath and body awareness: Invite clients to close their eyes, place one hand on their chest and the other on their abdomen, and notice the rhythm of their breath. Encourage slow, intentional breathing while observing sensations like warmth, expansion, or tension — promoting physical awareness and calm.
3. Visualization with shared imagery: Use screen-sharing or verbal prompts to guide clients through a peaceful visualization — such as walking along a beach or sitting beneath a tree. Ask them to describe sensory details in real time, helping them practice mindfulness through imagination and sensory immersion.
Digital whiteboard techniques that enhance collaboration
Digital tools such as virtual whiteboards can support therapeutic connection and collaboration while keeping clients engaged with their treatment goals in online therapy. If you’re not fully confident with digital tools yet, start small and keep it simple. Practice using your whiteboard features before sessions, share your screen slowly, explain each step aloud, and invite clients to collaborate. This transparency can actually strengthen rapport and make the activity feel more accessible for both of you.
4. Mind mapping: Use your virtual whiteboard to create a visual web of thoughts, triggers, and coping strategies around a central theme — such as anxiety, self-esteem, or stress. Invite clients to add their own words or drawings in real time, helping them externalize complex emotions and identify connections between thoughts and behaviors.
5. Emotion charting: Draw a simple emotion wheel or mood scale on the whiteboard and ask clients to identify where they fall at the start and end of each session. Tracking emotions visually promotes self-awareness, opens space for reflection, and helps both therapist and client notice patterns over time.
6. Goal visualization: Collaboratively sketch a “pathway” toward a specific treatment goal, using milestones or stepping stones along the way. Clients can label each step with concrete actions or affirmations — turning abstract goals into a tangible, motivating visual they can return to each session.
Therapeutic games and activities that translate well to virtual settings
Games and activities can be a useful tool for making therapy feel less intimidating or vulnerable. In the setting of a game, clients may feel more comfortable opening up about their thoughts, feelings, or experiences — and you can also work on skills like emotion regulation, communication, and problem-solving in the game.
7. Thought detective: Ask clients to identify an unhelpful thought and “investigate” it using CBT-style questions such as “What’s the evidence for this?” or “Is there another way to view it?” Turning cognitive reframing into a game encourages curiosity and helps clients challenge automatic thoughts creatively.
8. Emotion wheel spin: Share a digital emotion wheel on-screen (or use an online spinner). Have clients “spin” to land on a feeling, then describe a recent situation when they experienced that emotion and how they responded. This helps deepen emotional literacy and awareness while keeping the activity light and interactive.
9. Strengths scavenger hunt: Invite clients to identify personal strengths by recalling moments when they handled challenges effectively. Use prompts like “Find an example from this week that shows your resilience” or “Name a time you used creativity to solve a problem.” This builds self-esteem, promotes reflection, and reinforces positive identity development in an engaging, conversational format.
Using multimedia resources to enhance engagement
Adding audio, video, and other digital resources into telehealth sessions can foster client engagement while making therapeutic concepts more tangible and relatable. These tools help clients process information through multiple senses, which can deepen insight and increase retention. Depending on your client’s treatment goals, multimedia can also spark creativity and connection in new ways.
10. Play calming soundscapes: Play short calming soundscapes or guided meditations to introduce mindfulness or breathing techniques for emotion regulation. Clients can bookmark or replay these clips between sessions for continued practice.
11. Use educational resources: To support cognitive restructuring, share clinically vetted educational videos or animated clips that explain CBT concepts visually, helping clients link thoughts, feelings, and behaviors in a concrete way.
12. Explore emotions with video: Use short video role-plays or recorded social scenarios to help clients identify body language, tone, and communication patterns, then discuss alternative responses together. When sharing your screen, be mindful that no PHI is showing. Close out of your EMR, calendar, and patient notes so they can’t be accidentally shown.
Adapting traditional therapy techniques for virtual connection
Moving therapy online doesn’t mean leaving familiar interventions behind. Traditional therapy techniques developed for in-person settings can be easily adapted for virtual settings with a bit of strategy. Using collaborative virtual tools such as screen-sharing, shared documents, or virtual whiteboards can make therapeutic modalities rooted in CBT, narrative therapy, and more feel connected and engaging — even through a screen.
Not sure where to start? The following examples can help you pivot from in-person to online therapy using your go-to therapeutic modalities.
| Traditional | Virtual |
|---|---|
| CBT thought records completed on paper | Used shared a HIPAA-compliant version of Google Docs, online CBT worksheets, or screen-sharing to fill out thought logs collaboratively in real time. |
| Narrative therapy using in-person journaling or whiteboard timelines | Invite clients to type or upload written reflections, use virtual whiteboards, or co-create digital story maps. |
| Experiential exercises, such as role-playing or chair work | Adapt using guided imagery, visualization prompts, or role-switching through dialogue while maintaining grounding check-ins to ensure emotional safety. |
| Mindfulness and grounding exercises practiced in-office | Guide clients through brief body scans or breathing techniques while encouraging them to personalize their environment — using items like candles, blankets, or calming music — to support comfort and focus during virtual sessions. |
Measuring and strengthening therapeutic alliance online
Just as you would for in-office appointments, take time to check in with clients about their experience with you in virtual therapy. Maintaining open communication from early on is an important aspect of building a trusting, healthy therapeutic relationship, whether you meet in-person or online. Encourage your client to share feedback about how telehealth therapy is going, and whether you can make any improvements to sessions, to promote engagement and connection.
Streamline your online therapy practice
Running an online therapy practice should feel fulfilling, not frustrating. With Headway, you can streamline everything from scheduling and telehealth sessions to documentation and insurance billing — all in one secure, easy-to-use platform. We handle credentialing, claims, and payments so you can focus on client care instead of admin tasks.
This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.
© 2025 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.
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