Are you even a child therapist if you don’t play Uno at least once a day at your practice? It’s an excellent way to build relationship, it’s fun, there’s a combination of strategy and luck involved, and kids of all ages already know how to play.

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A couple of my clients have struggled to get the links working properly, so I actually have played Uno in telehealth with a physical deck of cards. If you and the client both have Uno, you can each deal your own hand and hold up the card you are playing to the camera. This requires a level of trust with the client, but it can be a lot of fun.

Uno Freak lets you create private games with your clients. When you open the link, you are greeted with a screen that prompts you to create a game:

You can choose what settings work best for you

Typically, I make the room name and password something simple like Amy1 and use the same name and password. You can start with anywhere from 1-50 cards, but if you start with 50 the game can glitch because you might run out of cards in the pile. I recommend “Random Player Order,” as this will make the game alternate who goes first. I never check “Registered Players,” as I don’t want clients to have to create an account, and I always “Hide from Lobby,” as this is an added security layer to keep random people from joining your game (although if you password protect the game, they shouldn’t be able to join without the direct link anyway).

Uno also has some flexibility that other online games don’t have: you can choose to draw rather than play if you want to “go easy” on your client.

Pros of Uno as a telehealth intervention:

  1. I’ve found that kids have been more cooperative and stay engaged in the game even if they are losing, simply because the game automatically draws for them rather than them having to draw cards themselves.
  2. You can choose to add “bots” to your game if the child wants the feeling of a larger group.
  3. The game keeps track of “points” in between several games, which can be added fun.
  4. No shuffling!


  1. Again, you can’t change certain rules (like draw once and then pass versus drawing until you can go).
  2. Since you click “Uno” instead of saying it, some kids don’t verbalize they are almost out, which means I sometimes don’t realize they are about to go out.

Uno was one of the first telehealth websites I found because I knew, no matter what my practice looks like, I had to have Uno for my clients.

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Published by Dr Marschall

Dr. Amy Marschall received her Psy.D. from the University of Hartford in September 2015. Her clinical interests are varied and include child and adolescent therapy, TF-CBT, rural psychology, telemental health, sexual and domestic violence, psychological assessment, and mental illness prevention. Dr. Marschall presently works in the Child and Adolescent Therapy Clinic at Sioux Falls Psychological Services in Sioux Falls, South Dakota, where she provides individual and family therapy and psychological assessment to children, adolescents, and college students. She also facilitates an art therapy group for adolescents and college students with anxiety and depression. Dr. Amy Marschall is certified in Trauma-Focused Cognitive Behavioral Therapy and Telemental Health.

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