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.

Photo by fotografierende on

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.

Photo by Edgar Colomba on


UnoFreak has made an update to their website that requires you to make an account in order to use the platform. This is free, quick, and easy, but if you prefer not to make an account, or your clients aren’t able to make accounts, you might be looking for alternatives. Luckily for you, I found some!

  1. Scuffed Uno. The graphics are different, but Scuffed Uno has many similar options to UnoFreak – choose “Online Play” and “Create Room,” then have your client click “Online Play” and “Join Room,” then input the code that was generated when you created your room. You can play with up to 8 people, so this works for groups. You can specify rules, including whether or not you allow stacking, forced play (if you can go, you must go), jumping in, or an added twist that if someone plays a 0, you switch hands.
  2. Uno With Friends. This version lets you choose whether or not to score between sessions and how high to play to. You can play with two, three, or four players. Choose Online, the number of players, and make up a code to create a private room. Have your client go to the site and follow the same steps using the same code, and they will join you in your room.
  3. Uno Card Online. Choose Multiplayer, enter a nickname, then choose Create Match. You can choose 2, 3, or 4 players and give the room a password for security. You can choose whether or not to enable “special mode,” which allows stacking.
  4. Pizzuno. Imagine if Uno was also pizza. Choose Multiplayer and then share the link with your client. This version does not let you choose rules.
  5. Buddy Board Games Uno. Choose a nickname, create a room, and then share the generated link with your client. You can play with up to six players. This version also does not let you tweak the rules.

Published by Dr Marschall

Dr. Amy Marschall received her Psy.D. from the University of Hartford in September 2015. She completed her internship at the National Psychology Training Consortium with specializations in assessment and rural mental health. Currently, she specializes in trauma-informed and neurodiversity-affirming care, and she is certified in telemental health. Dr. Marschall runs a private practice, RMH Therapy, where she provides individual and family therapy as well as psychological assessments across the lifespan. Dr. Amy Marschall is an author and professional speaker.

%d bloggers like this: