There is a saying about cross stitch, “WARNING: This is proof that I have the patience to stab something 1,000 times.” Now, some might have trouble using a needle safely or navigating the fine motor skills of physical cross stitch, but the repetitive motion of cross stitch activities can be relaxing, mindful, or meet a sensory need.

You can complete cross stitch activities online, which removes the needle work but maintains the repetitive nature of the task. This website is accessible with telehealth sessions if you screen share and grant the client remote control. There are dozens of images to choose from.
You can also each pull up the website on your own device and work on different patterns, then share what you each created. This way, you can model the mindfulness of the activity or focus skills along with your client. Then you can share your creations with each other.
Unlike some other color by numbers websites I have found, online cross stitch lets you make “mistakes.” There is a pattern to follow, but you can deviate, though the color options are limited with each palate. This means you and your client can work through frustration if they make a mistake, or you can take a more creative approach to the task and let them make their own design.
If you do make a mistake, you can simply color over your error with another color. (Note: if you are deviating from the standard design, once you put the “correct” color on a square, it stays that color even if you try to change it.)
This is yet another way to make creative expression more accessible in therapy.