Tic Tac Toe is a pretty simple game that anyone can play, and even very young kids understand the rules. While it does not have some of the obvious therapeutic benefits of games like Chess or Battleship, it can be handy for rapport with kids who are nervous about meeting with a therapist.
You can play Tic Tac Toe in-person regardless of what games and supplies you have available as long as you have paper and a writing utensil. Over telehealth, a white board can allow for interactive Tic Tac Toe. In a pinch, a therapist could draw the grid on a piece of paper or physical white board, number each section, and hold it up to the camera, allowing the client to indicate their spaces.

PaperGames.IO has an option to play Tic Tac Toe in a private room. Go to the site, choose “play with friend,” make your choices, and send a unique link to your client, and the game begins when they join your link.
You can choose a classic 3×3 design with the goal of getting three in a row or a 5×5 board with the goal of four in a row. Then, decide whether you want you or the client to go first, or if you want the first move assigned randomly.
You also get to decide whether or not to have time limits for each turn and for the game itself. When I am working on rapport, I prefer not to have a time limit, but with clients who are working on focus, executive functioning, et cetera, you could add a time limit to practice these skills.
There is an option to create a tournament, so you could play with groups, but this feature requires each participant to input an email address, which might not be an option. Remember, confidentiality is the first priority!
By the way…stay tuned for more continuing education on telehealth! In October I’ll be partnering with the Telehealth Certification Institute to do trainings on play interventions, psychological assessment, and trauma-informed treatment.