Using Among Us in Therapy

Who would have thought a game rampant in paranoia, betrayal, and chaos would have been so popular? Oh wait…it’s 2020. Among Us has recently become the most discussed game among therapists so we decided to host a game night with our colleagues and livestream it on Twitch.

It was fun! And boy did we learn some things about one another…

If you are new to the game or simply curious about what being “sus” means, then read on as I explore some themes and clinical application of the game. To watch a recording of our livestream, visit:

Watch a recording of the livestream:

Using the Game in Therapy

Themes, metaphors, and intervention ideas

Among Us is an online, multiplayer game. Many have compared it to the game Mafia/Werewolf. The game can be played with 4-10 players. It can be played with people you know (by hosting a private room) or you can play online with strangers (in a public room). 

It is free to play on mobile devices (you can purchase an ad-free version of the game for $2). If you prefer to play on your PC, you can download the game from Steam for $5 plus tax (no ads). There are additional bundles you can purchase which gives you costumes for your avatar, mini avatars, and pets (pets do not impact the gameplay in any way, they’re just cute). The game has cross play ability meaning you can play with people across different devices.

In Among Us, players are randomly assigned as either a crewmate or an impostor. As a crewmate your job is to complete various tasks and figure out who the impostor/s are. Depending on the size of your group there can be between 1 to 3 impostors. The crewmates win the game if they choose the impostor/s correctly or complete all their tasks before everyone is dead. 

Impostors must do everything they can to sabotage the tasks and kill off crewmates. Throughout the game, meetings are called, and everyone comes together to compare alibis, discuss any “sus” (suspicious) behaviors, and vote on who the impostor/s are. 

It is a game that requires deduction, teamwork, communication, and the ability to multi-task…oh and betrayal, lots of betrayal.

I’ve broken down some of the skills utilized in the game along with some thoughts on themes, metaphors, and provided some processing questions to explore.

Teamwork, Problem Solving, and Communication

Among Us is a game that requires strategic thinking and planning. Crewmates work to complete their tasks and fix the ship whenever the impostor engages in a sabotage. Crewmates share their observations with one another during meetings to figure out the impostors between them. It’s a game that requires striking a balance between patience, investigative skills, and logical reasoning to find the impostors. Some players choose to form alliances and work to provide alibis for one another.

The Tasks: Practicing Executive Functioning Skills

The tasks are important in the game because they keep the spaceship working. They’re my favorite part of the game and probably to a fault because I often find myself so focused on them that I forget to be aware of my surroundings. Tasks come in a variety level of difficulties. Some examples of tasks include matching wires of the same color, completing a memory game, swiping a card at just the right speed, and tasks that require a swift reaction time. The skills required for tasks include planning, self-control, attention, time management, observation, working memory, organization, and patience.

Something to note is that players are still responsible for their tasks even after being killed. Players who are out still feel very much part of the game and can contribute to the crewmates’ win. Another great feature is that ghosts can chat amongst themselves without living crewmates or impostors being able to see their chat. This makes dying not as boring since ghosts can communicate and share their thoughts as the rest of the game unfolds.

Good Sportsmanship

You must have good sportsmanship if you want to stay friends after an intense game of deceit. That includes not teasing others because they lost and commending the winner for their strategic skills. Digital citizenship and the qualities of good sportsmanship can be a discussion topic before and after the game.

A Lesson on Dysregulation vs. Regulation

If you watch a replay of the game, you’ll see a key moment where I witnessed a murder. Right there. Right in front of me. But because the adrenaline was coursing through my veins, and my anxiety was on high alert, I couldn’t remember what color the impostor was! When I started to think about that moment and check in with the physical sensations in my body, I realized I was in panic mode and that I was not able to think clearly in that moment. In sessions I often provide psychoeducation on Dan Siegel’s Hand-Brain model and how we must be calm and regulated before learning and reasoning can take place. I’ve also had many conversations about how the eerie music in the game affects our nervous system. 

The game provides a great segue into the topic of regulation. The therapist and client can engage in a discussion on coping skills and ways one can regulate themselves when feeling anxious in the game and in real life.

Is it Violent? Is it Safe?

The game is currently rated for ages 9+ for Fantasy Violence and Mild Blood. There is the use of guns and knives in the game. The animation is very cartoony in a way that makes the betrayal less devastating and keeps the game silly and fun. It is important to engage in a discussion with parents to explore concerns, if any. I would explain what my purposes are for utilizing this game (rapport building, exploring themes surrounding trust, loyalty, rejection, etc.). I always try my best to have parents engage with me and try the game out for themselves.

The minimum required number of players to start a private game is four. This would work well if the therapist is running a group. If you are working with an individual client, and your only option is to play a game with strangers, then I recommend being a host of the room. You can do this by creating a private room and then opening it up to the public. 

As a host, you can control the settings. The host can set the number of impostors in the game, choose the map (there are currently 3 maps available), adjust the time to discuss and vote on impostors, change the speed of the players, adjust the difficulty for killing other players, adjust visibility within the map, limit the number of emergency meetings, and most importantly, the host has the ability to ban individuals who are engaging in inappropriate language or cyberbullying (while there is no voice chat option in the game, players may still spam the text chat with inappropriate language). Inappropriate words are censored by default in the game. If this setting is not enabled, you can activate “Censor Chat” in the settings. If someone joins your room with an explicit username, you as a host can remove them from your game. 

As always, it is important to ensure your clients practice cyber-safety and to remind them that people online might not be who they say they are.

Ensuring Privacy

As with any video game, it is recommended to create non-identifying usernames. All verbal communication occurs in your HIPAA compliant platform. Among Us does not have a built-in voice chat function. The game consists of an in-game text-based chatroom where voting and deliberation occurs. There is currently no option to add friends in the game.

If you are working with a group, video and voice chat can occur in your HIPAA compliant platform. Being able to witness verbal and non-verbal cues would certainly provide interesting insight!

Freeplay Mode

Freeplay mode is a great way to practice tasks as a crewmate and your sabotaging skills as an impostor. I recommend using this before you play so you feel comfortable with the controls and learn how to perform the tasks.

The Mask Intervention

Our persona is our public face. It is what we present to the world to adapt and fit into society. It conceals one’s true nature. Among Us can serve as a great example when exploring the many facets of ourselves (inside vs. outside selves). 

For this intervention, I normally incorporate a blank mask to represent two sides of a conflict or a problem. This type of intervention allows individuals to externalize and distance from their problems. This is especially helpful for treating anxious individuals who have difficulties expressing emotions, individuals with histories of loss and separation, and adolescents struggling with identity issues.

To connect this intervention with the game, I would recommend printing out the characters from the game and directing the client to write on one side (the front of the character) words describing how the outside world sees them, and on the back, write who they are on the inside. This intervention assists clients in discovering the difference between their persona and who they really are at their core. 

Who are we when we take off the mask? Do you feel like an impostor when you are not being your authentic self? Does the figurative mask get lowered when heightened emotions are involved (when you’re being blamed for something you did not do, for example)?

Processing Questions:

  • Do some group members have a “tell”? What makes you or others look sus? (for ex: I would give myself away simply by doing my nervous laugh)

  • What makes a good impostor? What is your strategy?

  • Which do you prefer being, the impostor or the crewmate. Why?

  • What is your favorite task in the game?

  • What is the most difficult task?

  • What physical sensations do you feel in your body while playing the game? What coping skills do you use when feeling anxious?

  • Was there ever a time when you did not feel heard or understood by others (in the game and in real life)?

  • Discuss internet safety and boundaries.

  • Do you form alliances or work on your own?

  • How do you build trust and loyalty (in the game and in real life)?

  • Do the color stereotypes sway your decisions? (For example, people often say “Pink is always sus.”).

  • Have you made friends while playing Among Us?

  • What are the best Among Us memes you’ve seen?

  • Paranoid people can make irrational decisions. Regulated people can help others by staying rational and exploring all the evidence. Explore your experience of playing the game. Were you rational or irrational at times? Do you believe everything you read?

  • What are the dangers of jumping to conclusions/making assumptions early in the game? Has this happened to you in real life? If so, what was the outcome?

  • Do you ever feel like an impostor in your group of friends? Why or why not?

  • What makes a loyal and trustworthy friend?

  • Discuss the differences between a toxic relationship vs. a healthy relationship.

  • Have you ever taken the deception by a friend in the game personally? How did you handle it? Has a friend ever betrayed you in real life? How did you handle it?

  • Have you ever felt rejected or misjudged by people in real life? What did you do? Did it affect the way you look at others and yourself?

  • Being a good detective is important in this game. How can we become a good detective to determine what our mind and body need? What physical, mental, and emotional cues arise that tell us we need a break, need to eat, need to utilize a coping skill, etc.?

Other Ways to Play:

  • Hide and Seek is another fun way to play the game.
  • Players have created their own versions of the game in Roblox!


One of the biggest communities on the internet is the gaming community. Gaming communities have offered us a space to socialize and connect in a time of social distancing and quarantine. Among Us hurls you into a sci-fi world of panic and chaos, but also, a lot of fun and laughs that the betrayal doesn’t feel so personal. The central themes of the game allude to topics adolescents can very much relate to such as not being heard or understood, feeling like an impostor amongst peers, and learning how to discern between a toxic relationship vs. a healthy one. I can certainly see this game facilitating a lot of important discussion surrounding these topics and more.

We look forward to playing more games with you! If you have a suggestion for a game, please reach out to us at [email protected]

Keep Playing!

Sophia Ansari, LPCC, RPT