While there are numerous serious games that explore cognitive behavioral therapy (CBT) techniques through gamification on smartphones, the framework for developing interactions is not often thoroughly discussed. The objective of this study is to outline the process of combining CBT techniques, narrative setup, and game mechanics to create two types of interactions (verbal- and physical-based) using the player interaction framework (PIF). The PIF consists of three key sections: setup, aim, and execution. In the setup section, it utilizes the ABCDE (activating events, beliefs, consequences, disputation of beliefs, and effective new approaches) model to combine narrative and CBT techniques such as gratitude and self-monitoring. The aim section is used to break down the intended experience of both the player and their main character, at the same time clarifying the CBT goal of the interaction. Finally, the execution section includes the representation of how players will interact in the game through input and feedback. The efficacy of the framework in visual narrative serious games remains to be investigated through a randomized controlled trial after the completion of our serious game, BlueLine.