Never in my wildest dreams did I think that my journey as a mental health therapist would lead me down the road of playing Tabletop RPGs. In fact, fully merging these two concepts did not even occur to me until our clients were doing it on their own; propelling their treatment substantially.

Our journey with Tabletop RPGs started when my coworker and business partner (Pat) researched D&D as a way to build rapport with a challenging client. Instantly, this client’s attitude towards him changed and his investment in treatment improved drastically. Pat then started spending his free time researching Tabletop RPGs and got me on board with approving a D&D campaign for the clients who were interested. I didn’t pay this group much attention but as time went on, it became evident that this group had become invaluable and that the clients were unknowingly (to us and them) processing their trauma through role playing, developing social skills, and being provided with a safe place to practice their coping skills that we had been spending months teaching them. It became evident that our clients were making connections between their characters and themselves that was propelling their treatment. It was then that I really started to consider what a more therapeutic and intentional approach to Tabletop RPGs would look like.

I brought this idea up with Pat who humored me and thought there was no way I really wanted to get fully on board with Tabletop RPGs. And he wasn’t completely wrong, part of me didn’t. I knew that merging these concepts would mean more work for me but honestly, I couldn’t ignore the countless benefits our clients were already getting from D&D and it seemed selfish to not jump on board. After long conversations on how this approach would work, we created Tabletop Recovery, implementing it with our own clients.

Our goal was to create Tabletop RPG campaigns founded on best practice and researched therapy concepts with courses/campaigns tailored to both laypeople (goals of increasing social skills) and professionals (goals of increasing social skills and processing through trauma). We draw from cognitive behavioral therapy, dialectical behavioral therapy, and drama therapy. Utilization of these research based concepts allowed us to create an effective program for teaching both social skills and processing trauma in a group setting.

One of the questions people often have is for us to explain how the merger of these two concepts (therapy and Tabletop RPGs) actually work. So we have broken it down into our guiding theory:

• – Ability to explore choices/decisions: One of the main benefits of Tabletop RPGs is that the client is able to create their own character including backgrounds and memories that drive these characters. They are allowed the freedom to give their character personality traits and morph this character into anything they want to. Research has shown that when individuals create characters, they see these characters as representing aspects of themselves (Shay, 2014). This allows the clients to try out new ways of interacting with others and view, through their character, how certain decisions could play out.
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Ability to gain social skills: Social skills training is something we are constantly working on with our clients and Tabletop RPGs provide both an opportunity to work on this in and out of character. We have seen teens who barely look or speak to their peers engage in assertive communication while looking others in the eyes. The transformation and ability to work on these life skills has been life changing for our clients!

– Ability to process through their trauma: As previously stated, we had no idea that clients were independently processing through their trauma in character. I would say that recognition of this is what really drove us to implement TTR because we realized that that the results we were seeing were clinically significant. Being in character and processing trauma allows the client to process through their trauma as a form of In Vivo Therapy (based on CBT). However, the client is far enough removed from the situation to allow them to feel enough to fully process thoughts and feelings.

– Ability to practice acting contrary to impulses: This is one of my favorite benefits of Tabletop RPGs. Many of our clients struggle significantly with impulse control. They act based on urge and instant gratification versus thinking through a variety of options, making informed decisions. Tabletop RPGs allow an opportunity to practice taking a step back-sometimes at the prompt of the GM/DM or support staff, sometimes through a failed attack (seeing the consequence and realizing that they need to act contrary to impulse next time), and sometimes through realizing that they need to act based on their character versus their own desires/impulses. Research on ADHD and other impulse control disorders shows the need to slow down the relationship between experiencing a feeling and acting (Phillips, 2019), therefore, we take steps throughout the campaigns to assist our clients in understanding this connection and working to achieve reduced impulsivity.

We have come to realize that the possibilities are endless when it comes to how Tabletop RPGs can benefit our youth and every week we utilize this approach, both the clients and staff are identifying more and more benefits and possibilities.