Definitely has to be done well! Not tabletop but I thought the recent videogame Neva did a good job of this kind of story. You could say I screamed but more so out of heartbreak 😂

I love a good ethical dilemma in my games but yes, I can appreciate that these are only meaningful if not over-used

I hope that in some small way, throwing this all out into the ether perhaps helps combat a bit of that. Or at least feels informative for some folks to read. For a lot more on any of this, there are people who literally wrote books on the subject: @gametogrow.bsky.social and @meganpsyd.bsky.social!

Why? I’m curious to hear thoughts. It’s probably some combination of stigma about therapy in general, and the sort of attitude some people have about things like GMs for hire or using safety tools that are “ruining the game.” Keep therapy out of my D&D! Sure, you weren’t paying me anyway. (15/16)

I think it’s positive. After all, there was an article about therapeutic D&D in the recent TIME magazine issue devoted to D&D. But every now and then in forums, subreddit threads, Discord servers, etc. I will see some pretty negative reaction to the idea of combining TTRPGs with therapy. (14/16)

Therapists familiar with D&D are never surprised to hear about therapeutic D&D groups. Those without familiarity are typically pretty open to the idea after learning about them (I’ve done a number of conference presentations to this effect). The vibe in the broader TTRPG community?(13/16)

So, therapeutic TTRPG groups can be really effective. But they are definitely not for every client, or for every concern. IMHO they should only be run by facilitators who are already trained group therapists, who are also comfortable with GMing, which is admittedly a small group. (12/16)

There’s a lot of reasons I can think of for that that go beyond the scope of this thread (roleplay is a tool in many therapies), but the biggest one I think is because the nature of RPGs tends to put guards down a bit. It’s not “you” that’s taking that risk after all, it’s your character. (11/16)

Process groups are much more about exploring the interpersonal dynamics between group members, and they are AMAZING at getting into what makes people tick when facilitated well. When you add a TTRPG into a group like this, it can be like a turbo button for these kinds of group processes. (10/16)

Therapeutic TTRPG groups are best thought of as “process” groups, meaning their main way of helping people is through an interpersonal process as opposed to something like a DBT or CBT group, which is much more about teaching and practicing skills (we call these “psychoeducational groups”). (9/16)

So, measurable things like developing social skills and reducing social anxiety symptoms can be a real benefit that therapeutic TTRPGs are uniquely good at compared to standard therapy. But that’s not even taking into consideration the less measurable benefits of group therapy when done well. (8/16)

I’ve had clients in my groups tell me that they’ve tried ALL the therapy, including other forms of group therapy, and it hasn’t helped them in the way they wanted. Then they tried the therapeutic D&D group and it was a revelation to them. It’s good to have options! (7/16)

Applied therapies are often used where other more traditional forms of therapy may not be effective or efficient. If your goal is for example to help people with social anxiety, or other social obstacles due to things like autism, ADHD, etc., then traditional therapy can be pretty… not great. (6/16)

Therapeutic TTRPG groups are an “applied therapy,” meaning there is some agent that is NOT by design a therapy tool that is being applied in a therapeutic way. Better known applied therapies include music therapy, art therapy, equine therapy, drama therapy, and sandtray/play therapy. (5/16)

So how can this be therapeutic? There are layers. First, if you’ve had a positive experience with a TTRPG, you have probably incidentally gotten something therapeutic out of it. They are social games that require social skills and often emotional vulnerability. (4/16)

First, what’s a therapeutic TTRPG? Broadly, it’s any TTRPG group whose primary purpose is to provide a therapeutic benefit. This is an important distinction from recreational groups, whose purpose is and should be FUN. Therapy groups can be fun too, that’s just not the main goal. (3/16)

As far as my “cred,” I’ve been a therapist for coming on 13 years, a therapeutic game master for 6, and a lifelong nerd. I’ve done the @gametogrow therapeutic TTRPG training and have read the research and the books. I’m comfortable identifying this as a specialty, though I’m not an expert. (2/16)

Oh yeah! In no particular order:
- Mario 3
- Mario 2
- Dr. Mario
- Legend of Zelda
- Dragon Warrior (best garage sale find ever)
- TMNT (only ever had the first one)
- Blaster Master
- Blades of Steel
- Jackal

One of my FLGSs! Love Hourglass, appreciated reading the interview