An introduction to Therapeutic Tabletop Roleplaying Games, a unique therapeutic experience that blends storytelling, teamwork, and personal growth through play
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Seeking help with life’s struggles does not mean you must do it alone! Therapy can be fun, collaborative, and a social experience. Especially when you are playing Dungeons and Dragons.
For those who do not know what Dungeons and Dragons is, it's a tabletop roleplaying game (TTRPG) created in 1974 inspired in part by the fantasy writings of J.R.R. Tolkien who wrote Lord of the Rings. It’s different than most board games in the way the story and direction of the game is guided by a person called the Game Master (GM). Collaboration between the players and the GM creates an evolving story that everyone helps shape and participate in together. Players create their own characters, interact with one another, and navigate the world and story created by the GM through the lens of their character. This can become a great practice area to work through various situations in game that are designed to help build confidence for similar situations in their real life. Dice rolls also introduce unpredictability into the story, encouraging players to practice flexibility and “going with the flow” when things do not go as planned. For people who feel anxious when situations feel uncertain or outside of their control, the game can provide a supportive space to practice adapting and responding without needing everything to happen perfectly.
What does Therapeutic D&D look like? As a certified Therapeutic Game Master, I have training to tailor gameplay to the goals collaboratively identified during a pre-group one-on-one meeting. This allows me to shape scenarios that create opportunities for growth through fun fantasy settings. Whether it’s practicing assertive communication against a dangerous villain, using frustration management skills when you get a bad dice roll, or discovering more about yourself as you grow through your character, you’ll move closer to the version of yourself you want to be while having a good time.
Roleplaying is a commonly used therapeutic intervention that gives clients a safe way to test new behaviors, identities, and rehearse responses to different situations. Engaging in roleplay of skills in a group setting helps you practice with others and helps make the learning process more effective. Therapeutic roleplaying draws from evidence-based therapy approaches, including Acceptance and Commitment Therapy (ACT), which focuses on building psychological flexibility, effective coping skills, and values-based action.
Acceptance: In the game, you will face unexpected challenges and setbacks with your character, a perfect opportunity to notice patterns in your reactions without judgment. This practice helps you acknowledge your thoughts and feelings as they are, and stay engaged in the adventure instead of letting those reactions pull you out of the experience.
Values: As you play, you’ll have chances to make choices for your character that reflect what matters most to you, like collaboration, courage, or creativity. This helps you practice aligning your actions with your values, even when it feels challenging. Practicing in this setting can help you focus on bringing that same value into real life situations, such as friendships, family interactions, or handling difficult emotions and uncertainty.
Flexibility: Throughout the game, you’ll work together with other players to solve problems and navigate challenges as your character. Because the game creates a shared story rather than a “perfect” outcome, mistakes and unexpected situations become opportunities to practice flexibility, communication, and recovery. Over time this helps you build confidence in your ability to handle difficult moments both in the game and in everyday life. Along the way, you may also begin to notice patterns in how you approach stress, teamwork, conflict, or uncertainty.
In the beginning stage of the group, players get together to build a plan and backstory for their character. During character creation, I encourage players to consider utilizing different aspects of themselves they may want to explore through their character. Two different approaches to character creation might emphasize one version of yourself that highlights your imperfections and vulnerabilities, or one version of yourself that captures the aspirations and qualities you strive for. These approaches can help players safely explore parts of themselves that normally feel uncomfortable, vulnerable, or difficult to express. Looking at some of your best and worst qualities through a character lens can help you reflect without judgment and see yourself in a different light. You often hear the phrase “fake it ‘til you make it”, but through roleplaying, “make it” might be closer than you think.
A typical session begins with a recap of the previous session, a quick check in, and then the game begins! Depending on where the previous session ended, players may find themselves solving in-game puzzles, navigating social situations, exploring new locations, or working together during combat encounters. Sessions are collaborative and interactive, encouraging players to respond to new situations as their characters which can look like a fantasy themed improvisation group. With the randomness introduced through dice rolls, players naturally encounter moments of frustration, disappointment, success, and uncertainty while also practicing how to recover and adapt during the session.
Sessions end with intentional time for reflection, where players can discuss meaningful moments from the game, and situations that they may have handled differently. These conversations help players practice self reflection, recognize patterns in how they respond to stress or uncertainty, and carry those insights into future sessions and real life situations.
I believe that therapeutic role playing games can become more than just entertainment, but also a space to practice connection, confidence, and communication in a supportive environment. If you are interested in what it could be like, or if you know anyone who might be interested, please send them this blog post and reach out to us to get started! We welcome all walks of life to the party and would love to have you. Happy Adventuring!
