https://www.cbc.ca/news/canada/calgary/dungeons-and-dragons-therapy-calgary-1.7065300

How Dungeons and Dragons is making its way into therapy

Game being used as a tool in correctional environments, schools and
hospitals

Jade Markus · CBC News · Posted: Dec 23, 2023 9:00 AM EST | Last
Updated: December 23

Sarah Atkinson's official job title is child and youth counsellor, but
every so often she also goes by game master.

Atkinson works at Discovery House, which helps women and children who
are fleeing domestic violence. The Calgary organization is testing a new
program that uses Dungeons and Dragons and other tabletop role-playing
games in a group therapy setting.

Dungeons and Dragons, also known as D&D, is a role-playing game where
people go on quests while developing their own character. A game master
or dungeon master — in this case, Atkinson — leads by describing
scenarios, guiding the group and enforcing the rules.

"Sometimes when kids experience really difficult things, it helps them
to take on a different role, to be somebody else for a little bit, to
work through some of those themes," Atkinson said.

D&D has seen a resurgence in popularity, and has been depicted in
television shows and movies like Stranger Things and this year's
Dungeons & Dragons: Honor Among Thieves.

It's also being used as a tool in correctional environments, schools and
hospitals.

In group therapy at Discovery House, Atkinson said a player can create a
character that has characteristics and personality traits they aspire
to, or their character could represent something they're struggling with.

"If you take a young person who has a history of victimization or abuse
or something like that, they can work through some of those themes by
playing a warrior who maybe doesn't experience those same things or
maybe experiences it in a different way," she said.

"But it's taking place in sort of that creative space, that imaginative
space, so it feels safer," she said.

But, she said, each player gets a card they can flip over if things feel
too heavy and they need to take a step back.

At Simon Fraser University in B.C., David Lindskoog, a registered
clinical counsellor, uses D&D in group therapy sessions mostly with
students who are experiencing social anxiety.

Using a pre- and post-session assessment tool on about 80 students, he
said students experience an average of 25 to 30 per cent reduction in
the severity of social anxiety symptoms.

The sessions are typically quite structured and usually about 60 to 90
minutes long.

"The gameplay itself requires a lot of interaction and social skills,
communication, problem-solving, creativity, imagination," he said.

The program also has a waitlist each term.

"It can be kind of tough to get students to commit to groups, oftentimes
the individual services are more in demand. So the fact that this one
has a waiting list pretty much every term is kind of a bit of a
testament to what the experience is like in the group for folks," he said.

Megan Ann Connell, a psychologist who uses Dungeons and Dragons as part
of her practice and wrote a book on tabletop role-playing therapy,
started playing the game in middle school.

Connell, who lives in Charlotte, North Carolina, said she took a long
hiatus from the game but fell in love with it again after becoming a
trained psychologist.

"I recognized as I was playing, I was running into a lot of the things I
struggled with, and so I had made characters that wouldn't struggle with
some of the things I do," she said.

"I was like, 'Oh, how interesting that my stuff is still showing up in
the character, even though it's not me' … that's where I started going
down this rabbit hole of utilizing this game as a tool for therapy."

Many groups use it to teach social skills to kids with ADHD and autism,
Connell said.

"However, we've been able to broaden it and utilize tabletop
role-playing games to teach a wider variety of therapeutic skills," she
said.

Her work often focuses on assertiveness training and building strong
peer relationships.

"There's just a lot of different tools and techniques that you can
utilize and fold into the game."

Connell said D&D can be applied to a broad range of experiences, and
it's not clear if it's more effective for certain disorders because that
research hasn't been conducted.

She said those types of studies are just starting to pick up.

Dungeons and Dragons first came out in 1974. Connell said that in the
early 1980s, there were a number of therapists and school counsellors
who started to notice that tabletop role-playing games were helpful to
their students and their clients.

While not a widely held belief anymore, the game was once considered a
danger to society. Many became fearful of Satanism or Satan worship in
the early 1980s, and D&D was pulled into that panic, spurred on by
television pundits, anti-D&D campaigners and evangelical Christians.

"With the satanic panic, people stopped using it as an intervention
tool. And so it wasn't until the fifth edition released we started
really seeing that starting to pick up," Connell said.

"It's a very, very new intervention style, even though the gaming system
itself has been around for quite some time."