Mental Health

Use of Role-Playing Games (RPGs) in Therapy

By November 9, 2022February 10th, 2023No Comments

Authored by Vilte Baliutaviciute, MA, QMHP, a member of the IntraSpectrum Counseling clinical team.

There are different approaches to psychotherapy, including Art Therapy, Cognitive Behavioral Therapy, and many more. Different types are used for different client situations; therapists typically draw on one or two different theories based on their training and the types of issues they specialize in.

Using role-play for therapy is one method sometimes used within Psychodrama Therapy, and its history is longer than one might think. Psychodrama involves using acting or role-playing to process key issues, emotions and concerns, and it’s been an established approach in therapy for decades. For people struggling with anxiety, autism spectrum disorder or social isolation, a role-play game can be a safe, fun way to practice new skills or process important feelings. And it’s been shown to be effective across a wide variety of cases.

The fantasy tabletop role-playing game “Dungeons and Dragons” (D&D) was created in the 1970s, and has had demonstrated success as part of mental health treatment plans:

  • As early as 1994, a young man with schizophrenia, with the help of his therapist, used the popular game to safely explore his inner identity
  • For children with Autism Spectrum Disorder, playing a tabletop role-playing game (known as an RPG) with a group can help with cooperation and communication
  • These benefits are not limited to specific groups or diagnoses either! D&D has been used to help college students practice moral reasoning, and teen players in RPG group therapy settings improved social skills, self-esteem, self-confidence & impulse control.

Given the variety and complexity of available role-playing games, therapists agree that the right game can help with anything from math and strategy skills to identity development. Role-playing settings offer a safe and engaging practice ground for a lot of things, including:

  • trying on new identities
  • relating to other people
  • experimenting with new plans or ideas
  • thinking creatively

Want to give it a try? There is such a variety of role-play settings and systems, there’s sure to be one that works for you! D&D is perhaps the most famous, but it’s far from the only option.

  • There are role-playing systems built for settings such as sci-fi futures to royal court drama
  • If meeting regularly for weeks is too much, there are short “one-shot” games meant to be played in a single sitting
  • If you want to go-all in and move your body, look for Live-Action Role-play (LARP) groups in your area
  • Not into swinging foam swords? Tabletop games are a classic
  • Or, if you’d prefer creative writing for your role-play needs, try online forums such as RPNation
  • If getting a group (or even a single partner) just isn’t feasible, there are even Solo LARPs and journaling roleplays, meant to be a self-paced personal journey of exploration and adventure for just one person.

Role-play games initially achieved popularity as fun & engaging entertainment. Now it’s increasingly common to find therapy D&D sessions too, because RPGs can be such valuable tools in mental health therapy, particularly with adolescent & young adult clients.

Want to learn more? Check out these Therapy-Gaming Groups and Resources:

  • Game to Grow: a 501(c)(3) non-profit dedicated to the use of games for therapeutic, educational, and community growth
  • Geek Therapy: a 501(c)(3) non-profit that advocates for the effective and meaningful use of popular media in therapeutic, educational, and community practice


IntraSpectrum Counseling is Chicago’s leading psychotherapy practice dedicated to the LGBTQ+ community, and we strive to provide the highest quality mental health care for multicultural, kink, polyamorous, and intersectional issues. For anyone needing affirming and validating support, please click here or contact us at