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Dungeons & Dragons is a classic role-playing game. Players create characters and go on adventures, shaping stories with a roll of the dice. Roll high, and things go well. Roll low, and a dragon might eat you. D&D has long been a fun pastime, but recently, people have been exploring it as a tool for therapy. From Portland, Oregon, Deena Prichep reports.
DEENA PRICHEP, BYLINE: This D&D game could be any D&D game. You've got dice and snacks and tween boys and a cave of adventurers trapped by magic ice.
UNIDENTIFIED CHILD #1: Let's melt them.
UNIDENTIFIED CHILD #2: We might die in the process.
UNIDENTIFIED CHILD #1: So make a fire.
PRICHEP: The kids are solving problems, being goofy. But it's also more than that. Jenny Siler is a speech and language pathologist. She runs therapeutic games for kids with autism and ADHD.
JENNY SILER: The mechanics of the game have been tweaked so that we actually address the goals that the kids are working on for their communication.
PRICHEP: So for kids working on expressive language, Siler creates monsters that are defeated when you describe them. Or for softer skills like self-advocacy, figuring out how to ask for help could get you a bonus roll of the dice.
SILER: You have a chance to try out what it looks like before you have to do it in real life, and you can do that with support.
PRICHEP: And this is not just for kids. Seth Dellinger is a Marine Corps combat veteran. He joined a therapeutic D&D game through a Veterans group to help with his PTSD. The person running the game, aka the dungeon master, worked with licensed therapists and met with players one on one to help them figure out the deeper issues they wanted to work on over the course of the game.
SETH DELLINGER: Our characters are dealing with an adventure chock full of trauma 'cause that's what D&D is all about. But truly, we're working through our own conflicts.
PRICHEP: Usually players give their character whatever abilities and vulnerabilities they think sound fun to play. But for Dellinger's therapeutic game, the players base the characters on themselves.
DELLINGER: Say that you're looking inward towards yourself and finding what your strengths are and what your weaknesses are, but it's under a guise and veil of Dungeons & Dragons.
PRICHEP: Dellinger's character had his qualities. As he describes it, high strength, lower wisdom. But he was also a monk who could run up the sides of trees and do amazing leaps. And these fantasy scenarios had real emotional impact, like when another veteran in the group risked his own character's life to save Dellinger's.
DELLINGER: We had to stop playing 'cause he just ended up crying. And he finally had came to terms with not being able to save his friend.
PRICHEP: Stories like this show how healing this game can be, but also how carefully it needs to be navigated. Soren Henrich is a psychologist at Manchester Metropolitan University, who has studied therapeutic gaming.
SOREN HENRICH: You need to have a lot of safety tools around. Like, how can the client or patient pull themselves back again if it gets to a place that is too overwhelming. There are loads of things that could potentially go wrong, and we need more structured research.
PRICHEP: Henrich, a D&D fan himself, has rounded up the studies on the therapeutic value of these types of role-playing games. He says there aren't that many studies, but they do show promise.
HENRICH: The moral reasoning part, creativity, empathy, perspective-taking - those things seem to be increased. We're also seeing a lot around self-empowerment.
PRICHEP: A group called Geek Therapeutics now offers a nine-week therapeutic game-master training class to teach best practices for running these games, and they've graduated over 2,000 students. Some are licensed professionals, like speech and language pathologist Jenny Siler. And some are just everyday players who want to go a little deeper. Alicia Figliuolo directs the program.
ALICIA FIGLIUOLO: I mean, slaying dragons and taking names and coming out a little bit of a better version of yourself is the coolest thing to witness.
PRICHEP: Advocates like Figliuolo hope that with proper guidance and perhaps more research, these mythical quests can provide real-world insights and healing and help some people slay their dragons.
For NPR News, I'm Deena Prichep.
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