If a player is struggling with feeling that they do not count, the therapist can have the player create cardboard shields before they go into a battle. On the front, they can draw what they consider important about their character/themselves (values, achievements, personality traits). Then they can pass it around, and their teammates can sprinkle it with "magic" by writing on the back side what they think makes the character/person special.
Conclusion RPGs offer a novel landscape for clinicians to delve into a fantasy world with the participants while using metaphors, necessary psychological distance, and the features of RPGs to help clients gain valuable social experiences and interpersonal insight. Clinical observations of therapeutic RPG groups indicate a reduction in social isolation, with participants reporting that it is easier to be open to meeting others when they can initially utilize the psychological safety of a character’s persona. Feedback from families includes the clinical value of “bleed-out,” noting increases in real-world self- Increasingly, embedding therapeutic goals into fantasy scenarios allows play therapists to expand the traditional boundaries of the playroom, transforming cooperative gameplay into a catalyst for lasting social connections.
References Abramson, A. (2025). Improving treatment with role-playing games.
de Oliveira, D. A. M., Werpp, M., Moraes, L., & Lotufo Neto, F. (2023). Social skills training with a tabletop role-playing game intervention
doi.org/10.3389/fpsyt.2023.1276757 Bleed and identity: A conceptual model of bleed and how bleed-out from role-playing games can affect a player’s sense of self Dungeons & Dragons Games g4h.2023.0122 Otani, V. H. O., Novaes, R. A. C. B., Pedron, J., Nabhan, P. C., Rodrigues, T. M., Chiba, R., & Vissoci, J. R. N. (2024). Framework proposal for role-playing games as mental health intervention: The Critical Skills
doi.org/10.3389/fpsyt.2024.1297332 Rosenblad, S. R., Wolford, T., Brennan, R. S., III, Darnell, J., Mabry, C., & Herrmann, A. (2025). Mastering Your Dragons: Using Tabletop (4), 441.
https://doi.org/10.3390/bs15040441 Schaefer, C. E., & Drewes, A. A. (2014). (2nd ed.). John Wiley & Sons.
Yuliawati, L., Wardhani, P. A. P., & Ng, J. H. (2024). A Scoping Review of Tabletop Role-Playing Game (TTRPG) as Psychological Psychology org/10.2147/PRBM.S46666
ABOUT THE AUTHORS
Julie Skelton, MSW, LCSW, RPT™ has six children and two grandchildren. She and her husband have fostered over 40 teenagers and hosted eight exchange students. She loves using games, crafts, and puzzles to build relationships with the teenagers in her home and with her
julie@sd-path.net
Samantha Irey, MSW, LMSW, graduated from Ohio State University in 2020. She is following in her mother's footsteps as a social worker. She is especially interested in working with neurodivergent clients and in using her own neurodivergent experience to help others achieve
sam@sd-path.net
Future Play Therapy™ Topics
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