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Example Dialog regarding RPG Therapy on

by Hawke Robinson published Oct 15, 2015 09:50 PM, last modified Oct 15, 2015 09:50 PM
There is an interesting thread regarding the Bodhana group and the use of role-playing games for therapy. I recently stumbled across it and have been enjoying the dialog. I thought I would share a snippet that might be helpful others to understand an example of how the use of RPG for therapy would be applied...

View the discussion thread here:

Adding the trappings of D&D fills me with skepticism, though. Is that just an entry point, or are they literally rolling d20 to defeat the orc warboss, somehow inspired by your domineering father (or whatever)? I'd be curious to see some transcripts.[/QUOTE]

It is unlikely such transcripts for real clients would see the light of day due to patient confidentiality. That is true for all my clients. Though anonymous versions, or overall reports certainly could be.

Generally you want to set up challenges and choices that address the issues, and are not going to be limited/determined overly much by a dice roll, instead letting them learn cause and effect of choices (empowered, more balanced internal locus of control), rather than overly arbitrary luck (un-empowered, excessive external locus of control). Learning when to accept what is in their control and doing some about it, and "letting go" of what they can't control, be prepared for that possibility, and accepting it, is very challenging for many of these populations. Some have very entrenched generalized psychological vulnerability (they learned that the world is dangerous and out of their control, and they fear they won't be able to cope)) while others are trying to control too much. There can be plenty of standard game mechanics (any system, d20, Rolemaster, GURPS, whatever) for specific steps along the way of course.

Again, I'm speaking from working with other populations with other challenges, I haven't implemented specific modules for abuse (though do run for at-risk youth that may have such issues in general).

For PTSD and others with trauma related,issues in general complex issues such as triggers, hypersensitivity, desensitization and reprogramming (at a biological level of fight/flight response to stimuli), can be addressed (theoretically) through gradual exposure techniques. That is a huge over simplification of a still evolving science.

In my case, I have specific modules, built for specific populations to achieve specific client goals, but they are for the therapist GM to run, not for the player to read. So they are not "self help", rather they are guided activities that have both inherent benefits from the RPG format itself, as well as specific targeted benefits through situations set up by the GM and interactions with NPCs, events, etc.

Using your example with an Orc warboss. They will make many choices along the course of the adventure module leading up to finally facing the warboss. Those are the powerful mechanisms of choice and causality and risk assessment. The game mechanics help manifest some of the unpredictable/uncontrollable risk elements of course. The game mechanics determine the details of action resolution and the battle results.

Whether they succeed or fail to defeat the boss is secondary to what they learn along the way leading up to it. Another typical step is a post-game discussion, to help them understand "what happened" and learn from the process, and attempt to "generalize" those lessons into application in real life in healthy ways. A third is before the following session, discussing if any issues that came up during the week that might have applied to what they learned in prior sessions, and if it helped them to make "better" choices based on what they learned.

While the "fun" is the orc fight, getting the loot, fame, fortune, improving their character, etc. (which is very much a token reward system that many therapeutic settings try to implement without a game context), the module may have been intended to teach them some concepts along the way, let's say understanding how to solve problems in a cooperative way, communicating with others effectively, how to avoid getting into fights when more diplomatic goals may be wiser (so losing the fight might teach them that violence isn't always the best solution, next time they might want to use more cunning, or diplomatic, or even if battle is inevitable they can learn to be more prepared that than just charging in headlong, etc.) or more mundane learning such as asset management, purchasing, haggling, the list goes on.

In a more modern setting, it might be how to learn using the local public transit system, or civic resources (finding a movie theater, or doctor, hospital, or fire department, and how to interact correctly with those resources). All of this primary learning is meant to be transparent due to the focus on the fun of the game, and they learn it in an osmotic way.