Rolling for Insight: A therapeutic D&D program

This is how a role-playing game outperforms technology. 

Our heads contain the finest hardware and software ever made. Don’t believe it? Just ask the Tanager Place inpatient youth spending their time in isolation away from a screen and yet not being mentally isolated.

By using a specialized therapeutic version of the popular tabletop role-playing game Dungeons and Dragons, the youth have traveled as a group to faraway lands, battled fierce foes and unearthed treasures – all while gaining flexibility and tolerance, and learning to better adapt to disorienting social situations.

Tanager Place Inpatient is using a new therapeutic version of D&D to build social skills.For the uninitiated, D&D, as the game is affectionately known, is a fantasy game born in the 1970s that gained a cult following in the following decade. Players work as a group, with each creating a character by rolling dice to determine characteristics such as strength, dexterity and charisma. When the group of characters is established, they are led through various adventures by a game narrator, historically known as the dungeon master. The narrator provides the story and often maps of the places to be explored or other props that help bring the story to life. Players make choices that further develop the story, and their actions have consequences (based on the roll of a die) for the individual player and for the adventuring party.

STEP ASIDE SMARTPHONE

Such mental journeys are not typical for today’s youth, who are rarely without their screens. Common Sense Media, a nonprofit that provides education and research for families, released a 2019 survey showing skyrocketing ownership of smartphones by tweens and teens. The group learned tweens spend, on average, five hours each day on social media. And, as youth age, the digital addiction expands, with the average teen reporting seven hours of screen time each day. Digital interactions include video games, YouTube videos, Snapchat communications and more; our youth now experience more social interaction in the virtual realm than in reality.

Sadly, this technological takeover is interfering with cognitive development, innate creativity and mastery of real-world social skills. Breaking this cycle is vital, but requires an option equally as engrossing and “techless.”

ENTER DICE AND PENCILS

One effective and exciting option begins with the time-tested use of paper, pencils, a few dice and a lot of imagination. Within an imaginary D&D universe, players adventure their way through unlimited possibilities, solve problems, face consequences and work as a team. They tap into cognitive creativity, temporarily escaping into a safe, healthy, meaningful and unexpected new place.

The D&D adaptation used with inpatient youth at Tanager Place is the brainchild of three staff members: BHIS Caseworkers Jordan Pinckney and John-Paul Blix, and School Based Therapist Darren Kirk. Their social skills RPG program focuses on specific verbal, interactive and cognitive skills development. In their program, a “Master of Stories” creates and leads the youth, or “adventurers,” through predetermined stories that contain imaginary creatures, obstacles, traps and treasurers. Working through the perspective of their characters, the youth role-play through different levels of challenges, puzzles and problems, using communication, conscious-functioning, decision-making, predictability-thinking and other skills.

The very nature of the game means that players will experience natural consequences, success, failure, highs, lows, good and bad. It is within these imaginary conflicts that trust is built and relationships are strengthened – among the characters as well as among the players. All without ever viewing a screen.

ADDRESSING A NEED

Too often children between age 6 and 18 are challenged by low levels of confidence and an inability to engage or function in society. Sometimes this social anxiety worsens as the child ages, crippling the ability to succeed. When working alongside others as part of group activities, seeking relationships outside of the home or performing rudimentary social interactions, some youth do not have the knowledge or confidence to advance. There are many therapies that target needed skills – cognition, mindfulness, emotional expression, etc. – but only a few group therapies that use group-focused role playing interventions to battle social anxiety, depression and Autism Spectrum Disorder.

Tanager Place staff members Jordan, John-Paul and Darren were like most teenagers in that they each experienced internal and environmental challenges that impacted their social confidence and perspective on the world. Looking back on their younger selves, the three agree a D&D program like the one they developed would have helped.

That perspective, combined with their passion for serving others and playing RPGs, led them to put their heads (and hearts) together to mix mental health services with gaming interventions. Development and implementation of the pilot program took two years.

Although the onset and spread of the coronavirus has brought many challenges to Tanager Place, Jordan and John-Paul saw the crisis as an opportunity to reach and teach inpatient youth in a different way. They also saw the inherent escapism of RPGs as an added benefit during an emotionally trying time.

“This program is much more than just a game, it’s a quest for self-discovery,” Jordan said. “It is a world kids can tap into where they can be who they want to be or who they see themselves becoming. In today’s world, our society has a sharp grasp on exploring creativity and imagination, so it’s vital to utilize that trend in ways that help, inspire, and encourage our youth battling the everyday challenges of life.”

“This program is meant to create not just a safe space, but an entire realm of imagination, adventure and possibilities. With that and a little bit of mental health and therapeutic practice, this program – and these kids – can go a long way.”

GAME DAY REIMAGINED

While maintaining necessary health precautions, Jordan and John-Paul have created a safe and sanitary gaming environment for the kids. They currently meet with a small group, age 12-18, for two hours twice each week. The gaming sessions focus on specific social, cognitive and emotional-management interventions.

Inpatient staff members have already seen a difference in the participating youth and hope to expand the program into other cottages.

“I feel like this is helping [a youth] to participate more in general programming. He’s still isolating, but has seemed more willing to participate in scheduled activities,” a staff member reported following the first four-week session.

Some participants are using what they learned to more confidently build relationships and share their emotions with others.

“It is awesome – I look forward to doing it more,” a youth said about the program. “It helps me get over my depression and not being able to do anything.”

A WORLD OF SUPPORT

Recognizing the opportunities this program offers, along with a need for supplies, Jordan and John-Paul reached out to a variety of groups and communities online. Already, an overwhelming flood of support has arrived at Tanager Place from the RPG community around the globe.

The program has been a labor of love, with both therapists volunteering their time to make it a success. Given the initial responses from surveys and data collection, combined with analysis of behavioral responses, hopes for the future of this program are high.

Their vision, however, isn’t intended to stop with the youth participants but to carry over into their families, creating more opportunities to serve in a wider arena. If fate rolls high, this program could have a ripple effect around the world. Time will tell.

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