For most people, therapy means couches, tissues and lots of questions.
But for some Brigham Young University students at the school’s Counseling and Psychological Services center, therapy includes dragons, dungeon masters and lots of dice.
That’s because while the center has therapy groups for things like anxiety and body image concerns, it also has Dungeons & Dragons therapy groups.
Sami Chun, a Ph.D. candidate at BYU and staff member at the center, helped start the groups in 2022 after learning about the nonprofit Game to Grow, which trains people in using role playing games in a therapeutic setting. After Chun became certified in the group’s methods, the center started offering one D&D group. Due to interest, the center now has three groups this fall semester.
Chun said he was initially drawn to this concept because he’s been a D&D player.
“I thought it [D&D therapy] was such a cool, geeky thing,” he said. However, since learning more about the method, he now views it as a powerful and helpful form of therapy.
“This is therapy. This is not just for people who want to play D&D,” Chun said.
What Dungeons & Dragons therapy looks like
The center’s therapy groups follow the same timeline as BYU’s semesters.
When a D&D therapy group starts, their first weekly meeting, or “Session Zero,” is where they get to know each other, go over expectations and talk about therapy confidentiality rules. And then, they work together to build the world they’ll be playing in.
First, they’ll draw figures and pictures up on the whiteboard to represent things that appear in this new world, said Brett Merrill, a licensed psychologist and clinical professor at BYU who helps run some of the groups.
The therapists will then give the group members instructions on creating a “therapeutic” D&D character.
Merrill said there are a few different ways people can go about this. The participants can look at their weaknesses and create a character who has a strength in that area. Or, they can create a character who is exactly like them, but in a fantasy form. A person can also choose to give their character the weaknesses they want to overcome or traits they are ashamed to show.
Many participants, Merrill said, come to the group because they’re experiencing anxiety, loneliness, depression or self-destructive perfectionism. The overall goal that Merrill and Chun have for participants is to feel safe, have fun, connect to self and connect with others. Outside of that, some players might focus on changing their weaknesses or accepting who they are.
During the weekly sessions after the initial meeting, the group will spend 5 to 10 minutes checking in and then move into 50 to 70 minutes of therapeutic gameplay. Afterward, they spend 5 to 10 minutes transitioning out of gameplay before moving into 50 to 70 minutes of therapeutic processing.
In each group, there are two clinicians. One acts as the dungeon master and guides players through the game. The second therapist is a player in the game and will help nudge the group in the right direction if needed. Chun said the dungeon master wears a black wizard’s robe with gold detailing and will put the hood up if they’re stepping into a character.
“This is particularly important when I’m playing evil characters because I don’t really want my clients to associate me, as a therapist, with evil, and selfishness, and abusing them because that’s really not what we’re going for,” Chun said of the hood.
Before each session, the therapists plan out different encounters, or scenes, that they want to have in the gameplay.
“These encounters hopefully parallel the goals that people have.,” Chun said.
If a lot of players struggle with anxiety, Chun might plop a dragon in front of them to activate their threat response. Since it’s a game, there’s an ability to step back and analyze their reaction. Players can see how they normally react when they’re anxious. If a player gave their character a strength that they want in real life, Chun said they might try doing something that goes against their usual response.
People tend to create the same thinking, feeling and relationship patterns within group therapy as they have out of group therapy, Chun said. So they’re able to have this social microcosm, analyze it and then compare it to their world outside. He added people can also work on being more comfortable experiencing things like conflict.
Confronting the ‘shadow shelf’
Chun ran a D&D group where all of the members were extremely self-critical. He created what he called a three week “magic mirror encounter.”
In the encounter, each character had their reflection step outside of a magic mirror.
Even though none of the reflections carried anything threatening, “every single one of the party members attacked their own reflection and nobody else’s,” Chun said.
“The players didn’t notice, but the reflections took the exact same actions and did the exact same amount of damage as the players did,” Chun said. “They all called it the ‘Shadow Self.’ I did not say anything about a shadow, but they automatically assumed the reflection was evil and bad.”
The following week, Chun planned an attack where the group could only survive if they asked their reflection for help.
“And the most critical people in the group couldn’t do it until the very, very end,” Chun said.
In the last week of the encounter, the group had to say goodbye to their reflections and they got in-game rewards depending on how they did it. Like, they got a boost if they held their reflection’s hand. Chun recalled what one player said afterward: “I’ve been told my entire life I need to be compassionate towards myself, but I have never practiced it until this moment.”
Out-of-game growth
After the group members finish playing, therapists help them process what happened and convert what they’re learning to out-of-game growth. During the post-gameplay processing, Chun said group members can connect with each other about what they just experienced and discuss parallels between the gameplay, their therapy goals and their lives outside the group.
Merrill and Chun both said the research is limited on the effectiveness of D&D group therapy and added that it wouldn’t be helpful for everyone, like people who struggle to separate what is real and what is not. For Chun’s Ph.D. dissertation, he’s collected data from some of the D&D groups and is currently in the process of analyzing it.
Merrill has observed that since the group is working together on something, the members tend to bond together much quicker than in other kinds of therapy groups he’s run.
“Seeing a lot of these players want to continue to be friends, even after the group, says something, I think, about the impact that it has. Even if the data isn't quite there yet,” Merrill said.
