Tabletop Role-Playing Games as Drama Therapy in the Wild: Developing Personal Bonds with Characters Improves Players’ Self-Concepts

Clinicians have started to experiment with using tabletop role-playing games like Dungeons & Dragons (D&D) as complementary to more traditional psychological treatments or as a standalone form of therapy in a group setting. However, researchers still do not understand well the therapeutic processes and mechanisms through which such forms of play might be helpful to patients. Following insights developed by drama therapists, we anticipated that the bonds players formed with imaginary persona —in this context, gaming characters —might importantly contribute to the positive experiences of role-players. To test this idea, we collected ethnographically informed interview (N = 54) and survey (N = 149) responses from North American gamers, to clarify relationships between players’ reported bonds with their characters and those players’ broader concepts of self. We found that players relating to their characters in more personal ways—for example, as symbolic secondary selves, as is characteristic of role-playing games like D&D—also showed improvements in their sense of identity. Further, our analysis pointed to the importance of cultural and personal factors to these processes, including players’ felt sense of social support and “safety” in their gaming groups and their facility for imaginatively absorbing into fantasy worlds. Overall, our study suggests that using tabletop role-playing games in clinical settings might profitably focus on fostering strong player–character bonds, while being aware that such interventions might work best in certain cultural settings and for specific patients.