What is Therapeutic D&D? A Clinician's Guide

Therapeutic D&D (also called Dungeons & Dragons therapy) is the use of the world’s most popular role-playing game as a structured, intentional tool for mental health growth. In a therapeutic setting, trained mental health professionals adapt the game to help clients build social skills, explore identity, and develop coping strategies.

While D&D began in 1974 as a fantasy adventure for “nerds,” it’s now embraced by clinicians, educators, and community groups for its unique ability to combine fun with real-world skill building.

Mental Health Benefits of D&D Therapy

When used in a therapeutic setting, D&D can become a tool for growth, connection, and self-discovery. Therapeutic TTRPG groups are led by trained mental health professionals who use the game to support clients with their specific emotional, social, or behavioral goals. So while every group is different, depending on who is leading it and who is playing in it, some common themes exist.

Safe Exploration of Identity

Playing a fictional character lets people try on different roles or behaviors in a nonjudgmental environment.

Emotional Expression

Through characters, players can not only explore feelings (e.g. fear, anger, compassion), but also change how they think about and express them in real-life.

Resilience and Coping Skills

Characters face failure, setbacks, and tough situations, allowing players to strengthen problem-solving skills and learn to recover.

Teamwork and Communication

Players must cooperate, listen, share ideas, and make group decisions both as themselves and as their characters.

Trust and Connection

Shared storytelling can create meaningful bonds for players and their characters. Players can experience these moments in parallel with each other and their characters.

Social Confidence

Practicing assertiveness, leadership, or conflict resolution in-game can translate to real-world confidence.

Growth through Metaphor

The events a character experiences in the story can enable the player to find similarities to their own life and process in a creative, indirect way.

How Therapeutic D&D Differs from Regular Play

While Dungeons & Dragons is often seen as a fun hobby or a way to hang out with friends, therapeutic D&D adds to it. In a therapy group, the game is guided by a licensed clinician who intentionally shapes the story and game structure to support participants mental and emotional growth. Safety tools and consent are prioritized to create a supportive environment where everyone feels comfortable sharing and exploring. Unlike a casual game where the goal is just to have fun, therapeutic D&D balances enjoyment with personal therapeutic elements, making it a powerful tool for growth, social skills development, and self-discovery.

Bringing Therapeutic D&D Into Practice

Therapeutic D&D offers a unique, creative space to develop real-life skills while having fun. If you’re a clinician interested in using D&D or any TTRPG to support your clients, or someone curious about how this innovative therapy can help, there’s much more to explore.

For Clinicians: Ready to bring therapeutic D&D into your practice? Explore our clinician resources to get expert guidance and useful materials to confidently start your own therapeutic roleplaying groups.

For Clients: Curious if a therapeutic D&D group is right for you? Learn more about them here and stay tuned for when we launch our directory of clinician's who offer online groups.

Also check out Scientific American's fantastic video on the topic: https://www.youtube.com/watch?v=zGqnMP_yPrU