Dungeons and Dragons and Therapy: An Interview With Dr. Megan Connell
Roleplaying and tabletop gaming as therapy
Dr. Megan Connell often speaks on the intersection of gaming and psychology. She has been featured on several podcasts and web series, including GM Tips on Geek and Sundry, the Dragon Talk Podcast, D&D Beyond, Nerdarchry, and others. She has been featured in print media in places such as SyFy Wired and Forbes. She regularly speaks at gaming conventions such as PAX, Gamehole Con, and Gary Con.
What is the elevator pitch for your methodology?
So, when I explain what I'm doing, I say that I use tabletop role-playing games, specifically Dungeons and Dragons, to help people learn therapy skills in a fun, supportive, and safe environment where it is enjoyable, where participants feel reinforced for being there, learning and practicing these skills, and seeing the direct applicability to role-played situations.
When were you first introduced to Dungeons and Dragons?
Well, I started playing as many people do. I think in Middle School with my friends back in ye' olden times when you wrote your character sheet out manually on spiral notebook paper. I played with my friends, and I only remember playing one session, not even a campaign, but a single session. However, we made dozens and dozens and dozens of characters. That was how we spent lunch. We made D&D characters, and we rolled dice. Almost all of my characters were off-brand Lord of the Rings because I was obsessed with it at the time. Then I drifted away from role-playing games for a long time and returned to them as an adult while watching Geek and Sundry. It was The Ashes of Valkana fantasy series that Wil Wheaton ran, and I really liked it. I was like, "I remember playing D&D; that was super fun." Then I started watching Critical Role and had to play D&D again. I jumped back in and haven't looked back since.
What led you to implement Dungeons and Dragons in therapy?
It was learning about myself. I had been playing a campaign with my family, and I had one character for that campaign. Then I started playing with my Sunday gaming group and made another character. Both were seemingly very different people, but I was like, "they came from my brain; they have something in common." So I was trying to figure out the common thread between them, and when I figured it out, I felt the rug pull out from under me. I thought, "Oh, I need to work on that; that's me," and "that was behind so many layers of defense I never would have come to that in therapy."
It's interesting; it's not the obvious stuff you'd think; it's more like, "is this an unknown curiosity that I have?" Or it's wrestling with an idea and what that idea means. It's fascinating the stuff that we learn from these characters. So, when I had that realization, I thought, "I've got to use this in therapy; this is an incredibly powerful tool to learn about yourself."
I started to wonder how this would work and how this would look. So, serendipitously, Dr. Raffael Boccamazzo, who has become an excellent friend and colleague, was featured on Dragon Talk that week. He talked about using D&D to teach social skills to kids on the autism spectrum. I reached out to him, and you know what started my groups. It has been just phenomenal since!
How would you describe the difference between a video game mentality and a tabletop RPG mentality?
It's fascinating because many people view tabletop games from a video game perspective. In the first therapy group I ran, the characters got into the first town, and they all treated it like a video game. They said, "I need to sell all my equipment and buy better equipment." I reminded them that this is a tiny village, that they don't have magic items, and that you don't have enough money for shopping anyway. It took a while of really talking to them about their character's experiences, and one of the players finally got it and went, "oh, we're supposed to do what our characters would do, not what we want to do!"
It's such a different gaming paradigm. For example, I'm a big role player in video games. If I play a video game, I want to buy into the world, so my husband teases me a lot when we play Minecraft as a family. He treats the villagers like they are a resource in the game, and I say, "no, they are their own sentient creatures, and we have to treat them with dignity and respect."
If I'm going to be in a world where I'm going to see games as something important, then how we treat the world and what we do matters. So it was a natural transition for me to buy completely into the world of gaming. When I talk with other people about tabletop role-playing games, I explain that it's like playing a video game, except the code you're using is your imagination. So, your only limitation is also your imagination.
What are your guidelines for utilizing D&D in therapy? How does someone perform it in a therapy session?
I made a little note of this in my book, talking about how it is liberating for some therapists to do whatever they want with this tool. They can turn this tool into anything they need, but for other therapists, this is terrifying, and they don't know what to do with it. So I want to set rules that tell precisely how to behave and what to do, and that's an enormous challenge. I'm working on a treatment planner for using tabletop games in therapy. But it's hard for me because my philosophy is that you do what works. However, that doesn't work in a treatment planner where you must give concrete guidelines.
At the same time, that's the beauty of this tool; it is adaptable and can bring in pretty much anything. I don't do Cognitive Behavioral Therapy; that's not my cup of tea for treatment, but you can very easily teach CBT through tabletop role-playing games. You can go through an existential crisis. For example, there's a role-playing game, Ember Wind. One of the developers of it is a psychologist who designed it to help people going through existential crises.
I saw Ted Talk once, and it was from a kid, so that's already one of those moments where you think, "oh man, this kid's seeing things I'm not." He was talking about having a hacker mindset. People who aren't hackers, you give them a tool, and they say: what does this do? But if you're a hacker, you're given a tool, and you think: what can I do with this? That's the mindset you need to have when utilizing a creative tool in therapy. Not just Dungeons and Dragons; this goes for music therapy, art therapy, dance therapy, and Equine therapy. It's not necessarily formulaic. It's how can I use this? How can I take this to do these things that I know work in a way that will engage the clients?
One of the biggest challenges we have with therapy is that we know what works. We have so many interventions for a wide variety of incredibly helpful diagnoses. But getting people to do them, that's the hard part. Not just the elevator pitch but getting people to engage in the behavioral change. So, when you've got an intrinsically rewarding toolset, just playing a game is fun, your reward pathways will go off in your brain; you're going to feel good. If we have that intrinsic motivation, people will want to show up and want to be a part of your group, so that's powerful. Then we can start slipping in the therapy stuff. We can say, "all right, we're going to role-play, but we're also going to learn how to say no. We're going to learn how to speak up for ourselves. We're going to learn to compromise, and we're going to learn to be a part of a team." These lessons are taught in a truly compelling way.
In one of the groups I ran, one kiddo was trying to showboat because they knew how to play D&D, so they were trying to show off to everybody. They played a barbarian and kept running out like the group would devise a plan and work together. The showboating kid kept running out ahead and going off on his own, and he kept going down. The cleric brought him up a couple of times, and then after healing him the second time, he went down again. What ended up happening was the cleric stood next to him and kept fighting, and the player got frustrated and said, "heal me, get me up." The cleric replied, "no, I'm not going to because I've done it twice, and you've gone down again. You need to stop. You're not listening to the plan. You're not working with us. I'm not going to let your character die, but I'm not going to bring you up so that you can get knocked down again." It is such a decisive moment for that kid to go, "I didn't think about how this was impacting others and what others might think of this."
Would you say that the therapy is 'cooked' into or inherently a part of the game?
Exactly, exactly, and that's the fascinating thing. For many of my groups, I don't tell them the specific goal I'm trying to get them towards, not because I'm trying to be sneaky about it; it's that they're here to have fun. I'm here to measure their growth, so they don't need to know it, but so often, they are growing, they are developing, and it's through the use of the story that it becomes beneficial for them.
Why do you think people love D&D, and why has it endured? Why do you think D&D has flourished and is more popular than ever in recent years?
I love living in a fantasy world, like reading fantasy books. I even run an Epic Fantasy book club through my media company, which I love! So, being the main character in a story is cool as hell and so much fun! In one of his earlier videos, Matt Colville said that he thinks D&D is the most fun you can have with your brain. I agree. It's so much fun, the stuff you can come up with, how ridiculous it is, and just seeing the delight on people's faces when they do things. It is excellent, so just that flexibility to do whatever- you know- sit around and tell a story and be goofy, unique, heroic, and intense; all of the things all at once. That's part of why it has endured because stories endure. We've been sitting around telling tales since the beginning of time, and this is just a way to do that in a structured manner where everybody gets to participate.
Why is it more popular than ever now? Twitch and live streaming have probably been the biggest gift to D&D it could have ever received. Because, often, when you're looking at these rule books and even reading through examples of what a game looks like, it doesn't give you an idea. I remember my business partner when he first started getting introduced to D&D. I told him to watch the first couple of episodes of Critical Role, and he was two hours into the first episode and texted me: when do they start playing? I texted him back and said they were playing and that that was the game. They are telling a story by rolling dice, and that's what it is. It can be challenging for people to grasp what this is. Where's the game board? How do you win? That's the other tricky thing for people to understand-- there's no win condition to D&D. The winning is having a good time and everyone telling a story.
I love Critical Role, and if I were to turn people to the power of playing, I highly recommend anybody watch the Age of Calamity campaign they ran a few months ago. It was only four episodes, but super good, and it shows the players losing but also winning and having fun and enjoying themselves, and it's just a wonderful example. So, in part, I think that's why D&D has exploded; so many people can finally see and realize this looks enjoyable.
Dungeons and Dragons is so much fun, and it is so powerful! It's enjoyable to have those experiences because the other thing we crave is a little adventure. We desire that ability to be powerful, not in a power-mongering way, but in how you can make a difference—playing a game where a small group of heroes can shape the course of events in a fantasy world. That's something nice to be like, "at work, I can't stop my boss from making this stupid decision that's going to waste everybody's time, but in this game, I can go in, and I can save a town," and that's a good feeling.
What would you say to those curious people who may be too nervous or socially anxious to try?
If you want to find the right situation to play, most game stores have a form of Dungeons and Dragons called Adventures League, designed for people to pop in and out. Many of them have Dungeon Masters who are very open to new players. As a Dungeon Master myself, one of my great joys is introducing people to the world of D&D, getting them hooked, and seeing them fall in love with this game. I am not alone in that! It's about finding a Dungeon Master who loves working with new people to come to their table and have that fun experience. I've DM'd for a few different Adventures League games. The players there are super fun; they're connective, know their character sheets well, and are open to helping others learn the character sheets and being a part of the game. Super duper fun! I suggest that!
Or if that's too much, there are resources to dip your toe into role-playing without having to go full into D&D. There's this fantastic book by James D'Amato called The Ultimate Micro-RPG Book. You can play 40 short role-playing games within two hours, and they're all designed by an assistant cover. It's like you tear it out and play it, giving you a little scenario, a couple of characters, and some basic rules to follow. It's an excellent way to dip your toe without fully submerging yourself.
There's also Honey Heist by Grant Howitt. He talks about how his games are just super simple and goofy. It's another straightforward way to try role-playing without going deep. Something like Honey Heist, you're going to get comedy, you're not going to get the drama side of it, but it's okay; that can start to give you an idea. If it is for you, dip your toe in a little further, try the Adventures League, or try something else out.
Thanks for doing this with me, Megan!
Thanks for having me!
You can find Megan Connell online at:
Web: www.MeganPsyD.com or www.HQPsych.com
You can also preorder Dr. Megan's forthcoming book from W.W. Norton! Tabletop Role-Playing Therapy: https://wwnorton.com/books/9781324030607
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