WILL KIRK / JOHNS HOPKINS UNIVERSITY
H E A LT H + W E L L - B E I N G
TABLETOP THERAPY: HOW DUNGEONS
& DRAGONS CAN IMPROVE MENTAL
HEALTH
Staff psychologist William Nation offers an innovative approach to
counseling with his D&D therapy group
Claire Goudreau / Dec 4, 2023
Over the past few years, Dungeons & Dragons (D&D) has exploded in popularity, turning up in
countless television shows, movies, and podcasts. Now, the game has once again found itself
somewhere new: Mental Health Services Homewood, formerly known as the Counseling
Center.
(Social) Skills Quest is a D&D-centered therapy group run by staff psychologist William
Nation with help from doctoral intern Meagan Henry. Originally introduced in the spring of
2020, this innovative approach to group counseling combines role-playing with traditional
therapy.
For the uninitiated, Dungeons & Dragons is a tabletop role-playing game in which players roll
dice to improvise a fantastical adventure. It was invented by Gary Gygax and Dave Arneson in
1974 and has since become the most popular game of its type, having drawn in an estimated 50
million players worldwide.
"The game itself serves as this sandbox," Nation
explained. "It allows you to experience things in
a way that is different from the way you would
experience them if they happened to you. There's
a sort of psychological distance between you and
whatever you're engaging in."
According to Nation, this "distance" can be
extremely useful in a therapy setting, since
IMAGE : WILL KIRK / JOHNS HOPKINS UNIVERSITY players can explore real-life problems without
the potential discomforts of a one-on-one
counseling session.
"This feels accessible to them," he said. "It's a game, and they understand games."
Nation got his first taste of D&D as a high schooler in the early 2000s, though he didn't become
a regular player until college. Since then, he's become an expert "dungeon master" (DM),
leading countless campaigns both at work and in his own time.
A typical D&D session with Mental Health Services follows the same two-hour formula: First,
60 to 90 minutes are spent playing the game. Then, after the monsters are slain and the
adventurers are resting around a campfire, the players take a step back to reflect on the session
and how it relates to their own lives.
Each campaign has about three to six players, with Nation occasionally running multiple groups
at the same time. The membership of these groups tends to change thanks to graduations and
new semesters, but regardless of the roster, the support remains the same.
Different players can get different benefits from the group. For example, those struggling with
anxiety can practice making choices and interacting with others without real-world
consequences. Alternatively, those experiencing isolation on campus can break out of their shell
and meet new people, improving their social skills.
And, according to Nation's players, this strategy works.
"You can test the waters with other players to see how they react to an action or dialogue, and
see what kind of response you might elicit with your friends and colleagues [in real life],"
explained one student, who asked to remain anonymous. "Overall, it feels like a more fun
version of group therapy. There is a space for open dialogue as needed, and exploration of
topics that would not come up in a normal group."
"I AM BEYOND THANKFUL TO BOTH OUR DM AND THE
GROUP FOR GIVING ME A PLACE TO FEEL SEEN AND
HAVE FRIENDS WHEN I'VE STRUGGLED SO MUCH AT
SCHOOL. … I WOULDN'T TRADE THAT EXPERIENCE
FOR ANYTHING."
—Anonymous
Undergraduate student
"This group has reduced my social anxieties," shared another of Nation's players. "I am beyond
thankful to both our DM and the group for giving me a place to feel seen and have friends when
I've struggled so much at school. … I wouldn't trade that experience for anything."
After working with so many students, Nation now believes that the D&D format can be tailored
to support almost any mental health concern.
"I worked with somebody who had experienced religious trauma, and they found it very
difficult to talk about that," he said. "[So] they created a character in Dungeons & Dragons that
was a druid who had previously been a cleric and their god in the setting had died. … None of
that is true, but the person was talking from their own experience of being a religious person in
the real world. … They grieved the loss of their religious experience as this character."
D&D also offers a more universal benefit: Stress relief. Simply having a fun game to look
forward to can be one of the greatest perks of the group, especially during midterms and finals
season. Last spring, Nation even taught students at Peabody how to lead their own campaigns
in hopes of relieving some stress on campus.
And students don't need to be experts to have fun with the game. Most of Nation's players had
little to no D&D experience before joining his therapy group.
"You can teach someone to play Dungeons & Dragons pretty effectively in sub-20 minutes," he
explained. "It's popular for a reason. It's a pretty easy system to learn and to get people into."
Interested in joining the group? There's plenty of room for new players next semester.
"As long as you're eligible for our services, we'd be happy to have you," Nation said. "We only
do it because we know it works."
To learn more about (Social) Skills Quest or other counseling options available to students,
visit the Mental Health Services website or call one of its clinics. Mental health crisis and
suicide prevention services are also available at JHU through the Behavioral Health Crisis
Support Team (410-516-9355) and nationwide by dialing 988.
Tagged mental health, student life, counseling center
