Therapeutic Techniques Used in TTRPG Therapy

How Tabletop Roleplaying Games Support Trauma-Informed Healing

Tabletop roleplaying games (TTRPGs) are often associated with fantasy, dice, and storytelling. But when used intentionally by a trained clinician, they can become a powerful therapeutic tool. TTRPG therapy blends evidence-informed mental health practices with collaborative storytelling to support emotional regulation, connection, and growth.

Below, we answer some of the most commonly asked questions about TTRPG therapy and explain the therapeutic techniques used inside these groups and individual sessions.

What therapeutic techniques are used in TTRPG therapy?

TTRPG therapy integrates established clinical techniques into the structure of play. Sessions are not improvised games alone. They are carefully facilitated therapeutic experiences designed with safety, consent, and clinical goals in mind.

Common therapeutic techniques include:

• Narrative therapy

• Trauma-informed group therapy practices

• Attachment-focused interventions

• Skills building for emotional regulation

• Experiential and role-based learning

The game provides a shared structure, while the therapist guides pacing, reflection, and integration.

How does roleplaying help with trauma and emotional healing?

Roleplaying allows clients to explore experiences at a safe distance. This is often referred to as psychological distance, which can reduce overwhelm while still allowing meaningful emotional work.

In TTRPG therapy, clients may:

• Practice boundaries through character choices

• Explore identity and values in a symbolic way

• Experience agency and competence through decision-making

• Revisit themes of trust, power, or fear in a contained environment

This approach aligns with trauma-informed care by prioritizing choice, predictability, and safety.

Is TTRPG therapy evidence-based?

TTRPG therapy is not a single modality. Instead, it is a delivery system for evidence-informed practices.

Clinicians often integrate:

• ARC framework principles (Attachment, Regulation, Competency)

• Cognitive and behavioral skill development

• Group process theory

• Narrative and meaning-making interventions

• Mindfulness and grounding strategies

The therapeutic value comes from how the game is facilitated, not from the game mechanics alone.

How does TTRPG therapy support emotional regulation?

Emotional regulation is practiced continuously during play.

Examples include:

• Using grounding breaks when intensity rises

• Modeling co-regulation through the facilitator and group

• Pausing gameplay to name emotions and body sensations

• Practicing distress tolerance through in-game uncertainty

Because emotions arise naturally during storytelling, clients can practice regulation skills in real time, then reflect on how those skills apply outside the game.

What attachment-based techniques are used in TTRPG group therapy?

TTRPG therapy groups are designed to foster connection and belonging. Attachment-based techniques are woven into the group structure itself.

These include:

• Consistent session rituals and predictable pacing

• Collaborative problem-solving rather than competition

• Emphasis on teamwork and mutual support

• Repair conversations when conflict arises in game or group

Over time, participants experience safer relational patterns that can transfer into real-world relationships.

Can TTRPG therapy help with social anxiety or neurodivergence?

Yes. Many clients seek TTRPG therapy specifically for social anxiety, neurodivergence, or difficulty with traditional talk therapy.

The game provides:

• Clear social roles and expectations

• Turn-based communication that reduces pressure

• Shared focus, which lowers social demand

• Opportunities to practice communication skills indirectly

For many neurodivergent adults, TTRPG therapy feels more accessible, engaging, and regulating than unstructured conversation alone.

How do therapists ensure TTRPG therapy is emotionally safe?

Safety is not assumed. It is intentionally built.

Therapists use:

• Clear informed consent and group agreements

• Collaborative world and content boundaries

• Predictable session structure

• Ongoing check-ins and choice points

• Explicit differentiation between character and self

These practices ensure that play remains supportive rather than overwhelming.

What makes TTRPG therapy different from playing games with friends?

While playing games can be enjoyable and socially supportive, TTRPG therapy is clinically distinct.

Key differences include:

• Sessions are facilitated by a licensed clinician

• Therapeutic goals guide gameplay choices

• Reflection and integration are built into sessions

• Emotional safety and consent are prioritized

• Skills are explicitly named and practiced

The game is a tool, not the treatment itself.

Is TTRPG therapy right for me?

TTRPG therapy may be a good fit if you:

• Struggle with traditional talk therapy

• Want to work on relationships or social connection

• Are exploring identity, confidence, or emotional regulation

• Prefer experiential and creative approaches

• Enjoy storytelling or collaborative problem-solving

No prior gaming experience is required.

TTRPG Therapy at Resilience Quest

At Resilience Quest Consulting & Counseling, therapeutic tabletop roleplaying games are used as a structured, trauma-informed intervention. Groups and individual sessions are designed to support connection, resilience, and personal growth through intentional storytelling.

If you are curious about whether this approach fits your healing journey, you are invited to explore your next quest.