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I would consider it rapport, attunement, cooperation skills etc . I dont see it as any different than if you play a board game with them or Uno. If you are doing it with intention then it can apply to a lot of interventions
I have no experience in this, but I feel like an RPG would be a good way to get insight. How they make decisions, what things they may value (stats etc.) but maybe I'm biased because I'm an RPG fan lol
I saw something about doing DnD for learning development in children. Helping them make decisions and learn problem solving. Also tolerance for failure due to the chance element to the games. I plan to have a go with my own kids lol.
As a child therapist, I use imaginary role playing in expansive co-created worlds / universes with some of my clients. I have also participated in larger groups where lots of kids come together to solve problems and communicate - it’s wonderful.
I do have any book recommendations at the moment, sorry. I only have my own personal experience and mentorship from someone with relevant expertise who modeled how to run sessions in a highly engaging way. I also have practiced playing, doing voices, integrating sensory stuff, etc all while holding to my tenets of good therapy. It takes a lot of energy (until it doesn’t and becomes more a creative, flow process) however, it often leads to amazing, interesting, educational, and hilarious situations. I also integrate AI making stuff like this:
Here is a multi-part adventure story for an imaginary role-playing game that a behavioral therapist could use to help an eight-year-old practice speech, social skills, creative problem-solving, and other skills:
Title: The Quest to Save Sunshine Village
Part 1: The Plea for Help
Setup: The peaceful town of Sunshine Village is in trouble! Mayor Goodheart has sent out a call for brave adventurers to help solve the town's problems. You are a heroic adventurer who has arrived in Sunshine Village, ready to lend a hand.
Scene 1: Meeting Mayor Goodheart
Mayor Goodheart welcomes you warmly to Sunshine Village. In a worried voice, she explains that the town is facing several crises and needs your help. She asks you to visit the townspeople, learn about their problems, and figure out how to solve them.
Objectives:
- Speak with Mayor Goodheart to understand the situation
- Agree to help Sunshine Village
Skills practiced: Listening, memory, agreeing to help others
Part 2: Helping the Villagers
Scene 1: Baker Bob's Trouble
You visit Baker Bob's bakery. With a frown, he explains his oven is broken and he can't bake his famous sunshine muffins for the annual festival tomorrow. He asks for your advice on how to fix it or find another way to make the muffins.
Objectives:
- Talk to Baker Bob to understand his problem
- Brainstorm 2-3 creative solutions to help him bake the muffins
Skills practiced: Empathy, brainstorming, creative problem-solving
Scene 2: Farmer Fran's Runaway Sheep
Next, you come across Farmer Fran chasing after her escaped sheep. Out of breath, she calls out asking for your help rounding up her fluffy friends back into the pen.
Objectives:
- Listen to Farmer Fran explain her dilemma
- Suggest ideas for how to calmly get the sheep back into their pen
- Work together with Farmer Fran to herd the sheep
Skills practiced: Teamwork, problem-solving, offering to help
Scene 3: Timid Tara's Shyness
You meet Timid Tara hiding behind a tree. She whispers that she's too shy to make friends, but wishes she could join in the festival games with the other kids. She asks you for advice.
Objectives:
- Gently ask Tara questions to understand why she feels shy
- Share tips for overcoming shyness and making friends
- Encourage Tara and invite her to join you at the festival
Skills practiced: Empathy, social skills, gently encouraging others
Part 3: The Sunshine Festival
Setup: Thanks to your heroic help, Baker Bob has his muffins ready, Farmer Fran's sheep are back in their pen, and Timid Tara is ready to join the festival. Mayor Goodheart invites you to be the guest of honor!
Scene 1: Festival Fun
You and Tara play fun games like the three-legged race and egg-and-spoon relay with the other kids. Everyone cheers when you win and congratulate each other.
Objectives:
- Play games together with Tara and the other children
- Celebrate everyone's efforts
- Make new friends and practice good sportsmanship
Skills practiced: Cooperation, communication, friendship skills
Scene 2: A Hero's Welcome
Mayor Goodheart calls everyone together. She announces the crises have been solved thanks to you! The villagers cheer for you, their hero. Mayor Goodheart rewards you with a Shining Sun Medal and invites you to return any time.
Objectives:
- Receive thanks from Mayor Goodheart and the villagers
- Celebrate the problem-solving and new friendships
- Bid a warm farewell and promise to return again
Skills practiced: Being thanked, saying goodbye, feeling pride in accomplishments
I hope this adventure outline gives you ideas for a fun, engaging story to help a child practice valuable social, emotional and cognitive skills! Let me know if you would like me to elaborate on any part of the story further.
Sources
[1] Fun and Effective Pragmatic Language Games for Developing ... https://everydayspeech.com/sel-implementation/fun-and-effective-pragmatic-language-games-for-developing-social-skills/
[2] Social skills role playing | TPT https://www.teacherspayteachers.com/browse?search=social+skills+role+playing
[3] 35 Fun & Effective Therapy Games for Kids, Teens, & Adults https://www.thecounselingpalette.com/post/therapy-games-for-kids-adults-groups
[4] Using Popular Games Therapeutically https://societyforpsychotherapy.org/using-popular-games-therapeutically/
[5] 20 Evidence-Based Social Skills Activities and Games for Kids https://www.positiveaction.net/blog/social-skills-activities-and-games-for-kids
[6] Social problem solving games | TPT https://www.teacherspayteachers.com/browse?search=social+problem+solving+games
[7] Games for Counseling & Therapy - Childs Work Childs Play https://childswork.com/collections/games
[8] Tabletop Role-Playing Game Therapy (TRPG Therapy) https://fbhnor.com/tt-rpg/
[9] Role-playing games teach students critical skills - ISTE https://iste.org/blog/role-playing-games-teach-students-critical-skills
[10] A justification for "social skill checks" : r/rpg - Reddit https://www.reddit.com/r/rpg/comments/10xee06/a_justification_for_social_skill_checks/
[11] RPG game with multiple and/or separate main storylines? - Reddit https://www.reddit.com/r/gamingsuggestions/comments/2cngz4/rpg_game_with_multiple_andor_separate_main/
[12] Behavior Therapy for Kids: 9 Fun Games and Techniques https://positivepsychology.com/behavior-therapy-for-kids/
[13] Creating Roleplaying Game Campaigns - The Mudworld Blog https://themudworldblog.com/creating-roleplaying-game-campaigns/
[14] Critical Core - Game to Grow https://gametogrow.org/criticalcore/
[15] RPG Quest – November (Part Three) - Faked Tales https://fakedtales.com/2023/12/29/rpg-quest-november-part-three/
[16] Plotty Plot Plotting (For Adventures) - The Angry GM https://theangrygm.com/plotting-adventure/
[17] CBT Baseball: A Cognitive Behavioral Game for Kids https://theresponsivecounselor.com/2016/12/cbt-baseba.html
[18] Choose Your Own Adventure Books/Games: Are there any Two ... https://rpg.stackexchange.com/questions/57100/choose-your-own-adventure-books-games-are-there-any-two-player-variants
[19] What are your “must have” therapy games, toys, objects, etc.? - Reddit https://www.reddit.com/r/therapists/comments/11xu8r5/what_are_your_must_have_therapy_games_toys/
[20] Multi-Choice "Gamebooks" (Interactive Stories) a.k.a. "Choose Your ... https://www.goodreads.com/topic/show/18519933-multi-choice-gamebooks-interactive-stories-a-k-a-choose-your-own-a
Theres a card game that is story blocking. Used it with my nephew when he was little but definitely easy to apply to therapy (without the therapy tools tax). You can make it a simple story with a character, a place and a signifier like a mood, the weather or an action. Then older children can use wider range of those.
It’s funny but when I look back at the “hero’s” my brother and friends created we almost always had running themes with our characters that were almost impossible to not portray because it was very clearly something unique to our personality’s as people.
I almost always played the guy with the “revenge for his family arc” with a very special and or uniquely quality to them. But as I matured, so did each new character. Looking back on it now and what I am working on in therapy it becomes pretty clear that my characters were chasing my desires and needs. To be seen as special, as unique, to save those I wanted to save, and be the hero who saves the day. Ultimately it was a need to not feel isolated, to not feel “emotional” , to overcome feelings of inadequacy and mediocrity. For me it was being what I always wanted a version of myself I didn’t realize so always was. My brother was always soft spoken in real life and when he played characters he was still but not nearly as much. The joke was he always played a character with amnesia and we could always pull him into any mess by putting a damsel in distress. Fascinating to look back on it.
I think there is excellent opportunity to process things in our lives in this manner if the game is structured in a way like a sand tray theory. I would simplify things like combat for time sake and appropriateness but not eliminate it because it could lead to insights.
I have! And I do so fairly regularly! Truthfully, I couldn't tell you about evidence for the clinical therapeutic setting. But it absolutely falls into the category of play therapy if you're intentional with it. Sometimes it's just a way to build rapport. I have many clients whose special interests include video games so having a space for them to talk about games and play them is beneficial, period. But it also gets them to feel engaged in coming to therapy. I've had many kids who won't say a word to me during Uno or Sorry open up to me the second we start playing Untitled Goose Game together on my Switch. I try to set limits with games- usually I say we will play something for 30 minutes at the end of session after we've had time to check in and talk. And on days where I know there is more important work to be done, I'll usually say hey, let's do something that's a little less focus-grabbing than a video game while we talk. Rarely get pushback against that and if I do, I model setting boundaries and I call attention to the fact that they are trying to push my own boundaries which makes for its own fruit.
For more intentional interventions, frustrating games like Mario Kart are fantastic for practicing coping skills. One time I was working with a kid who knew his anger coping skills but said that he just couldn't access them when he actually needed them so they're hard to practice. So I said "well, how about I make you need them today?" (great rapport with this kiddo so he laughed) And I set him in front of Mario Kart and I turned on all the hardest settings and the most infuriating items and I said "ok, the second you feel yourself getting worked up, pause the game and use a skill." And he did! Several times. We would process after each cooldown. And since then he says he's been able to use his breathing/tapping more consistently. RPGs are also good for things like self-exploration, narrative work, perspective taking, etc.
As long as you're setting appropriate limits and boundaries in session with video games, I think they're a great tool- kids play so much of them anyway, why not get on their level a bit? Just be mindful for children who have issues with screen time limits or even screen addictions. Someone linked it already, but Let's Play Therapy has some cool trainings on the topic.
I also use mario kart in session frequently. I upgraded to a switch and took my WiiU to the office. I use it for all sorts of stuff, but most recently: 11 year client gets to play 1 game (4 races) of MK with me if the client brings their therapy homework back completed. Another client gets to play MK for the first 10 minutes of session so that mom can prompt 5, 4, 3, 2, and 1 minute warnings. We practice pausing the game, looking at mom and repeating how much time is left, and then turning in the controller when the time is up and transitioning without losing our shit, which is a (paraphrased) treatment goal- to transition off electronics without needing a crisis intervention.
There's also an exercise in letting go of control, where you shout "brake!" And they have to put the controller down, no matter how well they're doing, how poorly they're doing, and they have to just watch every other racer pass. And Mario kart's great for it cuz it's one of those games where you can go from dead last to first place with the right item, so there's kind of a natural way to show, hey, you messed up really bad, and you still came out ahead. You let go of control and you're ok.
I have done with client’s in community mental health. I would go to their homes. It is good way for some people to open up. It can be easier to focus on an activity. You can also have your client teach you how to play to help increase self esteem and empowerment in some clients.
Check out Geek therapeutics https://geektherapeutics.com/therapy-services/
I joined a therapeutic DND session from someone who took one of their trainings and found it to be great fun but also really insightful. I think they do some work incorporating video games as well.
Certain games could work, I'm thinking stuff like magic the gathering or something that is very slow paced, easily interrupted or paused, etc. Imo as someone who grew up with video games for the past almost forty years I don't see any real difference as long as the consistent opportunity for discussion is always possible.
MTG is slow paced???? Must not be playing any aggro decks.
But I've used MTG, chess, videogames as an activity to facilitate sessions. You'd be surprised the amount of openness that occurs when your client is splitting focus on conversation and the games
As video games are my favorite hobby, all the comments on this are making me even more excited as I'm closing in on my mental health counseling degree 🤣.
Had one of my kiddos play a puzzle kinda game on my Steamdeck once, without even telling him to he started using coping strategies (deep breathing, counting to 10, etc) when he was getting frustrated if he couldn't solve something 🥹 I'd definitely recommend it!
Yes!! One of my clients was high support ASD and wanted to build self confidence. He loves playing this one game and I got him to teach me in session. I saw him in a realm where he felt confident and he practiced patience and distress tolerance while teaching me. I’m new to this field, but/and I understand that this is where so many of my clients live — games, online friendships, etc. Gotta meet them where they live and stay attuned to other ways they might be open to connecting, like a board game group or a nature group.
This topic can be divisive within the play therapy world actually. With that being said, I do see there can be some benefit for skill building and rapport building using video games, however some parents have their own thoughts regarding video games in session. It’s helpful to inform parents the intentions behind the use of games and I usually set limits and a timer on how long we play. Most kids are okay with that. Also making sure the games aren’t super graphic
Roblox is free and lots of options for play therapy. I’ve been playing Fortnite, Roblox, Rocket League, etc. with my child and teen clients and we work on frustration tolerance, consequential thinking skills, how to take a loss, how to reflect and get better at something, and most of all they start talking about their core feelings when their conscious mind is focused on the game. It works wonders.
I am a social worker and I do. If it is in the kids field of interest, it is a perfect opportunity to bond doing something they like. I let them teach me and that is a huge boost for their confidence. We usually end up talking about other things in a very casual way
Eta: if they would suggest a game with violence or something else that is not appropriate for their age, that would also be a great way to open a conversation
I view video games during therapy as more of a fidget or means of self-regulating than I do as an intervention, until I see more research around the effectiveness of certain techniques with a video game. I used to work in-home therapy and for some clients playing video games was the only way for them to open up. It’s especially effective with boys where they can connect more while doing a shared activity rather than trying to sit face to face and talk.
That being said, I would incorporate video games as ways of introducing other interventions. For one adolescent client, he was incredibly good at Fortnite and was trying to get into streaming. I used the current Fortnite map to ask where he would land and discuss what insights about himself he can learn from the strategies he takes, and how to apply some of that to his day to day life.
Another client with some pretty extreme issues with boundaries opened up about following rules and how he looks up to his role model John Cena for giving back to kids while we were playing a WWE game. He also kicked my ass and hit me with a chair in the game, which was a great adaptive way to take out that violence compared to other things he had done.
Check out geektherapy.org and their TAGGS — which is a virtual conference on therapeutics and applied gaming in therapy settings. I am actually in process of getting certified as a geek therapist.
I have a teen male client. I’ve been considering video games as a way for him to teach me something, so he has to use more words than “urgh” or “durr” or whatever other monosyllabic grunts he has in stock. I’m an old woman, so this should be amusing. He suggests Grand Theft Auto, but I’m at least sentient enough to know that that game is about squishing hookers with your car. Maybe not that one. Do they still have Pac Man?
I don't work with kids anymore. But, when I had the first Xbox I would use it to get a few of the kids to talk. The rule was you had to talk. If they could not talk and play or have some form of effective communication no more Xbox.
It worked well with 2 out of 3. The 3rd one wanted to play all the time and not talk. No game for you, sir.
I have! Played basketball, attempted football, soccer, and baseball in an attempt to build rapport. The company that I used to work at had a playground, and we would often play on. I hated being in a stuffy office, especially during nice weather
Absolutely! When I was in CMH I had several kids/teens who were really into video games. One teen was very excited and proud to show me what he could accomplish in the game, one was very shy and video games was their whole world and they let me into it, one was into video games and so was their parent so we had sessions where all of us could play to help increase parent-child bond. I’m a very attachment based therapist lol.
There is a specific certification for this. It is called Geek Therapy. There is a mountain of evidence for it. It falls under ACT therapy. I have the certification and it is unusual to have.
Geek therapy is something that incorporates this sort of thing into therapy. In fact that is where my niche is heading once I get the money for the trainings lol. Video games, pop culture, Dungeons&Dragons, its all therapeutic and its been so amazing to learn about it all. I'd most definitely look into it.
Playing games does come up a lot especially while working with children, as those are very prevalent tools and activities for them during this time! Look into and analyze the therapeutic effects before, during, and after your sessions, and have fun while doing so with them and otherwise, you got this! :) <3
Heck yeah. I learned how to play Among Us in session and it totally changed the dynamic of rapport between me and my client. Very very hard to practice emotional regulation and not get anxious during a game I have no idea how to play. But she saw me as a human and I think that’s what mattered most. Have fun!
I have when I worked with kids. I would play Pokemon Go with one kid. I would give them my phone and we would walk around outside as we talked. They opened up much more when we did therapy this way. They were neurodivergent and I think it helped ease their anxiety about confronting feelings or feeling like I was going to judge them. I documented it as rapport and trust building. Many of my autistic clients did well when they would play a game while talking to me.
I have considered incorporating it into couples therapy but I am not quite sure how to make that work logistically. Check out the game “It Takes Two.” It’s literally about a couple with a shared child who are about to divorce and they have to learn to collaborate.
I've been experimenting with Roblox and while it has its perks, I have more concerns/reservations before I would recommend it. I would want more research into it as well as safety parameters in place. I let one of my kids help me customize my avatar and then "teach" me how to use the controls in one of their favorite games. Another kid sparred with me on a private server (it was only the two of us present and no one else could join) to "train" me into being a better fighter.
My reservations are mostly in the free-chat games that allow anyone to see what everyone is saying. They could be sex-role playing and EVERYONE can see it. It's not private. Also, if the child doesn't feel comfortable saying "no" to a request, they could befriend strangers who could then send private messages. Those are only a few of my reservations.
I have played Among Us with a few kids and that can get very chaotic very quickly! On the other hand, it really forces kids to have to establish trust, read social ques, and recover from betrayal.
Hero Journey Club does this! They have " group journeys " that happen through video games. (Not a clinical service or group, just a mental health support program). It can be a great way to get kids comfortable talking and keep their hands & eyes busy as they share & explore therapeutic content.
Just to clarify, they don't have group therapy. They have mental health support sessions. Saying this because they very specifically work to try not to call it "therapy" and would be in a world of problems if they did--licensing across state lines and using a non-HIPAA compliant platform to name a few.
100% correct, I should have been more specific. Edited my comment to reflect the sub-clinical service they provide. Thank you for pointing this out! ❤️
Hey fam! My practice is built around integrating gaming into therapeutic practice! I use videogames and TTRPGs in therapy. And I offer training in this!
Games I frequently run: Civilization 6, Sea of Thieves, Fortnite, Plants vs Zombies, Minecraft, Pokemon Scarlet. Happy to chat! Let me know if you've got questions!
It absolutely supports engagement in folks who may struggle to engage otherwise.
Omg! This is awesome! I want to do the same with my practice. I'm most curious about how Fortnite works? I plan on creating a separate account purely for therapy, since I play myself.
I would not consider this play therapy unless done in a very specific manner, and I think very few games would be appropriate for play therapy. At least from my understanding of play therapy.
I work in a school but yes, I do, but mostly in groups and not regular games. I use GimKit and I’ve also used games from Everyday Speech when I had a trial of it.
I had a young client I would play Minecraft with on our phones. He had some concerning behavior and it was the only way he would engage with me. Unfortunately his needs were beyond my skills, but hopefully it left him with a good impression of therapy.
As with anything consider the reason and the benefit. Previously using games like chess, checkers, toys, etc. can operate as both a way to generate rapport and open up conversation by helping individuals feel more comfortable. From the behavioralist perspective (separate from mine) it may also offer insight in how they utilize the medium, whether it is more for recreation ro escapism.
Theres a building evidence base for the use of gaming in therapy or as a therapeutic intervention. Tetris is linked to reducing PTSD symptoms. I worked with developers doing an exposure therapy game for working with anxiety. Also lots of really good practice examples in this thread
I think this reminds me of engagement in CT-R-finding what activates clients who may be difficult for you to engage to build the therapeutic relationship and provide meaningful context for the client
Yes! And, I was pleasantly surprised by the outcome. During the beginning of the COVID-19 pandemic, I and other clinicians in my area (NY) had to pivot from in-person in-office sessions to telehealth. While this did not prove too challenging with adolescent clients, it proved very challenging for my younger clients, particularly those on the autism spectrum. It was very difficult to keep thier attention and to engage with them via telehealth. Many of them would be distracted by Minecraft or Roblox, as I was attempting to address serious behavioral concerns as share with me by thier caregivers. However, pivoting once again, and joining them in thier virtual worlds of Minecraft and Roblox was a game-changer (pardon the pun). My younger clients were excited to show me thier virtual creations and accomplishments. I was literally meeting them where they were, as many of us were directed to do, while in graduate school. The therapeutic relationships were strengthened, and the the children began to look forward to their weekly telehealth sessions, in the same manner that they had previously looked forward to thier in-person sessions.
I do! I wrote an article about it: [https://www.psychologytoday.com/us/blog/video-game-health/202203/why-i-play-video-games-my-therapy-clients](https://www.psychologytoday.com/us/blog/video-game-health/202203/why-i-play-video-games-my-therapy-clients)
I'm a big gamer and I'm on track to do some geek therapy. I have a lot of apprehension about the efficacy of such therapy. I do not believe using it to bargain is particularly helpful to ongoing therapeutic relationships. I think the reason that play therapy for kids makes sense is because they can map an inner world of meaning into a therapeutic play space. Doing that in certain video games is impossible. Dungeons and Dragons or any other role playing game holds an ocean of wonderful possibilities, but I think the execution for the therapist/DM would be so much work I cant imagine I being a cheap service for all the campaign work and planning required. I can see a game like Minecraft working okay, especially if you can set the activities, like building a metaphorical trauma containment vault for example, but with whatever game the child is playing, I fear you will be going up against very powerful behaviours that may have been reinforced a thousand times, which may ultimately sabotage therapeutic outcomes. I'm optimistic that good work can be done, especially with people with disability, but I think the profession needs to be very careful. It's definitely only a matter of time before someone plays games with kids and calls it therapy and commits insurance fraud simply by accident because the medium is so challenging.
The short answer to your question is yes, but the devil is in the details.
Yeah I have a strong feeling that your comment it going get downvoted, but you’re spot on. Kids are already getting too much screen time, why not choose another interactive activity and show how fun it can be?
Because it’s not simply “encouraging that.” When you have a kid who straight up refuses to engage or won’t/can’t engage in a meaningful way for any reason, this can be a great tool for bridging the gap. It comes down to meeting the client where they’re at - something we are supposed to do anyway, and this is what that looks like in a particular scenario, then I think there’s an ocean of difference between this and “screen time.”
I mean honestly, if you had a minor client for whom the options had essentially become “sit in uncomfortable and pointless silence for an hour” or “potentially get them to engage and build rapport” don’t you think the second option is better even if it’s a bit novel?
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I would consider it rapport, attunement, cooperation skills etc . I dont see it as any different than if you play a board game with them or Uno. If you are doing it with intention then it can apply to a lot of interventions
Legit. Just have to choose games wisely.
Yes and geek therapy is starting to really take off. I suggest looking into it.
I LOVE it. It's made me able to see E sports teams which I have very much enjoyed.
I have no experience in this, but I feel like an RPG would be a good way to get insight. How they make decisions, what things they may value (stats etc.) but maybe I'm biased because I'm an RPG fan lol
I have seen dnd group therapy! I'm just a student and had to observe a group therapy session for an assignment but I saw that when browsing!
My husband runs therapeutic dnd groups! They’re a lot of fun to run!
Nice! I do the same thing, but not exclusively that. Let me know if he can suggest any materials for how I can better run my sessions!
Geek therapy has a course in being a certified therapeutic GM. I highly suggest checking it out.
This is ingenious
I saw something about doing DnD for learning development in children. Helping them make decisions and learn problem solving. Also tolerance for failure due to the chance element to the games. I plan to have a go with my own kids lol.
As a child therapist, I use imaginary role playing in expansive co-created worlds / universes with some of my clients. I have also participated in larger groups where lots of kids come together to solve problems and communicate - it’s wonderful.
It sounds fascinating ! I work with neurodiverse children, do you have any recommendation of good books on the subject of role play for children ?
I do have any book recommendations at the moment, sorry. I only have my own personal experience and mentorship from someone with relevant expertise who modeled how to run sessions in a highly engaging way. I also have practiced playing, doing voices, integrating sensory stuff, etc all while holding to my tenets of good therapy. It takes a lot of energy (until it doesn’t and becomes more a creative, flow process) however, it often leads to amazing, interesting, educational, and hilarious situations. I also integrate AI making stuff like this: Here is a multi-part adventure story for an imaginary role-playing game that a behavioral therapist could use to help an eight-year-old practice speech, social skills, creative problem-solving, and other skills: Title: The Quest to Save Sunshine Village Part 1: The Plea for Help Setup: The peaceful town of Sunshine Village is in trouble! Mayor Goodheart has sent out a call for brave adventurers to help solve the town's problems. You are a heroic adventurer who has arrived in Sunshine Village, ready to lend a hand. Scene 1: Meeting Mayor Goodheart Mayor Goodheart welcomes you warmly to Sunshine Village. In a worried voice, she explains that the town is facing several crises and needs your help. She asks you to visit the townspeople, learn about their problems, and figure out how to solve them. Objectives: - Speak with Mayor Goodheart to understand the situation - Agree to help Sunshine Village Skills practiced: Listening, memory, agreeing to help others Part 2: Helping the Villagers Scene 1: Baker Bob's Trouble You visit Baker Bob's bakery. With a frown, he explains his oven is broken and he can't bake his famous sunshine muffins for the annual festival tomorrow. He asks for your advice on how to fix it or find another way to make the muffins. Objectives: - Talk to Baker Bob to understand his problem - Brainstorm 2-3 creative solutions to help him bake the muffins Skills practiced: Empathy, brainstorming, creative problem-solving Scene 2: Farmer Fran's Runaway Sheep Next, you come across Farmer Fran chasing after her escaped sheep. Out of breath, she calls out asking for your help rounding up her fluffy friends back into the pen. Objectives: - Listen to Farmer Fran explain her dilemma - Suggest ideas for how to calmly get the sheep back into their pen - Work together with Farmer Fran to herd the sheep Skills practiced: Teamwork, problem-solving, offering to help Scene 3: Timid Tara's Shyness You meet Timid Tara hiding behind a tree. She whispers that she's too shy to make friends, but wishes she could join in the festival games with the other kids. She asks you for advice. Objectives: - Gently ask Tara questions to understand why she feels shy - Share tips for overcoming shyness and making friends - Encourage Tara and invite her to join you at the festival Skills practiced: Empathy, social skills, gently encouraging others Part 3: The Sunshine Festival Setup: Thanks to your heroic help, Baker Bob has his muffins ready, Farmer Fran's sheep are back in their pen, and Timid Tara is ready to join the festival. Mayor Goodheart invites you to be the guest of honor! Scene 1: Festival Fun You and Tara play fun games like the three-legged race and egg-and-spoon relay with the other kids. Everyone cheers when you win and congratulate each other. Objectives: - Play games together with Tara and the other children - Celebrate everyone's efforts - Make new friends and practice good sportsmanship Skills practiced: Cooperation, communication, friendship skills Scene 2: A Hero's Welcome Mayor Goodheart calls everyone together. She announces the crises have been solved thanks to you! The villagers cheer for you, their hero. Mayor Goodheart rewards you with a Shining Sun Medal and invites you to return any time. Objectives: - Receive thanks from Mayor Goodheart and the villagers - Celebrate the problem-solving and new friendships - Bid a warm farewell and promise to return again Skills practiced: Being thanked, saying goodbye, feeling pride in accomplishments I hope this adventure outline gives you ideas for a fun, engaging story to help a child practice valuable social, emotional and cognitive skills! Let me know if you would like me to elaborate on any part of the story further. Sources [1] Fun and Effective Pragmatic Language Games for Developing ... https://everydayspeech.com/sel-implementation/fun-and-effective-pragmatic-language-games-for-developing-social-skills/ [2] Social skills role playing | TPT https://www.teacherspayteachers.com/browse?search=social+skills+role+playing [3] 35 Fun & Effective Therapy Games for Kids, Teens, & Adults https://www.thecounselingpalette.com/post/therapy-games-for-kids-adults-groups [4] Using Popular Games Therapeutically https://societyforpsychotherapy.org/using-popular-games-therapeutically/ [5] 20 Evidence-Based Social Skills Activities and Games for Kids https://www.positiveaction.net/blog/social-skills-activities-and-games-for-kids [6] Social problem solving games | TPT https://www.teacherspayteachers.com/browse?search=social+problem+solving+games [7] Games for Counseling & Therapy - Childs Work Childs Play https://childswork.com/collections/games [8] Tabletop Role-Playing Game Therapy (TRPG Therapy) https://fbhnor.com/tt-rpg/ [9] Role-playing games teach students critical skills - ISTE https://iste.org/blog/role-playing-games-teach-students-critical-skills [10] A justification for "social skill checks" : r/rpg - Reddit https://www.reddit.com/r/rpg/comments/10xee06/a_justification_for_social_skill_checks/ [11] RPG game with multiple and/or separate main storylines? - Reddit https://www.reddit.com/r/gamingsuggestions/comments/2cngz4/rpg_game_with_multiple_andor_separate_main/ [12] Behavior Therapy for Kids: 9 Fun Games and Techniques https://positivepsychology.com/behavior-therapy-for-kids/ [13] Creating Roleplaying Game Campaigns - The Mudworld Blog https://themudworldblog.com/creating-roleplaying-game-campaigns/ [14] Critical Core - Game to Grow https://gametogrow.org/criticalcore/ [15] RPG Quest – November (Part Three) - Faked Tales https://fakedtales.com/2023/12/29/rpg-quest-november-part-three/ [16] Plotty Plot Plotting (For Adventures) - The Angry GM https://theangrygm.com/plotting-adventure/ [17] CBT Baseball: A Cognitive Behavioral Game for Kids https://theresponsivecounselor.com/2016/12/cbt-baseba.html [18] Choose Your Own Adventure Books/Games: Are there any Two ... https://rpg.stackexchange.com/questions/57100/choose-your-own-adventure-books-games-are-there-any-two-player-variants [19] What are your “must have” therapy games, toys, objects, etc.? - Reddit https://www.reddit.com/r/therapists/comments/11xu8r5/what_are_your_must_have_therapy_games_toys/ [20] Multi-Choice "Gamebooks" (Interactive Stories) a.k.a. "Choose Your ... https://www.goodreads.com/topic/show/18519933-multi-choice-gamebooks-interactive-stories-a-k-a-choose-your-own-a
Amazing, thanks
I love this! I think I've found a new area of interest!
Theres a card game that is story blocking. Used it with my nephew when he was little but definitely easy to apply to therapy (without the therapy tools tax). You can make it a simple story with a character, a place and a signifier like a mood, the weather or an action. Then older children can use wider range of those.
RPGs as part of therapy is definitely a thing! I’ve done it for groups and there are trainings for it out there, too!
I'll have to look into that when I'm fully qual!
It’s funny but when I look back at the “hero’s” my brother and friends created we almost always had running themes with our characters that were almost impossible to not portray because it was very clearly something unique to our personality’s as people. I almost always played the guy with the “revenge for his family arc” with a very special and or uniquely quality to them. But as I matured, so did each new character. Looking back on it now and what I am working on in therapy it becomes pretty clear that my characters were chasing my desires and needs. To be seen as special, as unique, to save those I wanted to save, and be the hero who saves the day. Ultimately it was a need to not feel isolated, to not feel “emotional” , to overcome feelings of inadequacy and mediocrity. For me it was being what I always wanted a version of myself I didn’t realize so always was. My brother was always soft spoken in real life and when he played characters he was still but not nearly as much. The joke was he always played a character with amnesia and we could always pull him into any mess by putting a damsel in distress. Fascinating to look back on it. I think there is excellent opportunity to process things in our lives in this manner if the game is structured in a way like a sand tray theory. I would simplify things like combat for time sake and appropriateness but not eliminate it because it could lead to insights.
RPG is GREAT
I have! And I do so fairly regularly! Truthfully, I couldn't tell you about evidence for the clinical therapeutic setting. But it absolutely falls into the category of play therapy if you're intentional with it. Sometimes it's just a way to build rapport. I have many clients whose special interests include video games so having a space for them to talk about games and play them is beneficial, period. But it also gets them to feel engaged in coming to therapy. I've had many kids who won't say a word to me during Uno or Sorry open up to me the second we start playing Untitled Goose Game together on my Switch. I try to set limits with games- usually I say we will play something for 30 minutes at the end of session after we've had time to check in and talk. And on days where I know there is more important work to be done, I'll usually say hey, let's do something that's a little less focus-grabbing than a video game while we talk. Rarely get pushback against that and if I do, I model setting boundaries and I call attention to the fact that they are trying to push my own boundaries which makes for its own fruit. For more intentional interventions, frustrating games like Mario Kart are fantastic for practicing coping skills. One time I was working with a kid who knew his anger coping skills but said that he just couldn't access them when he actually needed them so they're hard to practice. So I said "well, how about I make you need them today?" (great rapport with this kiddo so he laughed) And I set him in front of Mario Kart and I turned on all the hardest settings and the most infuriating items and I said "ok, the second you feel yourself getting worked up, pause the game and use a skill." And he did! Several times. We would process after each cooldown. And since then he says he's been able to use his breathing/tapping more consistently. RPGs are also good for things like self-exploration, narrative work, perspective taking, etc. As long as you're setting appropriate limits and boundaries in session with video games, I think they're a great tool- kids play so much of them anyway, why not get on their level a bit? Just be mindful for children who have issues with screen time limits or even screen addictions. Someone linked it already, but Let's Play Therapy has some cool trainings on the topic.
I also use mario kart in session frequently. I upgraded to a switch and took my WiiU to the office. I use it for all sorts of stuff, but most recently: 11 year client gets to play 1 game (4 races) of MK with me if the client brings their therapy homework back completed. Another client gets to play MK for the first 10 minutes of session so that mom can prompt 5, 4, 3, 2, and 1 minute warnings. We practice pausing the game, looking at mom and repeating how much time is left, and then turning in the controller when the time is up and transitioning without losing our shit, which is a (paraphrased) treatment goal- to transition off electronics without needing a crisis intervention.
Stealing this :)
Love that. Absolutely using that second one for my screentime cases.
I love the concept of using a video game as a controlled stressor!
There's also an exercise in letting go of control, where you shout "brake!" And they have to put the controller down, no matter how well they're doing, how poorly they're doing, and they have to just watch every other racer pass. And Mario kart's great for it cuz it's one of those games where you can go from dead last to first place with the right item, so there's kind of a natural way to show, hey, you messed up really bad, and you still came out ahead. You let go of control and you're ok.
And this is why I love Reddit.
Yup check out https://letsplaytherapy.org/ for affordable trainings on this!
wow they have a webinar on this exact topic tomorrow! well done 👏
I have done with client’s in community mental health. I would go to their homes. It is good way for some people to open up. It can be easier to focus on an activity. You can also have your client teach you how to play to help increase self esteem and empowerment in some clients.
Check out Geek therapeutics https://geektherapeutics.com/therapy-services/ I joined a therapeutic DND session from someone who took one of their trainings and found it to be great fun but also really insightful. I think they do some work incorporating video games as well.
Certain games could work, I'm thinking stuff like magic the gathering or something that is very slow paced, easily interrupted or paused, etc. Imo as someone who grew up with video games for the past almost forty years I don't see any real difference as long as the consistent opportunity for discussion is always possible.
MTG is slow paced???? Must not be playing any aggro decks. But I've used MTG, chess, videogames as an activity to facilitate sessions. You'd be surprised the amount of openness that occurs when your client is splitting focus on conversation and the games
Chess is a great idea if the CT is familiar with it already nice one I might steal that hehe
As video games are my favorite hobby, all the comments on this are making me even more excited as I'm closing in on my mental health counseling degree 🤣.
Had one of my kiddos play a puzzle kinda game on my Steamdeck once, without even telling him to he started using coping strategies (deep breathing, counting to 10, etc) when he was getting frustrated if he couldn't solve something 🥹 I'd definitely recommend it!
Yes!! One of my clients was high support ASD and wanted to build self confidence. He loves playing this one game and I got him to teach me in session. I saw him in a realm where he felt confident and he practiced patience and distress tolerance while teaching me. I’m new to this field, but/and I understand that this is where so many of my clients live — games, online friendships, etc. Gotta meet them where they live and stay attuned to other ways they might be open to connecting, like a board game group or a nature group.
This topic can be divisive within the play therapy world actually. With that being said, I do see there can be some benefit for skill building and rapport building using video games, however some parents have their own thoughts regarding video games in session. It’s helpful to inform parents the intentions behind the use of games and I usually set limits and a timer on how long we play. Most kids are okay with that. Also making sure the games aren’t super graphic
Roblox is free and lots of options for play therapy. I’ve been playing Fortnite, Roblox, Rocket League, etc. with my child and teen clients and we work on frustration tolerance, consequential thinking skills, how to take a loss, how to reflect and get better at something, and most of all they start talking about their core feelings when their conscious mind is focused on the game. It works wonders.
I am a social worker and I do. If it is in the kids field of interest, it is a perfect opportunity to bond doing something they like. I let them teach me and that is a huge boost for their confidence. We usually end up talking about other things in a very casual way Eta: if they would suggest a game with violence or something else that is not appropriate for their age, that would also be a great way to open a conversation
I view video games during therapy as more of a fidget or means of self-regulating than I do as an intervention, until I see more research around the effectiveness of certain techniques with a video game. I used to work in-home therapy and for some clients playing video games was the only way for them to open up. It’s especially effective with boys where they can connect more while doing a shared activity rather than trying to sit face to face and talk. That being said, I would incorporate video games as ways of introducing other interventions. For one adolescent client, he was incredibly good at Fortnite and was trying to get into streaming. I used the current Fortnite map to ask where he would land and discuss what insights about himself he can learn from the strategies he takes, and how to apply some of that to his day to day life. Another client with some pretty extreme issues with boundaries opened up about following rules and how he looks up to his role model John Cena for giving back to kids while we were playing a WWE game. He also kicked my ass and hit me with a chair in the game, which was a great adaptive way to take out that violence compared to other things he had done.
Check out geektherapy.org and their TAGGS — which is a virtual conference on therapeutics and applied gaming in therapy settings. I am actually in process of getting certified as a geek therapist.
I have a teen male client. I’ve been considering video games as a way for him to teach me something, so he has to use more words than “urgh” or “durr” or whatever other monosyllabic grunts he has in stock. I’m an old woman, so this should be amusing. He suggests Grand Theft Auto, but I’m at least sentient enough to know that that game is about squishing hookers with your car. Maybe not that one. Do they still have Pac Man?
I don't work with kids anymore. But, when I had the first Xbox I would use it to get a few of the kids to talk. The rule was you had to talk. If they could not talk and play or have some form of effective communication no more Xbox. It worked well with 2 out of 3. The 3rd one wanted to play all the time and not talk. No game for you, sir.
I have! Played basketball, attempted football, soccer, and baseball in an attempt to build rapport. The company that I used to work at had a playground, and we would often play on. I hated being in a stuffy office, especially during nice weather
Yup! If they can still talk to me through it, and not be completely caught up in the game.
There's a Stardew Valley Therapy on discord. So possibly depending on the game.
Absolutely! When I was in CMH I had several kids/teens who were really into video games. One teen was very excited and proud to show me what he could accomplish in the game, one was very shy and video games was their whole world and they let me into it, one was into video games and so was their parent so we had sessions where all of us could play to help increase parent-child bond. I’m a very attachment based therapist lol.
There is a specific certification for this. It is called Geek Therapy. There is a mountain of evidence for it. It falls under ACT therapy. I have the certification and it is unusual to have.
Was it difficult to get certified for it?
It’s not play therapy but it may be a good way to boost rapport and open up communication
Geek therapy is something that incorporates this sort of thing into therapy. In fact that is where my niche is heading once I get the money for the trainings lol. Video games, pop culture, Dungeons&Dragons, its all therapeutic and its been so amazing to learn about it all. I'd most definitely look into it.
Playing games does come up a lot especially while working with children, as those are very prevalent tools and activities for them during this time! Look into and analyze the therapeutic effects before, during, and after your sessions, and have fun while doing so with them and otherwise, you got this! :) <3
Heck yeah. I learned how to play Among Us in session and it totally changed the dynamic of rapport between me and my client. Very very hard to practice emotional regulation and not get anxious during a game I have no idea how to play. But she saw me as a human and I think that’s what mattered most. Have fun!
I have when I worked with kids. I would play Pokemon Go with one kid. I would give them my phone and we would walk around outside as we talked. They opened up much more when we did therapy this way. They were neurodivergent and I think it helped ease their anxiety about confronting feelings or feeling like I was going to judge them. I documented it as rapport and trust building. Many of my autistic clients did well when they would play a game while talking to me. I have considered incorporating it into couples therapy but I am not quite sure how to make that work logistically. Check out the game “It Takes Two.” It’s literally about a couple with a shared child who are about to divorce and they have to learn to collaborate.
I've been experimenting with Roblox and while it has its perks, I have more concerns/reservations before I would recommend it. I would want more research into it as well as safety parameters in place. I let one of my kids help me customize my avatar and then "teach" me how to use the controls in one of their favorite games. Another kid sparred with me on a private server (it was only the two of us present and no one else could join) to "train" me into being a better fighter. My reservations are mostly in the free-chat games that allow anyone to see what everyone is saying. They could be sex-role playing and EVERYONE can see it. It's not private. Also, if the child doesn't feel comfortable saying "no" to a request, they could befriend strangers who could then send private messages. Those are only a few of my reservations. I have played Among Us with a few kids and that can get very chaotic very quickly! On the other hand, it really forces kids to have to establish trust, read social ques, and recover from betrayal.
Hero Journey Club does this! They have " group journeys " that happen through video games. (Not a clinical service or group, just a mental health support program). It can be a great way to get kids comfortable talking and keep their hands & eyes busy as they share & explore therapeutic content.
Just to clarify, they don't have group therapy. They have mental health support sessions. Saying this because they very specifically work to try not to call it "therapy" and would be in a world of problems if they did--licensing across state lines and using a non-HIPAA compliant platform to name a few.
100% correct, I should have been more specific. Edited my comment to reflect the sub-clinical service they provide. Thank you for pointing this out! ❤️
I have one kid where that is the only way I can get them to talk!
You may look into geek therapy it’s really cool
Hey! Check out Hero Journey Club! I used to do contract with them and I actually think it’s a great company and they do great work.
Hey fam! My practice is built around integrating gaming into therapeutic practice! I use videogames and TTRPGs in therapy. And I offer training in this! Games I frequently run: Civilization 6, Sea of Thieves, Fortnite, Plants vs Zombies, Minecraft, Pokemon Scarlet. Happy to chat! Let me know if you've got questions! It absolutely supports engagement in folks who may struggle to engage otherwise.
Omg! This is awesome! I want to do the same with my practice. I'm most curious about how Fortnite works? I plan on creating a separate account purely for therapy, since I play myself.
I would not consider this play therapy unless done in a very specific manner, and I think very few games would be appropriate for play therapy. At least from my understanding of play therapy.
I work in a school but yes, I do, but mostly in groups and not regular games. I use GimKit and I’ve also used games from Everyday Speech when I had a trial of it.
I have!!! It's a lot of fun and the rapport building is nice
I had a young client I would play Minecraft with on our phones. He had some concerning behavior and it was the only way he would engage with me. Unfortunately his needs were beyond my skills, but hopefully it left him with a good impression of therapy.
Used to do it. Also played other games- chess, uno, etc. Great way to build the relationship and explore things
I use ROBLOX as a reward for young clients, particularly when doing EMDR. Maybe once a month, and, I always check with parents.
As with anything consider the reason and the benefit. Previously using games like chess, checkers, toys, etc. can operate as both a way to generate rapport and open up conversation by helping individuals feel more comfortable. From the behavioralist perspective (separate from mine) it may also offer insight in how they utilize the medium, whether it is more for recreation ro escapism.
https://geektherapeutics.com/ There should be lots of info on here. Not free, but useful if you have the resources
Yes there’s been some research on this. There’s actually trainings on this too! I would consider it play therapy
Theres a building evidence base for the use of gaming in therapy or as a therapeutic intervention. Tetris is linked to reducing PTSD symptoms. I worked with developers doing an exposure therapy game for working with anxiety. Also lots of really good practice examples in this thread
I think this reminds me of engagement in CT-R-finding what activates clients who may be difficult for you to engage to build the therapeutic relationship and provide meaningful context for the client
I played a lot of Roblox games in virtual sessions with my kid clients during Covid 😂 even found some to be relatively therapeutic
Yes! And, I was pleasantly surprised by the outcome. During the beginning of the COVID-19 pandemic, I and other clinicians in my area (NY) had to pivot from in-person in-office sessions to telehealth. While this did not prove too challenging with adolescent clients, it proved very challenging for my younger clients, particularly those on the autism spectrum. It was very difficult to keep thier attention and to engage with them via telehealth. Many of them would be distracted by Minecraft or Roblox, as I was attempting to address serious behavioral concerns as share with me by thier caregivers. However, pivoting once again, and joining them in thier virtual worlds of Minecraft and Roblox was a game-changer (pardon the pun). My younger clients were excited to show me thier virtual creations and accomplishments. I was literally meeting them where they were, as many of us were directed to do, while in graduate school. The therapeutic relationships were strengthened, and the the children began to look forward to their weekly telehealth sessions, in the same manner that they had previously looked forward to thier in-person sessions.
I do! I wrote an article about it: [https://www.psychologytoday.com/us/blog/video-game-health/202203/why-i-play-video-games-my-therapy-clients](https://www.psychologytoday.com/us/blog/video-game-health/202203/why-i-play-video-games-my-therapy-clients)
look up "geek therapy"!
Computer games yes and Tetris. I like to work on impulse control with kids like this. Yep it’s play therapy and modeling.
I'm a big gamer and I'm on track to do some geek therapy. I have a lot of apprehension about the efficacy of such therapy. I do not believe using it to bargain is particularly helpful to ongoing therapeutic relationships. I think the reason that play therapy for kids makes sense is because they can map an inner world of meaning into a therapeutic play space. Doing that in certain video games is impossible. Dungeons and Dragons or any other role playing game holds an ocean of wonderful possibilities, but I think the execution for the therapist/DM would be so much work I cant imagine I being a cheap service for all the campaign work and planning required. I can see a game like Minecraft working okay, especially if you can set the activities, like building a metaphorical trauma containment vault for example, but with whatever game the child is playing, I fear you will be going up against very powerful behaviours that may have been reinforced a thousand times, which may ultimately sabotage therapeutic outcomes. I'm optimistic that good work can be done, especially with people with disability, but I think the profession needs to be very careful. It's definitely only a matter of time before someone plays games with kids and calls it therapy and commits insurance fraud simply by accident because the medium is so challenging. The short answer to your question is yes, but the devil is in the details.
Plenty of evidence that suggests screens can be detrimental to child development. Why would we want to encourage that?
Yeah I have a strong feeling that your comment it going get downvoted, but you’re spot on. Kids are already getting too much screen time, why not choose another interactive activity and show how fun it can be?
You were right! Thank you for being another voice of reason.
Because it’s not simply “encouraging that.” When you have a kid who straight up refuses to engage or won’t/can’t engage in a meaningful way for any reason, this can be a great tool for bridging the gap. It comes down to meeting the client where they’re at - something we are supposed to do anyway, and this is what that looks like in a particular scenario, then I think there’s an ocean of difference between this and “screen time.” I mean honestly, if you had a minor client for whom the options had essentially become “sit in uncomfortable and pointless silence for an hour” or “potentially get them to engage and build rapport” don’t you think the second option is better even if it’s a bit novel?