D&D as Therapy for Kids

When Katie Lear—children’s counselor, play therapist, and drama therapist in North Carolina—realized how beneficial Dungeons & Dragons was for her own mental health, she decided to use it to help kids too. I caught up with Katie and her colleague and actor Zachery Byrd on how they use D&D in Cognitive Behavioral Therapy online.

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“Man, I Wish They Could Just Go Play D&D!”

Two years ago, Katie Lear moved out of New York City to a small town in North Carolina. She was desperate to meet friends, so when she was invited to join a D&D campaign she jumped at the chance—even though she’d never played an RPG before. While Katie didn’t have a background in geek culture—she more of was a theater kid—she was a huge fan of The Adventure Zone podcast, and shew knew that a lot of D&D was essentially improv.

When the pandemic started, the campaign moved online. “It was so good for my own mental health to know I had a scheduled time every week to be creative, have fun, and interact with my friends in a meaningful way. Like many of us, I attended about a million open-ended ‘Zoom happy hours’ in the early pandemic that were usually awkward, because none of us had any small talk to make anymore.”

Meanwhile, Katie’s kid clients were struggling. Unprecedented numbers of kids were coming into her office with symptoms of depression. Everyone was lonely, and kids who hadn’t found a solid social circle before the pandemic seemed to have it the worst, because it was nearly impossible to meet new friends in the pandemic.

“The 20-person, all-class Zoom meetings weren’t any more helpful to them than the happy hours were to me. One day I caught myself thinking ‘Man, I wish they could just go play D&D!’ And then I thought…why couldn’t they?”

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The Value of Projective Techniques​

One of the most common techniques for treating depression in Cognitive Behavioral Therapy is called behavior activation. Negative experiences can trigger depression, but so can an absence of positive ones.

During the pandemic, kids were cut off from all of their positively reinforcing activities: things that let them connect socially, tap into their creativity, and generally have fun. The more depressed you feel, the harder it is to seek out those activities that will help you feel better. Behavior activation helps a person consciously schedule those rewarding activities, so they can break the vicious cycle and combat depressive symptoms. “My biggest hope for these D&D groups is that they can serve as a form of behavior activation for our players,” said Katie.

The term “projective techniques” is used in both play and drama therapy: it’s anything that allows a person to put their feelings or experiences onto something outside of themselves, which includes role-playing.

“Playing a character that’s not you frees you up to say and do things you might never consider in real life,” said Katie. “Because you ‘aren’t yourself,’ you have some safe distance to explore. But all those thoughts and ideas are still coming from your imagination, which means they’re a part of you. In my groups, I see middle schoolers using their characters to explore some pretty deep stuff, like their relationships with family, and gender and sexual identity.”

Sometimes, trying on a new role in D&D makes those behaviors more accessible in real life, too. “If you practice being assertive during our ‘pretend’ game every week, suddenly it’s not so pretend anymore—it’s a learned skill,” said Katie. “It’s possible to try on new ways of being for size in roleplay that you can eventually integrate into your real life.”

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Enter the Pro-DM

Zachery Byrd DMs these games, because he’s a veteran geek and performer. Zack holds an MFA in Acting from the University of Georgia and has appeared in films and TV shows including Hustlers, Blindspot, and Unbreakable Kimmy Schmidt. He’s also a professional game master.

“When I was 12 or so, I spent a LOT of time in comic book shops which had games like Pokemon and Magic: The Gathering,” said Zack. “But I was mesmerized by the groups that would come in with their heavily erased character sheets and dice bags ready to just ... play pretend. I was curious—a game played in everyone's imagination without distinct pieces or cards?”

The group said Zack wasn’t old enough to play, but thankfully one older kid said he'd run a game for Zack and his brother so they could learn. “I still think about that game to this day,” said Zack. “It was an avenue for creativity and emotional catharsis; I turned the ‘short kid’ bullying I received into a Halfling Paladin who proved all the traditional big, bulky knights wrong.”

Zack lived out his dreams of being a hero but at the cost of tough moral decisions and sacrifices—once he had to choose between saving his captured friends or saving the rest of the village being ransacked by an evil sorcerer. He even defeated a goblin in a pitch-black cave by bouncing sound off the walls to echolocate the creature!

“All of this happened sitting at a table with my friends just talking to each other and rolling dice on occasion,” said Zack. “I harnessed the power of my imaginative, communicative, and problem-solving skills just by having fun and being willing to jump in. I always promised that I would extend the same offer to young folks that was offered to me, because despite what the ‘older kids’ thought, it was the PERFECT time for me to start playing D&D.” Zack hasn’t stopped since.

Living in North Carolina, Katie would never have considered that she could work with Zach before the pandemic made online collaboration a viable option. They work with kids in all three states where Katie’s licensed, with players joining from New York, North Carolina, and Florida.

“Zack makes most of the creative decisions in-game. I provide support to our players to make sure things stay fun and safe, and manage the therapeutic angle,” said Katie. “We talk after sessions about our therapeutic goals for each group and how we can achieve those through gameplay. As much as possible, we try to use the game itself to achieve those goals, rather than explicitly talking about them. I never want the games to feel preachy: having fun is therapeutic, and the second we start preaching about stuff the game stops being fun.”

How it Works

Parents can reach out to Katie by email at katie@katielear.com to set up a quick 15-20 minute chat about whether their games would be a good fit for their child. “I like to meet with kids individually, as well, so they can put a face to a name and we can review the ground rules that help our games stay fun,” said Katie. “If it sounds like a good match, I’ll send along some intake paperwork to get us started.”

The games themselves are a combination of Zoom and Roll 20. The two tools do a decent job of mimicking the in-person round-table nature of D&D games, and being online tends to make scheduling easier and long-distance moot. Roll20 and D&D Beyond also have character sheet creators and dice rollers that make the math aspect of the game easy to update and manipulate automatically.

“We use Roll20 to create and display maps (some I draw in software, others I purchase from the marketplace), tokens, and music that sets the atmosphere,” said Zack. “In a recent game, our group entirely avoided a dangerous and eventful zone on the map by swimming through a swamp rather than going around it! Another group talked the area's major villain down from an identity crisis and became her ally.”

Zack tries to keep the games moving but grounded in consequences. “We developed a rule about ‘annoying the NPC’ that players learn quickly; the characters with whom they interact have perspectives too, and they won't just stand there while the group bickers!”

Zack also uses the “rule of cool” as often as possible. “If a player has an idea that isn't quite reflected in the D&D rules (of which there are many!), we roll some dice anyway to see how it goes, empowering them to always try new things and not feel boxed-in.”

Zack doesn’t hesitate to dole out inspiration for innovative and true-to-character contributions, but sometimes things don’t work out the way players may have planned. “The dice and the story have minds of their own—but our players learn from these moments too and can't wait for another try. Sometimes the most fun comes from rolling a natural 1!”

How it Helps

The structured interactions in D&D give kids a scaffolding to support them as they socialize. Since they have a common goal to work toward right from the start, they don’t have to worry about making small talk like in more open-ended social events.

Being in an adventuring party helps players learn to negotiate, speak assertively, and collaborate with each other. “If you want to avoid splitting the party all the time, you’re going to have to figure out how to solve problems as a group and make effective compromises,” added Katie.

There’s also combat, which gives an opportunity to practice turn-taking and sharing, and also offers chances to work together as a team. “I love seeing players learn each others’ strengths to come up with a really cool combined attack.”

Roleplay also helps kids better understand nonverbal communication, which is so important for building social skills. Things like facial expression, body language, and voice tones can help clue how other characters are really feeling—is an NPC being honest, or should the player roll for an Insight check?

Learning a new skill boosts self-esteem too. “It’s satisfying to master the rules of D&D as a new player,” said Katie, “especially if you’ve managed to pull off something really cool as a result.”

How You Can Help

You can learn all about the D&D groups at her website, katielear.com, and specifically on her D&D Group page. Katie has also written a few blog posts on the subject.

Katie has started getting inquiries from interested families across the U.S., and even from other countries around the world. So many kids are interested in playing D&D right now to feel a sense of belonging in this weird time. To meet that need, Zack and Katie are starting a second a new project called Young Dragon Slayers, where they’ll run non-therapeutic games available to tweens and teens everywhere.

“We’ll have a new website coming soon at youngdragonslayers.com, and we’d love for you to check it out!”
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Michael Tresca

Michael Tresca

As one of a crowd of ubiquitous latchkey kids of the 80's that all played together, can confirm, D&D saved the sanity and possibly even lives of many of my closest friends. It gave us a place to go and something to do, for all those of us who didn't have anything else that felt safe. So happy to see it's still serving that role.

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