Dungeons and Worry Dragons: How the popular roleplaying game takes on a therapy lens at SFU

For around two hours, every week, David Lindskoog leads a group of SFU students through a game session of Dungeons and Dragons: a tabletop role-playing game where players work together to fight evil-doing foes with quick thinking, strategic planning, and rolling dice. But Lindskoog’s version of the game is a bit different, and is about much more than just recreational fun.

Instead, the version of D&D Lindskoog is currently running at SFU is what’s referred to as a “therapeutically-applied roleplaying game,” where participants make use of imagined social environments and encounters to work through their own personal struggles.

Lindskoog is a longtime fan of D&D, having played earlier editions of the game as a kid in the ’90s. After taking a hiatus from D&D in high school and parts of college, he returned to the game a few years ago, in the midst of D&D’s recent resurgence in popularity.

During that time, Lindskoog got a degree in clinical psychology and a job with SFU as a clinical counsellor, and he’s continued to follow an ever-growing D&D community that is always sharing new ideas and approaches to running the game.

And so, after hearing that some groups, like the American non-profit organization Game to Grow, were using D&D as a way to facilitate therapeutic practice, of all things, Lindskoog thought it could be an idea worth trying within his own practice.

“I had been keeping an eye on what [Game to Grow] had been doing for quite a while,” says Lindskoog. “Once I started my current position at SFU, all of the counsellors are expected to run [counselling] groups… So I had a few ideas for what I might want to do, and I thought, ‘Why don’t I just give it a try?’”

Lindskoog’s own group focuses on helping students who have social anxiety. While D&D often employs a mix of social, combat and puzzle-solving elements, Lindskoog and the player-characters are able to tune the game to their own priorities, creating an imagined story environment that’s tailored to the social challenges that participants are hoping to improve on.

“The rules and mechanics of the game… allow people to approach these interactions in a different way than they normally would,” says Lindskoog. “You know, ‘I don’t have to be eloquent or be a smooth talker, I can just kind of say what I want to do’ and then roll the dice. It gives a whole bunch of freedom for people to experiment.”

Lindskoog says players have the chance to play as characters who might either reflect themselves and their struggles, or who might be more confident or adept in social situations. And over the ten sessions of the “campaign”, as it’s referred to in D&D terms, these characters, and the participants that play them, can have the chance to grow and develop over time.

“Many participants create characters who are aspirational in some sense, and then there’s the element of growing with the character,” says Lindskoog. “We might be able to work into the story of the group a meaningful arc for a certain character, and then the participant can take something from that as well.”

Lindskoog acknowledges that full story arcs can be harder to engineer consistently. But there are other, more consistent benefits of having the same group of players over ten weeks.

For example, as the participants, and their characters, get to know one another, Lindskoog says they’ll often be able to notice when someone is struggling with a certain social situation or anxiety. He says that usually, after a few sessions, he doesn’t have to encourage character participation with his own in-game personas as much, and can rely on other participants to take the lead on reaching out.

“Typically, one of the other characters will notice this other character hasn’t said anything, or hasn’t engaged in 20 minutes, and they’ll be like ‘Oh, my character goes and starts a conversation,’ or they’ll say, ‘Hey, what do you think, character?’ I think that’s really nice when that happens, and it usually does,” says Lindskoog.

But it’s a delicate balance of letting players work through things on their own, while also guiding and facilitating a therapeutic session. For Lindskoog, the best way to do this is to create an environment that is safe, first and foremost, but at the same time encourages players to step outside of their social comfort zone.

“I think what my role as a facilitator is, is doing everything I can to create and maintain that environment throughout the course of the group. If I’m able to do that, then people can engage and take oral risks and feel rewarded and supported and encouraged by the group as they do that,” says Lindskoog.

“D&D is a fun thing we get to do, but it’s not an end in and of itself. It’s a means to an end.”

Lindskoog allots anywhere between an hour to an hour-and-a-half to game time, where the rest of the time is usually dedicated to debriefing and group discussion about how things played out. He says that this is often where a lot of important conversation and reflection from the players takes place, both with Lindskoog, and each other.

But it doesn’t hurt that along the way Lindskoog has managed to create a natural yet imagined environment where players have the chance to explore themselves and their anxieties without judgement.

“I’ve had feedback more than once from people after a group, saying, ‘You know, I forgot it was therapy.’ And I came out of it realizing, ‘Oh wow, I kind of did this and it did feel different,’” says Lindskoog.

“And so that’s kind of the whole point. We don’t want it to feel like therapy most of the time.”