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Therapeutic D&D: Using Role-Playing Games for Healing and Growth

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By Alec Wright

Introduction

Roll for initiative! A phrase synonymous with hours of time spent rolling dice and calculating skill checks, often with some story that carries on long after those in attendance have parted. Dungeons and Dragons may not be the first thing to come to mind when one thinks of therapy, or even at all. What places do bugbears and goblins have in the therapy office? Well, I am glad that you asked! Now, I know what some may think: “What does this have to do with therapy or mental health?” “Isn’t D&D just a nerdy role-playing game (RPG)?” 

 In a rapidly digitalizing world where it’s easy to be “friends” with hundreds of people on social platforms while at the same time still feeling a disconnect from anyone in terms of socializing and actual friendships, therapy hasn’t been far behind in joining the bandwagon of an online presence (hello Rainbow Counselling!). Laying on a couch while a psychotherapist looms over you poking at your thoughts and experiences isn’t the only option anymore, nor does it sound all that appealing. 

But what if we could take therapy and the skills it often carries and put those into an engaging model that is beneficial for multiple aspects! And it has elves…

What Is Drama Therapy and How Does It Work? 

I know, it sounds like it should contradict itself. Therapy is supposed to help sort through the drama of one’s life, develop the skills to process and move forward. So why are we bringing drama into it? Drama therapy, kind of like drama class during elementary and high school years, brings in the ability to create and explore a fictional reality to interact with others and experiences in a safe and creative environment. The therapy part comes in the form of personal growth through the use of delving into emotions and the process of moving through them, developing relationships, and working on one’s self-awareness.  

Rather than sitting across from the therapist or the group, drama therapy allows individuals to actively partake in role-playing, storytelling, and improv. In a way it is similar to and borrows from other therapeutic models in the way it works with different parts of ourselves and our relationships with others via the character being portrayed.

Why Dungeons & Dragons Should Be Gaining Ground

Role-playing games, those things parents at one point warned their children about…they’re really not as scary as they may have been made out to be. Taking on the role of a character that is the total opposite of oneself can be daunting. The barbarian orc who is the first to confront the NPC could be played by someone who in real life is very shy and timid. The sneaky and quiet halfling with a knack for knowing where the best places for a bite to eat could be the creation of an outspoken and bold individual. The beauty of these types of games is that they give players the chance to try out something new, something they may otherwise not get to portray.  

Dungeons & Dragons 

Dungeons & Dragons specifically, being the one I am most familiar with, grants all manner of opportunities to explore one’s character outside of the skills and equipment listed down on the character sheet, and to further that, explore one’s own self too. Anyone who’s met me knows I tend to be a disaster of a human being as I stumble over words, lose my train of thought, and have a strange collection of hobbies. This translates over to many of my characters, like my half elf with a disdain for magic, or the things he doesn’t understand.

What Does Therapeutic Gaming Actually Do?

Now put it all together! Studies have found that the skills and techniques learned through the playing of games like D&D have been transferable to the world outside of both the fantasy world and the therapist office. Social situations are met with more confidence, attitudinal changes, increases in self-esteem, awareness, and empathy, and in forming and shaping identities. The games give the space for these skills to develop and be practiced, while also being fun and something different from the traditional talk therapy session. Whether it be facilitated as part of a group therapy with the therapist as the game master, or as something put together by a few people from the neighbourhood, maybe those shiny math rocks and scribbled on sheets of paper have a little something to them.

Who can benefit from Therapeutic RPGs like D&D?

Therapeutic RPGs like Dungeons & Dragons can be especially beneficial for neurodivergent folks, who thrive in spaces that blend structure with creativity. They also offer identity-affirming support for 2SLGBTQIA+ individuals seeking ways to process experiences in safe and imaginative ways. Youth and young adults who feel disconnected from traditional therapy models often find therapeutic gaming more engaging and relatable. For people navigating anxiety, trauma, or social discomfort, these games provide a low-pressure opportunity to build emotional skills and confidence. And for anyone craving connection, storytelling, and a break from the everyday, RPGs offer a collaborative and reparative path toward healing.

From swashbuckling elves to paladin tieflings, D&D has something for everyone in numerous senses of the phrase. Working through tough emotions, experiences, and situations isn’t everyone’s cup of tea, but sometimes being able to take the step back and come at it from a different angle and perspective can be the key to unlocking potential and taking that first step forward on the journey of healing.

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Therapeutic D&D: Using Role-Playing Games for Healing and Growth

Therapeutic D&D: Using Role-Playing Games for Healing and Growth

If you have both Autism and ADHD (also known as AuDHD), you might have noticed that navigating your gender identity comes with unique challenges and insights. Maybe you feel conflicted about your relationship with gender, or maybe you’ve been exploring what gender means to you for a while. Wherever you are in your journey, your experience is valid.

In this post, I’ll explore how living with both Autism and ADHD might impact your relationship with gender and how therapy can support you in connecting more deeply with your body and identity.

The Unique Experience of Navigating Gender Expansiveness with AuDHD

Having both Autism and ADHD can create a unique lens through which you experience the world, including your understanding of gender. On one hand, you may feel disconnected from or question societal norms and expectations around the gender binary. This can be freeing and open up possibilities for gender expansiveness. On the other hand you may experience impulsivity, hyperfocus, or difficulty in managing the nuances of gender exploration.

For example, you might spend hours researching gender identity, reading everything you can find, and thinking about how you want to present yourself. But when it comes to taking the next steps—whether that’s experimenting with clothing or even accessing gender-affirming care—challenges with executive functioning might make those tasks feel overwhelming or hard to start.

This combination of deep introspection from Autism and the impulsivity or difficulty with follow-through from ADHD creates a unique path to gender exploration. It’s okay to feel both empowered and overwhelmed at times. Therapy can help you unpack these feelings and offer strategies for moving forward in a way that feels manageable.

Executive Functioning & Gender Exploration
Executive functioning—skills like organizing, planning, and managing time—might be a struggle for you if you have ADHD, Autism, or both. If you find it difficult to plan out your steps toward gender exploration or taking action on gender-affirming care, that’s totally okay. These steps are often overwhelming and can come with a lot of mental load.

Your journey doesn’t need to be linear or follow any particular timeline. It’s perfectly fine if you’re unsure of your next step or if things feel messy right now. A therapist can help you break things down into more manageable steps, and together, you can figure out what feels most important to you in your exploration.

Emotional Regulation & Gender Dysphoria
Emotional regulation might be another challenge if you have AuDHD. If you experience gender dysphoria (feeling discomfort or distress related to your gender), it can bring up intense feelings like anxiety, frustration, or sadness. These emotions may be harder to manage if emotional regulation is already tricky for you. On the flip side, gender euphoria—the joy of feeling aligned with your gender—can feel even more powerful and affirming.

Learning to manage the highs and lows is important, and working with a therapist can help you develop tools to feel grounded and present during those emotional waves. This can give you more room to experience your gender in ways that feel affirming, while also holding space for the emotional complexities that come with it.

How Therapy Can Help You Tune Into Your Body
If you’ve ever found it hard to connect with your body or understand what it’s telling you, you’re not alone. Many people with Autism and ADHD experience challenges with interoception—the ability to understand and feel what’s going on inside their body. This can make it difficult to tune into things like hunger, thirst, or even feelings of gender dysphoria or euphoria.

Therapy can help you improve interoception by teaching you how to reconnect with your body. This might mean learning to notice the subtle ways your body responds to different experiences, such as moments of gender euphoria or discomfort. Over time, this awareness can help you feel more in tune with your gender and how it shows up in your body.

Your Journey is Yours
If you’re feeling conflicted about your gender identity and how your AuDHD might be impacting this journey, remember that there’s no “right” way to explore your gender. Your path is unique, and there’s no set timeline for figuring things out. AuDHD might bring its own set of challenges, but it also brings strengths—like creativity, deep introspection, and hyperfocus—that can support you on your path.

At Rainbow Counselling, we’re here to support you as you navigate these intersections in a way that feels true to who you are. If you’re ready to explore how therapy can help you on this journey, we invite you to book a consultation with one of our team members, or submit our online form to be matched with a therapist on our team!

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