Levelling up: Tabletop role-playing therapy helps young people conquer mental health challenges

Harnessing the power of imagination and story-telling, the services have adopted tabletop role-playing games for therapeutic use.

The result is tabletop role-playing therapy, a non-traditional approach to counselling for children and young people affected by neurodivergence, violence, abuse, neglect and trauma-related challenges.

Developed to improve emotional, psychological and wellbeing health outcomes for at-risk groups of children and young people, the tabletop role-playing therapeutic group adopts play-based therapy, an alternative to traditional talk-based models of counselling.

The group-based game is facilitated by counsellors with young clients role-playing a character of their own creation as they collectively embark on fantasy-based quests alongside other clients of the service.

Through storytelling, structured play and peer interactions, tabletop role-playing therapy supports children and young people affected by violence, abuse and neglect to develop their identity, interpersonal and problem-solving skills while also providing an outlet for self-expression.

Rebecca Wyborn, a social worker for the Community Counselling Service says the tabletop role-playing therapeutic group has been particularly beneficial to encourage participation from clients who are reluctant to engage in traditional talk-based therapy.

“There’s a great sense of openness and acceptance with the group,” Rebecca says.

“It’s created a safe environment for children and young people to share different parts of their trauma experiences through the creation of their own stories within the game.”

Tabletop role-playing therapy has also demonstrated benefits for client identity, self-esteem, emotional expression and empathy.

Rebecca says the program’s character and story development has also provided an opportunity to uniquely apply generative AI tools within a healthcare setting.

“We use prompts to help guide the development of each client’s character and with this, clients’ imaginations can really run wild,” says Rebecca.

“We then use a software program to generate AI images of the character. Using the technology in this way really brings the characters to life for our clients.”

Feedback from the program also suggests that tabletop role-playing therapy is well suited to children and young people with neurodiverse presentations, which represent approximately 12 per cent of monthly referrals to the District’s Community Counselling Service.

“The program has clearly demonstrated that it has the potential to support a range of clients across our counselling streams,” says Rebecca.

Nepean Blue Mountains Local Health District’s Community Counselling Service intends to replicate the tabletop role-playing therapeutic group, enabling it to be offered to children, young people and families accessing services.

The initiative was recently recognised at NBMLHD’s Innovate Together Quality Awards, where the Tabletop Role-playing Therapeutic Group was the recipient of the Board Chair’s Health Research & Innovation Award.