A Practice-Based Framework for Therapeutically Applied Roleplaying Games

Therapeutically Applied Role-Playing (TARP) games function as structured social environments, where participants engage through known rules, a shared narrative, and collective problem-solving. My work does not claim to replace psychotherapy or clinical mental health care. Instead, TARP exists as a community-based practice that supports social participation with sustained engagement through intentional game facilitation. The value of this approach lies in how structure shapes interaction over time. My outcomes, supported by peer-reviewed literature, suggest how TARP fills a gap in accessible mental health supports. Furthermore, academically rigorous testing and editing make TARP games easily considered by third-party payers, like insurance providers, when facilitated within ethical guidelines. Reimbursements can be used to pay game masters and licensed social workers for their assistance and guidance. Without burying the lead: I believe TARP games can be billed to appropriate insurance coverages to help address issues like socialization, grief sharing, and gender-affirmation. This makes Game Mastery a key professionally-paid skill when partnered with social workers and group therapists. 

Recent scholarship has begun to examine tabletop roleplaying games as meaningful social systems rather than casual entertainment. A systematic review published in BJPsych Open analyzed tabletop roleplaying as a potential support tool for neurodiverse individuals and identified consistent patterns related to social engagement, communication, and group participation when games were facilitated intentionally (Thompson & Majumder, 2025). The authors emphasized that benefits emerged from predictability, a shared focus, and cooperative problem-solving. These findings align with how I design and run roleplaying programs in community settings. Many fellow Game Masters (GMs) would readily nod in agreement about the suggested elements needed in any adventure writing.

My practice draws on lifelong engagement with tabletop games, as well as professional facilitation in public environments, and decades of running structured campaigns in community and hobby spaces. I approach game mastery as applied social design. I plan encounters, pacing, and narrative tones to support participation without demanding emotional disclosure. This is a clear limit designed to insulate and protect players’ safety. I maintain clear ethical boundaries, so participants, families, and funders understand the scope and intent of the work. As long as I avoid spoiling an adventure, I am happily open to questions about my work and writing.

Structure as the Foundation of Engagement

Tabletop roleplaying games rely on explicit rules that govern action and consequence. These rules reduce ambiguity by clarifying how choices are resolved and how the shared world responds. Participants engage more readily when expectations remain visible and consistent.

A qualitative study in the International Journal of Role-Playing examined how players perceived the social impact of tabletop roleplaying. Participants reported that the rule structure supported cooperation and sustained interaction across sessions. They described the game as a space where social engagement felt manageable because the rules guided interaction rather than leaving it implicit (Orr et al., 2020). This perception matters because it centers lived experience rather than external judgments or whims.

From a facilitation standpoint, structure also distributes authority. Turn order, clear stakes, and a transparent resolution all reduce the risk of social dominance. The GM manages pacing and tone while supporting equitable participation, including directly asking players to work through their turn. This role becomes especially important in mixed-ability groups where participants may experience social interaction or communicate thoughts and emotions differently.

Narrative Framing Without Emotional Demand

“Narrative,” or the story arc, operates as a container for our shared experience. Mythic and fictional framing allows participants to encounter themes such as loss, duty, and responsibility through character action. To be clear: players are not forced through these emotional gauntlets, but their players may respond to similar narratives. The game invites engagement with these themes without requiring players to discuss personal experiences.

Occupational science research has described tabletop roleplaying as a meaningful occupation. A 2024 qualitative study identified tabletop roleplaying as an activity that supported social connection, creative expression, and a sense of belonging through shared practice (Hazlett et al). Participants described the activity as sustaining because it combined imagination with a consistent group structure. In group therapy terms, participants willingly and excitedly return to sessions. Having a TARP structure to social support groups helps monetize the activity. This funding pays for the continued use of space and pays for GMs’ and LSWs’ leadership. Wisely managed funds could help improve the space with longer or more frequently offered groups, refreshments, and continue to build upon social engagement organically.

In practice, narrative distance protects autonomy. Players choose how deeply they engage with story elements through their character. Emotional resonance arises from consequence and continuity rather than forced introspection. This design choice supports participants who prefer action-based engagement over verbal processing. In other words, players having ADHD diagnoses tend to enjoy the pacing of my TARP games because we successfully manage symptoms using dice, miniatures, tokens, treasure cards, etc.

Neurodivergent Accessibility and Social Safety

Peer-reviewed research has begun to examine how autistic adults experience tabletop role-playing games. A 2023 study found that autistic participants reported fewer social difficulties during tabletop roleplaying sessions than in everyday social situations. Participants described the game environment as easier to navigate due to explicit rules and shared narrative focus (Parks and Parks, 2023). The authors concluded that tabletop roleplaying can provide accessible social contexts when facilitation remains consistent.

These findings reflect patterns I observe in community programs. Participants often engage more comfortably when interaction follows known procedures. Silence carries no penalty. Turn-taking becomes formalized. Repair occurs through in-game consequences rather than social confrontation. 
Accessibility depends on preparation. Session Zero is the first collected meeting between interested players and their GM host. This first session establishes expectations, communication norms, and mutually-agreed safe boundaries. Participants learn how conflicts are resolved mechanically, per the rules, and how facilitators intervene when confusion arises. For example, I prefer Professor Dungeon Master’s advice via his Dungeon Craft YouTube channel: Do not flip through rulebooks at the table, nor be bound by stringent rules-lawyers. This groundwork supports sustained engagement across sessions with less delay.

Ethical Boundaries and Mental Health Context

Therapeutically Applied Role-Playing (TARP) games require explicit ethical framing. These programs do not diagnose or treat mental health conditions. They do not replace therapy. They provide structured environments for social participation that may support well-being through engagement.

A 2024 pilot study examining tabletop roleplaying as a structured group intervention reported reductions in self-reported social anxiety among participants. The authors emphasized cautious interpretation and highlighted the need for clear boundaries between recreational intervention and clinical care (Otani et al., 2024). This caution aligns with my practice standards and further suggests an active partnership with supervised mental health professionals.

Families and caregivers deserve transparency. Programs grounded in ethical clarity build trust by stating what the work offers and what it does not promise. Facilitators redirect whenever play risks emotional harm. Participation remains voluntary and supported…and fun.

Program Design, Evaluation, and Sustainability

Sustainable programs rely on a repeatable structure. Facilitator training emphasizes rules mastery and group management for effective pacing. Sessions follow predictable rhythms that balance challenge and recovery. Participants know what to expect and when to expect it. The GM sets and models the table standard.

Evaluation focuses on engagement rather than diagnosis. Attendance, retention, and participant feedback provide meaningful indicators of ongoing program health. Consistent participation over time demonstrates social value without overclaiming therapeutic transformation.

Grant support enables facilitator training, outreach, and accessible materials. Community partnerships extend reach while maintaining ethical and fiduciary oversight. These investments support players’ access and affordability while maintaining long-term viability.

Why This Work Matters

Tabletop roleplaying games create structured spaces where people practice shared action. Research increasingly supports their relevance for social participation, particularly for neurodivergent individuals who benefit from predictable systems. This work occupies a space between recreation and support services. It offers meaningful engagement without medicalizing play. What is roleplaying other than creative interpretation of expected social scripts and donned roles?

Professionals recognize the value of community-based practices that respect autonomy and avoid overreach. Families recognize the importance of safe environments where participation does not depend on risky emotional disclosure. Participants recognize the satisfaction of shared challenge and continuity, following a system they enjoy, too.

Therapeutically Applied Roleplaying Games do not promise a cure. They offer structure, meaning, and participation. This contribution carries significant social value.

References

Hazlett, N., Smith, L., Murray, E., & Duncan, A. (2024). Exploring tabletop role-playing games as meaningful occupations: A qualitative exploratory study. Occupational Therapy in Health Care, 39(4), 759–776. https://doi.org/10.1080/07380577.2024.2403784
PMID: 39276064 PubMed

Orr, M., King, S., & McGonnell, M. (2020). A qualitative exploration of the perceived social benefits of playing table-top role-playing games. International Journal of Role-Playing, (10), 70–83. https://doi.org/10.33063/ijrp.vi10.277 journals.uu.se

Otani, V. H. O., Novaes, R. A. C. B., Pedron, J., Nabhan, P. C., Rodrigues, T. M., Chiba, R., Guedes, J. V. C., Marques, L. M., & Vissoci, J. R. N. (2024). Framework proposal for role-playing games as mental health intervention: The Critical Skills methodology. Frontiers in Psychiatry, 15, Article 1297332. https://doi.org/10.3389/fpsyt.2024.1297332
PMID: 38726380; PMCID: PMC11079307 PubMed+1

Parks, S., & Parks, A. L. (2023). Social learning among autistic young adult tabletop role players [Preprint]. ScienceOpen. https://doi.org/10.14293/PR2199.000157.v1 ScienceOpen

Thompson, M., & Majumder, V. (2025). Systematic review: Are table-top roleplaying games a useful therapeutic tool for people with neurodiversity? BJPsych Open, 11(Suppl. 1), S74. https://doi.org/10.1192/bjo.2025.10240
PMCID: PMC12242152