Tabletop games like D&D act as “drama therapy in the wild” to boost players’ self-concepts

A recent study published in the journal Transcultural Psychiatry provides evidence that the personal bonds people form with fictional characters in tabletop role-playing games can lead to noticeable improvements in their real-life sense of identity. The research suggests that using these games in clinical settings could be an effective way to help patients build self-esteem and process personal struggles. This psychological growth tends to happen most reliably when the gaming environment feels safe and socially supportive.

The project was guided by Jeffrey G. Snodgrass, a professor in the Department of Anthropology and Geography at Colorado State University. Snodgrass directs the Ethnographic Research and Teaching Laboratory, known as ERTL, and wrote the book The Avatar Faculty: Ecstatic Transformations in Religion and Video Games. “It was a collaborative study involving faculty and students and is part of my lab’s long-term aim to productively combine research and teaching,” Snodgrass told PsyPost.

Mental health professionals have started incorporating tabletop games like Dungeons and Dragons into psychological treatments. To explain the motivation for the study, Snodgrass noted, “This work represents my lab’s latest exploration of relationships between gaming and well-being.” He added that games like Dungeons and Dragons are particularly interesting because players form intensive relationships both with their characters and with other players in their gaming groups.

Drawing on concepts from drama therapy, the scientists wanted to see if the informal character creation that happens in living rooms mimics clinical processes. “Players also are able to imaginatively explore alternative identities via their characters,” Snodgrass explained. “We anticipated that such processes might contribute to these games’ therapeutic dimensions, in the manner they could help players improve their sense of self.”

To explore these psychological dynamics, the researchers collected data from North American gamers using a mix of surveys and in-depth interviews. The survey included 149 participants with an average age of about thirty years old. The sample was mostly male, which reflects the historical demographics of many gaming communities.

Free daily newsletter

Within this survey group, thirty-one percent primarily played tabletop role-playing games. Another twenty percent played digital role-playing video games. The remaining forty-nine percent played other types of video games like competitive multiplayer matches or first-person shooters.

The survey asked participants to describe their relationship with their primary gaming character. Players categorized their character as a mere object on a screen, a direct extension of themselves, a symbiote where the player and character share a blended identity, or a completely separate being. Participants also answered twenty-five questions designed to measure recent improvements in their overall self-concept.

These questions evaluated psychological needs like self-esteem, a sense of belonging, and the feeling that one’s life has meaning. The survey also tracked self-efficacy, which is the belief in a person’s own ability to achieve their goals. Additional survey questions measured how much social support players felt regarding their gaming hobby.

The researchers also measured absorptive capacity, which is a person’s natural tendency to become deeply immersed in imaginative experiences and lose track of time. Finally, the survey tracked how many hours each person played games during a typical week. Alongside the survey, the scientists conducted three rounds of interviews with a total of 54 role-playing game enthusiasts between late 2021 and early 2025.

The data revealed that the type of bond a player forms with their character is strongly linked to positive psychological benefits. Players who viewed their characters as symbiotes or as distinct other persons reported substantially greater improvements in their self-concept. This was compared to players who treated their characters as simple objects or tools to achieve a winning score.

Snodgrass summarized the core takeaway of these results. “Developing highly personalized bonds with imagined characters in tabletop roleplaying game settings can improve players’ actual-world sense of self,” he said. “Play such as this thus resembles clinical approaches such as drama therapy, where patients project themselves into imagined situations and stories with the aim of clarifying and potentially resolving emotional and other conflicts.”

Tabletop game players tend to experience more identity benefits than players of other game genres. The data suggests this advantage occurs because tabletop games naturally encourage players to build deeper emotional bonds with their characters. Digital games often limit how much a player can customize their digital avatar, which can restrict the emotional connection.

The interviews provided rich context to support these survey results, particularly for vulnerable individuals. “The therapeutic processes we examine seem particularly important for players experiencing identity threats,” Snodgrass noted. “This includes socially marginalized players such as queer gamers or others questioning or wishing to explore alternative gender identities.”

By acting out the lives of complex characters, players were able to experience what psychologists call bleed-out, where emotional lessons learned in the game transfer into real life. However, Snodgrass emphasized that the environment must be supportive. “Creating safe play spaces for such activities is critical to the achievement of the therapeutic gains described in our study,” he said.

Many participants noted that caring for their fictional characters and guiding them through challenges helped them feel more capable and compassionate in their own lives. Some players purposefully created characters who embodied traits they disliked about themselves. Role-playing as these flawed characters allowed the players to develop greater self-compassion.

Other interviewees explained how long-term gaming campaigns created a profound sense of social continuity. Groups that focused heavily on collaborative storytelling often stayed together for decades. These shared imaginative experiences helped players build lifelong friendships, share child care responsibilities, and cultivate a deep sense of belonging.

As with all research, there are a few limitations to keep in mind. The study relied on self-reported data, which means participants were estimating their own psychological growth. Regarding clinical applications, Snodgrass cautioned, “Using tabletop roleplaying games in therapeutic contexts would necessitate some degree of cultural familiarity with and acceptability of such forms of play as well as working with patients who themselves were open to such experiences.”

Moving forward, the scientists plan to look at other psychological benefits of gaming. “My collaborators and I are now aiming to understand how such forms of play might help train positive stress coping and emotion regulation, via the simulation of encountering and resolving stressors like threats of violence and social conflict,” Snodgrass said. “We also hope to further clarify the role played by cultural factors in these processes through a comparison of such play in various settings around the world.”

The study, “Tabletop Role-Playing Games as Drama Therapy in the Wild: Developing Personal Bonds with Characters Improves Players’ Self-Concepts,” was authored by Jeffrey G. Snodgrass, Seth I. Sagstetter, Choeeta Chakrabarti, Julia R. Branstrator, Katya Xinyi Zhao, Michael G. Lacy, H. J. François Dengah II, Aimee Wagner, Alessandro Giardina, and Joël Billieux.