Role-playing group intervention as adjunct to treatment-as-usual in a community mental-health setting

The current project aims to assess the efficacy of using a table-top role-playing game in a group setting as a means of improving treatment outcomes in a community mental health setting. All clients will continue to receive treatment-as-usual (which can include peer support groups, case management, psychiatrist reviews and medication) during the intervention. Unfortunately, it is not possible to collect data from all of these treatment-as-usual interventions because participants participate fluidly and inconsistently in various aspects of the programmes, as is common in a community mental health setting. During the intervention, clients will play the popular table-top game “Dungeons and Dragons” in groups of eight, which requires them to take on the role of a character and work collaboratively with other characters to solve problems and achieve goals. The clinical psychologist who leads the game ensures that therapeutic principles related to CBT, unhealthy schemas and psychoeducation are embedded in the game as learning experiences. Those in the experimental group will receive the group intervention across eight weeks (8 sessions, each session two hours long). The sessions will take place in a group room, at the community mental health facility where clients regularly attend. In groups of eight, the clients will play a popular table-top game of Dungeons and Dragons that has been infused with CBT and mindfulness- based concepts. They will role play a character in a fictional world and will be required to work together with other characters to solve problems and overcome obstacles. The clients will roleplay social interactions that will require them to demonstrate effective social skills to achieve their goals. Each client decides the actions that their character will take in the game and then use dice to see if they are successful. The game will include psychoeducation about mental health issues and exploration of personal strengths and weaknesses. Each client will project aspects of their personalities into the character they create. This allows for a safe platform for clients to explore psychological issues. The game will allow for two types of social anxiety exposure. The first is in-person exposure to other clients in the room. The second is in-game exposure as they roleplay social interactions with other characters. The clinical psychologist leading the game will ensure that all characters are involved in the story line, thus ensuring active participation by all clients. Drop out rates will be monitored.