The use of TTRPGs in improving Social, Emotional and Mental Health

The use of TTRPGs in improving Social, Emotional and Mental Health

On Monday 28th April 2025 I had the honour of presenting the work we do at Roll the Dice to the Autism Special Interest Group Conference in Truro. This is a summarised version of the presentation:

Imagine a game where kids aren’t just having fun—they’re building empathy, resilience, and real-world social skills. Tabletop Roleplaying Games are designed not only to entertain but to empower. Drawing from the rich tradition of games like Dungeons & Dragons, Critical Core (the system that we use) goes one step further: it’s a therapeutic intervention co-developed by game designers, educators, and mental health professionals to help individuals—especially neurodivergent youth—develop social and emotional competencies in a way that’s natural, engaging, and incredibly fun.

 

What Is a TTRPG?

A Tabletop Role-Playing Game (TTRPG) is:

  • Tabletop – Played face-to-face, not on a screen

  • Roleplaying – Players take on the identity of their characters

  • Game – There’s structure, but also immense freedom

Unlike board games or video games, TTRPGs are collaborative, not competitive. There’s no score, no winner. Instead, success comes from co-creating a story, where the group overcomes obstacles together. This makes it an ideal setting for learning cooperative behaviour and shared problem-solving.

And just as important: it’s not about collecting tokens or racing to a finish line. There are no plastic pieces or high scores—just players embodying characters, making decisions, and experiencing consequences together. In this way, it becomes not just a game, but a meaningful social experience.

The DOTS Model: How the Game is Played

Each scene in Critical Core is structured using the DOTS model:

  • Desire – What the players want to achieve

  • Obstacle – What stands in their way

  • Tactics – How they try to overcome the obstacle

  • So then... – The result, determined by roleplay, dice rolls, or the Game Master’s (GM’s) guidance

Here’s how that plays out:

The players come across a river. There are no bridges, and it can’t be crossed easily. One player, an elvish rogue, decides to leap across boulders. The GM decides this is an easy task for such a nimble character. They roll and succeed. Another player, an orc barbarian, tries the same—but fails. Not because they rolled poorly, but because the task doesn’t suit their character’s strengths.

This moment becomes a powerful, teachable lesson. The player learns: success isn’t about copying others—it’s about recognizing their own strengths and thinking flexibly. And this kind of social learning happens organically through play.

Why It Works: A Social Flourishing Model

Traditional social skills training often focuses on deficits—what a person lacks. Roleplaying Games flip this paradigm. It uses a social flourishing model, building on participants’ existing strengths and providing opportunities to practice essential skills in a natural, low-pressure environment.

Consider this scenario: a child has been taught to maintain eye contact during conversations. But in the classroom, their teacher turns away while speaking, undermining everything the child just worked so hard to learn. That’s a failure of context—not the child.

Critical Core avoids this by immersing players in real-time, dynamic social situations. There are no scripted responses. Players must read cues, collaborate, and adapt—just like in life.

The Five Core Capacities

At the center of the Critical Core model are five key developmental capacities that guide gameplay and growth:

1. Regulation

The ability to stay calm and connected during stress or excitement. Players shift through arousal states during the game, strengthening their nervous systems through practice and repetition.

2. Collaboration

Game mechanics require players to work together. Authentic relational play and mutual problem-solving make collaboration second nature over time.

3. Planning

Whether navigating dungeons or negotiating with dragons, players learn to plan, adapt, and reflect—developing both critical thinking and creativity.

4. Perspective

Understanding that others have different feelings, thoughts, and experiences is at the heart of empathy. By stepping into their characters—and responding to others’—players practice theory of mind in real time.

5. Pretend Play

Far from being just “kid stuff,” pretend play is vital at all ages. It enables safe experimentation, stress relief, and growth. It fosters imagination, which in turn fosters resilience and hope.

In a world where intervention can often feel like work, TA-TTRPGs makes growth feel like play.

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