Adam Davis, co-founder of the Dungeons & Dragons therapy group Wheelhouse Workshop, thinks kids with social issues aren’t being asked the right questions. In a dreary school counselor’s office, it can be hard to engage with “Why aren’t you doing your homework?” and “Have you tried joining clubs?” For Davis, more fruitful lines of inquiry start with “Who has the axe? Is it two-handed? What specialty of wizard to you want to be?”

Davis, who runs Wheelhouse Workshop out of an office in a large, brick arts building in Seattle, is used to seeing sides of kids that don’t usually come out in school. He, along with co-founder Adam Johns, designs D&D games that are less like hack-and-slash dungeon-crawls and more like therapy with dragons. In D&D’s Forgotten Realms world, the kids’ psyches run amok.

Earlier this month, over the phone, Davis told me about Frank (not his real name), a tall, lanky teenager who barely spoke above a whisper. In school, he tended to sit with his feet in front of his face, so no one could really see him. He hated to take up space. After his parents and teachers noticed that his body language seemed a little stand-offish to peers, they enrolled him in Wheelhouse Workshop.

“The character he chose was a dwarf barbarian,” Davis recalled. “He was really loud and bumbling and unapologetic. It was a really obvious opportunity for this kid to play with qualities other than his.” Adam had Frank sit like his character, spreading his legs apart and slamming his elbows onto the table. In dwarf-barbarian mode, Frank could experiment with new modes of relating to others.

In March, Davis and Johns, who helped him start Wheelhouse Workshop, gave a presentation at the PAX East convention in Boston. They joked that everybody running D&D therapy groups, themselves included, like to think it was their idea. Not so. There are a half dozen groups across the States tapping into tabletop RPGs’ therapeutic potential. Therapists have long used role-play to help their patients, inviting patients to role-play personal scenarios from friends’ or parents’ perspectives. But buying in can feel pretty lame without a good hook, or a fictional world’s distance from real-life. Because D&D is inherently cooperative and escapist, it urges players to reimagine the ways they interact with peers. And because each player has their own specialty, like communicating with dragons, they’ll have their moment to feel valuable in a group setting.

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At worst, kids who are socially isolated can enjoy hacking up some goblins after a crappy school day. “For someone who never leaves their house except for school, to have a peer say, ‘I need your help picking a lock’ makes a huge difference,” Johns told me.

Out of Ephrata, Pennsylvania, Jack Berkenstock runs the Bodhana Group, a nonprofit that uses role-playing games’ inherent social and educational value for therapy. He’s a Master’s level clinician who, for 23 years, counseled inner city kids. Later, for nine years, he provided mental health services to an all-male juvenile treatment facility that included sexual offenders. There, he got the bright idea to start running a D&D game. “How many times can you really watch Snow Dogs?” he laughed, referring to a laughably bad movie about sled dogs.

Immediately, Berkenstock said, the social benefits were clear. “We started to see kids who had issues from their families bringing that into the game,” Berkenstock told me. “It’s called ‘bleed’: how much does your personal identity impact the character you’re playing? And how much does your character impact you as a player?”

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What makes running a therapeutic D&D group different from any old ramshackle D&D party is “intentionality.” Berkenstock is careful to design games where players’ actions have consequences, so, for example, he wouldn’t protect an over-impulsive player from running into a dragon’s lair. If their character is severely hurt, that’s the natural repercussion. When his players raid an orc village, he makes sure to show how that affects child orcs or their mothers. “I believe you can explore consequence in an environment where nobody gets hurt physically,” Berkenstock said.

Wheelhouse Workshop’s Johns wrote a D&D one-shot that had Frank and his party infiltrate a royal dinner party to find information on a local politician. To get in, the party had to put on royal airs. So, they walked in and told whomever asked that they hailed from some made-up kingdom. “I had them sit down at our table as their characters would,” Johns said. For the party, Johns had provided mugs of soup to mimic the in-game meal. “[Frank] would reach over and grab the bread from the waiter with tongs, knocking the bread out of his hand, slurping his squid ink soup. Everyone else at the [fictional] table thought he was royalty.”

According to parents I interviewed, flexibility is a common issue among kids enrolled in Wheelhouse Workshop. Structure and rules can help kids with autism cope with a disorienting world, but also, make social interaction quite difficult. A parent of a Wheelhouse Workshop attendee told me that, among peers, her son has trouble deviating from his own ideas of what’s right. D&D forces players to consider others’ strategies for avoiding sleeping orcs or rely on other players’ high charisma score to negotiate with enemies. “He’s actually told me he disagreed sometimes with what his fellow adventurers have decided,” she told me, “and that later sometimes he’s come around and agreed that the decision turned out okay.” She added that “this is a startling increase in flexibility for him.”

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D&D isn’t about to become the next inkblot test or “and how does that make you feel?” But there is a strong continuity between players’ internal lives and escapist fantasies. Leveraging those fantasies in the service of therapy isn’t a big leap, in part, because it’s not entirely intuitive. D&D was never, and will never, be marketed as a tool for therapists. It’s just a game. That’s also why it might catch on with kids who need help.