Developing Therapeutic Applications of Tabletop RPGs

An Interview with Jack Berkenstock Jr., MHS (human investigator 8th)

Content Warnings: Sexual abuse (mention, non-graphic)

Elizabeth Parsons: Do you have a favorite type of NPC?

JB: I would probably have to say “foppish rogue.” It’s gone through many iterations, but they’re usually like, Poncho Villa, a joke-y character. For a while I actually patterned my vocal styling after the king prawn shrimp from the muppets, all these weird things based on other pop culture stuff. Foppish rogue—not as good as he thinks he is with the ladies, but has some clutch rolls here and there.

Alex G. Friedman: I think our optimal reader would be considered a foppish rogue.

EP: This is, after all, for hip and attractive professionals!

AF: How did you get started playing games and what keeps you coming back?

JB: I have been playing RPGs since I was twelve. It all kind of started, honestly, just courtesy of the “Satanic Panic” and the fact that I was growing up right in the middle of all of that. Loving fantasy and sci-fi and all kinds of different stuff, I discovered Dungeons and Dragons by accident because a couple of friends had it.

I was a very shy kid. I wasn’t as “out there” as I put myself out these days. It’s always been a dream of mine to be a published fiction author. So that’s what started my love of RPGs. I could tell these stories. That’s probably why I’m more of a GM than a player. I love creating these plotlines and seeing where they’re going to go. Like: Here is this cool setting and a start, and there are all these people around the table, where are they gonna take it and how can I keep up?

Not only do I have board games on my shelf that I’ve played or have yet to play, but I love reading about new role playing systems and learning about different settings and different mechanics, because I love finding out different ways to tell a story, especially if a game lends itself to different storytelling. I love playing characters and using voices and coming up with plotlines and dramatic moments.

Alex: Let’s talk about the book! What drew you to using TTRPGs in conjunction with traditional methods of therapy?

JB: I’ll try to give you an abridged version. It’s a story I tell often.

It started out of the nonprofit The Bodhana Group, which we started in 2009. Just like any nonprofit, we became in need of funds. We intended to be a training company. Most of my history is from working with juveniles and pre-adolescent males in residential settings—either victims or perpetrators of sexual abuse. We started Bodhana figuring we could train people in things like compassion fatigue, help people work with that very challenging population and also maybe talk to parents.

We decided to do a fundraiser. That’s when we started “Save Against Fear.” It’s an annual three-day gaming convention we run in Harrisburg, Pennsylvania. It’s our main platform for talking about the mission. This year, we had about 30 professionals attend from across the United States.

Gaming is therapeutic no matter how you slice it.

EP: There are a lot of different types of games to play now. I know of a few of them. We have Monster of the Week, and Pathfinder, and D&D, and I recently listened to a podcast where they played a game called “Oh, Dang! Bigfoot stole my car with my friend’s birthday present inside!”—definitely a weird game.

How do you see gaming evolving today?

JB: Even way back then, there were different systems. Traveler, Gamma World, Call of Cthulu were all out in the late 70s, early 80s. There was also one called Stormbringer that was based on the fiction of Michael Moorcock. There have always been a ton of different RPGs. Pretty early on, fantasy wasn’t the only bag. What I’ve seen in terms of where gaming has gone and how it has changed… I think the finesse of gaming has gotten a little bit different, especially in recent years. You’re seeing a lot more minimalist gaming systems. Back in the day, it was like, “Hey bro, you like charts?”But now what we’re seeing is a lot more narratively drawn and driven games, so it’s more about interpretation of die roll as opposed to, like, simple pass/fail mechanics.

Save Against Fear got us in contact with Rich Thomas, who was previously the creative director of White Wolf. He is now the CEO of Onyx Path Publishing, which puts out Scarred Lands, Pugmire, Cavaliers of Mars, and Worlds of Darkness Anniversary Editions. Rich was sharing with us how he had gotten so many letters over the years from people who had been working through personal trauma through fighting monsters in a game or giving them a sense of agency through being able to command their character in a game. When Rich had said that to us, we thought, “Hold on, guys, what do we remember about when we ran D&D on the unit?” And we started talking about some of the minor behavioral things, like: “Don’t blow it, you’re our cleric, we need you to show up on Saturday for the big dungeon run.”

It started out fairly pedestrian in terms of treatment goals. Then we kind of turned the lens on ourselves and we started examining our own gamer history. When I was twelve and was first playing all these stories—what was I doing? What was I working on? What characters did I play, either when my parents were going through their divorce and I was kind of this pushed-to-the-side kid, or when I was getting a little bit older and was now in college and meeting new people? Were there differences, not only in what I played, but in the way I played, that I could now see through the lens of a trained, experienced therapist—and it turned out, we had all gotten benefit. I had used this to be more socially outgoing and develop confidence in myself, because a lot of bad things were going on in my life at that time.

We then kind of took that self-understanding and put the clinical filter on top of it. What if a person who was not only a trained therapist, but also who was a skilled Game Master… What if we could meld those two worlds and apply some intentionality to the creation of characters, of plotlines and milleius… What if we build the world to tell a certain story, and that story was emotionally resonant with someone? You’re setting up this simulation where you can practice any number of skills through the use of the narrative and the flow of the gameplay—and it’s all about toggling the switches of the game appropriately to what the person needs to work on or what they want to work on and kind of where they’re at in their development. So that’s the way the model works and the way we arrived there through this process of examination and evaluation.

AF: How about the process you went through in defining those therapeutic benefits?

JB: Bodhana doesn’t just use tabletop RPG—we use tabletop board games as well. Initially, we had chosen the name ‘Bodhana’ because it meant ‘leading to an awakening or an understanding’—a Sanskrit word. We tried to come at mental health care from a different perspective that had concepts from Buddhist psychology and dialectical behavior therapy.

So what can you get out of this? Naturally, we started with what we call ‘the pedestrian benefits.’ Gaming is therapeutic no matter how you slice it. But ‘therapeutic’ doesn’t mean ‘therapy.’ We started to examine: What do you get out of playing with your regular gaming group? Well, low-hanging fruit, there: social skills. You’re around a table with a bunch of other people, you’re playing and having time and relaxing. It’s a dice-driven version of going to the bar.

Then, creativity and expression—I know people who have drawn their characters, I know bards who have learned to play music, people who have drawn the items their characters have, people who have dressed in character and made props, the performance aspect of it.

It could teach resilience, or the ability to deal with failure or adverse conditions, which is very therapeutic. What can we do with the concept of the game? Well, everyone knows dice rolls are not always your friend, so could that be therapeutic? Stuff doesn’t always go the way that you want it to.

We looked at our own hobby and started identifying core aspects. Which is why in our first volume of Wizards, Worries, and Wellness, there are seven main heroes, and then there’s one who’s sort of mentioned, Hawk.

We’re currently at work on a source book that’s gonna contain therapeutic adventure hooks. Each of those characters has a fully realized world that represents some of the struggles of what gaming can offer to a person. So, Rowe the dwarf, for example, who is the avatar of resilience, he comes from a very harsh world. There are constant storms, not a lot of crops, not a lot of food—so it’s all about Rowe learning to thrive in an adverse climate. Everybody kind of has a tough go at it. We felt that if we could set stories in those worlds, which is what this project is, you can use it with any game system.

We looked at our own hobby and started identifying core aspects.

AF: I found the section on ‘Initiative’ to be really interesting. Would you speak on how you relate initiative in Pathfinder and D&D with willingness to take risk in real life?

JB: Initiative is several different things. One, we love initiative because it helps people learn to take their turn—because sometimes you can’t just rush in. But we also looked at the fact that initiative is equivalent to ‘drive’ or ‘interest.’ When you have initiative, you have the drive or the will to do something. In a lot of game situations, you can do things that you may not have the opportunity to do in real life. In some cases, like time travel or something like that, you can obviously try things that you would never get the chance to do. But it’s also about taking risks. Part of life is developing the confidence to know that taking a risk doesn’t mean you’re throwing everything away.

Some of the kids we work with have some of those social challenges. They’re not the most popular kids, and the kids that do hang out with them are not necessarily the best of role models. We want these kids to develop confidence, and the only way to develop confidence is to take a risk and to learn to weigh out those consequences.

They would ask: “Why would he want to talk to me?”
And I would say, I don’t know, #reasons.

So the concept of initiative is very key, especially if you’re talking about someone who doesn’t speak up often in order to develop more confidence. The natural way we do this is in the fabric of RPG. Maybe the king doesn’t want to talk to the guy who always talks every session; maybe the king wants to talk to your character. They would ask, “Why would he want to talk to me?” And I would say, I don’t know, #reasons. Because you’re an elf, because you’re short, because you have blond hair, because you’re tall, because you have a shield. Whatever reason is convenient to the plot. It’s the way we institute a certain skill development, which offers that opportunity for someone to take that risk.

AF: You mention in the book that you’re writing a manual to use for therapeutic gaming, and it sounds like that’s a pretty expansive project. Would you like to tell us about the format that that might take?

JB: We thought it was going to be, you know, one big, old, dusty, cobweb-filled tome, the pages like 28 by 14 or whatever. With Wizards, Worries, and Wellness, we’re looking to do kind of short bursts, almost booklets if you will, that can be utilized by a therapist or a practitioner based on what they’re working with.

Wizards, Worries, and Wellness was originally intended as kind of an initial volume that will be expanded to multiple different volumes that are going to be easily affordable. Let’s say we’re working with someone with an anxiety disorder, or someone with a depression diagnosis. What are some ways that we can customize the game, skill-develop or develop elements of a storyline that we can put into a world? It will also have some story-starters, like one-shots that would facilitate a little more specialization.

One of the biggest things we’re finding, now that we’ve been doing this pretty solidly for the better part of five or six years, is the question of “why do you think this works” is kind of the “duh” moment. People say that of course [TTRPG as therapy] works. It makes sense. But then they ask: “How do you do it? How do you create a world that exemplifies anxiety to a person?”

Well… Consider this. Maybe everything is very fast-paced in this culture. Maybe people feel rushed. Maybe the adventure is always on a timeline. Maybe the king decrees that ‘at this time every day, every hour or every interval, we have to do this certain thing.’ If you look at stories, anything from Doctor Who to Star Trek to Star Wars to whatever—there are ways that show you how this creative thinking can be applied. But what we’re finding is for a lot of therapists, that’s the real trick: How do you put [therapeutic concepts] in the game?

This is my biggest joke I tell everywhere: “You just slaughtered an entire Orc village. How does it make you feel?”

I love the experience I have working with kids and teens, because man, they’ll tune you out quick. But if you’re running an adventure that’s driven and inspired, and it makes narrative sense—you got ‘em. And they’ll go along with that narrative. We all know it’s for therapy, it’s not a secret. But it’s not something we have to hit you over the head with, either. I tell you we’re going to build the story around what your goals are and what you want to work on. We’ll reflect on it occasionally.

It’s psychodrama narrative therapy and expressive arts therapy, and there’s elements of cognitive behavioral therapy and rational emotive behavioral therapy. The story is what makes it unique, so to us, the focus is the story that drives the process of learning and exploration, investigation, practice, and rehearsal. To us it’s more how to apply a certain diagnosis or a certain challenge or certain disorder in a way that makes it narratively interesting, into something that a kid would want to explore.

“You just slaughtered an entire Orc village. How does it make you feel?”

EP: It does sound like, if you’ll forgive this terrible joke I’m about to make, instead of the DSM-V, you’re creating instead a GM guide for people with therapeutic backgrounds.

JB: We don’t use the same adventure twice. We craft every story arc uniquely to the player mix that we have and we make alterations based on player response as well as additions or removals—someone graduates the program or goes on to another form of treatment or whatever.

This is why the first question I ask when other practitioners ask: “So, tell me how you run therapeutic RPG.” My answer is always: “I know your CV, your Curriculum Vitae. I need your GV—your Gaming Vitae. Have you ever played an RPG? Before you go to do this, you have to understand what a role-playing game is.”

Because that’s the meat, that’s the heart of it. If you don’t understand plot and pacing and character development—if you don’t know how to wave that wand, there is no spell. Yes, there’s good group methodology and there are techniques, approaches and modalities, but this is an “adjunct” form of treatment. It’s based around simple group concepts—forming, norming, storming, performing. All of that stuff is built into this, but the story is where the magic happens.

EP: What’s next for The Bodhana Group?

JB: Of course we’re putting the finishing touches on the board game version of Wizards, Worries, and Wellness that will talk about how to stylize the way you teach a game and what board games can offer, with examples of good games that kind of highlight certain concepts.

Kids will want to game. Kids love gaming.

Our eventual goal is we would love to be able to offer this service to kids and teens for free. So our idea is: We have proposals out. We’re looking to get our first proposal accepted, which will fund a group of six kids for a year, for less than $6,000. We want to pay our facilitators, so if we get big investors to participate, they could cover the cost of not only the facilitation, but every kid would get their own book and dice bag.

Another big thing we do is we partner a lot with local game stores and actually run sessions at these shops—in hopes that the kids will then start to develop natural supports for themselves. They can develop their own friends, and have a new language to speak—and that language is RPG.

Eventually we’d like to open our own “YMCA for nerds.” A Bodhana Center—a place where we could offer after-school programs and classes and workshops, as well as summer programming, predominantly for at-risk youth. Kids will want to game. Kids love gaming.

The Bodhana Group

Facebook: Bodhana Group

Twitter/Instagram: @thebodhanagroup, @bodhanajack

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