Steamforged Games is pleased to announce our support for charity, Game Therapy UK.

I’m Rae Dixon, the Brand Manager at SFG and I sat down with Game Therapy to talk about what and why they do what they do! 

Before we dig into our interview, Richard August, Lead RPG Designer and Developer, had this to say:

“I know how essential games, and especially roleplaying games, were in helping me develop as a person and dealing with the difficulties of long-term, chronic depression. When our Creative Director, Mat Hart, heard about the work of Game Therapy UK, he immediately recognised what a great initiative it was. It didn't take long for everyone else at Steamforged Games to become equally convinced, and decide we wanted to help.”

“The unique combination of a warm, supportive social setting, and the ability to safely engage with fantastical imaginative worlds on their own terms, makes RPGs a brilliant vehicle for helping people learn (and relearn) vital skills. Game Therapy UK's invaluable work is taking the amazing experience of RPGs and using it to make a difference. That's something we at Steamforged want to support in any way we can.”

And with that let’s hear from Game Therapy UK!

Can you tell us a little bit about Game Therapy UK?

Game Therapy UK is a newly registered charity set up to combat isolation through evidence-based ‘therapeutic gaming’ and we currently run therapeutic gaming projects for people experiencing homelessness, survivors of modern-day slavery, people in addiction recovery, and military veterans. We are also starting projects for young people who are socially excluded or at risk of gang involvement, and for adults and young people with diagnosis of neurodivergence (ADHD and autism). 

We also aim to provide research and education into the benefits of therapeutic gaming. 

How was the charity set up? 

The charity initially came about following a conversation between myself and my colleague Finbar Macdonald-Westall. We had both played TTRPGs since the late 1970s and were both working in the homeless sector in London. I was working as an NHS doctor providing End Of Life Care and Outreach and Finbar was working as recovery coordinator for people experiencing homelessness. 

We were aware of the growth of ‘Game Therapy’ in the US. We recognised that whilst there was evidence of benefit it was limited. Partly because the amount of data was small. But also, because the US experience of health and social care system is very different to the UK in that most of their health provision, including ‘Game Therapy’, was private healthcare and in the market-place. 

We had spoken to health and social care professionals in the UK who had tried to set up Game Therapy projects and we learned that their experience was that the projects did seem to be beneficial however the projects often struggle to take off because of lack of support and funding. 

Therefore, in November 2021 we started Game Therapy UK as a charity to set up and run some initial projects (in homelessness health and veterans’ mental health) and to also provide support, funding and research into evidence-based TTRPG projects across the UK.  

Why are TTRPGs helpful? 

Like many mammals, playing games is fundamental to how we learn new things, pick up skills and develop our brains. However, humans are a little unusual, compared to other brainy animals, in that we continue to play games throughout adulthood. 

Cooperative games, such as TTRPGs, also have an advantage in that they allow players to act out scenarios which facilitates creativity, imagination, learning, insight, and growth. They also allow cooperation, and social interaction. All these things are important to learning, or re-learning, skills and behaviours. 

Games also have the benefit of being fun and are therefore self-motivating… we keep learning with games because it’s enjoyable. You come for the fun game but benefit from a therapeutic experience. 

What areas is the charity addressing?

Humans are a very social species, and there is a great deal of evidence that social exclusion causes real harm. Research has shown that social exclusion (such as loneliness) can have a similar risk of harm as smoking, obesity and high blood pressure. All our projects therefore are aimed at promoting social inclusion in groups at increased risk of social exclusion. For example, there is evidence that people experiencing homelessness spend on average 18 hours a day alone. 

Most of our projects address mental ill-health, such as Common Mental Health Disorders (depression and anxiety), but also PTSD, complex psychological trauma and addiction recovery. 

We are also developing projects to support adults and young people with diagnosis of ADHD and autism. 

Which games are the most therapeutic?

At the charity we believe that all games have the potential for being beneficial or therapeutic for the reasons outlined above. At its most basic level a cooperative fun game between a group of friends is likely to promote social inclusion. However, all games can also have the potential of being harmful or toxic. I think the difference is primarily how the game is played rather than which game is played.  

Happily, most players and GM will usually have a beneficial experience during game play. The chances of maximising this therapeutic experience can be improved if the GM and players are thoughtful in their approach. This is especially the case if you’re playing a game with people who have mental health challenges such as depression, phobias, PTSD, or addictions. 

What game systems do you use in the Therapeutic Gaming projects?

At Game Therapy UK we are pretty much ‘games agnostic’ in that we don’t think there is such a thing as a ‘therapeutic game’ per se. Any game can be played in a therapeutic or toxic way. 

What is more important is the ‘thoughtfulness’ of the process that goes into the way the game is played between the GM and the players. Therefore, we are currently developing in-house training for our volunteers designed by Clinical Psychologists, recovery workers and gamers.  

All of our projects are designed thoughtfully with input from clinicians, psychologists, gamers and of course our clients. 

At the moment we are using modified 5e D&D rules with our veteran groups- this was because after discussion with the veterans it became clear that 5e was the most accessible. We have made the rules a bit more lethal (like old school D&D) and also the themes darker and more Cthulhu-esqyue.   This was in part because this is what the veterans asked for, but also because the psychologists felt it would be helpful if the game could stress the veterans albeit in a safe, controlled, and thoughtful way.

For our project for people experiencing homelessness, we use either a simplified 5e D&D rules or a homebrewed, very simple 6-sided ‘exploding’ dice system. The rules are simpler to make them more accessible to clients who may not have English as their first language or have literacy or numeracy skills. 

The game for our future neurodivergence projects are still being co-created with our potential players, but again it’s looking as if the players are favouring 5e D&D. 

In future we are happy to look at any game, or rules system and this could include video RPGs. 

For example, we have been asked by the NHS to develop a project for people with cognitive impairment or early dementia and we are initially looking at a cooperative board game (possibly along the lines of games such as Pandemic).  However, we are also looking at the use of ‘murder-mystery’ type board games or TTRPGs. 

What are our current projects?

The beauty of using RPGs is that they are infinitely adaptable- we can design a project for any group.

Homelessness

In our first year we ran 'therapeutic gaming' projects playing 5e at a homeless hostel in Camden for people experiencing homelessness, women's only group for women experiencing homelessness, survivors of modern day slavery, and people in addiction recovery. The results are very positive, and we presented them to the Pathways International Symposium on Homelessness Health in March 2023. In our second year we will be expanding that project into Newcastle, Liverpool, Glasgow and Cardiff where we will be gathering more data for future publication. 

Military Veterans Mental Health

We have also been working with the NHS on Veterans Mental Health Op Courage on setting up an online NHS hub for military personnel with PTSD and other mental health problems caused by combat.  We have been running a couple of small pilots with a few groups playing a 5e campaign online. Later in the year the online 'hub' should go live. We also have online military groups setting up in the US, Canada, and Australia. 

School Clubs/ After School activity

We are setting up a working group of educators (teachers, teaching assistants, librarians and psychologists) looking at evidence-based, best-practice and training on running TTRPGs in schools and after-school clubs. Most of these projects are currently 5e. We are also setting up three after-school projects at community centres in London for young people at risk of gang-involvement. 

Neurodivergence

We are also piloting an online 5e projects for young people and adults living with diagnosis of autism/ ADHD. 

Education

In April 2023 we piloted our first online training course to train up our first 'batch' of military therapeutic gaming GMs (this will develop into full CPD training). We are also currently preparing for our first pilot of out online training course in therapeutic gaming for people experiencing homelessness, modern day slavery, complex trauma and addiction recovery.  We are already in talks with Universities and CPD providers about having our Therapeutic Gaming training recognised as CPD. 

We are also currently preparing a Kickstarter for a Therapeutic Gaming Youtube channel to be block-filmed in London, LA and New York with the support from the gaming industry, and also some of our comedian and Youtube pals.  

Research

All of our projects collect data for future publication into the benefits, or otherwise, of therapeutic gaming. 

What are our future projects?

As well as expanding our current projects for military veterans and people experiencing homelessness we’ve been asked to set up a  are also setting up a working group    that   and sponsorship. . We currently rely mainly on have two projects developed. One is a bunch of fortnightly online 5e D&D games for serving military personnel and veterans to help with social isolation, common mental health disorders, PTSD and addiction. The second project are weekly face-to-face games for people experiencing homelessness in Camden London. This includes groups who are in addiction recovery and survivors of modern-day slavery. 

We are currently developing projects for young people and adults with neurodivergence, which we hope to role out later this year. 

Looking into 2024 we are already doing work to develop projects with HM Prisons for prison populations and with the NHS for people with early dementia. So we’re very busy. 

How is the charity funded?

We are a fully registered charity which is run by a small, diverse board of unpaid trustees and our projects are largely delivered by volunteers who are either gamers, specialists (psychologists, educators, recovery workers) or often both.  Therefore, there are very few central ‘admin costs’ and the vast majority of our funding is spent on the ground delivering the charitable projects.  

As with most charities funding is always a major challenge. Whilst we do apply for grants and awards most of the funding comes directly from donations. Luckily the gaming industry has been incredibly generous in supporting the work of the charity. That can be through donating products, such as games, miniature figures, dice and paints, or by amplifying our work through their social media. 

We also run fundraising events, such as regular comedy fundraising events at The London Comedy Store where top tv comedians kindly perform to help us raise money. The next event is on 24th May and we have Milton Jones, and a host of TV comedians, performing to raise money for the charity. (Tickets here)

Even though there is a long history of using games in a therapeutic setting it is not used very much in the UK, why is that? What do you think needs to be done to increase its use?

I agree, and this is why we started the charity. After a conversation between various professionals (occupational therapists, educationalists, psychologists) in the UK it was clear that an umbrella Game therapy charity to support the various projects would be helpful. The various professionals in UK had run promising small-scale trails in therapeutic gaming but then they often found it impossible to get further support or funding. Supporting research is on the main aims of the charity and all of our projects gather data for research.   

How can people help?

We are always looking for volunteers (GMs or specialist) to help with projects or fundraising events. 

If you would like to help it would be great to hear from you. Drop us an email at uk.game.therapy@gmail.com

Also follow us on your favourite social media or sign up for our newsletter via www.game-therapy.co.uk and we’ll keep you updated on all our work. 

If people want more info about you or the charity, where should they go?

If people want more information, then visit our website, sign up for our newsletter and join the conversation on our socials. We can always be contacted direct via our website, and its always great to hear from people interested in our work. 

https://www.game-therapy.org

https://www.facebook.com/gametherapyuk/

https://twitter.com/GameTherapyUK

https://www.instagram.com/ukgametherapy/

https://www.linkedin.com/company/gametherapyuk/

https://discord.com/channels/942169666053345281/942169666749628449