Dungeons & Dragons as Therapy? How Tabletop Roleplay Games are Making a Difference | Charlene MacPherson of Nerd Adventure Therapy 20 (NAT20)

It was going really well at the college and I wanted to start working with adults because, again, I got late, diagnosed ADHD at 35, and my entire life changed because I started medication. I knew what was going on. You know, it wasn't a personal failing, like all of those things. And I'm like, okay, well, now go out and find a neurodivergent adult support group for somebody over 30. It doesn't exist. And even in the research, play therapy with adults age 30 plus doesn't exist. And I was like, I could use that. If I know I could use it. And I'm a therapist, other people could use it.

Welcome to the Mental Health Entrepreneur Podcast. We are here to inspire creative ideas and connections for entrepreneurs and advocates working to address our mental health crisis. As you listen, I hope you will experience new ideas and motivation to innovate in your business, your community, and in your life. Welcome back, everyone, to the Mental Health Entrepreneur Podcast. I am your host, Rachel Harrison, and with me today is Charlene McPherson. Charlene is innovating in the therapy space with her practice called Nerd Adventure Therapy. Darlene, welcome.

Hey, thanks for having me.

Yeah, so let's dive in a little bit to this. I mean, your name starts to kind of get people interested. What is Nerd Adventure Therapy 20?

Well, it's my therapy private practice that I started. Actually started it in 2021, but went full time the next year. It is a practice where I do individual therapy as well as group therapy, but I do therapy a little bit differently. I have blue hair. You all might not be able to see that here. And I work with people through their nerdy interests, through their geek interests, through fun. And then I also run Dungeons and Dragons therapeutic groups. So we take our goals, we build them into the characters, and we run the game. And you practice your goals through the game. So that's what I've started.

Yeah, in a nutshell. So I'm curious, how did this come to be? How did this idea sort of spark for you?

So I've been playing role playing games since 2004, and I love it. It's an amazing game. I had actually been playing a personal game where it was just voice, I couldn't see people. And I have adhd, so, you know, social cues are hard for me anyway, let alone if I can't see people. So I was a little anxious starting that session with those people. But there was a point where we captured a pirate ship, took over the crew, and we had to come up with who the captain was going to Be. And before my dungeon master, my game master, like, finished the sentence of who are we going to make captain? Everyone was like, rip, which was my character, Bomb Brippenstein iii, he's a bullywook bard, needs to be the captain. And of course, you know, that's me. So once they said that, it was like everybody at once. And they all unanimously were like, oh, you're the guy. And it made me feel, like, super accepted. So I was like, wait a minute. I had some pretty intense anxiety going on, and now I don't have the anxiety anymore because I feel accepted by this group. This might work. This might work for my clients. And that was around 2017. And so I did some research at the time, and there wasn't anything out there that I could find. There were people out there, but I think they were just building. And then in 2019, I interviewed for my job as a college counselor, and they asked me what type of groups I wanted to run. And I straight up said, I want to run D and D therapeutic groups. And they were like, okay.

And so set the stage for me. Somebody walks in to this group and I don't know, people may have ideas of a therapy group and what it looks like, but give me a picture of what these groups look like when you walk in.

So when you walk in, my office is definitely not a normal therapist's office. There's a stained glass window sticker that says welcome Adventures, and It has a D20, which is the 20 sided dice on it. You walk in and you see my Blue's Clues couch, which it looks exactly like the Blue's Clues couch. Not kidding.

Wow.

You have a huge table that has chairs around it. And I have a TV mounted on the wall so that we can pull up maps and things like that. Everybody will be sitting around the table just like you would in a regular D and D game. But their dice, their characters, you know, laptops, things like that. And the most important thing I have in that office is the snack table, because you can't have D and D without snacks. So I have a little refrigerator too that I keep, you know, waters in and things like that as well. So I try and make it a relaxed environment. I have all of my D and D books and knickknacks and everything on bookshelves. And anybody is welcome to use anything that's there. My dice, my miniatures, which are the little people that you can move around the map, things like that. So that's what it looks like. And the people that are sitting at the Table so far actually have been a lot of neurodivergent women over the age of 30 or people who identify as female. Some non binary folks as well. But that's kind of who's been coming. And obviously, you know, me marketing, I identify as female as well. So I think hopefully the idea is that this space is a safe space for female identifying people or non binary people to come and explore D and D. Whereas like when you're out at a game store, you never know what you're going to get when it comes to kind of the culture of gaming. Sometimes it's very male dominated. So that's who kind of sits around my table is neurodivergent femme presenting or non binary people. I have had male clients as well and they have just as much fun, you know, do just as much work, but that's the majority of them.

Was that a surprise for you?

It was and it wasn't. It kind of makes sense.

Yeah. And so is D and D therapeutic in and of itself or what do you do to make it therapeutic?

Yes. I went through training, through Game to Grow and Geek therapeutics. And both of them, the way we kind of all say it is DND can be therapeutic. It's a game, it can be a coping mechanism, it can be something that you're having fun doing, that you're taking care of yourself with. But it's not therapy until you put a therapist at the head. That's what makes it therapy. Because anybody who plays D and D, or for those that don't, we put our stuff into our character, whether we mean to or not, because you're literally personifying an avatar. Right. Like your stuff is going to go in it. You're the one reacting, you're the one playing the character. You know all of those things. And it is very well known across the fandom that stuff comes up, hard stuff comes up. And a lot of DMs, Dungeon Masters have to deal with people crying at the table or going through anxiety or going through depressive symptoms or, you know, things like that. And so obviously that's a lot to put on an untrained person.

Sure.

So taking it and creating a process, a therapeutic process, which is what I'm currently doing now, to be able to do that on purpose instead of by accident taking the cognitive behavioral goals or the act goals and taking them and putting them into the character's backstory. So I'll have people actually take their symptoms of what they're working on. So it's not trauma. We don't recreate trauma or anything like that. We just take the symptoms. We say, okay, well, your character also has these symptoms, or your character has the opposite of these. So you're practicing where you want to go. So that's how that kind of works.

Wow. And so when somebody has that tough moment come up that maybe brings some emotions or something, what happens then?

Well, it's actually kind of amazing. This is why I'm definitely falling in love with group work. Because everybody at that table knows that it's a safe space. I have safety tools which are ways that you can stop the game if it's getting too intense. There's an X card in the middle of the table and you can just press it and we stop immediately. And, you know, lines and veils. I have people fill out forms what they are okay with, talking about what they're not okay with, talking about topics and things like that. So everyone at that table knows that it's a super, super safe space. So that's the first thing that I have to make sure happens. But once that happens, and I've had a few people build stuff in there, even though they were doing it on purpose, they didn't think about how intense it was going to be when it came up or didn't realize that they put it in there still and it comes up and they might start crying at the table or getting upset or panicked or whatever. And so far, that's when the most amazing work happens. I know it's not fun for that stuff to be induced or whatever, but they're at a table, a safe place, with four or five other people who are working on very similar things. And what's happened is everybody just rallies. Everybody rallies around the person and is like, are you okay? What do you need? I feel that way too. They will actually support whoever is having a hard time at the table. It's amazing to see because as the therapist, you know there's that power differential, right? And the teacher. So I can say something to somebody and they're like, oh, yeah, Charlene, you gotta say that. I pay you to say that. But when it comes from a peer, especially with my adult groups, when it comes from a peer, it has a different impact. It has a different effect on the person that is receiving the support. And it's amazing to watch. I also run teen groups because I had one mom basically beg me to run a team.

Yeah, I bet.

I was like, okay, sure. So I'm running teen groups as well. And the same thing happens with them. Like when one of them starts having a hard time, they all rally. I had a group last week and I buy them pizza every once in a while just for funsies. And they all were like standing around the pizza talking to each other and socializing. And every single one of them there had social anxiety or didn't have a lot of friends, Wasn't very confident in themselves. They're having a blast standing around the pizza, just eating. So we do D and D. But it's also the whole point of my groups is to get them to relate to each other. And if they, you know, eventually contact each other outside a group and they're friends, that's perfectly fine with me. I know that's a little bit different than normal groups, but that's the whole point is I want them to learn how to socialize and make connections.

Right. It sounds like you are kind of specifically working on social skills a lot of the time, maybe as well as coping strategies with anxiety and things like that that come up.

Yes. Yeah, I'm very neuro. Affirmative. So. So whatever goals people want to work on, I'm not teaching social skills that society wants people to know or I don't. I don't want to teach masking. That's not what. What we're trying to do here. I want to create a space where you don't have to mask and so that you can relate to others on your own level, but also learn skills and work on your goals that you have. Right. Like, I'm not going to tell you what you need to do. You're going to come to me, we'll talk, we'll figure things out. I'll help you come up with those goals. But it's their motivation, you know, for how they want to present to the world. That's what we're going to work on.

Okay, so that part of setting up goals happens before coming into the group then.

Yes. And so eventually what I want to do is kind of run a DBT program. Like a DBT program. So once a week, individual therapy. And once we group, I have some people that are doing that now. And what I do is if somebody is doing individual, we'll come up with the goals and things like that. I'll start individual before the group starts so that I can get to know the person. Stuff like that. Then we'll come up with goals, build the character, you know, do all that stuff, and then they'll take that into the group. If they're not doing individual therapy with me, they already have an individual therapist or they don't have an individual therapist. I highly recommend they get one. And we will build beforehand. We'll build the character beforehand in a couple of sessions. For the teens, we're kind of changing the procedure a little bit. We're going to be building the characters in session. Just trying to get a teen to build a character with goals outside of the session has not worked so far.

Yeah, sounds about right. What about people that say, you know, this is fantasy. You're teaching people to, like, live in fantasy land. You're actually having a therapy group about that. What about that?

Yeah, so the thing that always gets me is that people think that we stop learning through play just because we grow up.

I love that. I love that.

Like I did with my original idea, D and D group, I was just playing. I was playing a game with a group of people that I didn't know very well. And I learned something about myself in there. Right?

Yeah.

And the other thing I have to say too, is, like, heck, like, yes, I know kids have to play and stuff like that, but us adults have a lot to deal with, a lot of responsibility, a lot of stuff that we gotta. And we know what's going on in the world. And, you know, all this. I need play. I need play to survive that and to cope. And again, like, anytime you're interacting with other people, you're learning about yourself. When somebody does something that you don't like, you have to respond to that in some way, shape or form. You know, you're going to respond and then be like, oh, oh, I got upset there. Like, what happened there? And that's the type of stuff that will happen at the table. Especially since they're playing a character that they've built that has some of their characteristics in it. You can actually use that as a tool in the groups is it's called aesthetic distance. So if someone's getting too close to their character, they're getting upset because their character is getting upset. You can say, hey, look, your character seems to be really upset. What's going on with them? Whereas if they're kind of just playing a character, not really putting themselves into it or whatever, be like, hey. And they're having a reaction. Hey, you seem like you're having a reaction. What's going on there? How do you think you would respond? Are you going to have your character respond the same way? So you can bring them closer to the character just by asking those questions as well. So, yeah, it's a lot of fun.

Yeah. So what do you think is next for Therapy in this realm. Like I'm curious what else is out there? What else is brewing around in your mind?

So research, obviously. I am a research based person. This has been a bit of a journey for me because I'm like, there's some research out there, but there's not a lot. But right now, game to grow Geek Therapeutics, take this. A whole bunch of, of the older companies and nonprofits that are going out there and they're doing the research and they're writing the books. They came out with books. Dr. Megan Cottle is associated with Geek Therapeutics. She came out with a book as well. So it's starting to gain traction. But research really needs to be done because again, I don't want to do something and accidentally be hurting anybody. You know what I mean? Not that I think that that's the case but, but you always want to make sure and check, you know, when you're a therapist, your ethics that you're, you're doing good. So that's the first thing. The expansion of this is just going to get bigger and bigger because Dungeons and Dragons is getting bigger and bigger. It's a multi billion dollar industry. You have TV shows, you have, you know, YouTube channels, critical role dimension 20. You have all sorts of actual play podcasts which people actually will get on and just record them playing the game. And so it's getting bigger and bigger. So I think more and more people are going to get to know what's going on. I also want to expand, you know, when you think about a private practice as a therapist, a lot of people just think as the therapist, just think of seeing clients and I'm like, that's not going to sustain this. I would like to expand, you know, I expanded to include the groups. I'd like to expand to into speakerships going and talking to about this stuff going out. I actually do panels at comic cons.

Oh nice.

The big nerd conventions. I'll go out and we'll do a panel and talk about what I do and you know, things like that. So I'm hoping to get to San Diego Comic Con at some point. That's the big one. I also want to expand to a group practice instead of just me. There are plenty of nerd therapists out there. And the other thing that isn't as well known if you're not in the community is the lack of representation of the bipoc community in gaming is a big issue as well. And so add in treatment for the bipoc population. That's something that I really would like to tackle head on with a partner so that we can make everybody feel welcome at the table because it's a well known problem in the industry. And then I want to do a nonprofit too. I just want to do all the things. I want to create a nonprofit as well, to raise funds to just straight up pay for therapy, group therapy, and the individual therapy. I want a clinician to be able to come to me and say, hey, look, here's demographic information. This is how much I'm charging for this person. Here's the invoice of how many times they came. Here's. And I'll give them the money.

The end.

And I actually work with a nonprofit right now that is doing exactly that called Change the Conversation. Oh, my God.

Katie was on our podcast. Katie Cashman. Yes, yes, yes. I love Change the Conversation.

Yeah, I think I found them and I was like, Katie, like, hey, look. Like this seems really awesome, like, blah, blah, blah. And so they certified me as not certified, but you know, as a trauma therapist. And I have a client that's receiving services through their grant money, which I love. It's amazing.

That's fantastic. I mean, I think the application for this could be even more far reaching than what you've done. It seems to me that there's also an accessibility piece, like sitting down and having a conversation and doing talk therapy with a therapist probably sounds like a nightmare for some people, but they also feel like they have issues and things that they want to work on. So this feels like it really bridges that gap very well for people that gaming doesn't seem as intimidating as talk therapy.

That's my favorite part about it is I'm like, hey, let's come have some fun. You're still doing work. You said earlier that a lot of people will kind of vet me. They'll be like, I don't want individual therapy. It didn't work for me before. Like, you know, but they're like, I'll try the D and D group. And then usually around week four or five, they'll come to me and be like, hey, do you have any individual therapy sponsor? Yes, I do. In fact, I always joke they're vetting me, but they finally figure out that I'm the therapist sitting at the end of the table playing a goblin who has a Bronx accent. I am not somebody that is going to judge you in any way, shape or form because I'm literally making weird voices at the end of the table. So once they figure out that that's kind of where I go and how I run it, people tend to get a little bit more comfortable, and then they might come in for individual therapy, which, again, I completely understand and can support.

Yeah, I'm wondering about this entrepreneur side of things. Right? You started this originally at the college you were working at. Right. And then you kind of launched your own thing. How did you decide to take that leap? That's a big leap of faith to say not a lot of people are doing what you're doing. There are some, and it's gaining ground. But you said back in 2017, you were like, gosh, nobody's really even doing this. So how did you get the courage, I guess, to just jump out there and do this?

Well, the college definitely helped. It was either that the college students were not coming to group at all, or they're coming to a D and D group. So, again, like, getting people together versus them not getting together at all is already a positive. Right. And that's what I say, too, is like, everybody at my table who has signed up to be there has already done a whole bunch of work because there's gonna be anxiety and things you need to get done and all that different kind of stuff. So it was going really well at the college, and I wanted to start working with adults because, again, I got late, diagnosed ADHD at 35, and my entire life changed because I started medication. I knew what was going on. You know, it wasn't a personal failing, like, all of those things. And I'm like, okay, well, now go out and find a support group or a neurodivergent adult support group for somebody over 30. It doesn't exist. And even in the research, play therapy with adults age 30 plus doesn't exist. We had things on how adults learn in college when they go back. But as far as I could see at that time, there was nothing. And I was like, I could use that. If I know I could use it. And I'm a therapist, other people could use it. And so I just started marketing, marketing my butt off. Going to the gaming stores in the area. There are tons of them around here, at least five big ones. So going to local game stores, putting out flyers, just going to the places where I know my people, my neurodivergent, you know, self would hang out at. That's where my people are gonna be. So that's what I started doing, was just starting marketing, and I marketed to current clients, and I was like, hey, I'm gonna run this thing. Are you interested? And that first group actually was made out of quite a few of my individual clients that had been seeing me for a while. And so we started it, and that campaign went for a year. Now I'm only doing 18 weeks. But the first campaign, the very first in the community with adults campaign, lasted for a year. And it was amazing the things that came out through that campaign. And then it just didn't stop. I kept recruiting while I was doing the first game, and then more people came, and then when they were done, another group came, and then when they were done, another group came. I have pretty much haven't stopped since I started in 2021, just by marketing on Facebook, going to cons, you know, things like word of mouth, that type of thing.

Awesome. Well, we are out of time, but any last words that you want to leave with everybody?

Just go out and play, you know, find something that you like Football. You know what I mean? Like doing the brackets for football, you know?

Oh, yeah, yeah. Fantasy football.

That is play. That is adult play. We need it. You need to take care of yourself. And if it's going to be through video games or tabletop gaming, which is Dungeons and Dragons, or, I don't know, like, go out and dance in the ring, do something, but just play. You don't stop learning from play just because you turn 18.

Well, thank you so much for being here. It was awesome to chat with you.

You too. Thanks.

Hey, everyone, before we go, I wanted to mention a podcast that I am loving right now. It is the Back Porch Bestie. I love this podcast because it gets pretty real pretty quickly. There's a lot in there that Casey and Kelsey share about their own personal growth, and they have such great guests on there that really share their own journeys as well. Listen to the trailer now. Then head to the Show Notes to find the show's link and subscribe. I think you'll like it too.

So, Kelsey, so, Casey, serious question. Did you ever think you would be here?

No, I didn't. And by here, do you mean, like,

literally right here in this moment, recording a podcast about a book that you are in?

No, absolutely not.

Like running this business in the way that you are. Building a house, having seven people in the house we're currently living in. Oh, and a new pottery business and doing consulting. Did you ever think that you would be here?

No, I think that there's pieces of me that always have wanted to be here, but I didn't know. I kind of just stumbled across it back two years ago, our conversation. It just unraveled a thread.

Yeah. So you think you had the potential all along. You just needed.

Yeah, I just needed somebody to believe in me.

Oh, well, I think I'm the opposite. You know, like, always out looking for more, looking for the next thing, like doing this, doing that, and, you know, all of. All of it. And then I met you, and you slowed me down substantially.

Yeah, you're a cliff jumper, and I'm more of like a puddle jumper.

I don't even think you're a puddle jumper. I think you're like a puddle viewer. Let me see where the rocks are. Oh, there's a minnow. See it?

But it protects me.

From what?

I don't know, Myself.

What, are you gonna hurt yourself?

Maybe jumping off that cliff. I might break my neck.

You'd be like a little roly poly. Like, just curl up in a ball

and roll down the hill. Pew. Oh, God.

So for real, how does it feel to be a little bit more like maybe a heel jumper now? Yeah.

I mean, I like it more because it makes me more confident and feel competent that when I do jump off the hill, that I land on both feet. And if I don't land on my feet, I figure it out. Right?

Yeah. And I think you've helped me because now when I am jumping off things, I'm not just jumping off cliffs just to say that I did it. I'm jumping off because there's joy there. Hi, I'm Casey, and right here beside me is Kelsey. We are licensed professional counselors, mothers, entrepreneurs. Oh, and besties. We know firsthand what it's like to wake up one day and think, how in the heck did I wind up here?

Through our own journeys of self discovery, we found that joy is something that has to be pursued through internal work. Now we are on a mission to help women from all walks of life understand themselves more so they can have real, lasting joy.

Join us every Thursday to hear fun and insightful interviews with experts who can point you toward self discovery and fulfillment.