Recent research published in journals cross-cultural psychiatry This provides evidence that the personal bonds people form with fictional characters in tabletop role-playing games can lead to marked improvements in their sense of identity in real life. This study suggests that using these games in clinical settings may be an effective way to help patients build self-esteem and process personal conflicts. This psychological growth tends to occur most reliably when gaming environments feel safe and socially supportive.
The project was directed by Jeffrey G. Snodgrass, a professor in the Department of Anthropology and Geography at Colorado State University. Snodgrass heads the Ethnographic Research and Education Laboratory, known as ERTL, and wrote this book. Faculty of Avatar: The Transformation of Ecstasy in Religion and Video Games. “This is a collaborative study involving faculty and students and is part of my lab’s long-term goal to productively combine research and teaching,” Snodgrass told PsyPost.
Mental health professionals are beginning to incorporate tabletop games like Dungeons and Dragons into psychotherapy. Explaining the motivation for the study, Snodgrass said: “This study represents my lab’s latest exploration of the relationship between gaming and happiness.” He added that games like Dungeons & Dragons are particularly interesting because players develop close relationships with their characters and other players in their gaming group.
Drawing on the concept of drama therapy, the scientists wanted to see if the informal character creation that takes place in the living room mimics the clinical process. “Players can also imaginatively explore alternative identities through their characters,” Snodgrass explained. “We anticipated that such a process might contribute to the therapeutic aspects of the game by helping players improve their self-awareness.”
To explore these psychological dynamics, researchers collected data from North American gamers using a combination of surveys and in-depth interviews. The study involved 149 people with an average age of about 30 years. The sample was mostly male, which reflects the historical demographics of many gaming communities.
Within this study group, 31% primarily played tabletop role-playing games. An additional 20% played digital role-playing video games. The remaining 49% played other types of video games, such as competitive multiplayer games or first-person shooters.
The survey asked participants to describe their relationships with key game characters. Players categorized their characters as mere objects on the screen, direct extensions of themselves, symbiotes in which the player and character shared a blended identity, or completely separate entities. Participants also answered 25 questions designed to measure recent improvements in overall self-concept.
These questions assess psychological needs such as self-esteem, a sense of belonging, and a sense that one’s life has meaning. The study also tracked self-efficacy, which is a person’s belief in their ability to achieve a goal. Additional survey questions measured how much social support players felt regarding their gaming hobby.
The researchers also measured absorption capacity, the natural tendency of humans to become deeply immersed in imaginative experiences and lose track of time. Finally, the study tracked the number of hours each person played games in a typical week. Alongside the study, the scientists conducted three interviews with a total of 54 role-playing game enthusiasts between late 2021 and early 2025.
This data reveals that the type of bond a player forms with a character is strongly linked to positive psychological benefits. Players who viewed their character as a symbiote or another person reported significantly improved self-concept. This was compared to players treating characters as simple objects or tools to achieve a winning score.
Snodgrass summarized the key takeaways from these results. “Forming highly personalized bonds with imaginary characters in tabletop role-playing game settings can improve players’ sense of self in the real world,” he said. “Such play is therefore similar to clinical approaches such as drama therapy, where patients project themselves into imaginary situations or stories with the aim of clarifying and potentially resolving emotional and other conflicts.”
Players of tabletop games tend to perceive more identity benefits than players of other game genres. Data shows that this benefit occurs because tabletop games naturally encourage players to form deeper emotional bonds with their characters. Digital games often limit the extent to which players can customize their digital avatars, which can limit emotional connection.
The interviews provided rich context to support these findings, particularly with vulnerable populations. “The therapeutic process we examine appears to be particularly important for players facing identity threats,” Snodgrass said. “This includes marginalized players such as queer gamers and anyone who questions or wants to explore alternative gender identities.”
By enacting the lives of complex characters, players were able to experience what psychologists call bleedout, the emotional lessons learned in games that translate into real life. However, Snodgrass emphasized that the environment must be supportive. “Creating a safe play space for such activities is critical to achieving the therapeutic effects described in our study,” he said.
Many participants stated that caring for a fictional character and guiding them through their challenges made them feel more capable and compassionate in their own lives. Some players have intentionally created characters that embody traits they dislike about themselves. Role-playing as these flawed characters allowed players to develop greater self-compassion.
Other interviewees described how long-term gaming campaigns created a deep sense of social continuity. Groups focused on collaborative storytelling often stayed together for decades. These shared imaginative experiences helped players build lifelong friendships, share parenting responsibilities, and foster a deep sense of belonging.
As with all studies, there are some limitations to keep in mind. The study is based on self-reported data, which means participants are estimating their own psychological growth. Regarding clinical applications, Snodgrass cautioned that “the use of tabletop role-playing games in therapeutic settings requires a degree of cultural familiarity and acceptance of such forms of play, as well as collaboration with patients themselves who are open to such experiences.”
In the future, scientists plan to investigate other psychological benefits of gaming. “My collaborators and I are currently aiming to understand how such forms of play can help train positive stress coping and emotional regulation through simulations of encountering and resolving stressors, such as the threat of violence or social conflict,” Snodgrass said. “We also hope to further clarify the role cultural factors play in these processes through comparisons of such play in different settings around the world.”
The study, “Tabletop Role-Playing Games as Wild Drama Therapy: Developing Personal Bonds with Characters Improves Players’ Self-Concept,” was authored by Jeffrey G. Snodgrass, Seth I. Sagstetter, Choeeta Chakrabarti, Julia R. Branstrator, Katya Xinyi Zhao, Michael G. Lacy, HJ François Dengah II, and Aimee. Wagner, Alessandro Giardina, and Joel Bilyeu.
