------------------------------------------------------------------ Playability Podcast Episode 36: Therapeutic Gaming (Emma Carlson) Run time: 12 minutes, 34 seconds Episode recorded by Rebecca Strang. Playability is produced by Mike Risley. Transcript auto-generated by Temi and edited by Rebecca Strang. ------------------------------------------------------------------ Intro Music: 00:00 Rebecca Strang: 00:09 Hello and welcome to Playability where we hold conversations at the crossroads of gameplay and accessibility. I'm your host, Rebecca Strang, and I'm joined today by Emma Carlson. Emma is a clinical therapist in British Columbia. She got her Bachelor of Science in behavioral neuroscience from Simon Fraser University and her master's in counseling psychology from University of British Columbia. Today we'll be discussing how and why she uses tabletop gaming as a therapy tool. Welcome to the show. Emma. Emma Carlson: 00:38 Thank you so much for having me, Rebecca. I'm so happy to be here. Rebecca Strang: 00:41 Yeah, I'm very excited to talk about this topic with you. So first, could you tell us a bit about your therapy practice, um, who you typically are assisting and the counseling topics you specialize in? Emma Carlson: 00:54 Absolutely. So I kind of work in two different domains as of this point. For most of my career I've been working with high risk young folks. Um, so we're, I'm working primarily with young folks who are engaging in what I would call risky behaviors. So suicidality, non-suicidal self-injury, substance use, as well as risky sex behaviors and other things are surrounding impulsivity. Basically these folks are having a really hard time coping. Um, and are using kind of dangerous methods to try and regulate themselves? I also work with other, some other young folks who are, um, with kind of more general anxiety and depression, but most of my work is engaged with young folks at this point. New Speaker: 01:34 Okay. And what are some of the more traditional tools that you've used in your therapy practice? Emma Carlson: 01:40 Oh, I loved dialectical behavior therapy. Um, I could talk your ear off about it. Um, so I've been working with DBT for a couple of years now. I find it's one of the most effective tools to working with young people as it's just really accessible and I really liked that it treats everyone like they're very capable human beings of, able to, you know, to engage in their own type of regulation and just really kind of get on board with their own ways towards caring for themselves. Um, I also use, because I do a lot of grief therapy with folks, I use solution focused therapy as well as motivational interviewing. And then just good old CBT. Rebecca Strang: 02:11 Okay, great. And, um, I know that you are also using tabletop role playing games as a therapy tool. So how did you get started doing that in your practice? Emma Carlson: 02:21 Oh man. I think it kind of happened when, about two years ago when I realized that the worlds of me being a therapist and the worlds with me being someone who loved tabletop gaming were one in the same. And then I found that my clients actually enjoyed gaming kind of more generally, whether that's video games or board games. And so I thought, well why not bring these two together? Why not marry these two topics that I love so much? And so I began foraying into it kind of very carefully and I'm doing my research, uh, into the kind of more academic side of RPGs and found I wasn't the only one. There are a lot of folks out there using RPGs in some way, shape or form to work with their clients in a therapeutic manner. So I, I really wanted to see if this would work with high risk kids as well as just the younger folks in general. So yeah. So I started by running some games for clients I was working with and I got some really good feedback that like, "Hey, this is really fun. We really enjoyed it." And then began to foray not only into the group side but the individual work as well. So using like RPGs and character development as a tool for individual therapy, too. Rebecca Strang: 03:30 Great. And so what are some of the things about the format of role playing games that makes it particularly accessible as a tool for therapy? Emma Carlson: 03:38 It's really easy. There's very little setup that you have to do other than kind of any, any setup that is done it, it's more the traditional like character building set up for at least for the client. So you're helping them create a character or you know, they're creating a character if they have some experience with RPGs, regardless of the system you're using, that is often an analogy or an analog of themselves. They're putting so much of themselves into it, especially if it's kind of the first character or the first time they've ever done this. So they're really infusing a lot of themselves and that's like strengths and flaws as well. You often find that often comes out in the game and they're able to kind of really bring themselves to the table. They bring themselves in some way, shape or form into the game. And it's, it's really quite cool to see. Another thing is that it's, it's this essence of fantasy escapism. So you get to step outside yourself, um, and you get to almost like check yourself at the door and then you get to step into this wonderful character who maybe is the very best version of you that you don't get to access in everyday life, that there is maybe no way, shape or form you could ever be or the, you know, environment that you sur are surrounded with, you can never become that person. And also like magic and stuff like that. So being able to kind of have all of these wonderful things that they get to do can really provide a sense of like self confidence and uh, it's accessible and it gives you a sense of like accomplishment. They get to do something and complete something and be proud of themselves for it. It's really cool. Rebecca Strang: 05:12 Yeah. And I imagine it's also, um, I mean games in general, it can be a great icebreaker. So for someone who might be hesitant about stepping into therapy, especially young folks and kids, it's probably a great way for you to engage with them at the beginning and, especially if they're already familiar with, with role playing games, making that transition a little easier. Emma Carlson: 05:34 Absolutely. And also it makes group settings a lot easier cause it's a structured, purposeful reason that a bunch of people are going to be sitting down at a table for, you know, some extended period of time. And that they're not worried so much about being embarrassed because everyone's, you know, talking about all the spells they're casting or all the abilities they have or the, you know, the, the ways they're going to try and this problem. So it's very much a, a structured kind of engaged format that no one really has to worry so much about being embarrassed. Rebecca Strang: 06:05 Sure. And then, so how do you go about tailoring a game to target specific topics or skills? Emma Carlson: 06:12 Mmm. It's uh, oh, it can be so hard. Um. you really almost have to consider the challenges and the, and the strengths of each of those clients and kind of how they play together. Especially if you're, you know, if you're working with a group, um, I run some a game or two for a group that I know each other very well. They are quite integrated with each other, they play hockey together, all this kind of stuff. So it's very easy for that group that you can just kind of sit down and go. But for clients who may not know each other, this is a brand new avenue for them and there's always like that social pressure of wanting to fit in and to do well and, and be okay. So you kinda need to consider how these, you know, strengths and challenges that everyone is facing will play together and also make sure that every client has a moment where they get to feel special. They get to feel like they're the star of the story, um, and the hero and the hero. Because I think at the end of the day, that's what everyone wants is to be the hero in their own story. And a lot of the times I find that, yeah, the clients that I work with particularly are sometimes feel like just background characters in the story of their life. So it's really about allowing them that hero, you know, moment and realizing that that hero like lives within themselves in an ongoing basis. And a lot of the time I'm creating encounters or creating scenarios that really focus on distress tolerance. Um, so if something is difficult, like how long can we prolong that difficulty before things get really bad? Um, conflict resolution. So presenting them with a challenge or maybe like an inter-party conflict as well as just like standard problem-solving, looking for alternative ways or lateral thinking ways that would work solving a problem. Rebecca Strang: 07:47 Sure. And what systems do you use in your sessions? Emma Carlson: 07:52 I'm a, like, a hardcore D&D fan. Um, I really, I've played some D&D with my dad when I was quite young, so that would've been probably second or third edition. But when fifth edition came out, um, I hadn't played in years and a group of friends of mine got together and said, "Hey, like, do you want to be involved in this game?" And I said, "Yes, please. I have been waiting for so long." Uh, so I've been playing pretty much 5E mostly for over the last couple of years and using 5E within my therapeutic practice just because I know the system really well. But that's not to say that there isn't other RPG systems that are very, very utilizable for, um, for therapeutic. And so say you have a group that could be a bit more okay with say a more kind of like dystopian horror setting like Call of Cthulhu would be quite wonderful to use as well. There's also some like simpler systems. Um, I really like Grant Howitt's kind of one shot or one page RPGs, they're super accessible. You can kind of throw them down in front of a bunch of people, great characters super quick and get on the go. So those ones are kind of the ones that I will go to first and foremost. Rebecca Strang: 08:56 That's awesome. Yeah. And sometimes even just the process of creating the character, even if you don't ever play them, just going through that process can be therapeutic in itself. Emma Carlson: 09:05 Yes, absolutely. It, it really allows you to like create this person who is both separate from you and a part of you. I even find that with myself when I'm creating the characters that I have. There are moments where I'm like, "Oh that's, that's, you know, such a," one of my characters is named Serin and it's like, "Oh, that's such a Serin thing that I'm doing right now." Or "Oh, that's such a Napen," one of my characters is Napentha, like, "Oh, one of the, that's a Napentha thing that I'm doing right now." So I find that's the really wonderful thing with the individual component of therapy. You can often ask your clients like, "What would your character do in this moment? You're having a really hard time with this process. So your character, who is this, you know, superstar version of you, the superhero version of you with all of these other abilities and skills and accomplishments, what would they do if put in this exact same situation that you're in right now?" And it's a fantastic way to get them to think like, "Oh yeah, maybe I actually do have the skills because I am this person as well." Rebecca Strang: 10:01 Yeah, that's great. And so what kind of feedback have you been getting from clients who are participating in these sessions? Emma Carlson: 10:08 A lot of the times they didn't know it was therapeutic until we actually finished. They thought like, :Oh, this is the fun thing we're doing." And then I ex, you know, explaining the, the therapy kind of components of it. It's like, you know, I'm challenging you folks to work together and especially if there's been a lot of times you, I've done this group with kids who were quite socially anxious, um, and might have had difficulties being around other people and at the end of it they're all joking together and laughing together and they're like, "Oh, this is really fun. We didn't know therapy, especially group therapy could be fun." Um, and it's a very non-traditional way to engage a bunch of people who might not otherwise have access to RPGs or like therapy that much. So I get really positive feedback about it for those who engage. Rebecca Strang: 10:53 That's great. And I, I imagine that's, you know, equally rewarding for you to see people who may have been hesitant to come into therapy and then they're doing these group or individual sessions and benefiting from it and really loving it like that. Emma Carlson: 11:05 Yeah. And then I hear that they're going to go and do like create their own games or it is inspired them to, if they had played RPGs before to start writing a campaign again or to start, you know, getting involved in games. Whereas, you know, maybe there they'd been, they felt like they hadn't been, you know, weren't able to be involved because of some of the symptoms of depression and anxiety or whatever that they had been experiencing. So that to me is one of the most heartwarming things when I hear that they're getting back into something that they loved so much that has been distant from them for so long. Rebecca Strang: 11:36 Yeah. That's amazing. Ah, so if anyone would like to connect with you to discuss this topic or get some resources from you, where can they reach you? Emma Carlson: 11:47 Uh, yeah, you're welcome to contact me via email. My email is EmmaCarlsonCounselling, so that's the, I guess Canadian or British way of spelling counseling, so C O U N S E L L I N G at gmail.com [EmmaCarlsonCounselling@gmail.com]. And you're also welcome to find me in the Tabletop Therapist's group on Facebook where I am one of the moderators. Rebecca Strang: 12:06 Awesome. And then if anybody has any questions or comments they'd like to share with us, you can email us at playabilitypod@gmail.com and find us on social media platforms @playabilitypod. Emma, it's been great to have you on and learn a little bit about tabletop therapy. Emma Carlson: 12:24 Fantastic. Thank you so much for having me, Rebecca. So, so fun. Thank you. Rebecca Strang: 12:28 Great. And thanks everybody for listening. I hope this episode helps you play with a new perspective.