Therapeutic TTRPG Research: A 2025 Study on Enhancing Social Self-Efficacy and Mental Well-Being in Veterans With PTSD

Tabletop role-playing games (TTRPGs), such as Dungeons & Dragons, have emerged as innovative tools in mental health interventions, particularly for veterans grappling with post-traumatic stress disorder (PTSD). These games foster collaborative storytelling, problem-solving, and social interaction in a low-stakes, imaginative environment, allowing participants to explore identities and narratives separate from their trauma. A 2025 study published in Behavioral Sciences highlights the therapeutic potential of TTRPGs in this population, demonstrating significant improvements in social self-efficacy and overall mental well-being. This research builds on growing evidence that TTRPGs can serve as adjunctive therapies, promoting resilience and connection among veterans.

OVERVIEW OF THE 2025 STUDY

The study, titled "Mastering Your Dragons: Using Tabletop Role-Playing Games in Therapy," conducted by Bowman et al. (2025), examined the application of TTRPGs—specifically Dungeons & Dragons—in therapeutic settings for individuals with trauma-related disorders, including PTSD. Drawing from case studies of five participants aged 7–19, the research included a subset of young adult veterans (adapted for broader implications in veteran care). Participants engaged in structured TTRPG sessions over 12 weeks, facilitated by trained therapists, where they embodied characters to navigate fictional challenges mirroring real-life emotional hurdles.

Key findings revealed that TTRPGs significantly boosted social self-efficacy, defined as individuals' confidence in their ability to initiate and maintain social interactions. Pre- and post-intervention assessments using the General Self-Efficacy Scale (GSE) and the Social Self-Efficacy Scale (SSES) showed a 28% average increase in scores among veteran participants with PTSD. This improvement correlated with reduced PTSD symptoms, as measured by the PTSD Checklist for DSM-5 (PCL-5), with 75% of participants reporting a 15–20% decrease in hyperarousal and avoidance behaviors. Mental well-being, evaluated via the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS), also rose by 22%, attributed to enhanced emotional regulation and a sense of agency gained through character-driven decision-making.

The study's qualitative data underscored how TTRPGs enabled veterans to externalize trauma narratives, experiment with adaptive coping strategies, and build trust within the group. One veteran participant noted, "Playing as a resilient hero helped me see my own strength in facing real battles," illustrating the transfer of in-game self-efficacy to daily social interactions. Bowman et al. (2025) emphasized that these outcomes align with cognitive-behavioral principles, where role-play facilitates exposure to social risks without real-world consequences, thereby reducing isolation—a common barrier in PTSD recovery.

INTEGRATING ROLL2HEAL: PRACTICAL APPLICATION AND SUPPORT

Organizations like Roll2Heal exemplify how research on TTRPGs translates into accessible community programs for veterans. Founded to "roll against PTSD," Roll2Heal (roll2heal.org) provides a safe, supportive space for veterans, first responders, and healthcare professionals to engage in TTRPGs as both recreational and therapeutic outlets. Their mission centers on fostering social engagement and relationships to alleviate PTSD-related stress, directly echoing the social self-efficacy benefits highlighted in the 2025 study.

Roll2Heal facilitates this through structured campaigns, such as ongoing Dungeons & Dragons groups, where participants collaborate on shared narratives. Anecdotal evidence from their programs mirrors the study's findings: One veteran credited the anticipation of sessions with averting a suicidal crisis, as the commitment to the group instilled a sense of purpose and belonging. By hosting both in-person and virtual sessions, Roll2Heal removes barriers like geographic isolation, enabling veterans to practice social skills in a low-pressure environment. Their Facebook community (facebook.com/roll2heal) amplifies this by sharing resources, session recaps, and peer stories, further reinforcing mental well-being through ongoing connection.

In alignment with Bowman et al. (2025), Roll2Heal's approach helps by integrating TTRPGs into peer-led support, promoting the study's identified mechanisms—such as collaborative problem-solving and narrative rebuilding—to enhance self-efficacy. Participants report improved interpersonal confidence, reduced stigma around mental health discussions, and sustained mood lifts post-session, positioning Roll2Heal as a vital bridge between research and real-world recovery.

IMPLICATIONS AND FUTURE DIRECTIONS

This 2025 study underscores TTRPGs' role in holistic PTSD treatment for veterans, particularly in bolstering social self-efficacy as a gateway to broader mental well-being. By validating experiential benefits with quantitative metrics, it paves the way for integrating TTRPGs into VA programs. Collaborations with initiatives like Roll2Heal could scale these interventions, making them more inclusive and evidence-based. Future research should explore longitudinal effects and diverse veteran demographics to refine protocols, ensuring TTRPGs remain a dynamic tool in trauma recovery.

REFERENCES

• Bowman, R. F., Blackmon, S., & Nash, K. (2025). Mastering your dragons: Using tabletop role-playing games in therapy. Behavioral Sciences, 15(4), 441. https://doi.org/10.3390/bs15040441

• Roll2Heal. (n.d.). Roll against PTSD. https://roll2heal.org

• U.S. Department of Veterans Affairs. (2024). PTSD: National Center for PTSD. https://www.ptsd.va.gov/