VA North Texas group therapy uses storytelling… and dragons

Jamie Ferguson had never played the table-top role-playing game, Dungeons & Dragons, until it was offered to her at VA North Texas almost a year ago.

U.S. Navy Veteran Jamie Ferguson plays a game of Dungeons & Dragons during a therapy group held at Dallas VA Medical Center.

Ferguson is one of a handful of Veterans at Dallas VA Medical Center who attend a weekly group to play the interactive storytelling game, led by Psychologist Jared Kilmer, also known in the group by DM or Dungeon Master, as treatment for mental health diagnoses.

“I went into the group with an open mind,” said Ferguson, a U.S. Navy Veteran. “I wanted to see what is was all about, and maybe I would like it.”

Dr. Kilmer started the role-playing group at the Dallas VA Medical Center in 2018 as an alternative to traditional group therapy. He believes D&D helps Veterans focus on social skills, problem solving skills, stress tolerance and perspective taking.

“The VA offers many therapies, but for those Veterans who are uninterested in the traditional group format or may have tried it and bounced off it for one reason or another, this version works,” said Kilmer. “This alternative approach gets at the same treatment goals in a way that is approachable to the Veterans.”

Players in the game create their own character by choosing a race, class, background, personality and moral alignment. They also select a name, age and physical characteristics as they begin their story adventure into the game.

“One Veteran realized through her actions in the game she is very much afraid of failure and she was able to extrapolate what that meant in her character,” said Kilmer. “She saw how she approaches interactions with others in her life and how her freezing up in critical moments was related to that fear. Acknowledging and gaining that insight, she changed the way she started approaching fictional events in the game and changed the way she started approaching real life events.”

Kilmer sees a lot of impulse choices with members in his group, especially among Veterans with a diagnosis of PTSD. While playing the game, some players will kick open doors or run into a trapped room, and at the end of the group they will talk through their decisions, process what happened and what they could have done differently.

A character creation outline sheet is held up during a game of Dungeons & Dragons during a therapy group held at Dallas VA Medical Center.

“One of the big things I hear back from Veterans is impulse control,” said Kilmer. “You can see the light turn on and they will speak to it and say they are doing those actions without thinking them through or checking in with other people.”

Kilmer saw confidence and leadership skills develop in Ferguson, while other Veterans displayed stronger social skills and the ability to work together in a group.

“I always thought I can’t do this, or I can’t do that, because I’m always worried about what other people think and what they are going to say,” said Ferguson. “This group has helped me venture out and get out of my comfort zone.”

Story and Photograph by Jennifer Roy, public affairs specialist with the VA North Texas Health Care System.