Bringing Tabletop Games Into Therapy: Intro and Engagement

Last weekend I attended one of my favorite board gaming events ever. The event was Gamefest 22, held here in Atlanta, Ga. It was a gathering of 300 or more hobby gamers and had perhaps some 1000+ games for attendees to play. Most people outside of the hobby sphere have very little idea that these events happen or that they are growing in popularity. But hobby gaming is growing and with that growth comes a new influx of ideas, new people, larger social gatherings, and more opportunities to learn what it is that attracts us to board gaming. 

Atlanta Game Fest 20

For my part, I have been gaming since I was a child. Perhaps not the sophisticated cadre of games that was available at this game gathering, but I knew well the names of Milton Bradey, Hasbro, and Parker Brothers at a very early age. My best friend had a huge closet of games; anything from the McDonald’s game (in which you developed your McDonald’s business by selling food and staying ahead of your opponent, to Payday (a game geared more towards the realities of paying bills and developing budgeting skills), and my family (particularly my mother) played games with me constantly. 

So perhaps it should come as no surprise that I have stayed involved in the universe of board games since that time. That said, through media outlets such as the Tabletop program on Geek and Sundry, and podcasts such as those within the Dice Tower network of podcasts, I have gotten considerably deeper into the board gaming universe. What I have found is an amazing amalgam of friendly and welcoming people all dedicated to the hobby of board gaming. People who plan their weeks around when they come together in friendly rivalry, face one another across the table, and plot strategies for increasing victory points or winning conditions. 

Bringing Tabletop Games Into Therapy

As a therapist and as a member of the community, I believe this needs further consideration. What drives the hobby gamer to develop in the hobby? What social and cognitive benefits are there to be gained from getting involved in this wonderful and geeky pastime? In the next year or so I intend to find out, report, and speculate on the benefits of gaming. Furthermore, I intend to offer a forum for using board games both in therapy and within our own social groups. Sometimes I will offer such an in-depth perspective about specific games, others I will look for trends in gaming, as well as the mechanics behind gaming and ultimately define the key ingredients that make playing games not only fun, but an intellectually and psychologically stimulating pursuit that makes each of us as players better people for engaging in games.

For the moment, I want to focus on how games can be used in therapy. As a therapist, I am often seeking innovative interventions to use in therapy. Far too often our media has demonized the therapy process and made it look like an invasive and manipulative program. Families and individuals who have come to therapy by way of juvenile justice and protective services often see therapy as yet another encroachment into their space. It is not easy to put a positive spin on required services. Especially when the therapist espouses a free will dictate; therapy is a choice, and the state offers a “you’ll do this, or else” philosophy. In other more community-based therapy offices, it is expected that you can walk into the room, get therapized and walk out. This version of the public sees therapy as mechanics for the soul and psyche. They are looking for the therapist to work magic tricks and weave psychological spells. There are certainly many reasons that a client ends up on the couch so to speak, but from the therapists perspective, trying to balance all of these different motivations and requirements can be daunting. Games can help manage these responsibilities.

“It is not easy to put a positive spin on required services.”


Engagement has become the key word in therapeutic practice. Our ability to effect change in our clients hinges specifically on building a relationship of trust so that clients can feel free to express themselves. Many researchers agree that a high percentage of therapy rests on the ability to develop rapport. We build rapport by meeting clients where they are. This of course means that not all families will have the same needs. We will need to tailor our approach to the families and clients we serve. However, almost all clients will have some previous relationship to games. Whether they have played only Uno or Monopoly, most people have played games and this makes the use of games an easy engagement tool, provided they were not previously traumatized by the Park Place/Boardwalk hotel business. This means that games are rife with potential for developing relationships with others. 

Multiple games can be used in the engagement process. In fact, there are so many good games with which to develop engagement that I cannot list them all for you here. I can however suggest a template for using games in engagement and offer some off the beaten path games that may heighten client motivation and involvement with the therapy process. Let’s start with the template.

A Template

Having and offering clients access to games can make the first 1-2 sessions much easier for clients. Provided that you have determined that the clients are open to using games in therapy, this can be a good opportunity to help the clients share their own gaming passions. In that first session, a familiar game can become an anchor to making the session more comfortable for the client. Many of my clients have suggested Checkers, Chess, or Sorry as our first engagement game. In this first session, there is no need to abstract the game by adding new rules, or making the game “therapeutic” because the game is already therapeutic. It is in this moment a tool for developing the relationship. Have your client teach the game to you and do not hold tight to your own rule sets. In these early games, what matters is acknowledging the expertise of the client and accepting their world on their terms. This is not a space for interpretation, it is instead an invitation to be with someone authentically, engaged in their presence. That said, asking questions about rules and how rules play a part in the game is a great place to start the discussion of relationship to others. 

As the relationship develops, offering the client an opportunity to make their own rules, asking open ended questions about rules and the feelings that result when games go awry, or allowing the client to amend rules as they wish, serves not only as an engagement tool, but also as an assessment technique. Whatever you may think of games, if they are good games, they are self sustaining universes within the rules that are presented. They are an abstraction of reality. As we look into and identify the various rules and mechanics in the game, we can listen and observe reactions to in- game conflict. We can pose questions about how these rules in the game are reflective of the daily environments of our clients. We can acknowledge the abstraction by asking how daily rules play a part in successfully meeting personal goals (whether those goals are to do well in school, or to go out and play, etc). These are some of the many ways we can use games as engagement tools. 

I come to you all not as an expert, for I know very little about the scholarship behind this idea. I do however know that as a game player I am often confronted with a great many psychological dilemmas. If these challenges are so obvious to me, it stands to reason that others experience games in the same way. Whether conscious or unconscious, the motivations, frustrations, and strengths that become present during game play must come into contact with those mechanisms that nurture mental health. That will be my contention as I develop this topic. 

As I want this investigation to be informed by the community, I would love to hear stories from other therapists about how they use board games to engage and assess clients. I will suggest several newer games with which to engage clients in future posts.

5 thoughts on “Bringing Tabletop Games Into Therapy: Intro and Engagement”

  1. I love to use games to promote engagement and help the client feel they are being therapized. There are so many avenues and information that can be obtained from playing games and the client’s feel like this is not therapy. I love when I allow the client to set the rules and be the expert and teach me how they would like to play the games. I am welcome and open to this blog. thanks so much for sharing

  2. Thanks for participating in this discussion Heather. Would you be willing to share how you use games to engage and what you feel makes such an engagement tool effective?

  3. I’m a little late coming into this article, but it might be worth mentioning that I currently run a business in Seattle, WA that does just this thing. We use Tabletop games (like Dungeon’s and Dragons) to help teach social skills to teens. Often these kids have Asperger’s, Autism, or are generally lacking in social skill development.
    By running groups with Tabletop games we are about to make it a fun interactive space that often keeps these kids coming back again and again. It provides the perfect environment for these kids to continue to come to a social setting without being ostracized the way they often are in classes or in other group settings. I’ve heard from many of our client’s parents that this is the only group that they get excited to go to each week, and the only time when they are actually interacting positively with a group of their peers.
    It works amazingly well, and I’m looking to both build this business up as well as spread the word on doing this exact type of therapy intervention. I have seen a lot of value in this type of group, and I think there is a lot that you can do to expand on the model.

  4. Denisse Morales

    I am very late here, but I want to thank you for publishing this! I provide therapy to kids, teens, and adults. One of the first things I learned when I started to train in play therapy was the engagement of the “right brain” during play, which helps one to feel less inhibited, therefore more open in therapy. Games have definitely served as a great tool to build rapport and create a therapeutic bond. I am often surprised at how many kids tell me that they do not have tabletop games at home, so I will often suggest to parents that they go out and look for a board game that they can play together, and to pick a day of the week for family game night. It helps them create a stronger bond as a family as well 😀

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