Therapeutic Use of Role-Playing Game (RPG) in Mental Health: A Scoping Review

Abstract

Background Role-playing game (RPG) is a term that covers a series of forms and styles of games that involve, in some way, the creation, representation and progression of characters who interact in a fictional world under a system of structured rules. Its applications and effects on human behavior and mental health are, however, still an underexplored area. Methods A scoping review was performed on the literature about RPGs as a therapeutic tool or prevention strategy in psychotherapies and mental health, highlighting studies’ populations, forms of RPG and interventions used. To that, a systematic search in the PubMed/MEDLINE, Embase, PsycINFO, BVS/LILACS databases and grey literature was performed. Results Of the 4,069 studies reviewed, 50 sources of evidence were included. The majority was published as of 2011 (78%) in journals (62%) and targeted therapeutic uses of RPGs (84%). Most interventions used computer (50%) or tabletop RPGs (44%), mostly with cognitive and/or behavioral (52%) therapeutical approaches and targeting adolescents (70%). Conclusion The findings suggest a potential use of RPGs as a complementary tool in psychotherapies. However, only 16% of the studies included were experimental. We identified considerable heterogeneity in RPGs definitions, outcomes and interventions used, preventing a systematic review. Thus, more empirical and well-designed studies on the application of RPGs in mental health are needed.