Exploring the efficacy of cognitive behavioral therapy and role-playing games as an intervention for adults with social anxiety

ABSTRACT Tabletop role-playing games (TTRPGs) have increased in popularity as a hobby and allows multiple people to play together online or in person. Group activities such as TTRPGs have been used to improve social skills and mental well-being Although there is qualitative and anecdotal studies and reports about the efficacy of the therapeutic application of TTRPGs, no related studies have employed quantitative measures or mental health screening tools. This study explored whether intentionally introduced cognitive behavioral therapy (CBT) delivered through the medium of TTRPG groups could positively affect social skills, reduce anxiety symptoms and behaviors, and enhance the mental well-being of participants. Data was collected from May 2020 to February 2021 using the Social Phobia Inventory, Generalized Anxiety Disorder Assessment, Social Skills Inventory, and Group Satisfaction Scale and debriefs with participants. The study was completed virtually. All the groups showed an average decrease in self-reported anxiety; one of the therapeutic TTRPG groups decreased in self-reported social anxiety, while the others remained the same. All of them showed improved social skill scores and the participants were very satisfied with the overall group experience, thus suggesting that their needs were met.