Board Games as Play Therapy for Adults

Connection, growth, and healing… around a table

“Play isn’t the opposite of work—it’s the opposite of stuck.”

Why therapists are leaning into games

Board games (and tabletop role-playing games like Dungeons & Dragons) give adults a structured, low-risk space to practice real skills: flexible thinking, emotion regulation, social problem-solving, and asking for help. A large systematic review found that board-game interventions improve knowledge and motivation, enhance interpersonal interactions, and can even reduce symptoms tied to ADHD, anxiety, and cognitive decline. PMCPubMed

Another review and scoping paper surveying “board games for health” reported outcomes across social functioning, anxiety, and executive functioning, while also noting study-quality caveats—useful context when we set expectations with clients. UCL Discovery

Clinician takeaway: Games are not “just for kids.” They’re experiential tools that can make therapy stick.

How games disrupt unhelpful patterns

Most games ask us to plan, adapt, tolerate uncertainty, and cooperate. That nudges clients out of rumination and into the present—often into a mindful “flow” state—while they practice turn-taking, frustration tolerance, and repair after conflict. Findings across aging and rehab populations echo benefits for attention, mobility, balance, and cognition when programs combine light physical engagement with cognitively demanding board play. journalmsr.com

Group dynamics you can feel

Therapeutic game tables function like social microcosms. You see live patterns (pleasing, dominating, withdrawing, “rules lawyering”) and you can coach in the moment. In tabletop RPGs specifically, emerging evidence (plus clinician training ecosystems such as Game to Grow and Geek Therapeutics) highlights gains in social skills and anxiety reduction—with or without explicit CBT overlays. Harrisburg UniversityTaylor & Francis OnlineWIREDgametogrow.org

Why this lands with many men: Narrative teamwork and problem-solving create a safe, concrete path to share feelings and ask for support—without the pressure of “performing therapy.” WIRED

Facing fears in a fictional world (that still changes the real one)

A skilled Dungeon Master can weave client-named fears into the story for symbolic exposure: social rejection becomes a guild trial; loss of control becomes a cursed item only lifted by asking for help. Players earn “mastery reps” in metaphor—and often carry that competence back into life. Popular press coverage has documented how trained clinicians apply TTRPGs to trauma processing, identity exploration, and autism-related social goals. WIRED

Brain health, connection, and aging

For older adults, gameplay is a two-for-one: cognitive stimulation and social engagement. Reporting on recent gerontology research, coverage has highlighted trials where twice-weekly board-game sessions were linked with improvements in memory, attention, comprehension, and quality-of-life—alongside broader evidence that socially engaging strategy games (Chess, Scrabble, Mah-jong) are associated with lower dementia risk. While not definitive, the signal is promising and the intervention is low-risk and enjoyable. The Washington Post

“Face-to-face play combats isolation and gives the brain a social workout—arguably as important as the strategic one.” The Washington Post

How I integrate board games in therapy

• Group cohesion: Cooperative titles (e.g., Sky Team, Forbidden Island) to strengthen prosocial communication and shared problem-solving. (Targets: turn-taking, perspective-taking, repair.)

• Executive function reps: Modern strategy games with short cycles (e.g., Splendor, Duel) to practice planning, inhibition, and error recovery. (Targets: cognitive flexibility, frustration tolerance.) Findings from educational and EF-focused studies support this skill framing. ScienceDirectPMC

• Narrative exposure: TTRPG one-shots tailored to goals (e.g., social risk-taking, boundary setting), with informed consent and clear safety tools (lines/veils, X-card). Training communities for clinicians exist. WIREDgametogrow.org

• Aging-well groups: Light, social strategy (Ticket to Ride, Tapple, Catan) to pair cognitive challenge with belonging, aligned with aging research signals. The Washington Post

Tips for clients: playful “home practice”

Want to try this between sessions? Keep it light, social, and repeatable.

1. Five-Turn Challenge
   Pick any short game (Monopoly, No Mercy Uno, Sushi Go!). After each of your first five turns, say out loud: USE ORID

• What just happened? (Objective)

• What do I feel? (Reflective)

• What does this say about us or our group? (Interpretive)

• What do I want to do the same or what will I change? (Decisional)

1. Ask-for-Help Token
   In a co-op game, give yourself one physical token each round. You must spend it to ask for help at least once (rules question, idea, resource). Practice receiving help without apologizing.

2. Reframe the Miss
   When a plan fails, name one of each before your next move:

• One thing I controlled (decision),

• One thing I didn’t (dice/event),

• One thing I’ll try now (adjustment).
  You’re building frustration tolerance and cognitive flexibility.

• Role-Play a Micro-Risk (TTRPG or story game)
  Choose a tiny social risk your character will take (e.g., ask an NPC for support, set a boundary, give a compliment). After the scene, reflect: What felt hard? What went better than expected? That’s exposure—safely.

• Connection Quest
  Before game night, set a connection goal or a BINGO card (e.g., learn two new things about someone at the table; offer one genuine “good play” comment each round). You’re practicing prosocial behavior on purpose.

• Two-Minute Wind-Down
  Post-game, everyone shares:

• a moment they enjoyed,

• a moment they handled frustration,

• one thing they appreciated about another player.
  Brief reflection consolidates gains—and feels good.