Can playing Dungeons and Dragons be good for you? A registered exploratory pilot programme using offline tabletop role-playing games to mitigate social anxiety and reduce problematic involvement in multiplayer online video games

Gamers with poor self-concept, high social anxiety and high loneliness are more at risk of problematic involvement in video games, such as massively multiplayer online role-playing games. There is a research gap concerning treatment approaches to cater to socially anxious gamers with problematic pat...

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Main Authors: Joël Billieux, Loïs Fournier, Lucien Rochat, Iliyana Georgieva, Charlotte Eben, Marc Malmdorf Andersen, Daniel L. King, Olivier Simon, Yasser Khazaal, Andreas Lieberoth, Jonathan Bloch
Format: Article
Language:English
Published: The Royal Society 2025-04-01
Series:Royal Society Open Science
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Online Access:https://royalsocietypublishing.org/doi/10.1098/rsos.250273
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author Joël Billieux
Loïs Fournier
Lucien Rochat
Iliyana Georgieva
Charlotte Eben
Marc Malmdorf Andersen
Daniel L. King
Olivier Simon
Yasser Khazaal
Andreas Lieberoth
Jonathan Bloch
author_facet Joël Billieux
Loïs Fournier
Lucien Rochat
Iliyana Georgieva
Charlotte Eben
Marc Malmdorf Andersen
Daniel L. King
Olivier Simon
Yasser Khazaal
Andreas Lieberoth
Jonathan Bloch
author_sort Joël Billieux
collection DOAJ
description Gamers with poor self-concept, high social anxiety and high loneliness are more at risk of problematic involvement in video games, such as massively multiplayer online role-playing games. There is a research gap concerning treatment approaches to cater to socially anxious gamers with problematic patterns of gaming involvement. This registered exploratory pilot programme tests the feasibility and initial effect of a structured protocol in which socially anxious online gamers are exposed to real-life social interactions while playing an offline tabletop role-playing game (TTRPG). Our structured protocol lasted 10 weeks and involved 10 sessions organized into three modules in which participants played a TTRPG inspired by the game ‘Dungeons and Dragons’. Each module deployed a role-playing scenario designed to challenge the players in game terms and involve them in a story based on maturing relationships with other characters and solving challenges by social means and investigation. Our study used a quasi-experimental multiple single-case design with a three-week baseline across groups (four groups of five gamers with sub-clinical problematic video game use and social anxiety) and a three-month follow-up. Primary outcomes were time spent gaming, gaming disorder symptoms and social anxiety symptoms. Secondary outcomes were assertiveness/social skills, self-concepts and perceived loneliness. In terms of feasibility, we observed that most participants completed the programme (two of the 20 participants dropped out) and were involved in terms of participation and weekly psychometric assessments. Moreover, participants were largely able to attain the progressively more difficult objectives implemented in the TTRPG programme. Multiple single-case analyses showed that most participants benefited from the intervention through a reduction in social anxiety symptoms and problematic gaming symptoms, although to varying degrees. Some participants also reduced their gaming time or presented with reduced perceived loneliness. Assertiveness and self-concepts were not improved. This pilot study shows that a TTRPG intervention approach is feasible and may be used to reduce social anxiety and gaming disorder symptoms. The present programme must now be tested with clinical participants.
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spelling doaj-art-b3d24f751d2e44ae8c07bcc062d326d42025-08-20T03:05:11ZengThe Royal SocietyRoyal Society Open Science2054-57032025-04-0112410.1098/rsos.250273Can playing Dungeons and Dragons be good for you? A registered exploratory pilot programme using offline tabletop role-playing games to mitigate social anxiety and reduce problematic involvement in multiplayer online video gamesJoël Billieux0Loïs Fournier1Lucien Rochat2Iliyana Georgieva3Charlotte Eben4Marc Malmdorf Andersen5Daniel L. King6Olivier Simon7Yasser Khazaal8Andreas Lieberoth9Jonathan Bloch10Institute of Psychology, University of Lausanne , Lausanne, SwitzerlandInstitute of Psychology, University of Lausanne , Lausanne, SwitzerlandSpecialized Facility in Behavioral Addiction ReConnecte, Department of Mental Health and Psychiatry, Geneva University Hospitals (HUG) , Geneva, SwitzerlandInstitute of Psychology, University of Lausanne , Lausanne, SwitzerlandCentre for Gambling Research at UBC, Department of Psychology, University of British Columbia , Vancouver, CanadaInteracting Minds Centre, School of Culture and Society, Aarhus University , Aarhus, DenmarkCollege of Education, Psychology and Social Work, Flinders University , Adelaide, AustraliaCenter for Excessive Gambling, Addiction Medicine, Lausanne University Hospital (CHUV) , Lausanne, SwitzerlandCenter for Excessive Gambling, Addiction Medicine, Lausanne University Hospital (CHUV) , Lausanne, SwitzerlandInteracting Minds Centre, School of Culture and Society, Aarhus University , Aarhus, DenmarkInstitute of Psychology, University of Lausanne , Lausanne, SwitzerlandGamers with poor self-concept, high social anxiety and high loneliness are more at risk of problematic involvement in video games, such as massively multiplayer online role-playing games. There is a research gap concerning treatment approaches to cater to socially anxious gamers with problematic patterns of gaming involvement. This registered exploratory pilot programme tests the feasibility and initial effect of a structured protocol in which socially anxious online gamers are exposed to real-life social interactions while playing an offline tabletop role-playing game (TTRPG). Our structured protocol lasted 10 weeks and involved 10 sessions organized into three modules in which participants played a TTRPG inspired by the game ‘Dungeons and Dragons’. Each module deployed a role-playing scenario designed to challenge the players in game terms and involve them in a story based on maturing relationships with other characters and solving challenges by social means and investigation. Our study used a quasi-experimental multiple single-case design with a three-week baseline across groups (four groups of five gamers with sub-clinical problematic video game use and social anxiety) and a three-month follow-up. Primary outcomes were time spent gaming, gaming disorder symptoms and social anxiety symptoms. Secondary outcomes were assertiveness/social skills, self-concepts and perceived loneliness. In terms of feasibility, we observed that most participants completed the programme (two of the 20 participants dropped out) and were involved in terms of participation and weekly psychometric assessments. Moreover, participants were largely able to attain the progressively more difficult objectives implemented in the TTRPG programme. Multiple single-case analyses showed that most participants benefited from the intervention through a reduction in social anxiety symptoms and problematic gaming symptoms, although to varying degrees. Some participants also reduced their gaming time or presented with reduced perceived loneliness. Assertiveness and self-concepts were not improved. This pilot study shows that a TTRPG intervention approach is feasible and may be used to reduce social anxiety and gaming disorder symptoms. The present programme must now be tested with clinical participants.https://royalsocietypublishing.org/doi/10.1098/rsos.250273gaming disorderMMORPGproblematic gamingregistered reportrole-playing gamesocial anxiety treatment
spellingShingle Joël Billieux
Loïs Fournier
Lucien Rochat
Iliyana Georgieva
Charlotte Eben
Marc Malmdorf Andersen
Daniel L. King
Olivier Simon
Yasser Khazaal
Andreas Lieberoth
Jonathan Bloch
Can playing Dungeons and Dragons be good for you? A registered exploratory pilot programme using offline tabletop role-playing games to mitigate social anxiety and reduce problematic involvement in multiplayer online video games
Royal Society Open Science
gaming disorder
MMORPG
problematic gaming
registered report
role-playing game
social anxiety treatment
title Can playing Dungeons and Dragons be good for you? A registered exploratory pilot programme using offline tabletop role-playing games to mitigate social anxiety and reduce problematic involvement in multiplayer online video games
title_full Can playing Dungeons and Dragons be good for you? A registered exploratory pilot programme using offline tabletop role-playing games to mitigate social anxiety and reduce problematic involvement in multiplayer online video games
title_fullStr Can playing Dungeons and Dragons be good for you? A registered exploratory pilot programme using offline tabletop role-playing games to mitigate social anxiety and reduce problematic involvement in multiplayer online video games
title_full_unstemmed Can playing Dungeons and Dragons be good for you? A registered exploratory pilot programme using offline tabletop role-playing games to mitigate social anxiety and reduce problematic involvement in multiplayer online video games
title_short Can playing Dungeons and Dragons be good for you? A registered exploratory pilot programme using offline tabletop role-playing games to mitigate social anxiety and reduce problematic involvement in multiplayer online video games
title_sort can playing dungeons and dragons be good for you a registered exploratory pilot programme using offline tabletop role playing games to mitigate social anxiety and reduce problematic involvement in multiplayer online video games
topic gaming disorder
MMORPG
problematic gaming
registered report
role-playing game
social anxiety treatment
url https://royalsocietypublishing.org/doi/10.1098/rsos.250273
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