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Using Dungeons & Dragons and Other Games to Reach Kids – Dr. Megan Connell (POY 60)

Most things humans have created can be used to help others. Dr. Megan Connell uses role-playing games to help kids learn about themselves.

Most things humans have created can be used to help others. Dr. Megan Connell uses role-playing games to help kids learn about themselves.

Episode Notes

This month, I’d like to introduce you to Dr. Megan Connell. She’s a board certified psychologist and self-described applied game master who lives in Charlotte, North Carolina. She’s also the co-founder of a therapy group in Charlotte called HealthQuest, where they combine traditional therapy models with cutting-edge science, technology, and gaming, too. It’s an interesting approach to therapy that has modernized the field for the 21st century.

Megan takes pride in being a lifelong geek, and she brings that energy into her daily practices. She serves all sorts of patients but specializes as a game master or game leader for groups of them, especially those who are younger and could use help with their social skills. We’ll talk more about that in a few minutes. She has a YouTube channel, G33ks Like Us, where she talks about using psychology while running tabletop role-playing games, or TTRPGs, like Dungeons & Dragons. She’s also written a book about using TTRPGs as a tool in therapy, titled Tabletop Role-Playing Therapy: A Guide for the Clinician Game Master.

I reached out to Megan for this episode because I’ve been so fascinated by her and her work. I like role-playing games and board games, and we can all benefit from therapy. It didn’t occur to me that these things could be joined together into something new. Our conversation gets pretty nerdy and she mentioned some games and some people that I’ve had to look up myself. Even if you don’t follow everything we talk about, I hope this conversation will remind you that anything can be used to help others. It’s all about intention, and I appreciate that Megan made time to talk with me about hers—to reach others through therapy and through gaming.

Here’s my conversation with Dr. Megan Connell, board certified psychologist and applied game master at HealthQuest.

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Interview Transcript

Josh: We live in this era where—I’m still getting used to it—but you can basically go online and look at details for any person and read about their history. I was looking at your history and realizing that you have been to a lot of different corners of the country. You’ve tried a lot of different variants of psychology. Would you mind walking me through your professional career and where you are today?

Megan: I started this path with trying to be a music therapist. I went to Berklee College of Music in Boston. Loved it. Great education. Really psyched that I went there studying music therapy.

I am not saying this in false modesty ways, this is genuine: I suck at playing the guitar. I am really, really bad at it. My department chair sat me down and was like, “Look, you either need to take a year off and really perfect playing the guitar or switch your major and not be a music therapist. You really have to be a proficient guitar player to be effective as a music therapist.” I already knew at that point I wanted to study psychology. I was like, “I’ll switch my major and I’ll shift.”

When I was in undergrad, September 11 happened. I actually called up a Navy recruiter because I grew up near the ocean. I was like, oh, it makes sense to join the Navy. They must have hit their numbers so quick after September 11 because this recruiter said, “Hey, we’re good. What do you want to do?” I was like, “Well, I’m kind of thinking of going to grad school and becoming a psychologist.” They were like, “Don’t join now. Go get your degree. Join as a psychologist. We’re going to need psychologists.” That was already in my head as my trajectory.

Iwent to grad school out in Hawaii, and then I ended up joining the Army because they had a scholarship program that I could join halfway through grad school. The Army paid for half of my grad school. [I had a] guaranteed job, guaranteed paycheck coming right out the gate.

I finished up my graduate training in Hawaii, got my first duty station out in Joint Base Lewis-McChord in Tacoma, and did a deployment to Iraq from there. My second duty station was out in Virginia, and then I moved down to North Carolina for private practice reasons.

Josh: Are you originally from North Carolina, or is that where you are at the moment?

Megan: It’s where I am at the moment. I am originally from Maine. My family has lived on the peninsula I grew up on for over 200 years.

Josh: That’s pretty impressive.

Megan: Yeah. [There are] Mayflower connections in my family line. I am New England through and through. [laughs]

Josh: I could see that. You said you settled in North Carolina for private practice reasons. Do you mind explaining what you mean by that?

Megan: There is a practice down here called Southeast Psych that I came down to join and be a part of. I recently left to open up my own practice with another provider called Healthquest Innovative Therapeutics. We’re really focused on innovation in psychology and making therapy fun and connecting with people, but really trying to do as much as possible to progress the field forward and to bring new things into the field.

For myself with therapeutic gaming, my business partner does a lot with virtual reality. We’re trying just to bring people in who are really interested in trying new things in therapy and trying to broaden the field in that way.

Josh: I don’t know who was responsible for designing the lobby, but I saw pictures of it on the website. It’s really impressive. I’ve never seen a lobby that looks like that in a psychiatrist’s office. There’s all kinds of lighting and, you know, a lot of ambience that I, like I said, I haven’t seen before.

Megan: We hired a designer to help with that. The instruction we gave her was we wanted, essentially, like a health and wellness center on the Starship Enterprise was what we were trying to go for.

Josh: Nice.

Megan: I think we really achieved it. It’s a really innovative space, and we want it to be immersive, that the second you walk in, it feels therapeutic, it feels healing, it feels like a just comfy, cozy place to be.

Josh: It sounds like when you co-founded HealthQuest, that you already had gaming in mind. Is that true, or did that come later?

Megan: No, the gaming has been since 2017. My book came out on it in 2023, so I’ve been running games off and on since 2017. The pandemic kind of put a bit of a kibosh in it.

I found now that I’ve written the book, I’m still running games. It’s still fun, but I’m finding more and more I’m wanting to train other people to run the games and sit back and let them run the games.

Josh: I see. Well, what was the eureka moment that you had where you’re like, “Oh, I could use tabletop role-playing games as a tool for introspection for some of my clients.”

Megan: I remember very clearly. I was doing chores, and I was myself playing in two different campaigns and had made two seemingly very different characters. I was thinking about my two characters, and my brain’s going, ‘Well, they both have come from you, so they have to have some things in common. Let’s figure out what they have in common.’ And when I realized what they had in common, it was sort of like the bottom drop down of something. I’m like, ‘Oh, no, that’s my core issue that I need to work on.’

That was when that eureka moment came from where I was like, ‘I don’t know that I would have gotten to this in individual therapy,’ like knowing traditional therapy interventions and styles and stuff. That core issue was behind so many defensive walls that I just, even if somebody had reflected and like, “Oh, I think this is what’s going on with you,” I don’t think I would have been able to see it the way I was able to see and take in that feedback from my characters. I was like, ‘Oh, this is too good. This has to be used in therapy.’

Kind of fortuitously, I heard another provider, Dr. Boca Bizzarro [sic?] out in Seattle, talking about how he was using tabletop role-playing games with kids on the autism spectrum to teach social skills. I talked with him, and he agreed that there’s a therapeutic aspect because he was using it as an educational tool.

I really wanted to start trying to hit therapy goals. This is where life weaves things together in a really nice way. My training as a music therapist was all about, how do you take something that can be therapeutic on its own, but then intentionally use it for therapy, intentionally build in skills and interventions? I had all this training on how to teach assertiveness, communication, movement, group cohesion through playing music. I was like, ‘Oh, I can do that through playing a game.’ It’s the same stuff. It’s just a different medium.

Josh: Yeah, I was just thinking that. It’s two different mediums, but it sounds like a lot of the same characteristics.

Megan: Yeah, there’s a lot of overlap: tabletop role-playing therapy, art therapy, music therapy, movement therapy, equine therapy. A lot of these all have this common thread of, like, we’re using something that, on its own, can be therapeutic. Therapeutic is more—you find something beneficial out of engaging in that activity. Running can be therapeutic.

The difference between therapeutic versus therapy is therapy is set up with a goal in mind. Therapeutic is like, we’re just kind of doing it, and sometimes we can get a benefit, and sometimes we don’t. Either is okay when we’re talking, that we are trying to intentionally be therapeutic. It’s. I have a goal and objective that I’m trying to reach through this medium, and so that’s what we’re doing.

Josh: That’s super interesting. Have you played games like Dungeons & Dragons your whole life, or did you come into that later on?

Megan: I started in middle school, I think as a lot of people do. I was very obsessed with Lord of the Rings, so I made lots of characters that were basically just Legolas over and over again. He was my favorite character in Lord of the Rings—probably still is.

This was back in ye olden times, before we had printouts and things. It was all just done on notebook paper where you had to manually write everything out.

Josh: I remember that.

Megan: It was mostly us just goofing around. After I left middle school, I took an incredibly long hiatus from it.

I was watching Geek & Sundry, The Ashes of Valkana, Wil Wheaton’s limited series of the Fantasy AGE system. I was like, “Oh, this seems really cool. Let me give this a try.” That led me to Critical Role.

This was in 2015. We got this starter set Players Handbook [for Dungeons & Dragons], started playing, found a group of people on Roll20 to play with just kind of randomly. The first game we were all in, the dungeon master was terrible. We all rage-quit at the same moment, but all the players reached out to each other like, “That DM was terrible, but you seemed cool. Do you want to, like, try again?” We tried again, and we’ve played pretty much every week since then.

We started off as strangers on the Internet. Now we’re all incredibly good friends. We have been to each other’s weddings and things, so it’s great.

Josh: Awesome. That is a whole other conversation we could have: the community building components of role-playing games. It’s cool that you’re still involved with those same people.

Megan: That’s a big part of, I think, the appeal on the therapeutic side is building those connections. A lot of the folks that I work with are highly anxious and very nervous about meeting new people. It’s one of the reasons that I have continued to use D&D, even though I think there’s other gaming systems that, from a therapeutic standpoint…

Josh: …could be better or might be easier to pick up, I can imagine.

Megan: Yeah. One of the systems I really want to run and I’m really a big fan of, is Outbreak: Undead. Ivan van Norman kind of helped develop this one. It’s a very realistic zombie horror survival game where you make a character sheet for yourself. You’re surviving in this weird zombie apocalypse world.

Josh: Oh, neat.

Megan: Yeah, it’s really cool. It uses a lot of neat mechanics and stuff like that. The challenge is, if I get people who enjoy playing it and then they go off to college or move to a new town, it’s going to be hard for them to find other people who play that. I’m wanting to give them a game that they can very easily find other people who play. D&D 5E has been that game because it’s the most widely played role-playing game. I actually have this book behind me. I might be switching to Tales of the [Valiant] from Kobold Press pretty soon because I like it a little bit better.

I’m not a fan of a lot of the things that Hasbro is doing with D&D. I feel a little bit of an ethical obligation to not put people into a predatory gaming system that’s just going to try and exploit them for money.

Josh: Yeah, I guess for people that are listening, and maybe don’t understand, my understanding is it’s becoming a little more pay-to-play.

Megan: It is. It’s still always going to be that if you have the rules and you have your imagination and some dice, you can play the game.

Wizards of the Coast made an incredible tool with D&D Beyond which is a digital character sheet ability to store notes, quickly look up spells, quickly look up resources. It is an awesome tool, I really like it. They are scaffolding that into a virtual tabletop, and they’re incorporating things like microtransactions, upping subscription fees, and putting a lot of tools and things that you want behind a paywall. I’m really not a big fan of that.

Josh: Right, but you have given us two other games to look at, like Tales of the Valiant. Based on the title alone, that sounds like a neat game.

Megan: It’s awesome. It is very similar to [D&D] Fifth Edition with a few tweaks here and there. One of the things I like that Kobold Press has done is they’ve made it incredibly easy to port things in from [D&D] Fifth [Edition]. I have a ton of supplements for Fifth Edition as well, which is kind of a hard thing to walk away from. They made it very easy to supplement that stuff in and bring it in.

Another system that I really like, too, is called Emberwind. It’s designed to be an exploration of existential psychology. It’s a really cool system. I really like it.

Josh: [There are] a lot of different ways to go about the same goal as far as building community and working with clients toward therapeutic purposes.

Megan: Yeah. I think that’s the thing, too, is like, again, you give people a tool that they can use to meet people. In a very similar sense, if you were pretty much anywhere else in the world, if you wanted to meet people, a really good tool to meet people is a soccer ball. You just show up somewhere with a soccer ball, people are going to want to do a pickup game, and you’re going to meet some people. For folks who are a little klutzy or a little bit more introverted, maybe not wanting to do such an aggressive thing, showing up with some dice and a character sheet at a D&D club is a little bit easier, and it’s a little bit easier bar of entry.

In that way, it can be this great tool. Especially for folks who are neurodivergent, where you’re not reading social cues very well, you’re struggling to understand what’s expected, playing a game is a great way to socialize.

An article came out, oh, gosh, three, four months ago that showed like— I’m going to forget the exact number. Forty percent is what’s sticking in my head, but I think it’s like 40% of people diagnosed with autism are in the board gaming hobby, whereas it’s only like 2% of the neurotypical population. I might be completely wrong on those numbers, folks, so please don’t quote me.

Josh: I got the gist, though. Yeah.

Megan: Yeah. It is significantly higher.

Josh: That’s fascinating.

Megan: Yeah. If you think about it, it’s like, board gaming. We’re all going to sit down and do something together. There’s rules, there’s structure. There’s a flow to it. I know what the expectations are.

It’s not like a cocktail party where I have to just kind of wander around and figure out who wants to talk to me and what are we talking about and what’s okay to talk about and what’s not okay to talk about. That’s so jarring for folks who have a hard time with social skills. Doing something like this, wherever we’re going to just build in an activity that is going to help you talk with folks. There’s been this misconception for a very long time that folks on the autism spectrum don’t like to socialize, and that’s not accurate at all. A lot of folks feel burned out through social interactions. They get very tired easily, but they want connection. They want to interact with people. It’s also such a huge mental load to try and read the social cues, to try to figure out what’s going on. I would almost equate it to, like, you’re trying to follow a conversation in a language that you haven’t spoken since high school.

Josh: …or they have different stats on their in-person character sheet.

Megan: Yeah. It’s just like, what is going on, what’s expected, and it’s hard. When we put a board game or a tabletop role-playing game in front of folks, it’s like, “Okay, now I have a script that I can follow. I understand what’s expected. If there’s side conversations and things, too, it’s okay because we know eventually we’re going to circle back to the game.”

Josh: I got the impression looking through your bio and everything, that you not only do you enjoy working with neurodivergent groups, but you also enjoy working with young girls. What is it that’s special to you about working with that group?

Megan: With the gaming side, for so long women were just kind of neglected from the hobby. Incredibly sexist comments from [D&D creator] Gary Gygax aside, women were there from the start. Especially in the Eighties, the tables felt unwelcoming to women. When we think about, like, the typical play that younger girls engage in, it’s imaginative. It’s make-believe, it’s story, it’s role-playing. This is a game that fits, like, kind of how we socialize girls to play and yet girls don’t feel like they have a space to play. That was really one of the reasons I wanted to do that.

We also know that in groups, just because of how our society is, is if there is one man at the table, it completely throws off the balance. Even if they are not the person in charge, if they are not the most highly educated people still will defer to him.

Josh: Right.

Megan: I wanted to create a space where women could speak, could have their voices heard, and could build strong, supportive relationships with one another. It’s another thing in our culture where women are taught to not be supportive of one another. A lot of people will argue it’s like, well, that’s biological. No, that is completely something that is taught by our society.

Josh: Yeah, that’s social.

Megan: This is an n of one case study, but I had a parent session with one of my players. This was somebody who had been in two or three rounds of my group. The parent was coming in, and I was having my little imposter [syndrome], like, “Oh, God, they’re going to say, what the heck are you doing? I haven’t seen any improvement in my kid, blah, blah, blah.” And I’m like, “I’ve seen all this growth in this person.”

The parent came out [and I said] “So what are your questions? You know, I’ve enjoyed having them in group, blah, blah, blah.” They’re like, “I just want to know what the heck is it that you’re doing in there? Because it’s amazing.” I was like, “What? Explain.”

My OG group had this tradition that whenever somebody had a birthday, they would have a sleepover at the birthday person’s house, and that person would run a game. [The parents were] like, “My kid has their school friends over sometimes, and then they have their D&D friends over other times. When they have their school friends over, they’re being catty, they’re gossiping, they’re giving backhanded compliments, they’re being mean.”

“They have their D&D friends over. Everyone’s laughing, everyone’s being supportive. They’re cheering one another on. They are just being kind and goofy and fun. I want all my kids friends to be D&D friends.”

Josh: That’s a different dynamic. Yeah. That’s really meaningful. That’s awesome that you’re able to not only help convey that kind of setting where people feel like they’re safe, but also teaching them to kind of spread that on their own. That’s really cool.

Getting back to the talk about game masters and dungeon masters, are there different components of therapy that game masters can consider as they are running a game that might be beneficial to their players? Does that make sense?

Megan: Yes, so different psychological themes and things. I think the big thing is, first off, don’t be a therapist for your friends.

Josh: No, of course not.

Megan: Yeah, don’t do that stuff. When you’re talking about representation, you want to avoid stereotypes, right. You want to have thoughtful representation.

There’s an awesome webpage called Writing the Other that talks about how to write from other people’s perspectives that aren’t your own: representing blindness, deafness, physical disability, different types of psychological problems.

Josh: Looks like writingtheother.com.

Megan: Yes. Some of it’s paid stuff, some of it’s free, but there’s a lot of good resources on there.

I think one of the best things you can do as a game master is to create a world that is diverse and as inclusive as possible. I ran a live play called Clinical Role where it was all therapeutic game masters playing.

Josh: It’s on YouTube, by the way.

Megan: Yes, it is. I didn’t upload the end of the campaign because I started having audio issues with the recordings and I couldn’t figure out how to solve it. Now it’s been so long, I feel slightly embarrassed to upload it. [laughs]

Josh: Oh, shoot. I understand though.

Megan: We had a city that we built and I think a quarter of the population was halflings. When I was developing the different buildings and stuff in the city, I was like, “Okay, so if you have a quarter of your population is four foot or less, that’s going to require different architecture.” And also another 10% of the population was Dragonborn, who are usually over six feet. So it’s like, “Okay, we got this huge diversity and heights.” Creating that, the norm for doors was to have those— they’re not called nesting doors. I can’t remember the term where you have a door within a door.

Josh: I know what you’re talking about, but I can’t think of it either.

Megan: Yeah, there is a special term for it. Keith Ammann, who wrote The Monsters Know What They’re Doing, he knows the term. He was the one who taught it to me. I can’t remember, but that was the norm. There would have to be a big door that would work for your tall population and then a smaller door.

In the taverns, there’s two sets of stairs going up the stairs, one with smaller steps and one with larger steps. The bar stools are of varying heights and things just to show that there is inclusion and thought put into this, that it’s not just the world is set for one thing.

For dungeon masters who homebrew, intentionally seed NPC’s that are outside your norm. A lot of us have to come up with NPCs [non-player characters] on the fly because our players do something unexpected every single game. If you’re coming up with NPCs on the fly, your biases are going to come up. No matter what you do, they’re going to. Those biases will be there.

Josh: That’s a good point.

Megan: When we intentionally seed this stuff to more accurately show what we want, then we can have that more diverse experience, you know?

I think a lot about the lessons of Sesame Street, which maybe is a little weird, but Sesame Street was incredibly intentional with its casting. They realized a lot of kids who were going to watch Sesame Street wouldn’t have seen the same diversity as kids growing up in New York. They wanted to have people have that experience, and how amazing that is.

I just read a Reddit post about The Golden Girls, which is also great show. That one holds up. Somebody was talking about an episode where gay marriage was talked about as just kind of a normal thing. They said they watched that at like eight or nine, so they never thought gay marriage was a big deal. They were getting older and they’re like, “Why do people care so much? I saw it on The Golden Girls. It’s fine. What are you talking about?”

Josh: It’s interesting to me because I came into this conversation with you more focused on therapy, which— What you do obviously relates at its core to therapy, but then there’s also these other social opportunities. That’s just super cool.

Megan: Yeah. It’s a neat thing to think about a world that thinks about the consideration of others. I like engaging in that headspace and thinking about that. I guess I should say too, obviously use a session zero. Have a session zero. Talk with your players about their boundaries. If they’ve said they don’t want something in the game, don’t put it in the game. If you have to have that thing in the game and that player doesn’t want in that game, let them know that your table is not the right table for them. No disrespect. It’s okay.

Josh: Religion and politics, I guess, could be an example.

Megan: Yep. For those running one-shots, too, there’s an awesome product I want to plug that’s not mine. It’s called the Deck of Player Safety. It’s a deck of cards that you hand out and people can anonymously put them in envelopes and hand them to the game master. The game master puts all the cards out, and those are our no-go topics. It’s really quick, it takes like five minutes to do. I use it when I run games at conventions. It’s a great tool.

Josh: That sounds awesome. Thank you for recommending that.

You obviously have your book. In addition to your book, is there anything else you wanted to plug like your YouTube channel, G33ks Like Us?

Megan: Yeah, G33ks Like Us. We are hopefully going to be restarting a few different projects there in January. Amelia, who’s been our community manager, she and I are going to do a co-op of Baldur’s Gate so she can finish the game.

Josh: Is that Baldur’s Gate 3?

Megan: Baldur’s Gate 3. Yep. Love that game. Super fun. We’re also going to probably be doing some board game talk, doing some actual play of board games. I love tabletop role-playing games, but I have over 200 board games. [laughs]

Josh: Wow.

Megan: Yeah. I went through them, and I have played all but eleven.

Josh: That’s amazing.

Megan: Yeah.

Josh: What I found about people that play board games in my life is they are the ones that know the good ones. When you play board games with them, it’s like, “I need to get this game and this game and this game.” I would have never known about [them] otherwise.

Megan: Oh, board gaming is so much fun, and there’s so many good things to do. My kids are finally at an age where they can, like, they’re younger than 14, but they can play the 14+ board games and are really good with the strategy and stuff like that. It’s so much fun. We’re going to be doing something with board gaming on G33ks Like Us.

Check out my book, Tabletop Role-Playing Therapy. It is available as an audiobook as well as in print. I really pushed the publisher to do that, and I’m really pleased that they did. For those who are not clinicians, psychologists in the therapy field, it is written in a way that can be accessible to other folks.

I wanted to really hit two specific audiences with this. One is those who are professionals, psychologists, wanting to understand how to use this game as a tool in their practice. The other is for players of the game to understand, “Why the heck does this game make me feel so many things? Why does this imaginary land and imaginary character that I just do a silly voice for at the table with my friends live in my head so much?” My hope is that this book will give you a little bit of insight into that.

For people who are coming through college and wanting to study it, I have in my appendix, I have a whole section of research questions that we really need answered. So please do so.

Josh: Nice. I love that.

Megan: “Here is your thesis topic. Go.”

Josh: Very cool. Now, I’m asking for myself with this question. I usually ask, where can we follow you online? I’m leaning forward because I want to know where can we follow you online? I want to hear about more board games. [laughs]

Megan: Yeah, so @meganpsyd on pretty much on everything. That’s the highest degree I have. It’s a psychology doctorate. I’m switching away from Twitter because of…

Josh: Yeah.

Megan: …which is unfortunate, because that’s how I have most of my connections, most of my following. I’m trying to do a little bit more Instagram, more Threads, and Bluesky. I’m trying to find everybody on Bluesky.

It’s sort of like you graduate from one school and you go into the next, and all your friends are at the same school, but you can’t [find them]. You’re trying. You’re at the lake, the playground, or whatever, and it’s like, where is everybody?

Josh: Yes. I’m going through that right now, too.

Megan: Yep, but I am @meganpsyd on all of those things.

Josh: Okay, great.

Megan: Also HealthQuest is where I am. I do clinical work. I am pretty much always accepting new clients. I do professional consultations as well.

Josh: I know there’s a counseling compact coming, which I don’t know if that’s different than what you do, but are you able to see people in different states?

Megan: I am. I’m part of the Psychology Compact, the PSYPACT. It is in 42 states, legislation pending in New York and Massachusetts right now.

Josh: Okay.

Megan: It’s great. I’m always taking people. Almost 75% of my practice is virtual.

Josh: Oh, nice. Good to know.

Well, like I said, I really enjoyed this. I really appreciate the work that you’re doing.

Megan: Oh, thank you.

Josh: I hope you enjoy your evening. Thank you again for your time, and we’ll be in touch.

Megan: Awesome. Take care. Have a good night.