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Dungeons and Dragons \u2014 Maybe you grew up playing it. Maybe you think it\u2019s uncool. Maybe your main encounter with it has been on the hit show Stranger Things. Or maybe you\u2019re actively part of a Dungeons and Dragons (D&D) campaign right now. On today\u2019s A Public Affair, the Louisville-based mental health clinic OCD & Anxiety Colorado<\/a> is using D&D to help children and young adults with anxiety, ADHD, Obsessive Compulsive Disorder (OCD), and other mental health diagnoses.<\/p>\n D&D was invented in the 1970s. It\u2019s a fantasy tabletop role-playing game. It\u2019s facilitated by a Dungeon Master, or Game Master. That\u2019s the person who sort of narrates the story, helps create all the details of the fantasy world, and guides the action. Basically, it\u2019s a bunch of people, sitting around a table, playing different roles and imagining a story together. It uses a set of parameters about what characters can do and how. But it\u2019s the players who invent their own character, come up with their backstory, and make decisions throughout the story as that character.<\/p>\n Clinician Payge Wyman is a Licensed Social Worker (LSW) and Board Certified Assistant Behavior Analysts (BCaBA). She\u2019s getting certified as a \u201ctherapeutic game master\u201d through the Game to Grow<\/a> approach.<\/p>\n \u201cThe idea is you wanna tell a fun story with friends that has cool things happening in it,\u201d said Wyman. \u201cAnd sometimes that\u2019s gonna involve taking on a different role.\u201d That role could be a heightened version of yourself, or a completely different version of yourself.<\/p>\n \u201cThe idea is that you get to play and explore these things that you can\u2019t explore as much in real life, and then you come together with a group to collaboratively, cooperatively tell the story,\u201d she explained.<\/p>\n What underlies their approach is something called Exposure and Response Prevention therapy (ERP). Which the International OCD Foundation defines as practicing confronting the thoughts, images, objects, and situations that make you anxious and provoke obsessions.<\/p>\n In Anxie-D&D, Wyman uses the players\u2019 \u201ccontent\u201d \u2014 the things each kid is trying to work on in therapy \u2014 and incorporates that into the game so they can confront it in a safe environment.<\/p>\n \u201cWe had someone who had a fear of bugs, and so I made the souptender (we didn\u2019t do bartenders, \u2018souptender\u2019 so that it can be all ages friendly) a giant cockroach man. And they had to talk with the giant cockroach man to move through the story and get the information that they needed.\u201d<\/p>\n That was hard for the player at first, said Wyman, but they were able to do it. And by the end, \u201cthey were like, \u2018yeah, he\u2019s all right, I guess.’\u201d<\/p>\n Or maybe a kid has trouble with self-confidence. Wyman will put their character in a situation where they have to solve a puzzle on behalf of the group, and their character is the only one in the group with the right strengths (say, a high wisdom score) to solve that puzzle and advance the story.<\/p>\n The Game to Grow method Payge is using was co-developed by an Occupational Therapist named Virginia Spielmann, who is based in Centennial, CO. Her organization, STAR Institute for Sensory Processing<\/a>, also runs Game to Grow D&D campaigns for kids in person and online. She said they have trained thousands of facilitators in the method, and they estimate that around 1,000 certified game masters are actively running these programs now \u2014 with groups of kids in therapeutic settings, in community settings like libraries, and with groups of adults, including a veterans group. The groups span the US, Canada, Hong Kong, Australia, and the UK.<\/p>\n D&D has probably always helped neurodivergent kids as long as it\u2019s existed. Spielmann\u00a0 told me that she found her way to this work when she realized her nine-year-old son was struggling with anxiety at school, but totally opened up while playing Dungeons and Dragons. She noticed his D&D character was dealing with setbacks really well, and celebrating his successes confidently. And that formalizing something like this would be a good way for older kids who are struggling to have permission to \u201cplay pretend.\u201d<\/p>\n OCD & Anxiety Colorado was founded fairly recently, about a year ago. Alie Garza, LCSW, its founder and senior clinician, grew up in Superior. She created the clinic to address the needs of kids who grew up like she did.<\/p>\n \u201cI went through my whole adolescence having misdiagnosed, untreated OCD. It actually wasn\u2019t until I was 25 and a clinician myself that I discovered that I had OCD and what the evidence-based treatment was,\u201d said Garza. \u201cAt that point, I had gone through years and years of treatment in Boulder County, and felt like no matter what I did, I was actually getting worse, and figured that it must have been something wrong with me or that I wasn\u2019t trying hard enough.\u201d<\/p>\n Garza says this is a common experience for kids and young adults with OCD. By the age of 25, she says she was bedbound, unable to eat, and scared to drink water. She wasn\u2019t leaving her home, but did residential OCD treatment, which she says saved her life.<\/p>\n After that, she spent years working in different higher level OCD care programs throughout the country. When she moved back to Colorado, she worked at the OCD Clinic at CU Anschutz, where she says she witnessed the program repeatedly fail to get kids the higher level OCD care they needed, especially kids on Medicaid.<\/p>\n \u201cI discovered that nothing had changed since I had left, as far as treatment programs, treatment options for pediatric OCD,\u201d said Garza. That\u2019s why she founded OCD & Anxiety Colorado.<\/p>\n Still, kids who need higher levels of care need to be referred to specialists, sometimes in other states. And Garza has run into Medicaid roadblocks preventing that.<\/p>\n