Hi folks! I had the most AMAZING time in March with an AMA I thought I'd come back now that I've gone full time and am running new programs!

Insta post as proof here; https://www.instagram.com/p/CUppaCohvjq/?utm_medium=copy_link

My main social media profile is my Facebook Business Page: www.facebook.com/counsellingwithmike

But you can find my various socials at https://linktr.ee/thenerdtherapist

Link to March AMA: https://www.reddit.com/r/IAmA/comments/mgf5wr/iama_therapist_who_uses_dd_as_a_form_of_group/?utm_medium=android_app&utm_source=share

So hey, I'm a nerdy counsellor from Perth, Western Australia and my growing specialty is the use of videogames as therapy or to provide a shared activity during therapy. I've been running D&D therapy for nearly a year now and I'm hoping to soon have the opportunity to provide other TTRPGs in sessions. My practice is found at www.counsellingwithmike.com.au

I'm also using Roblox, Civ 6 and Minecraft in the therapy room and it's my hope to get my therapeutic Fortnite program rolling soon!

I also provide the Pop Culture Competence project, where I explain nerdy stuff to non-nerdy clinicians, teachers and parents. You can find it at http://popculturecompetence.wordpress.com

Edit 1: Hey folks holy heck I didn't expect this to go off like it has. It's 1:30am and I need to hit the hay! I will be back in the morning for followups! Good vibes and victory, y'all!

Comments: 462 • Responses: 68  • Date: 

CountDraco1445247 karma

No man’s sky is very calming in my opinion. Could this be a good program?

PerthNerdTherapist170 karma

I'll be honest, I haven't played it, but I've seen folks talking about using it for a mindfulness activity. It seems like it would be pretty chill

C_Splash228 karma

In what sense can a strategy game like Civ act as therapy?

PerthNerdTherapist369 karma

Civ is a great tool because it's strategic when it wants to be, and provides opportunities to express yourself in how you choose to engage in the game. There's values-based exploration, as well as addressing cognitive strategies and decision-making processes. You can explore rational mind vs emotional mind - I recently had to sit down and do a Pros and Cons list about some territory I captured during a war with Trajan of Rome.

I use Civ more to empower therapeutic conversations than as the actual therapy itself. But for clients who like to be intellectually engaged it's a great game, especially because it's turn-based, and can be left alone to really dig into a conversation.

typesett125 karma

is this like how some people take walks with their therapist? less awk to sit in a room?

PerthNerdTherapist265 karma

Yup! For some folks, especially neurodiverse people (ADHD, Autism), sitting down and talking to someone directly can be really uncomfortable, so having games can help reduce that tension.

I'm currently looking into the logistics of how walk-and-talk is done, because I think it'd be rad to offer, and summer is coming!

SteveWyz47 karma

Aha the comment about summer coming confused me for a sec (being from the US) but this whole thing you’ve got going is awesome! I love video games and am currently studying psych in my senior year of college. This seems like something that I could definitely adapt as well! How did you find yourself along this path?

PerthNerdTherapist19 karma

I came to working in mental health after four years in construction - we had a lot of mental health issues in the industry and I decided to study in order to help folks. As a therapist, I'm in a few professional groups, and I kept seeing really rude comments made towards gaming and nerdy stuff in them, so I created a free clinical resource to explain nerdy stuff to therapists, why folks like it and how they can use it therapeutically. I kinda leaned hard into nerdy stuff late last year when I realised that like... this was something it was okay to be and not something that'd be seen as unprofessional.

Zerothian10 karma

As someone with both ADHD and ASD, I can absolutely confirm that the secondary sources of stimuli being there help me greatly.

I find it incredibly awkward and difficult to talk 1:1 with people I'm not comfy with. So having something else to focus on and that shared experience to lean on while building trust is great for me. I never really considered it till now.

PerthNerdTherapist2 karma

I'm increasingly convinced I myself have ADHD, but this is also something I hear from clients or folks I talk to, that having something to do is helpful in itself.

C_Splash27 karma

Thank you for answering! I can see how Civ's nearly endless choices can be a good window into someone's decision making process.

PerthNerdTherapist28 karma

No worries! Thanks for the awesome question.

There's definitely a space to talk through the decisions and learn about biases and stuff.

ImpossibleParfait3 karma

Wait, how fucked am I if I sometimes try to win peacefully but always end up placing the world under my boot? Sometimes I dont have the loyalty too keep a city and I kill its population over and over again until they submit.

PerthNerdTherapist12 karma

You're not fucked - you do the best with the tools you have.

But you should probably assign a governor to that city to keep its loyalty high.

KDY_ISD27 karma

I'm not in any kind of formal therapy but I've always found the Civ games to be very calming and almost meditative. Saturated, cheerful color palette and it feels very constructive instead of destructive most of the time.

PerthNerdTherapist29 karma

Sometimes the UI can be overwhelming for me but I do agree, it's a nice game to sit down and immerse into, especially once things start running smoothly for my emerging republic. I really enjoy building up kingdoms and seeing things grow - setting up all the logistics of maintaining a civilisation.

It is definitely easy to lose time with it though!

KDY_ISD5 karma

There's something pleasing about slowly making the map all one color lol

PerthNerdTherapist15 karma

Funnily enough in my current game we've had very few warmongers and territorial expansions. I'm pushing for a science victory myself - I had to restructure my Civ when my cannons were met with Poundmaker's Modern Armour and I realised I'd fallen very far behind in that game.

Security_Chief_Odo163 karma

Welcome back, and thanks! Do you think that certain types of games can help with cognitive or memory work? Ones that are also fun for people to play.

PerthNerdTherapist124 karma

Thanks for the welcome! These are always fun and I've got such rad stuff to talk about now - the last six months or so have been SUPER transformative for me and my practice and I really wanted to share it with folks.

There's actually a set of cognitive stratgies called Stranger Thinks, which is like a guided activity, almost in a TTRPG way, which uses Stranger Things imagery to promote better thinking habits. I own a copy but I haven't used it yet!

I don't know much about memory work though. Are you talking about supporting neuroplasticity and working memory, or more about recovering old memories?

Security_Chief_Odo42 karma

talking about supporting neuroplasticity

This one. Basically anything than can help improve your recall and active cognition process.

PerthNerdTherapist40 karma

Thanks for the awesome question. I actually don't have an answer for that at this stage - it's not really the area I work in. I wish I could give you a better answer. I hope some of my colleagues see this question and dive on in - there will definitely be someone who can field this one.

imasitegazer31 karma

Have you heard of the board game Magic Labyrinth? I bought it on a whim but I love it. Playing it relies on short term memory but also processing strategy (planning a path). https://boardgamegeek.com/boardgame/41916/magic-labyrinth

PerthNerdTherapist19 karma

Oh that looks rad! I'm saving this for a better look tomorrow.

Coffee_monger6 karma

Ah! Where did you find Stranger Thinks? That sounds like a really helpful tool for my clients.

PerthNerdTherapist15 karma

The Geek Therapy Community! It's such an awesome place.


Coffee_monger15 karma

This is so exciting! I have wanted to use so many of these games in my practice but feel overwhelmed with where to start. Thank you for making this nerdy play therapist so happy!

PerthNerdTherapist11 karma

Go forth to victory! I'll see you in the group! :)

MuonManLaserJab4 karma

Facebook though

PerthNerdTherapist9 karma

At this stage I'm mostly there for work and family, but gods this is such a mood.

NeiderUnchained142 karma

Well this is new, sounds exiting but I'm quite curious in how does the therapy itself work.

What are the target issues that you solve through this therapy?

Do you play games during your therapy sessions with your patients or is this homework?

Do you for example use Minecraft as a platform for patients to express something and analyse behaviour based on that?

PerthNerdTherapist238 karma

Minecraft is a flexible approach - it can be used simply as a shared activity to reduce tension and support engagement in the session. Many clinicians use Uno or board games for a similar effect.

Alternatively it can be used to facilitate conversations - health, hunger, safety, survival, building collaborative skills, distress tolerance, emotional regulation. There's plenty of space to practice real-world skills in Minecraft. :)

LeanAlpaca-19 karma

I would imagine the idea behind the Uno type games is to get away from behind a screen. As too much time on a computer contributes to depression and social anxiety disorders

PerthNerdTherapist30 karma

The quality of the time spent, and the reason they're on a computer at all, are more important contributing factors to me.

But due to covid there's been a focus on online play - even with Uno

baymax1854 karma

How did you develop your practice? I'm a beginning therapist and I would love to learn to use video games in therapy. Is there a specific training needed?

PerthNerdTherapist53 karma

Welcome to the field! Answers will vary depending on where in the world you're from but I'm from Perth, Australia and I rely heavily on American-made resources and training programs.

I developed my practice over time, I opened in June 2020 - I started with the Pop Culture Competence program, and then moved to D&D, then to Minecraft, now to Fortnite and Civ. For some games it's more about having them and using them in therapy like how other clinicians may use Uno or Battleship. For others it's definitely worth taking a look at CPD or resources. Minecraft falls into the second category. If you use Facebook, join the Geek Therapy Community to find some support and resources: https://www.facebook.com/groups/1663320987305797

ohlookabug12 karma

Adding to this, what kind of academic pathway did you take? Were you always focused on going directly into therapy?

williamc_3 karma

I've tried to find a good background page on this dude but can't find any info if he's actually studied or not. Just that he uses evidence-based therapy programs

PerthNerdTherapist3 karma

I've got a BA in Psychology & Counselling - which is suitable for registration as a counsellor in Australia - and I'm looking at postgrad for 2022. Covid kinda screwed with my plans for 2020 and 2021.

Advice2Anyone2 karma

More interested in how you develop d your clientele. Lot of people who probably could benefit from therapy will never admit it and most that are in therapy are fine with therapist can be a rough start for a lot of people in the state going out on their own

PerthNerdTherapist5 karma

I do AMAs whenever my numbers get low

I kid. I do a lot of community stuff and I'm engaged with local nerdy community groups such as the Dungeons & Dragons community here in my city. They're all hella supportive of the projects I run.

alittlelurkback52 karma

What therapy do you suggest for a crippling video game addiction? Jokes aside… I’m having a really hard time understanding how playing Fortnite could help with anything

PerthNerdTherapist82 karma

I'm not an addiction counsellor so I'm probably not the best person to comment on videogame addiction.

Great question though, because it's definitely an eyebrow-raiser at first glance!

Fortnite has been a challenge but the main focus for that is building teamwork and communication skills, more in younger teens. By setting rules, roles and boundaries into a group setting, Fortnite can be used as a ground for strengths-based exploration, building team skills and communication, and the capacity for openness to feedback.

It's not 'therapy' in terms of treating depression or anxiety, more a therapy to support folks who don't do well with other people, but they'd like to learn.

alittlelurkback26 karma

I appreciate you responding thoughtfully to my question even though I was a snarky. I respect efforts to explore unconventional and novel therapies for a range of issues. Perhaps using online tools is necessary in a pandemic world but I would think in-person therapies for team and communication skills to be far more effective.

I have many friends that are parents struggling to get their children off video games. I have felt the addictive pull of them myself. They offer a kind of stimulation that makes boredom far less tolerable. There is a lot of discussion about the toxicity of many game communities. I think this stems from the lack of many social pressures when one is anonymous and isolated in their rooms. I can’t help but wonder if the bad out ways the good with these therapies? Is there any research to support the efficacy of your approach?

PerthNerdTherapist21 karma

I didn't see your comment as snarky :)

Honestly I'm moving to offer more and more in-person sessions, especially as I'm in Perth where we've had a ton of luck with managing the pandemic. In-person would be great but with Fortnite it would be expensive, which is why the program is currently online. I mean, with the right backing I'd *love* to run it in-person but you're talking like, 4 Nintendo Switches at its most simplest.

Many of my clients prefer online sessions for scheduling reasons - kids, other kids, work, travel, siblings. But there's definitely a need to be away from screens and that's part of why I run the D&D therapy program - it's nerdy, fun play in-person, flexing those creative muscles.

Toxicity in gaming communities is a heck of a problem and I really encourage people to take the time to find a good community and look out for red flags. And if you can't find one, make one. It's a real shame when folks in games stop the actual games from being fun - which is part of the reason I don't play MOBAs or Overwatch anymore.

KevinTheSnake6 karma

But is there any research to support the efficacy of using video games in this manner?

PerthNerdTherapist13 karma

There is! It's a growing part of the field, as Covid really needed us to be able to flex into new, digital tools for providing therapy.

Here's one about using Minecraft for Social & Emotional Learning: https://core.ac.uk/download/pdf/77239875.pdf

And another which shows positive mental health outcomes for gaming: https://psyarxiv.com/qrjza/

No_Soul_No_Sleep10 karma

It would seem to me that playing these games for people with social anxiety could help reduce the toxic environment. If not for the whole community, the individuals seeking therapy. Having a licensed therapist could help these children deal with negative reactions from the toxic environment and produce coping methods for avoiding a negative response.

PerthNerdTherapist8 karma

Cyberbullying and managing negativity on social media is a really common conversation we're having in professional spaces right now and have been for some time - and not just for children, but for teens and even adults.

Zatoro2548 karma

What do you do for your own mental health? Is there a trap that you can "fix yourself"?

PerthNerdTherapist63 karma

I read and reach out to friends and family for support. I use some cognitive questioning for myself at times if I catch myself acting oddly, but I also have my own professional supports I engage with regularly. :)

Carpe_DMX40 karma

Do you run DND as group therapy or is it one-on-one?

PerthNerdTherapist60 karma

I run full D&D groups. :)

I've run a one-on-one D&D session but it wasn't as fun - I've heard there's really good 1:1 RPGs out there and they're definitely on my to-learn list for folks who may want solo sessions.

FaxCelestis28 karma

Amber Diceless tends to be the best I’ve found for 1:1 sessions.

Also it’s really old, but if you can get a copy of Everway it would do very well too. Everway is like if you made Myst a TTRPG, and it has a very in-depth storytelling kind of character creation: your “stats” are classical elements (earth, air, fire, water), and they only have the mechanical effect of showing what your strengths and weaknesses are. There’s no dice: instead everything is resolved by the DM drawing a tarot card and interpreting its meaning into what happens. It’s a really cool concept and I think it could be very readily adapted to therapeutic play. Modeling yourself in Everway is easy, unlike a lot of other systems I’ve played.

PerthNerdTherapist13 karma

That sounds really nifty. Thanks for the advice! This really looks like something that could play out super interestingly.

FaxCelestis9 karma

Actually, I just went to look to see if I could find it digitally anywhere and it looks like there's a kickstarter going on right now for a 25th anniversary reprint!

PerthNerdTherapist24 karma

"I need a Tarot deck for work purposes" definitely isn't what I expected myself to be saying tonight.

Carpe_DMX4 karma

Very interesting. Do you keep sessions to an hour? What kind of breakthroughs or results are you looking for in this scenario?

PerthNerdTherapist22 karma

My sessions are two hours I've run smaller ones when I've been employed by schools and need to work within the confines of lunch breaks, but this isn't optimal. The main things I look for are improved collaborative skills, demonstrations of adaptive problem solving, or simply achieving their own personal goals.

If I'm running an Anxiety campaign, I want to see players use the anxiety managing skills they learn in the session. I'd want to start a new session, and during check in, have someone go "oh heck Mike I was in this situation this week and it stressed me out, so I used that skill from last week and it really made everything easier for me - I didn't have a breakdown after!"

Or something like that, y'know? Different groups are tailored to the members - so each group is its own interesting and unique experience

Carpe_DMX3 karma

This is very cool!

PerthNerdTherapist5 karma

Thanks for saying so! I think it's pretty cool myself. It's really nice to get to run a therapy which folks are excited to attend - and showing that they're getting something out of it.

PityUpvote27 karma

Ttrpgs as therapy sounds very interesting, I've heard anecdotally that roleplaying a character of the other sex then one's birth sex can lead to people realizing they might be transgender, do you have any experience with that?

PerthNerdTherapist29 karma

I've not had it come up in my sessions - but I've seen the discussions on the various FB, Reddit and Discord RPG groups and while I can't speak for the trans experience, I believe what's being described is folks using RPGs to get an idea of how comfortable they may be with using another set of pronouns or even a name of another gender.

We've probably heard the same anecdotes. It makes sense but I don't have much to help you with there.

Throwawayingaccount26 karma

What tabletop games do you suggest for getting someone able to better cope with death?

PerthNerdTherapist48 karma

I feel like Masks would be a great one for this. Masks is a superhero RPG about being a teenage superhero, balancing teenage life with superhero life. Dealing with the loss of a loved one would definitely fit within the scope of your characters' personal journey.

The Avatar RPG, as long as your DM could channel some Uncle Iroh vibes, would be good too.

Coping with loss is a hard one, and I feel like many RPGs would be good here - especially if your GM was supportive. It would be nice to have a stable, consistent and supportive group to be there for you in that time.

I hope things are doing alright for you, friend.

AwesomeDragon10119 karma

This thread is incredible, I freaking applaud you for breaking ground and finding new ways to reach out to more people. I feel like this approach to therapy would be helpful for me, but I’m in the states, do you know how widespread game therapy is, or where I can network with counselors who practice this?

PerthNerdTherapist16 karma

Thanks for your awesome and kind words! Community support means a bunch to me - it's how I know I'm on the right track. I'd reach out to Game to Grow and see if they run something nearby, or know someone who does. https://gametogrow.org/

JavierLoustaunau18 karma

I've always joked that you can learn everything about somebody watching them play The Sims. Ever tried that? Even character creation would say a lot.

PerthNerdTherapist15 karma

I swear I've seen someone actually do this, but it's not something I do, largely because I haven't played The Sims in ages.

I feel like there's a lot of room to learn and explore and think about our choices in The Sims, though, as expressed in the therapy room.

mjpache13 karma

Can you give a breakdown on how you do D&D therapy and what kind of problems does this therapy target?

PerthNerdTherapist43 karma

RPG therapy is often aimed at building social and emotional skills in neurodiverse teens, and I also use it for supporting folks who experience anxiety and depression. I use homebrewed game mechanics and campaigns to educate about mental health and teach coping strategies. I have the Lair of the Phobovore campaign for anxiety, and the Curse of the Black Dog campaign for depression.

youngbingbong13 karma

Can you give any tips on how you run a D&D session when one of your goals is therapy? What do you differently compared to if you were running a "regular" D&D game?

(I am an experienced Dungeons & Dragons DM and am planning on running a session soon for some first-time players, one of whom is struggling a bit with mental health. They love RPGs and I'd like to create an environment for them to unwind and meet some new people.)

PerthNerdTherapist22 karma

Run a session 0 and introduce them to the Monte Cook Consent in Gaming sheet, or just ask them directly if there's stuff they'd prefer to avoid. The the Monte Cook sheet is great but there's a lot on there I'd rather not even consider having in a session. You can also use the X-Card or the Traffic Light System to support their comfort through the session. Honestly just keep a dialogue going, be open to feedback and kindly redirect players if they're being a bit much, or pushing buttons.

Therapeutic games use homebrew campaigns for therapy goals, such as depression, anxiety or social/emotional learning. I have designed custom mechanics and obstacles which require players to learn about and use mental health coping skills in the session.

My regular, social D&D games are way less planned and way more chaotic, and I'm far less hesitant to throw random stuff at my players.

youngbingbong2 karma

thanks for the great response. keep up the good work!

PerthNerdTherapist11 karma

You too! There's actually a Youtube series from an American psychologist called "Psychology at the Table", and she does videos on supporting players with anxiety. It may help! https://www.youtube.com/watch?v=Ep6jW-Be2-M

loldragon0512 karma

As dumb as this might sound, among us might help with differentiating from truths and lies and it can get your mind to really work on what should be done.

Oh and Microsoft flight sim can be relaxing to some people to just fly endlessly over the world.

What are your thoughts on these? Have you ever tried these or do you think these wouldnt really be helpful?

PerthNerdTherapist12 karma

I've heard this about Among Us and really think there could be value in a structured, supervised, in-person group game of it. I haven't really thought much about running it myself, but I believe there's folks who have.

I haven't played Flight Sim since... Windows98. I bet it'd be serene now.

Greyuriel11 karma

I am running a group at a house for boys. We have been using games to establish therapeutic rapport and last spring ran a Dnd campaign. It opened up great conversations. What resources do you recommend on using games in a clinical setting?

PerthNerdTherapist11 karma

The X-Card system, a Consent in Gaming sheet, patience, and a willingness to encourage improv and creativity. :)

fawlen8 karma

So.. how does fortnite qualify as therapy? When i played it, i wanted to throw myself out of the window..

This is a genuine question btw, i ma curious.

PerthNerdTherapist8 karma

If you ever return to Fortnite please ensure your windows are secured.

Basically using the 4-player squad option to run groups for building personal resilience, communication and teamwork skills :)

IvanTheWebHed6 karma

Hello! I am a therapy student doing my last year before I get my degree (USA). Integrating DnD and video games into session with clients is something that I have been trying to dive into as soon as I heard about it. I will be graduating in May of 2022, and I am wondering if you have any tips on how to get started as a nerd therapist? Some of the questions I've been asking myself have been: where to go for training, How to compare different programs, what to look for, and is a physical space necessary or can it be just as effective online. Sorry if this is so much at once, I am just so excited to get a chance to ask someone like you 😅

PerthNerdTherapist8 karma

Honestly, I'm in Australia so I can't really help advise on a lot of the stuff around programs and how to get started there. I'm not even sure how your insurance system would cover it.

I run sessions in-person because I'm in a part of the world which hasn't been too heavily impacted by Covid. I have learned how to DM online incase of a new wave hitting us, but haven't had to run it yet. I'm concerned about maintaining engagement via the computer though.

Join the Geek Therapy Community! https://www.facebook.com/groups/1663320987305797

tobaknowsss6 karma

How does one join a DnD group if they're a bit of an introvert? I've always had interest in playing but I don't even know where to begin and no one seems to have the patience for a new guy which can lead to feeling like you're only bothering people....

PerthNerdTherapist5 karma

Hiya! I'm sorry that's been your experience.

The official D&D discord server has a looking for group channel. I'd also recommend looking for your local gaming store which sells stuff like D&D books and seeing if there's any local groups or boards available for new players.

Otherwise, do you have any friends who'd be interested in playing? I know a good amount of folks who just started with a small group of friends who'd never played before, and they worked on it together.

rcrabtr226 karma

I'm curious. What is your degree? Masters of professional counseling, clinical social work? I was trying to find information on it and I couldn't. Very interesting concept. Don't even think there is any place I could find a job at doing this kinda work.

PerthNerdTherapist3 karma

BA: Psychology & Counselling.

I'm currently looking at post-graduate study (social work or psychology) but I've got some stuff to think about in the meantime.

It's tough but it's out there! Places like Headspace or NDIS related services are supportive of stuff like this.

CyanideSeedbell2 karma

Absolutely. I use D&D as a headspace clinician (MHSW) and it's great. My group at the moment are mostly young people with ASD and anxiety and they've made more progress in 3 sessions of D&D than several months of CBT.

PerthNerdTherapist3 karma

Thats totally awesome! I know a few headspace centres here in Perth run it - I'd love a chance to help out with it.

ruckdiz5 karma

Dnd has always seemed interseting but intimidating to jump into. Do you clients usually have experience already or do you teach average joes how to start too?

PerthNerdTherapist13 karma

Most of my clients are first-timers. I have a bunch of handy resources I use to make things simple. I have an A4 sheet for Class, Race and Background, and players can pick from those handy posters. Plus I use the Dyslexia-friendly character sheets, as they have handy pictures on them to make things easier to approach for new players.

The D&D character sheet is intimidating until you learn it. It's definitely a lot to be faced with at first, but there's a lot of awesome folks out there who'll help you learn, especially at your local games store, or on Youtube, Facebook and Discord.

ruckdiz3 karma

That sounds amazing. Glad there are people like you out there looking to help in new and innovative ways!

PerthNerdTherapist5 karma

There's more of us out there than I thought originally - just that a lot of us don't have the time to speak up and do something like an AMA.

It's really awesome work though, I really appreciate being able to work in such an affirming and supportive way.

Derago3325 karma

As a gaming involved therapist, how do you think games like Crusader Kings and Europa Universalis could be used in therapy? Or are they too complex to really use in such a way.

PerthNerdTherapist5 karma

I need to do the degree in Paradox Games that you need to seem to do to get anywhere in them. I struggled with Hearts of Iron.

I can't see why not - but I feel like they'd best be used with folks who are familiar with the game itself before suggesting it. Otherwise I'd definitely start with a game with less complicated mechanics.

TheHornedKing5 karma

What edition of D&D are you running? And do you have a preference for a certain edition in a therapy setting?

PerthNerdTherapist3 karma

I'm running 5th - its simple and handy for newcomers to the genre, plus it's supported by current content.

etherstorm884 karma

Hello fellow nerdy therapist! I may be soon opening up my own shop here in the U.S. Do you have any go-to books or inspiring people you look to when using gaming as a form of therapy?

Second question, if I get one. How long did it take you to build your brand?

PerthNerdTherapist1 karma

I opened my practice in June 2020, and started offering nerdy stuff in October 2020. I went full time in my practice in September 2021. It's still in early growth stages but looking promising. :)

My inspiring people are the Geek Therapy Community on Facebook - Janina Scarlet, Sophia Ansari, and the Starship Therapise team to name a few.

As for books, see Janina Scarlet's Superhero Therapy series, and Starship Therapise by Justine Mastin and Larisa A. Garski.

davidkali4 karma

Would a game like dwarf fortress make therapy benefits unquantifiable?

PerthNerdTherapist2 karma

I haven't played Dwarf Fortress to be able to know how to answer that tbh - what do you think may be the case?

tanginato4 karma

Is there a possibility that these methodologies could go sideways? I'm asking because Hikikomori (recluse phenomena often found in Japan, and some asian countries), often engage in these games/etc. I think the question would be, what if this became an outlet of escape, and the therapy is a gateway to escapism?

PerthNerdTherapist4 karma

Most of my clients are already gamers - I daresay they'd be at more risk of that without therapy. Part of therapy is developing mentally healthy attitudes and building prosocial engagement with others, which is why I focus hard on the small group work like D&D therapy.

GameShill4 karma

What is your opinion on the greater male variability hypothesis being confirmed in connection to the socially destructive gamer rage phenomenon?

PerthNerdTherapist3 karma

This is a new one to me - I'd have to do some more reading to give you an honest opinion.

kalte3334 karma

What credentials or licensure do you hold? What types of evidence-based approaches do you blend into the game?

PerthNerdTherapist3 karma

I'm registered with the Australian Counselling Association. I use narrative, DBT, ACT and CBT based approaches in games depending on clients' needs.

legbreaker4 karma

While the group therapy aspect is huge. So many issues today are because of isolation and lack of social skills and friends.

Do you ever think of this being a “rent a friend”with insurance coverage?

Or for group sessions a “friend brokerage” with reimbursement coverage?

PerthNerdTherapist2 karma

I set boundaries on content and topics in-game that you probably wouldn't get in a friendly/social game, and I do mental health stuff throughout that you probably wouldn't get at a buddy's game.

But I do getcha - isolation and loneliness are huge issues and I feel like that's why a lot of youth centres are running stuff like D&D now too.

deadlyhausfrau3 karma

... how does one get into this line of work? I've been DMing forever and a day, is there a counselling course I could take for this?

PerthNerdTherapist3 karma

I'm a therapist first and DM second. So you'd have to go through whatever your local jurisdictions policy is for becoming a therapist - and that varies from place to place. Youth workers also run this sort of thing too. I'd suggest looking into whatever is out there for you, and then look at what it takes to become one of those folks, be it psychologist, counsellor, social worker or youth worker.

SableyeFan3 karma

Is it possible for an individual to be able to process and release past traumas on their own with no external assistance?

PerthNerdTherapist4 karma

Hi there - I'm not a trauma therapist so I can't give you a comprehensive answer to that, but I'd recommend reaching out to someone for support rather than going it alone.

plaidfox3 karma

Honestly, I'm a therapist from Florida doing some of the same. I can't get enough people interested in TARPGs at the same time, how do you market for it?

Also, are you using raw D&D, Critical Core, or some other game for your base?

I may ask more questions later. Thanks!

PerthNerdTherapist2 karma

I do a bit of community engagement - my state's D&D groups all let me post my advertisements in there for the therapy sessions, so do some of the autism pages. I have good community support and I'm reaching a point where I'm getting clients by word of mouth. I'd contact community groups, game stores, schools, even colleges, to see if you can get some advocacy and support.

I use homebrew campaigns with mental health stories, encounters and game mechanics, alongside D&D 5e. I have a copy of Critical Core but I haven't used it yet - I'm kinda hoping to wait for the official box to come. BUT I'm looking at creating a post about it and seeing if there's interest in a group for it. I've also used No Thank You Evil in the past, and I'm hoping to run Masks, Star Wars or the Avatar RPG in the near future.

I really recommend joining the Geek Therapy Community group on Facebook: https://www.facebook.com/groups/1663320987305797

solongandthanks4all3 karma

Are you actually covered under Australia's national health insurance scheme? Or are you one of those shitty private practice therapists that only serves rich assholes?

PerthNerdTherapist3 karma

As a counsellor and not a psychologist, I'm not covered by Medicare. The Counselling Association is currently advocating for us to be added to Medicare, but this is a federal decision and it will take time. I wholly intend on doing whatever I can to be able to provide Medicare services.

At the moment my rates are flexible, with concession and low-fee options available. I've also worked with public services and can help provide a referral to no-cost services if needed :)

SnowOpinionated3 karma

As an avid gamer with an autistic son (10), he's been enjoying, and coding Roblox and Minecraft. His mainstream autism center therapists belittle me when I stress the importance of his in-game successes and the game's role as a confidence builder. He's free to be himself when he games, and opens up, talks, and teaches his younger brother. They play together instead of fight. They have real conversations. What's your advice on pushing back to these close-minded therapists? I see the value in gaming as therapy, but feel unheard and ridiculed.

PerthNerdTherapist3 karma

I won't lie - that's been my experience too. I work with a lot of kids whose previous clinicians have belittled them and/or their parents for allowing them to play games, or appreciating the positive benefits of gaming. I'm in a few closed professional groups online and we get the occasional post from non-nerdy clinicians complaining about games or their clients who enjoy them - and it really upsets me.

I run a program called Pop Culture Competence - where I explain stuff like anime, superheroes, videogames, scifi and fantasy content to therapists, teachers and parents, and provide consumer perspectives and professional advice on navigating them. I've had clinicians message me in the past telling me that they'd never thought about x game in y fashion before.

My advice is to be honest. Tell them it's where your child feels their mastery, how he doesn't have to mask in sessions. Gamers hear criticisms of gaming all the time - and it hurts the therapeutic relationship, especially if gaming is part of where we feel confident, or from where we draw part of our self-esteem. Link them to Pop Culture Competence - https://popculturecompetence.wordpress.com and see if they change their mind. If they continue to belittle your kid, reach out to the Geek Therapy Community or Geek Therapeutics on Facebook for a referral.

idontmakehash2 karma


PerthNerdTherapist2 karma

The official D&D discord server has a looking for group channel. I'd also recommend looking for your local gaming store which sells stuff like D&D books and seeing if there's any local groups or boards available for new players.

queennbee2 karma

Why do I still play Civ 4 for endless hours even though I've owned it for over 15 years??

PerthNerdTherapist2 karma

Because it's an amazing series and each play through has something a little bit different. Games like Civ have withstood the test of time. Who's your top Civ? I haven't actually played Civ 4 yet

turkeysnaildragon2 karma

Is there a significant literature behind your specific practices? Any suggested papers for reading?

PerthNerdTherapist3 karma

There's a bunch of it behind RPG therapy; https://gametogrow.org/resources/research/

The use of gaming to provide therapy is a newer part of the field, but there's a good amount of it for Minecraft and other games' therapeutic and educational application. It is still an idea that's growing in its acceptance in the professional world, though, and research into gaming in general is sometimes tricky to navigate.



Zer0Summoner1 karma

I love some of those games. Hypothetically though, if you had a prospective client who wanted your services but hated those games, would you use a game of their choosing? If so, what kind of preparation would it take for you to adapt to the game they picked?

PerthNerdTherapist1 karma

It'd be navigated through a bit of a system; do I have the game? Can I get the game? Is there going to be value in the game? Is being a beginner at the game going to impact my ability to engage with this person? Can I play it with this person legally? Is it going to be way more trouble to explain than it's worth? I feel like GTA Online is going to be a no-go, even though I've written an article on the social skills one can develop in the game.

It'd really depend on a lot. That isn't to say it's not possible - I'm all about working with people and where they can meet me, but it isn't limitless.

Relevant-Book1 karma


As someone in the field in another country I have a few questions. I’m always excited to see new ideas like this being tried but am always a little dubious as well. I saw that your registered with the ACA, but they have multiple levels of registration, are you required to disclose the level with your clients?

Additionally I see you are familiar with DBT, are there other modalities that you feel are particularly aided through the use of games?

Lastly, do you have concerns about video games as an addictive and maladaptive coping mechanism for your clients long term?


PerthNerdTherapist1 karma

That's a great buncha questions. I've never been told I have to tell people my ACA level - but I answer it all the same. :)

ACT is a good one that can work well with games - the strong focus on acceptance is good for working with frustration, and so is de-fusion.

I do have concerns about gaming becoming problematic in folks' lives, and it is something I discuss in sessions. I actually have a talk coming up on the topic of "when to log out", covering healthier gaming habits and how to notice that you need to take a break.

GodSwimsNaked0 karma

Do you think it's ethical to have that kind of connection with a therapist?

PerthNerdTherapist5 karma

What kind of connection?