“Roll for intervention:” a (crit)ical look at the feasibility of online table-top role-playing games as group therapy for acquired brain injury

PURPOSE: The purpose of this pilot clinical trial was to investigate the feasibility and effectiveness of online table-top role-playing games (TTRPGs) as a treatment option for individuals receiving speech therapy for cognitive communication difficulties secondary to an acquired brain injury (ABI). METHODS: Five individuals with moderate-to-severe ABIs agreed to participate. Informal and norm-referenced assessments were administered pre-and-post treatment, including the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the LaTrobe Communication Questionnaire (LCQ), the Satisfaction with Life Scale (SWLS), and the Sydney Psychosocial Reintegration Scale (SPRS-2). Participants met virtually for two hours, once a week, for seven weeks. Individual goal progress was rated using Goal-Attainment Scaling (GAS). Participants' utterances were transcribed and analyzed using Systemic Functional Linguistics (SFL). RESULTS: Feasibility of this intervention was established by tenets laid out. For the primary outcome measure, generalized least squares model demonstrated individual GAS scores increased significantly by 0.24 (95% CI = 0.14-0.33). While pre- and post-formal assessment data comparisons did not reveal significant differences, SFL analysis revealed a positive change in participants' communication. CONCLUSIONS: TTRPGS are a feasible approach for addressing cognitive communication goals and improving social communication for individuals with ABI.