RPG Character Creation: Rolling Up a Hero Might Roll Out a Better You

The Oasis Health Journal · Submitted July 31, 2026 · 4:01 PM EDT

By Ray 'Sleeves' Okafor · Edited by Mona Trell

You walk into my shop, fifteen years old, unsure about everything, and I hand you a blank character sheet. You think we about to play a game. We are. But something else is happening too, and researchers just published the receipts on what I been watching for twenty-two years: RPG character creation does real psychological work, especially for young folk trying to figure out who they are.

A 2025 study published in Behavioral Sciences examined five individuals, ages seven to nineteen, who used Dungeons & Dragons in therapeutic settings to address anxiety, depression, Dissociative Identity Disorder, and nightmares. The researchers also looked at group therapy with autistic adolescents, LGBTQ teens exploring identity, and women in residential treatment for substance use and trauma. Every single case showed the same pattern: when people sat down to design a character, they were actually designing a version of themselves they needed to meet.

Not metaphorically. Literally. One participant with DID created multiple characters to explore what it meant to hold more than one self. Another group of LGBTQ adolescents used fantasy persona design to try on gender expressions and identities in a space that was explicitly pretend, so it felt safe. Except the trying-on was real. The feelings were real. The person they built on that sheet walked out the door with them.

What 'Pretensive Shared Reality' Actually Means (and Why It Ain't Just Pretend)

A 2022 paper in Frontiers in Psychology gave it a name: Pretensive Shared Reality. That's the fancy term for what happens when a group of people agree to pretend together in predictable, coherent ways. Childhood make-believe, but with structure. Rules. Dice. A tabletop character builder that makes you write down who your character loves, what they fear, why they left home.

The researchers argue this kind of play does three things. One: it generates enjoyment. Two: it builds or maintains social groups. Three: it allows the safe exploration of self-concepts, including alternative expressions of identity. That third one is the engine. You get to be someone else in a room full of people who accept that person completely, and then you get to see what parts of that person you want to keep when you take the dice home.

I watched a kid spend six months playing a paladin who could not lie. Could. Not. Lie. In the game, it was a mechanic. In his life, it was practice. By the end of that campaign he was the most honest sixteen-year-old I ever met, and I don't think that was an accident.

The Study That Finally Wrote Down What My Tables Been Showing

The 2025 study tracked real outcomes. One seven-year-old with nightmares created a character who fought monsters, and the nightmares decreased. A teen with depression built a rogue who survived impossible odds, and started talking about his own survival differently. The LGBTQ adolescent group used RPG character creation to explore gender and sexual identity in ways that carried over into their daily self-concept. One woman in the substance use recovery group said creating a character gave her the first narrative she controlled in years.

These were small samples. Twelve weeks. Not a cure, not a guarantee. But the pattern held: when young people engage in D&D character sheet templates, backstory prompts, stat distribution, all the mechanical parts of character building in RPGs, they are also engaging in identity work. The researchers called it flexible and effective. I call it: finally, somebody publishing what I been saying.

The same study noted challenges. Not everyone responds. Some participants struggled with the social demands of group play. Some needed one-on-one facilitation before they could join a table. Some campaigns fizzled because the facilitator didn't know the rules well enough to hold the space. It ain't automatic. But when it works, it works because the pretend gives you permission to try the real thing in miniature first.

Why the Pretend Part Is the Part That Matters

A 2026 study in the European Journal of Pain found something relevant about adolescents and media: young people, ages thirteen to eighteen, both with and without chronic pain, watched clips of pain in popular media and then talked about what they saw. One theme that came up over and over was this: media serves as a metric. It's how they compare experiences. It's how they decide what's valid, what's exaggerated, what's worth empathy.

That same logic applies to RPG character creation. When you build a persona in a tabletop RPG character creation guide, you are also building a reference point. A version of courage, or vulnerability, or anger, or joy that you can measure yourself against. And because it's pretend, you get to test it without the stakes of your actual reputation. The kid who can't speak up in class can play a bard who talks his way out of every fight, and then maybe, six months later, that kid raises his hand.

I got a whole shelf of character sheet notebooks, and I can tell you which ones belonged to a kid who was trying on confidence, which ones belonged to someone working through grief, which ones were just fun. You can see it in the handwriting. In the backstory. In whether they gave their character a family or made them an orphan. The game is a mirror, and the character is the part of you that you let the mirror show.

What the Research Does Not Show (and Why That Matters Too)

None of these studies claim that roleplaying replaces therapy. The 2025 paper explicitly states that further research is needed to assess long-term impact and broader clinical applications. Twelve weeks is not twelve years. Five case studies is not five hundred. The LGBTQ adolescent group showed promising results, but the study did not track participants after the campaign ended. We don't know if the identity exploration stuck, or if it faded once the game table was gone.

The 2022 paper on Pretensive Shared Reality is a framework, not an intervention study. It describes the phenomenon, it does not measure outcomes. And the 2026 media study didn't look at RPGs at all; it looked at pain portrayal in film and TV. I'm drawing a line between that research and what I see at my tables, but that line is mine, not theirs.

What we know for sure is this: some adolescents, in some settings, benefit from using character creation in RPGs as a tool for self-exploration. We know the mechanism involves shared pretend play, social collaboration, and the safety of fiction. We know it worked for the people in these studies. We do not know yet how to scale it, who it works best for, or how to train facilitators so it works consistently.

But I know what I see. I see a kid walk in scared and walk out six months later standing a little taller because they spent twenty sessions pretending to be brave, and then one day they forgot they were pretending.

That's what the dice do. That's what the character sheet does. You roll up a hero, and sometimes, when you stand up from the table, you take a little bit of that hero with you. Not because the game is magic. Because you are, and the game just gave you a place to practice.

This article is education and reporting on published research. It is not medical advice, and nothing here is intended to diagnose, treat, cure or prevent any disease. Talk to your own clinician about your own situation.

Sources

1. Mastering Your Dragons: Using Tabletop Role-Playing Games in Therapy, Behavioral sciences (Basel, Switzerland) (2025).
2. Pretensive Shared Reality: From Childhood Pretense to Adult Imaginative Play, Frontiers in psychology (2022).
3. 'Heroes Were (And Could Be) Created': An Exploration of Adolescents' Perspectives of Portrayals of Pain and Empathy in Media, European journal of pain (London, England) (2026).