Board games as a therapeutic tool for mental health recovery
Neil Parker
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London (west)
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We know playing board games is a lot of fun and we may have found them therapeutic ourselves, a way of relaxing with friends or engaging with family. I work for a mental health charity (Rethink Mental Illness) in a day recovery service and over the last year I've established a board games group, initially once a week, then twice a week, as an option for those seeking to spend time in a safe environment, engaging socially with others.

It has been met with success and I wanted to share my findings with the community. A few weeks ago I promoted the group internally and the media team picked up on this and contacted local media to gauge interest. Radio Harrow asked to interview me and if you are interested you can listen to a section on their website (I don't know how long it will stay up for) - from 36:15...

http://www.radioharrow.org/news/carousel/lets-talk-depressio...

The full interview is due to be uploaded soon - about 20 minutes long - I did promote BGG too

I'm listing some of the more significant games we've played below, but first I'll explain the service and then summarise my findings.

The recovery centre takes referrals for those with mental ill health as a primary diagnosis. The aim of the service is to help clients in 2 main ways, firstly, to engage in recovery based activities ranging from the physical such as Qi Gong, Kundalini Yoga, Virtual Gym sessions at the local leisure centre and Gardening, to counselling and other therapies such as creative writing, art and music therapy, mindfulness, psychological support through self-esteem and assertiveness groups and then social groups looking to tackle social isolation such as our quiz and board games groups.

Secondly, to engage with key work support to set goals to promote recovery.

The board games group. In essence, what I have seen are clients who are willing to undertake games they have never played before, engage socially, which for some has proven challenging, build their social and communication skills as well as build their self-esteem and help reduce social isolation. They have also developed confidence through roleplaying elements of games and an understanding of strategy and tactics. The numbers have varied, some have dropped out or only attended a few sessions, but there is a rough core of 5-6 players that usually make it.

The success has led clients to feeling less isolated, having something to look forward to, helping them feel they are liked and helping them to engage with our service.

The next challenge is to help them move forward and maintain the group as a peer-led activity.
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1. Board Game: Carcassonne [Average Rating:7.43 Overall Rank:152] [Average Rating:7.43 Unranked]
Neil Parker
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London (west)
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The supply of games at the centre when I joined was very limited as the games were traditional including playing cards. I started to introduce some of my games. In order to fit into the group a game must be playable essentially within 60-90 minutes, be relatively easy to learn, have strong elements of interaction and have good replay value.

So I started off with Carcassonne. This proved successful, and although some elements of the game caused confusion - ie farmers scoring - clients were happy to play as long as I was there to help. It became very clear from the outset that clients were willing to support each other in learning and that helped everyone engage.
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2. Board Game: Ultimate Werewolf [Average Rating:6.62 Overall Rank:4419]
Neil Parker
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The big hit. I introduced this with some doubt that clients would find it interesting or enjoyable. Sometimes these games appear too challenging, but I was pleasantly surprised when clients agreed to try it.

What I have found is that whilst they do still find it a challenge, they have relished the game and thoroughly enjoyed playing this as a regular. It is quick and whilst being a werewolf has put pressure on individuals, they have come back for more. Reading body language is not always reliable as we are dealing with clients who naturally can feel nervous or are not particularly talkative, so we filter that out.

The clients have become confident in roleplay and being in a secret role, they have become assertive when challenging, they have developed a strategic understanding of how to work with others and deduce roles and they have had a lot of fun doing so.

I started off being the moderator, but one or two clients prefer the role so to build confidence, I allow them to take the moderator role (which also means I get to play too!) A downside to being a player too mind is that often I am either targeted for lynching or by the seer first night! but it is all fun.

Currently, we have groups of 5-7 players and we usually use the following combination of roles: Seer, Mason x2, Werewolf and Prince. We add a werewolf sometimes for a 6 player game as the clients feel less pressured if they are the werewolf although the game can be brutally quick. We also have used the Bodyguard, the occasional ordinary villager and at the start, the Sorceress - which they didn't really like much.

It has proven to be successful partly I feel because clients get to engage socially. Their roleplaying and ability to deduce and bluff has also made for some very interesting and funny games.
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3. Board Game: Spyfall [Average Rating:6.98 Overall Rank:494] [Average Rating:6.98 Unranked]
Neil Parker
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One of the clients introduced this and it has been played with some regularity. This has proven to be a fairly popular game but also challenging too. Yet it is quick and clients have developed their poker faces and confidence.
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4. Board Game: Hey, That's My Fish! [Average Rating:6.73 Overall Rank:738]
Neil Parker
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Another quick and easy game I introduced which went down well was this. Not played as much now, because of other games, but nevertheless it has proven easy to learn and good for developing tactical thinking.
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5. Board Game: Frank's Zoo [Average Rating:6.61 Overall Rank:1351]
Neil Parker
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This has proven to be another regular game. It is easy enough and quick and clients have again understood how to play tactically.
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6. Board Game: Cockroach Poker [Average Rating:6.63 Overall Rank:1094]
Neil Parker
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A game one of the clients introduced. It isn't played much now, but it was quick and fun and easy to learn.
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7. Board Game: 221B Baker Street: The Master Detective Game [Average Rating:5.97 Overall Rank:3864]
Neil Parker
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We were given a copy as a donation. It went down well thematically although we instantly made a house rule to roll 2d6 for movement and choose one of the dice. It does have some replay value although we've only played it once and I think it is because it seems like a long game.
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8. Board Game: Ticket to Ride: Europe [Average Rating:7.56 Overall Rank:102] [Average Rating:7.56 Unranked]
Neil Parker
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I introduced the group to this using my own copy. Later we had a copy donated via request. We have only played it about twice as although some like it, some have found it challenging and long.
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9. Board Game: The Downfall of Pompeii [Average Rating:7.13 Overall Rank:480]
Neil Parker
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This has proven to be very popular. It didn't take the group long to get to grips with the rules, although building the deck is still something they find a bit confusing and sometimes placing relatives also. However, it still gets regularly played and one of the key highlights is how the clients are developing their strategic and tactical awareness. It is also great to see clients help each other with genuinely helpful advice and suggestions, even to the extent that some will drop out to support others which is helpful given the game only takes up to 4 players.
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Neil Parker
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I introduced Dungeons and Dragons to a small numbers of clients. One of them knew the game and understood how to play, but the others did not and found it very confusing. I bought the starter set and the adventure that comes with it and used the pre-set characters and I did a lot of the hard work for them so they could focus on roleplaying. Despite clearly being out of their comfort zone, they still wanted to continue and we completed about 3 sessions and reached a natural pause. We haven't played it since as not everyone in the group is regular, but I was pleasantly surprised how they were willing to try what was a completely new and challenging game for them.
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11. Board Game: Qwirkle [Average Rating:6.79 Overall Rank:708]
Neil Parker
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Another game that has gone down very well is Qwirkle. Initially it seemed daunting to some, but it was quickly understood by others. This is one of the games where players have been very keen to support each other with maximising scoring.
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12. Board Game: Beyond Balderdash [Average Rating:6.81 Overall Rank:1179]
Neil Parker
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This has proven popular and although can be challenging for some at times, it still has been a good and fairly quick game. It is particularly interesting and funny to hear the clients' answers. Sometimes there are similarities ie several answers can have a mental health theme and at other times the answers are inspired.
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13. Board Game: Tsuro [Average Rating:6.67 Overall Rank:849]
Bill Fogarty
United States
Seffner
Florida
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Psychology Today featured an article from a counselor who uses Tsuro in his practice. He works with teens on the autism spectrum. The article can be found at:

https://www.psychologytoday.com/us/blog/promoting-empathy-yo...
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14. Board Game: Batik [Average Rating:5.97 Overall Rank:5609]
Jeff Binning
United States
Rollinsville
Colorado
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I run game nights a few times a year at local businesses, usually restaurants. Batik goes over well, and would be good for all levels of cognition. It's only 2 player, but each game is only a few minutes long, so it can be used as a filler for people waiting to play other games.
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15. Board Game: Build Up [Average Rating:7.53 Overall Rank:8664]
This game has been very popular among therapists, occupational therapists, and special education. Check it out.

It is currently having its 3rd edition kickstarted.
https://www.kickstarter.com/projects/1302865215/build-up-3rd...
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16. Board Game: TransAmerica [Average Rating:6.66 Overall Rank:970]
Neil Parker
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London (west)
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Introduced Transamerica to the group last Friday and it was a bit hit. One person though it was too complicated, but the others picked it up quickly.

To keep it simple, we just played a series of standalone games and this avoided scoring. The games are quick enough and after a few games after someone won gold, we would carry on for silver and bronze position.

We has some interesting discussion too about strategy and players were willing to test their ideas out.
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17. Board Game: Dixit [Average Rating:7.29 Overall Rank:221] [Average Rating:7.29 Unranked]
Neil Parker
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This has been a more recent introduction and it has gone down very well. It can prove challenging as the storyteller and it is quite funny sometimes to hear the clues as either too obvious or too vague, but nevertheless this doesn't put clients off. It is a game that everyone seems to enjoy and get to grips with quickly.

It also encourages conversation and using social skills and we sometimes have a quick chat about the clue and the cards after each round. I've noticed that players do usually spend a bit more time looking at the cards in more details to pick up on clues which is good as they learn the different playstyles of each other.
We have one of the expansions that one of the clients donated and that has provided us with a bit of variety.
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18. Board Game: Exploding Kittens [Average Rating:5.95 Overall Rank:3558] [Average Rating:5.95 Unranked]
Neil Parker
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This was a donated game. Not played it before, but introduced it successfully. We had a flurry of games before Christmas and we now use it as a popular filler.

It is very quick, so players don't mind so much which they get eliminated, and it has proven easy to learn. Players do have a tendency to dump the kittens on the top of the deck giving the next player increased pressure.
It is interesting though to see play styles vary over games as players look to be more cautious early on and build up a hand to help them for later. I can also see how they have improved tactically to choose cards from players who are more likely to have decent cards to take.
 
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