# Study Protocol of a Pilot Trial Evaluating the Efficacy of an Integrated Therapeutic Intervention Based on Role-Playing Games (RPGs) in Adolescents and Young Adults with Anxiety, Depression and Emotional Dysregulation Disorders

## TL;DR

This study explores using role-playing games as a mental health intervention for young people with anxiety and emotional issues.

## Contribution

It introduces RPGs as a novel, engaging therapeutic tool for adolescents and young adults with emotional dysregulation.

## Key findings

- The pilot trial aims to assess feasibility, acceptability, and efficacy of RPG-based interventions.
- Expected outcomes include improved emotional regulation and increased treatment adherence.
- Results may support larger trials on RPGs in youth mental health services.

## Abstract

Adolescence and early adulthood are critical developmental periods marked by an increasing vulnerability to emotional dysregulation and social difficulties, highlighting the need for engaging psychosocial interventions. This protocol presents a pilot study on the efficacy, feasibility, and acceptability of a structured group intervention based on Role-Playing Games (RPGs), designed to promote and support psychological well-being in transitional-aged youths. The study plans to recruit 54 participants (aged 15–24) who will take part in a 12 weekly, 2 h RPG-based intervention facilitated by trained clinicians. These clinicians will guide patients through narrative role-playing and a guided mentalization-based therapy through the gaming experience. All participants will be assessed at pre-, mid- and post-intervention, as well as during the 1- and 6-month follow-up, in the following dimensions: (a) mood, (b) anxiety, (c) emotional regulation, (d) alexithymia, and (e) coping skills. The following assessment tools will be administered: Hospital Anxiety and Depression Scale (HADS), Difficulties in Emotion Regulation Scale (DERS), Toronto Alexithymia Scale (TAS-20), and Coping Orientation to Problems Experienced (Brief-COPE). We expect the trial pilot will demonstrate good feasibility, greater participant engagement and treatment adherence, and improvements in all emotional and affective dimensions. This study seeks to establish foundational data to inform larger randomized controlled trials, with a follow-up, positioning RPG-based group interventions as potentially accessible, engaging, and convenient tools within youth mental health services.