title: The impact of unstructured games of fantasy and role playing on an inpatient unit for adolescents.
abstract: Games of fantasy and role playing such as Dungeons and Dragons (1983) have become increasingly popular among adolescents and young adults. This article reviews the negative impact of such games on an adolescent inpatient treatment setting. The unrestricted play of such games contributed to the disruption of a treatment setting, resistances to treatment, reinforcement of character pathology, disruption of individual treatments, and to the normalization of violence. When such games begin to be played on a psychiatric inpatient unit or are prominent in discussions of individual patients, treaters should examine them in the context of their potential to reinforce and foster resistance and maladaptive patterns of relating to the environment. Treaters are also encouraged to attempt to understand the meaning and risks of such games in the context of an individual patient's psychiatric difficulties and of group dynamics, both within the patient group and between patients and treaters.
authors.affiliation: Menninger Clinic, Children's Division, Topeka, KS 66601.
authors.forename: L I
authors.initials: LI
authors.lastname: Ascherman
mesh_terms: D000293:Adolescent; D000987:Antisocial Personality Disorder / Q000523:psychology / Q000628:therapy; D003674:Defense Mechanisms; D005201:Fantasy; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy; D010988:Play and Playthings; D011573:Psychoanalytic Interpretation; D012381:Role Playing