Clinical training in the delivery of gamified psychotherapeutic interventions is increasingly available in the United States, despite the current lack of strong empirical evidence for this approach. These interventions are purported to be more acceptable, engaging, and intrinsically motivating than available alternatives. The present pilot and treatment development study proposed a theoretical approach to empirically evaluate the claim gamified psychotherapies represent an intrinsically motivating treatment approach, and to explore the outcome and acceptability of the therapeutic tabletop role-playing game (TTT-RPG) developed by the author for small group delivery of adapted dialectical behavioral therapy skills training (DBT-ST). A non-clinical sample of 287 university students seeking interpersonal skills training completed an online pre-screening survey, providing self-report data on baseline variables of interest (e.g., demographics, interpersonal distress, etc.) as well as the acceptability of both TTT-RPG and a more traditional group skills training alternative. Thirty-three students from this initial sample then participated in at least one session of TTT-RPG, with twenty-five completing the protocol over the course of three weekly sessions (approximately 3.5 hours each). Completers provided self-report data on changes in interpersonal distress and acceptability over time, as well as motivation, perceived progress in skills training, group positive bond, and usability/playability. At baseline, students found the TTT-RPG to be more acceptable than a more traditional alternative. Following participation significant changes were observed in TTT-RPG acceptability (increasing) and interpersonal distress (decreasing). Further, participants reported high levels of perceived progress, group positive bond, and usability/playability. These data provided evidence of the usability, acceptability, and potential for further development of TTT-RPG for therapeutic use.