What a great topic!!... Real quick, before I reference my personal experience on the matter, in regard to escapism vs. therapy.... It most certainly is escapism before it is therapy however escapism (given the circumstances) can also certainly have therapudic, and problem solving, value.... To deny that fact would be like saying Vicodin doesn't assist in recovery from dental surgery. The medicine may only cover the immediate problem, but doing so can help solve it... in other words, without the Vicodin a man can't go to work and pay the pricey oral surgeon..... Ok, so that was a poor paralel to draw but you get the idea....
Anyhoo, in my own experience RPG's have proved life saving. I won't bore anyone with the gory details but lets leave it at growing up in my house was rough.... it was a volatile environment and if it not for liberating so many kingdoms from tyrannical empires, saving worlds from demons, and all with enough time to visit an alien planet in turmoil before bed I would have probably been all but completely consumed in the chaos around me.... Bottom line is, I was way more concerned with leveling up then I was the negativity that sat beside me through those years.... At that point games were more of a survival mechanism or coping strategy than simply just therapy or escapism.
Fast forward to adulthood. While not proud of the fact by any means, in adulthood I eventually found myself drug addled and highly addicted to some very demanding substances..... By demanding, I mean they DEMANDED all of my money, time, effort, thought, spirit and will eventually..... Once again, to make a long story short, I know when I made the decision to get sober and apply myself to not being a complete waste of space my whole life I returned to the fantasy realms that I found oh so comfortable as a child. The first 6-8 months of sobriety were like living a literal hell when I wasn't playing RPGs..... In all honesty I don't believe I could have gotten sober in the fashion I did without games (that is, without relapsing. without sublimating or substitution et cetera.....)
Fast forward now to present day. I am tattoo artist. As such my job carries with it a high degree of liability in a number of respects.... it is not all simple and fun as portrayed on TV, sorry to break the news..... and if I couldn't come home and escape the high level of liability I surely would not be able to return to work the next day inspired and ready to do it again.... While I love art, being simultaneously responsible for multiple deadlines at once, matters of permenance on clients bodies, and above all else the health and safety of the afforementioned involved, leaves one very drained eventually..... Quite honestly if it were not for video games I could easily see how I would seek out other forms of escapism under the level of stress I feel most days and potentially end up back at square one of trying to change how I feel through chemicals in some respect.
I can go on and on to illustrate my point and cite examples from my life but the point is RPG's and video games can and are useful in a number of respects beyond entertainment depending on the circumstances.