Psychodrama Therapy

Psychodrama is a kind of experiential therapy that uses role-playing and dramatic presentations to help clients explore issues from their past. This kind of therapy is rooted in psychology but contains some aspects of theater and sociology.

Usually, a group of people are involved in psychodrama therapy, but the group focuses on one person at a time, acting out scenes from that person’s past. This might take place on a stage, but it can also be easily done in an office or other communal space (like a classroom) where a group can gather and still remain somewhat private.

Psychodrama can help people with various conditions, such as eating disorders, mood disorders, grief, trauma, and relationship issues. It can also be used with substance abuse disorders and even schizophrenia.

Psychodrama therapy was developed in the 1920s by a psychiatrist and sociologist named J. L. Moreno.[1] He started by having his patients act out scenes improvisationally, as he believed that talk therapy did not have the same impact as improvisation on helping people work through their emotions.

He also believed that the process of taking on different roles would allow people to understand the world through new viewpoints. This process also lets clients explore new thoughts and feelings without being hampered by their previous thoughts or experiences, or ideas about how they “should” feel or react to something.

Because of this, psychodrama therapy hinges on the idea of roles. In a psychodrama, there are two main roles: the protagonist and the participants. The protagonist is the person whose memories and emotions are being explored, while the other group members, the participants, are there to help the protagonist express themselves and learn about different perspectives.

Psychodrama also includes the concepts of spontaneity and group dynamics. When individuals are allowed (or in some cases, pushed) to be creative, it permits them to be open to ideas and thoughts that they were previously closed off to. Being part of a group also allows the protagonist to learn from others who are peers in some way, rather than just hearing “advice” from an authority figure (the therapist).

In 2021, M. Angeles López-González, Pedro Morales-Landazábal, and Gabriela Topa completed a meta-analysis of the studies done on psychodrama in the past 100 years.[2] Joseph Moreno himself was the first one to perform studies on the effects of psychodrama, but many more studies have been completed since then.

In nearly all the studies that have been completed, psychodrama has been found to be effective in treating certain conditions. In the first half of the 20th century, Kellerman conducted a meta-analysis that concluded that psychodrama was effective in treating behavioral changes in adjustment, antisocial, and related disorders.[3]

In 2006, Weiser undertook a meta-analysis that concluded that psychodrama is effective for treating neurosis and schizophrenia, in large part because of its impact on the participants’ interpersonal relationships.[4]

In the 2021 review, López-González, Morales-Landazábal, and Topa concluded that psychodrama was effective in treating adolescents diagnosed with oppositional defiant disorder (impulsivity and oppositional conduct), people with anger, hostility, indirect aggression, anxiety/depression, social withdrawal (isolation), and burnout.[5]

Psychodrama sessions usually last about two hours and take place in three distinctive phases: the warm-up phase, the action phase, and the sharing phase.

Warm-up Phase

In this phase, members of the group introduce themselves and get to know each other. It is essential to build trust between the group members for psychodrama therapy to be effective. The therapist may have specific exercises for the group members to complete to build a sense of group cohesion.

Action Phase

During the action phase, the group focuses on one individual’s memory, acting out the scene together. Props and even costumes might be used as group members use different techniques (below) to act out the scene.

Doubling: A group member acts as the protagonist. The other group members will say what they think the protagonist might be thinking and/or feeling in the scene.
Mirroring: The protagonist observes an entire scene played out by the participants. This can help the protagonist gain perspective from the outside.
Role-playing: The protagonist acts as someone or something in their life that causes them tension.
Role Reversal: The protagonist plays the role of someone else in their life, while a group member plays the role of the participant. This can help the protagonist gain empathy.
Soliloquy: The protagonist describes their inner thoughts and feelings to an audience.

Sharing Phase

The therapist leads the group in a time of reflection. The protagonist can share their thoughts and feelings about the action phase, as well as any new insights they gained. Participants can also share their observations. In doing so, the protagonist is reintegrated into the group.