When it comes to mental health, there’s more than one way for a person to seek the support they need. While one-on-one cognitive behavioral therapy (CBT) is one of the most highly recommended options, it’s not the only way to find clarity.
For some people, a more immersive and collaborative approach is more effective when working through problems and past traumas.
Read on to learn more about psychodrama therapy, how it’s different from other techniques, and how it can help.
In contrast to CBT, which relies more on relaying events to a therapist, psychodrama therapy involves participants acting and roleplaying in a group setting. By doing this, they look for insights into behaviors and thought processes. As the name implies, there’s a bit of theater as well as sociology involved.
Rather than playing roles from a play or movie, participants are encouraged to dramatically act out real lived events as a way to understand what triggered those scenarios, potentially uncovering better methods for managing those stressors in the future.
The American Society of Group Psychotherapy and Psychodrama (ASGPP) notes that the goal is to help people gain perspective as the process of acting out a role often helps them view previous experiences from different viewpoints. An overarching goal is to break through barriers that might otherwise hinder growth and development.
Psychodrama has been around for a while, even though it’s still viewed as experimental. It was developed in the early 1900s, and the psychiatrist Jacob Moreno held the first psychodrama therapy session in 1921.
Anyone can benefit from psychodrama therapy, but evidence suggests that it’s most effective for people who need to work through past unresolved traumas. Most often, it centers around exploring relational roles, whether that refers to friendships, family ties, or professional associations.
One 1997 study looked into the effect of psychodrama for adolescent girls who wished to manage trauma. Researchers found that those who underwent psychodrama experienced reduced anxiety or depression. This group also reported feeling more competent and more capable of managing future stressors.
Similarly, a 2016 review of people with eating disorders who underwent psychodrama as part of overall therapeutic approaches also noted beneficial outcomes. The review looked at 196 psychodrama group meetings that occurred over 7 years from 2004 to 2010 involving people with eating disorders. The sessions focused on primary family relationships and potential emotions that often precipitated disordered eating episodes.
While noting that more reviews were needed, the researchers agreed that the immersive therapy technique was beneficial in determining the root cause behind each disorder and helping address it.
Traditionally, psychodrama therapy sessions are performed in a group setting, but it’s possible to also engage in one-on-one sessions between a client and a therapist. Usually, these are once-weekly sessions that will be attended by anywhere from 8 to 12 people with single sessions lasting from 1 to 2 hours.
Each session typically focuses on one individual from the group, with other attendees serving as key supporting roles to work through past traumas. While roleplaying is one of the key aspects of this type of therapy, dramatic self-presentations and group dynamics may also be explored.
Regardless of which tactic is employed, the overall goal is for each participant to gain better insight and understanding into past experiences and how those memories influence current decisions and shape interpretations of future events.
3 phases of a psychodrama therapy session
There are typically three core phases for any psychodrama therapy session: the warmup phase, the action phase, and the sharing phase.
Each stage is critical and shouldn’t be rushed as trust, and a willingness to be fully open is essential for participants to gain value from this type of therapy.
The warmup phase
During this introductory period, group members will introduce themselves. This is essentially an icebreaker period with the primary goal being to establish trust so that each person is willing to be vulnerable.
Because the goal of psychodrama therapy is to work together in a group to achieve a better understanding of past traumas and the influence they can create, the members must feel willing to work together.
The action phase
At this stage, one member has been selected to be the focal person — known as the protagonist — for the session and now a pivotal moment must be played out in real-time during the group session. While the protagonist is the focus, all other group members are assigned secondary roles to help the protagonist work through past traumas and uncover truths.
The therapist may serve as a director, helping to move group members through a “scene” to help encourage an emotional discovery. Multiple techniques may be used to achieve this goal.
The sharing phase
This is a critical stage where the protagonist is then guided by the therapist to help process the emotions that might be triggered during the action phase. Group members are encouraged to explore feelings that arose during the roleplaying activities and be willing to reflect verbally on what this means.
Group members are also encouraged to share their reactions and provide input that will allow the protagonist to better examine how the roleplaying scenario impacted their life.
Psychodrama group therapy techniques and activities
Several techniques may be employed during the action phase of a psychodrama therapy session to help the protagonist as well as other participants gain insight and wisdom from past experiences.
Common options include but aren’t limited to:
- Doubling: A member of the group will act out the protagonists’ actions or emotions. This individual will verbalize what they think the protagonist is feeling or attempting to repress. Doing this can help to create a connection between reality and the protagonist’s mindset.
- Mirroring: The protagonist takes a passive role and instead simply watches other group members act out pivotal scenes from their life. This can help protagonists maintain perspective as events are replayed because it allows for emotional distance.
- Roleplaying: The protagonist will specifically focus on a scene, event, or trauma that is a core stressor in their life.
- Role reversal: In this scenario, the protagonist takes on the role of a pivotal person in their life while someone else in the group plays the protagonist in a scene. This tactic helps to build empathy and emotional awareness.
- Soliloquy: This tactic requires the protagonist to verbalize their inner thoughts to the group. This is intended to provide an emotional release as well as allow for insights to arise.
Does psychodrama therapy work over telehealth?
While psychodrama therapy thrives best in an in-person environment, it has been proven effective even when used virtually.
In particular, a 2021 study looked at tele-psychodrama use in Italy during the mass COVID-19 shutdown. Researchers noted that those participating in this online group therapy found the process helpful in reducing the feelings of isolation that were often reported during shutdown efforts. Meanwhile, others reported feeling more optimistic or having better well-being.
What are the possible negative effects of psychodrama therapy?
Although negative physical side effects are unlikely when engaged in psychodrama therapy, emotional side effects are possible.
In particular, some people may find themselves experiencing further emotional pain or trauma as a result of living traumatic events or being reminded of triggers. In particular, this can happen to non-protagonist participants as they’re exposed to other people’s traumatic events.
This trigger should ideally be discussed during the final sharing phase of the session, but you can also discuss it privately with the therapist if that feels safer.
How effective is psychodrama?
Research has overwhelmingly shown that psychodrama therapy is beneficial. Specifically, it can help participants:
- learn to boost emotional intelligence and awareness
- effectively navigate conflict
- develop safe outlets for painful emotions
- process grief
- improve empathy
- effectively work through traumas
- learn how to actively work through conflict issues — especially those that come from close relationships
What is the goal of psychodrama?
Psychodrama therapy is ultimately a tool that allows people to process intense emotions either related to traumatic events or interpersonal relationships in a safe environment, guided by a licensed therapist.
What type of therapy is psychodrama?
Usually, psychodrama is a form of group therapy. While it can be performed in one-on-one sessions between a client and a licensed therapist, it’s usually done in a group setting with multiple other people also actively engaged in each session.
How much does psychotherapy cost?
Unsurprisingly, therapy can vary widely in cost depending on where you’re located, whether you’re insured, and the type of mental health support that’s covered by your insurance provider.
It’s not uncommon to find that therapy sessions can range anywhere from $100 to $200 per session.
How to find a psychodrama therapist
Not many therapists are well-versed in psychodrama. Start your search by visiting the American Board of Examiners in Psychodrama, Sociometry and Group Psychotherapy. You can filter by location as well as specialty (i.e., individual, families, couples, group, telehealth, etc.).
Click here for other tips and resources on finding the right therapist for you.
While not new, psychodrama therapy is still a lesser-explored niche within the overall behavioral therapy space. It involves using a group to act out scenes of past or current stressors for that session’s “protagonist.” Each session is carefully introduced, guided, and processed by a trained therapist.
It can be beneficial for a wide range of individuals but is often recommended as especially effective for people living with unaddressed trauma, eating disorders, or intense interpersonal relationships.