Psychodrama Therapy

Psychodrama sessions are performed once or twice a week in groups of eight to 12 people. Though sessions are usually around two hours, they may last longer.

Each session focuses on one individual. The remainder of the group acts in a supporting capacity as needed to assist the individual in their exploration process.

There are three components of a psychodrama session:

The Warm-Up Phase
The warm-up phase is an introductory session that allows the group participants to introduce themselves, get to know each other, and build trust for future experiences.

The Action Phase
The action phase includes psychodramatic techniques with the elements of role-playing and acting based around the focus individual – the protagonist. The therapist acts as the “director” to guide the experience using techniques like:

Mirroring
The protagonist observes others acting out scenes, events, and conversations. This builds perspective for the individual to recognize and interpret their emotions, reactions, and thoughts with emotional distance.

Role-Playing
Role-playing allows the protagonist to portray an object that is a source of conflict or stress in their personal or professional life – usually a person.

Doubling
A member of the group acts out the protagonist’s emotions and behaviors. They are free to interpret the protagonist’s thoughts and emotions, revealing what they may be holding back. This process creates a connection between reality and the protagonist’s internal perception.

Role Reversal
The protagonist acts out the role of someone in their life while another member of the group plays the part of the protagonist. This technique involves improvisation, unlocks empathy, and helps the protagonist recognize other people’s perspectives.

Soliloquy
With this technique, the protagonist shares their inner thoughts and feelings to the audience, modeled after the dramatic theater device that addresses the audience. The purpose of this technique is to help the protagonist gain insight into their feelings and thoughts to reach a catharsis.

Empty Chair
With the empty chair technique, the protagonist sits before an empty chair that represents a person, object, situation, or themselves. The protagonist then speaks to the empty chair and shares their feelings.

Surplus Reality
Surplus reality is a specific technique that can be used for anxiety disorders, obsessive-compulsive disorders, and trauma disorders. It involves acting out scenes that haven’t occurred, typically based around the protagonist’s fears or anxieties of the “worst-case scenario.”

The Sharing Phase
The sharing phase involves a therapist helping the protagonist process the thoughts and emotions that have surfaced during the session to deepen insights and move toward transformation.

During this phase, other group members are free to share their insights to help the protagonist on the journey to self-discovery.

Psychodrama has many potential benefits, including:

• An increased sense of competence and self-efficacy
• Deeper resolution of trauma
• Integration with other types of psychotherapy

One of the greatest advantages of psychodrama is that it has a variety of applications. It can be adapted to the individual’s needs and situations, accessing deeper healing.

Though similar, psychodrama and drama therapy are not the same. Drama therapy is a therapeutic technique that encourages participants to act out stories for personal growth or healing, but it doesn’t require the direction of a psychotherapist or licensed professional.

Psychodrama is a type of drama therapy, but it has some specific requirements:

• Psychodrama exists within the context of psychotherapy. Drama therapy can occur in many different settings with different group dynamics.
• Psychodrama focuses on one protagonist, while drama therapy may have a range of different focuses in each session.
• With psychodrama, there’s an emphasis on the new role the protagonist plays in their own story. Drama therapy is less focused in its approach, and though it may resolve psychological problems, that’s not necessarily the goal.
• Drama therapy is centered around expression in general, while psychodrama focuses on personal growth and healing.

More research into the effectiveness of psychodrama is needed, but limited studies suggest that it’s effective for a variety of health conditions.[3] In particular, doubling and role reversal techniques show the highest rates of improvement as interventions in adults and adolescents.[4]

Some studies show that psychodrama sessions can improve outcomes battling substance use disorder by helping them confront their problems, express their feelings, and improve their social skills for better well-being

Psychodrama is a form of therapy often used for substance use disorder and typically addresses issues that may affect the entire group, such as relapse risk and prevention or social issues surrounding substances. Participants can work both as a group and individually to confront the past and manage their triggers and stressors to manage the future.

Psychodrama can be helpful for a variety of different mental health conditions, particularly involving emotions, moods, and self-image. The conditions it may help include:

• Grief
• Identity issues
• Eating disorders
• Mood disorders
• Personality disorders
• Negative self-image
• Trauma
• Relationship problems
• Addiction
• Schizophrenia

Following detox, psychodrama therapy may be used in several levels of care, including during partial hospitalization, intensive outpatient, outpatient, and dual diagnosis programs.