What Is Psychodrama Therapy And What Does It Help With?

Psychodrama therapy is a creative therapeutic approach developed by Jacob Levy Moreno. Psychodrama therapy is often used in a group setting but might also be used in couples therapy or family settings. In this type of therapy, therapists use guided drama and role-playing to work through a client's challenges. 

In psychodrama therapy, the goal is often to achieve new insight, resolve conflicts, and practice new life skills and behaviors. Psychodrama therapy can complement cognitive-behavioral therapy (CBT) or be an alternative to other treatments. This type of therapy is often used to treat post-traumatic stress disorder (PTSD) or substance use disorders. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.

What happens in psychodrama therapy?

In the action phase, scenes that are acted out may involve past situations, dreams, or preparation for a future event. The therapist can begin by guiding the group through warm-up exercises. When they're ready to start the main exercise, the therapist chooses a protagonist representing the main elements of the group's challenges or one client's struggles. The others in the group enhance the scene by playing the roles of family members, significant others, friends, or strangers. They offer support, bring out underlying beliefs, and help the protagonist draw healing conclusions. 

After the scene has been played out, all participants can recognize and express feelings they couldn't express previously. At this time, the group discusses what their genuine emotions and responses would have been if they'd been able to express them at the time of the event that was acted out. The therapist might ask the group participants to reenact the scene once more by adding the desired changes. 

For example, a client might start psychodrama group therapy as the protagonist, reliving a challenging childhood event where their neglectful parent woke them up early in the morning and throughout the night to deprive them of sleep. Other group participants may play the role of the parent, whereas the client plays the role of their child self. 

After the scene has been enacted, the client can identify how they would have preferred their parent to act and treat them. Then, with the therapist's guidance, the group participants playing the parents can provide that support and ideal reality for the client in the group setting. These exercises are often personalized and structured with research-backed methods, allowing them to be effective in treating past traumas and challenging experiences. 

What techniques are used in psychodrama therapy?

Psychodrama sociometry is sometimes used to measure social interactions and relationships between group psychotherapy participants. Psychodrama sociometry and group therapy work together to provide information about group cohesion using surveys and interviews, potentially increasing the effectiveness of the drama therapy process.

Psychodrama therapists use the following techniques to guide the group.

Mirroring 

In the mirroring technique, a person in the group acts as a stand-in for the protagonist to see the situation from a more objective, outside perspective. They mirror the protagonist's actions as they understand the situation from the individual's telling of it. This technique may allow the person to see themselves as others do.

Doubling 

During a doubling activity, one person speaks for another in the group using a supportive tone. This technique may be helpful when the person isn't able or willing to speak for themselves. This technique might be used in couples or family settings where the individuals know each other profoundly. 

Role reversal 

Role reversal techniques allow the group participants to reenact the scene multiple times, playing various roles each time to experience the situation in a new way. For example, a participant may start by enacting a family situation from their viewpoint and then enact it from their parent's view or as a bystander. 

Future projection 

Many of the scenes in psychodrama therapy are around issues and experiences that the participants have already lived through. A future projection scene is one that a participant may experience in the future. This approach allows participants to demonstrate how they want to act when a situation occurs. It can be used to practice social skills, job interviews, or challenging conversations. 

Playback theater 

In playback theater, the group spontaneously acts out one person's life story or experience. The therapist allows the situation to unfold creatively, showcasing patterns of commonly experienced adverse events. 

What are the benefits of psychodrama therapy?

Psychodrama can be a powerful therapy because it allows the participants in the group to experience thoughts, feelings, and emotions in an active, real-time environment. This type of therapy can help them improve their relationships and communication skills. Participants of the group may also learn how to overcome grief and loss while restoring their mental health and well-being. A therapeutic group setting provides a safe, supportive environment for participants to express their feelings and emotions. In addition to enhancing their learning and life skills, group attendees will have a chance to experiment with new ways of thinking, acting, and responding. Sociometry and group psychotherapy, when combined, can offer group members more information about how they interact, offering new insights.

Conditions that are suited for psychodrama therapy

Therapists may choose psychodrama as a stand-alone therapy for addressing addiction, trauma, eating disorders, adoption, or attachment issues. It can also be combined with other types of therapy in some cases.

Psychodrama therapy for people dealing with traumatic experiences

Psychodrama therapy is often used in a small group of people who have experienced similar trauma. For example, the group may be survivors of violent acts, natural disasters, school shootings, or other challenging experiences. 

During a traumatic event, many individuals disassociate, often describing a sense of being "out of the body." The brain reacts this way to trauma to save an individual from experiencing the full impact of the occurrence. However, dissociation, fear, and pain can continue past the event's occurrence. Because these thoughts get harbored in the body with no way to process them, the body may become attentive to superficial threats when experiencing a trigger that reminds an individual of a trauma. 

Trauma affects the entire body, and memories remain in the body on a sensorimotor level. During the role-playing, participants re-experience the thoughts, emotions, and memories without letting their bodies shut down. Acting the scene out allows participants to tap into their sensorimotor level and release pent-up emotions. In addition, when clients can re-organize the event to change what happened to them, it may allow for healing. 

For example, a client might act out their caregiver treating them poorly as a child in foster care. After acting out the event, they can tell the person playing the caregiver everything they would have wanted to say if they could go back and defend their child self at the moment. The person playing the individual could then give them the response they seek or leave the situation, showing them they are safe. 

This type of therapy may be helpful when done in conjunction with individual treatment. Having a group of other clients to connect with can allow individuals to feel less alone in their experiences. PTSD is a condition that affects the mind and the body, which is why psychodrama is often suited for this condition. Clients can reframe their experiences and weave together formerly disconnected parts of themselves.

Psychodrama therapy for addiction 

Psychodrama therapy may help those living with substance use disorders or dependency challenges. Clients can learn more about themselves and their emotions, address conflicts, express genuine feelings, and enhance their social skills. It also helps them improve group interactions and unite with others experiencing similar challenges. 

Group sessions explore similar experiences for those living with addictions, such as the types of situations that could send them into a relapse or where the effects of their addictions led to social and behavioral problems. Psychodrama therapy helps them handle past and future situations by teaching them how to cope positively with stress and urges to use substances without relapsing. 

Studies have shown that psychodrama sessions successfully benefit people struggling with heroin dependency. The intervention strategies that worked best were doubling and role reversal. Clients improved communication, life skills, and social dynamics.

The role of “family members” in psychodrama therapy

Although a client's family may not participate in psychodrama therapy, other group participants often play these individuals. Clients can develop a sense of self-awareness and perspective, which helps them reconnect with family members they've hurt. In addition, clients may heal wounds with family members they no longer speak to by addressing them in the group setting without the family members present. Psychodrama therapy teaches people how to express their needs healthily and fosters emotional, spiritual, and psychological growth.

Counseling options 

Research in psychodrama therapy is relatively new. Much of the current research has focused on women and traumatic experiences, such as survivors of violent acts. The research on women and psychodrama is promising enough for researchers to explore the benefits of the treatment for others. Psychodrama therapists have also successfully used psychodrama with adolescents because of its similarity to child's play and imagination. 

Regardless of your age or gender and what issue you may be struggling with, if you feel that psychodrama may be a good fit for you, many group therapists are available to support you. Although psychodrama therapy may not be offered online due to the physical nature of the exercise, other forms of trauma-informed therapy and role-playing therapy, like narrative therapy, are available to individuals and couples in an online setting. 

Online therapy platforms like Regain for couples and BetterHelp for individuals offer connections to thousands of therapists trained in unique specialties. Through an online platform, you can connect with a therapist through video, phone, or live chat sessions and gain connections to resources to support you through your healing. In addition, studies have found that online therapy can be more effective than in-person options and offer a greater sense of connection with the therapist.