Scene-Based Psychodramatic Family Therapy With Troubled Adolescents and Parents: A Pilot Study.

Scene-Based Psychodramatic Family Therapy (SB-PFT) is an innovative treatment used with troubled adolescents and their parents to improve family relationships and reduce adolescents' problematic behavior. It integrates the principles of family therapy, psychodrama, and multiple-family group methodology. This research is a pilot study to obtain empirical evidence on the SB-PFT therapeutic process by gauging the perception of change of troubled adolescents and their parents, and assess the perceived helpfulness of its methodology and techniques. Ten multiple-family intervention groups were drawn up, with 110 participants (63 adolescents and 47 parents), and we adopted a qualitative methodology with focus groups, using an inductive analysis of 290 active constructions of participant narratives. Concerning perception of change, the adolescents reported mainly gaining in social support, prosocial attitudes, keys to problem solving, and expression of emotions due to the treatment. The parents perceived improvement in social support, keys for educational practices, emotional well-being, and expression of emotions due to the treatment. Regarding the perceived helpfulness of methodology and techniques, both adolescents and parents highlighted the usefulness of the group methodology for gaining social support, relativizing the problem, and expressing emotions. Additionally, participants referred to role-playing and mirror techniques as the most useful techniques. In conclusion, this first study on SB-PFT presents and describes its treatment for troubled adolescents and their parents. The participants' positive perception of their personal and relational change after treatment should serve to promote further studies with quantitative methodology in order to verify the effectiveness of SB-PFT treatment.

La terapia familiar psicodramática basada en escenas (SB-PFT, por sus siglas en inglés) es un tratamiento innovador usado con adolescentes conflictivos y sus padres para mejorar las relaciones familiares y disminuir el comportamiento problemático de los adolescentes. Integra los principios de la terapia familiar, del psicodrama y de la metodología grupal multifamiliar. Esta investigación es un estudio piloto para obtener conocimiento empírico sobre el proceso terapéutico de la SB-PFT mediante la medición de la percepción de cambio de los adolescentes conflictivos y sus padres, y para evaluar la utilidad percibida de esta metodología y técnica. Se formaron diez grupos multifamiliares de intervención con 110 participantes (63 adolescentes y 47 padres), y adoptamos una metodología cualitativa con grupos focales utilizando un análisis inductivo de 290 construcciones activas de historias de los participantes. Con respecto a la percepción de cambio, los adolescentes informaron un aumento pricipalmente del apoyo social, de las actitudes prosociales, de las claves para resolver problemas y de la expresión de emociones debido al tratamiento. Los padres percibieron una mejora del apoyo social, de las claves para las prácticas educativas, del bienestar emocional y de la expresión de emociones debido al tratamiento. Con respecto a la utilidad percibida de la metodología y las técnicas, tanto los adolescentes como los padres destacaron la utilidad de la metodología de grupo para obtener apoyo social, relativizar el problema y expresar emociones. Además, los participantes se refirieron al juego de roles y a las técnicas del espejo como las más útiles. En resumen, este primer estudio sobre la SB-PFT presenta y describe su tratamiento para adolescentes conflictivos y sus padres. La percepción positiva de los participantes de su cambio personal y relacional después del tratamiento debería servir para promover más estudios con una metodología cuantitativa a fin de verificar la eficacia del tratamiento con la SB-PFT.

Psycho-art-drama: development and testing a new integrated complementary method of psychiatric treatments for hospitalised children with cancer (a case study).

Objective: Art therapy as a psychotherapy method using art, and psychodrama as a therapeutic method using role play, have different roots, principles, techniques and different effect mechanisms and advantages. Integrated psychotherapies are aimed to maximise each of the component advantages, as well as minimising disadvantages. Therefore, the main objective of this study was to develop a new integrated psychotherapy method, named psycho-art-drama (PAD) for hospitalised children with cancer and testing its effectiveness.Methods: After designing the PAD protocol, five hospitalised children with cancer accompanied with their mothers selected based on inclusion and exclusion criteria to participate in this single-subject study.Results: The results showed that PAD was significantly effective in reducing the bio-psycho-social expressions of incompatibility in the hospital (BPSEIH) in all of the five children.Conclusions: Findings of this study give preliminary support using the PAD model in similar conditions.

Life-crossroads on stage: integrating life review and drama therapy for older adults.

OBJECTIVE: This paper examines the contribution of a new group of therapeutic interventions for older adults, based on a rudimentary life-review intervention. The intervention includes narrative elements together with drama therapy. The current study examines the influence of this therapeutic intervention on key indicators of mental health and psychological well-being among older adults. METHOD: Fifty-five people (n = 55), ranging in age from 62 to 93, participated in a before-after study design. The following indices - meaning in life, self-acceptance, relationships with others, depressive symptoms, and experience of successful aging - were compared between an intervention group (n = 27) and a care-as-usual control group (n = 28). RESULTS: Repeated measures analyses of variance showed a significant improvement over time in the experimental group. In addition, results also showed time-group interaction regarding the treatment's effectiveness for self-acceptance, relationships with others, sense of meaning in life, sense of successful aging, and depressive symptoms. CONCLUSION: Our findings confirm that the new therapeutic intervention, which integrates life-review with drama therapy, increases self-acceptance, relationships with others, sense of meaning in life, and sense of successful aging; in turn, it also decreases depressive symptoms among older adults. The contribution of this research is based on the development of a therapeutic intervention that combines narrative together with drama therapy tools, which can be used in focused and short-term group treatments with the elderly.

Implementation of the Veder contact method in daily nursing home care for people with dementia: a process analysis according to the RE-AIM framework.

AIMS AND OBJECTIVES: To perform a process analysis of the implementation of the Veder contact method for gaining insight into factors that influence successful implementation. BACKGROUND: Research showed that the original Veder method, which is a 'living-room theatre performance' provided by actors, positively influenced mood and quality of life of people with dementia. Training caregivers to execute such 'performances' and accomplish the same effects as actors proved difficult. However, key elements of the method were considered suitable for application in daily care, resulting in the development of a modified version of the method, named the Veder contact method. The Veder contact method combines elements from existing psychosocial interventions, e.g. reminiscence, validation and neuro-linguistic-programming with theatrical, poetic and musical communication, and applies this into daily care. DESIGN: For this process analysis a multiple case study design was used with the nursing home ward (n = 6) as the unit of analysis. METHODS: Eight focus groups with caregivers (n = 42) and 12 interviews with stakeholders were held. Using the Reach, Effectiveness, Adoption, Implementation, Maintenance framework, a thematic analysis was conducted. RESULTS: The reach of the intervention (43-86%) and aspects of implementation-effectiveness (e.g. increased experienced reciprocity in contact with residents) facilitated implementation. For adoption and implementation, both facilitators (e.g. development of competences, feasibility of the Veder contact method without requiring extra time investment) and barriers (e.g. insufficient support of management, resistance of caregivers against the Veder contact method, organisational problems) were identified. Little effort was put into maintenance: only one nursing home developed a long-term implementation strategy. CONCLUSIONS: The Veder contact method can be applied in daily care without additional time investments. Although adopted by many caregivers, some were reluctant using the Veder contact method. Organisational factors (e.g. staffing and management changes, budget cuts) impeded long-term implementation. RELEVANCE TO CLINICAL PRACTICE: The findings from this study can be used for the development of successful implementation strategies for the Veder contact method and other person-centred care methods.

In-session behaviours and adolescents' self-concept and loneliness: A psychodrama process-outcome study.

As adolescents spend many hours a day in school, it is crucial to examine the ways in which therapeutic practices in schools promote their well-being. This longitudinal pilot study examined the contribution of school-based psychodrama group therapy to the self-concept dimensions and perceived loneliness of 40 Israeli adolescents (aged 13-16, 60% boys) in public middle schools. From a process-outcome perspective, we also examined the understudied trajectory of adolescents' in-session behaviours (process variables) and its associations with changes in their self-concepts and loneliness (outcome variables). Psychodrama participants reported increases in global, social, and behavioural self-concepts and a decrease in loneliness compared to the control group. In-session productive behaviours increased and resistance decreased throughout the therapy, but varied process-outcome relationships were found. The study suggests that conducting further research into the process-outcome relationships in psychodrama group therapy is warranted to pinpoint specific mechanisms of change. Suggestions for future studies are provided.

'Welcoming the Other': psychodrama in an acute inpatient unit.

OBJECTIVE: In this article, the author uses the leitmotifs inherent in a critically acclaimed film and in the philosophy of Emmanuel Levinas as a backdrop for discussion around how we encounter the humanity in the Other and its particular relevance for psychiatry. She proceeds to describe the existential underpinnings of psychodrama and demonstrates how she has been directing a psychodrama group, 'Theatre of Life', which has been operating for well over a decade within a public mental health system, acute inpatient unit. Through the ensuing discussion, she illustrates how the humanistic ethic of 'welcoming the Other' is actualised in the 'here-and now' of the psychodrama group psychotherapy process. CONCLUSIONS: A thematic analysis derived from group-members' evaluation of each session illuminates their felt sense depicting the ethic in action.

[Theatre as a form of physical mediation]. / Le théâtre, une médiation corporelle.

In psychiatric care, the specific physical relationship that the nursing staff have with people in distress must be taken into account. In a workshop, this physical relationship extends to the group. In a theatre workshop, it is even more complex as the body is engaged in play, in character and sometimes in front of an audience. This article describes the experience of participants and nurses with regard to the particularity of the body within the theatre setting.

[Beyond suffering, schizophrenic improvisation and therapeutic challenges]. / Au-delà des maux, improvisation schizophrénique et (en)jeux thérapeutiques.

Led jointly by an actress and an occupational therapist, an 'improvisation' activity has been set up within the Sainte-Anne University Hospital SHU Sector 14 for hospitalised patients, on medical prescription. This containing environment provides psychological support and encourages patients with schizophrenia to explore their creativity and to 'let go' so as to discover new physical possibilities. The group thereby becomes a support for the relationship and the development of verbal and non-verbal communication.

Implementing living room theatre activities for people with dementia on nursing home wards: a process evaluation study.

OBJECTIVES: A new communication method, the 'Veder Method', was implemented in the Netherlands. This method uses theatrical stimuli in combination with proven person-centred communication methods. Care staff was trained to apply the Veder Method in a 'living room theatre activity' for people with dementia. This study evaluates the implementation of the Veder Method on psychogeriatric nursing home wards. METHODS: Facilitators and barriers to train staff and implement the Veder Method in psychogeriatric nursing homes were identified by conducting semi-structured interviews with 12 stakeholders who were involved in the implementation, and five focus groups with 35 trained care staff. The interviews and focus groups were transcribed verbatim, and two independent researchers analysed the content of the transcripts. The Implementation Process Evaluation (IPE) Framework was used to categorize the data and the 7s-model to contextualize the qualitative findings. RESULTS: A structured overview of facilitators and barriers in different stages of the implementation process is presented. Positive reactions in residents and more reciprocity in caregiver-resident contact motivated trained care staff to work with the Veder Method. An action plan, executive support, the visibility of the method in the organization and a pioneer group that initiated implementation were essential for successful implementation. High work pressure for the care staff was a hindering factor. CONCLUSION: Respondents experienced the added value of the Veder Method. The facilitators and barriers to implementation we identified in this study can help to implement and disseminate the successful Veder Method and other person-centred communication methods in psychogeriatric nursing homes effectively.

Authoring experience: the significance and performance of storytelling in Socratic dialogue with rehabilitating cancer patients.

This article examines the storytelling aspect in philosophizing with rehabilitating cancer patients in small Socratic dialogue groups (SDG). Recounting an experience to illustrate a philosophical question chosen by the participants is the traditional point of departure for the dialogical exchange. However, narrating is much more than a beginning point or the skeletal framework of events and it deserves more scholarly attention than hitherto given. Storytelling pervades the whole Socratic process and impacts the conceptual analysis in a SDG. In this article we show how the narrative aspect became a rich resource for the compassionate bond between participants and how their stories cultivated the abstract reflection in the group. In addition, the aim of the article is to reveal the different layers in the performance of storytelling, or of authoring experience. By picking, poking and dissecting an experience through a collaborative effort, most participants had their initial experience existentially refined and the chosen concept of which the experience served as an illustration transformed into a moral compass to be used in self-orientation post cancer.

The feasibility of ethnodrama as intervention to highlight late-life potential for nursing students and older adults.

One barrier to the expansion of geriatric health care providers is the limited desire of nursing students to work with older adults. The purpose of this study is to evaluate the feasibility of using ethnodrama as an intervention to highlight late-life potential. Twelve baccalaureate nursing students were paired with 12 residents of an assisted living facility to complete transformative learning activities focused on the topic of late-life potential culminating in a performance of an ethnodrama developed from these data. Transcripts of initial student meetings, self-reflections, the performance, postperformance discussion, and open-ended survey questions were analyzed using in vivo and pattern coding. Older adult participants recognized and emphasized positive late-life potential, whereas students explored potential throughout the life span and reflected on its meaning in their own lives. Increasing discussion about late-life potential may alter the stigma associated with aging.

["Theater of the body" -- the possibilities of psychodrama in the treatment of irritable bowel syndrome]. / "A test szinháza" - az irritábilis bél szindróma kezelésének lehetoségei a pszichodrámában.

We present the case and psychodrama therapy of a patient suffering from irritable bowel syndrome (IBS). First we provide a review of the literature on IBS. The therapeutic possibilities of psychodrama are in the dramatization of the perception of one's own body. Interpersonal communication is the focus of group work: the greatest challenge for the patient is the expression of her emotions, impulses, wishes - without somatization. The source of the non-specific psychotherapeutic effect is the free, spontaneous and creative communication and the rediscovery of play.

Evaluation of an innovative tool for child sexual abuse education.

Child sexual abuse poses a serious threat to public health and is often unreported, unrecognized, and untreated. Prevention, early recognition, and treatment are critically important to reduce long-term effects. Little data are available on effective methods of preventing child sexual abuse. The current research demonstrates a unique approach to promoting awareness and stimulating discussion about child sexual abuse. Qualitative methods have rarely been used to study child sexual abuse prevention. Qualitative inductive analyses of interviews from 20 key informants identified both positive and negative assessments with six emergent themes. The themes revealed inherent tensions in using narrative accounts to represent the complex cultural context within which child sexual abuse occurs. More research is needed, but the program shows potential as a methodology to raise awareness of child sexual abuse.

[Kinderpsychodrama in a child guidance centre]. / Kinderpsychodrama in der Erziehungsberatung.

Kinderpsychodrama allows conflicts of children to become apparent in a specific sheltered environment. These conflicts often arise when children's needs for relationship, self esteem and self efficacy either are not sufficiently recognized by their caregivers and/or cannot be answered in a helpful way. This can lead to internalizing disorders like loss of self reliance, social fear, and depressive withdrawal on the one hand or to externalizing symptoms like oppositional, impulsive and aggressive behavior disorders on the other hand which endanger socio-emotional development. Kinderpsychodrama is seen to cushion children's dysfunctional conflict solutions and solve them with the therapists' help. Therapists realize the themes set on the scene during the play of the children's group; they mirror the scenes and encourage children to act in a different way making use of children's creativity during play as well as the support of the group. Children's chosen role serves as a secure base allowing them to find solutions for their conflicts. The development of each child as well as his/her themes becoming evident during the course of the group are made transparent to their parents during accompanying counseling sessions. We illustrate this therapeutic method by casuistics of our children therapy group.

Does theatre improve the quality of life of people with dementia?

BACKGROUND: A new communication method, the "Veder method", has recently been developed. Caregivers are trained to apply this method in a group activity ("living-room theatre activity") for people with dementia in which theatrical stimuli are used in combination with proven emotion-oriented care methods. The aim of this exploratory study was to evaluate the added value of the Veder method group activity compared to a regular reminiscence group activity and to investigate whether professional carers can achieve the same effects with the Veder method as professional actors. METHODS: A quasi-experimental three-group design was used. Experimental group 1 (E1; n = 65) joined a living-room theatre activity offered by trained professional caregivers. Experimental group 2 (E2; n = 31) joined a living-room theatre activity offered by professional actors. The control group (n = 55) received a usual reminiscence group activity. Behavior, mood and aspects of quality of life were measured using standardized observation scales at three points in time: (T1) pretest; (T2) during the intervention and; (T3) post-test, two hours after the intervention. RESULTS: During the intervention, significant differences were found in favor of the group that was offered a living-room theatre activity by actors (E2) on different aspects of behavior, mood and quality of life. At post-test, people in E2 were more alert compared to the control group. Moreover, they recalled more memories and showed less socially isolated behavior compared to the control group. CONCLUSION: This exploratory study shows that the Veder method has some clear positive effects on behavior and mood of people with dementia when applied by professional actors.

Five analogies between a King's Speech treatment and contemporary play therapies.

OBJECTIVE: Psychiatric patients frequently respond positively to play therapy, which may rely on psychoanalytic, Jungian, cognitive-behavioral, familial, school-based, or other theories. I wished to determine if there were unifying principles that tie together these various types of play treatments. METHODS: The fact-based film, The King's Speech, vividly illustrates play utilized by Lionel Logue in his speech treatment (1926-1939) of the future King of England. In the film I found five analogies to the play therapy I employ in office practice. RESULTS: The play scenes in The King's Speech point to five unifying principles among contemporary play therapies: (1) the crucial nature of the relationship, (2) the centrality of having fun, (3) the occasional reliance on others, (4) the interjection of pithy talk, and (5) the usefulness of a little drama. CONCLUSION: No matter what theory a play therapist ascribes to, these five unifying principles should be kept in mind during treatment.

[Therapy through film]. / La thérapie par le film.

For psychiatric patients, playing the role of their life, producing a film, editing it and presenting it to the public with the support of a group made up of patients and caregivers is a real form of self-distancing, a type of therapy. The video group from the Saint Ouen day hospital has been carrying out this creative and therapeutic work for several years. Screenings and exchanges between care centres are regularly organised.

"Waiting on the words": procedures and outcomes of a drama class for individuals with aphasia.

Drama therapy offers an authentic medium through which people with aphasia can interact and share their experiences. We describe the rationale and procedures of a drama class, informed by the principles and practices of drama therapy, in which individuals with chronic aphasia conceptualized, wrote, and produced a play addressing their experiences of having, living with, and coping with the effects of aphasia. Sessions were cofacilitated by a speech-language pathologist and a drama therapist. We describe the drama activities and techniques in each of four distinct stages of a drama therapy process through which the group transitioned. We also summarize patient-reported outcomes of a representational group of seven participants. Subscales of the Burden of Stroke Scale and the Communication Confidence Rating Scale for Aphasia were administered before and after participation in the 18-week class. Means, standard deviations, and effect sizes were computed. Results indicated perceived improvements in both communication and mood.

[Adaptation of psychodrama in psychotherapy of patients with anorexia nervosa and bulimia nervosa]. / Zastosowanie psychodramy w psychoterapii pacjentów chorujacych na anoreksje i bulimie psychiczna.

The aim of the article was an attempt to present selected theoretical motifs and moreover self experience in the adaptation of elements of psychodrama by Moreno in psychodynamic psychotherapy (individual and group psychotherapy) in a group of people with anorexia and bulimia nervosa. Psychodrama through own creativity, spontaneity and taking action on the "here and now" stage helps to attain and intensify therapeutic aims which concern the consciousness of inner conflict of persons with anorexia and bulimia nervosa, which is translocated on their body.

Using Applied Theater in Primary, Secondary, and Tertiary Prevention of Intimate Partner Violence: A Systematic Review.

There is an immediate need to advance knowledge around the effective prevention of intimate partner violence (IPV), which is responsible for significant negative health and well-being outcomes for women around the world. Creative approaches are being explored internationally-this systematic review provides a timely synthesis of applied theater interventions addressing primary, secondary, and tertiary IPV prevention. Six hundred and ten articles were identified through a comprehensive search of five cross-disciplinary databases. Eleven studies discussed in 15 quantitative and qualitative peer-reviewed articles and one book chapter met the inclusion criteria and were included in the review. Articles were appraised using a standardized quality assessment tool and were analyzed within the context of IPV prevention. Of the reviewed studies, five were classified as primary prevention, four secondary, and two focused on tertiary prevention. Specific strategies used by each of the studies included healthy relationship training, rising awareness and community advocacy, service provider training, bystander training, and working with survivors. While the paucity and quality of current literature make it difficult to determine overall efficacy, this review points to the potential of applied theater as a useful prevention strategy, particularly when interactive, participatory methods are incorporated. Further, applied theater could be an effective tool for working in culturally diverse settings as well as with minority groups. Future applied theater program planning needs to include comprehensive evaluation. More rigorous investigation, involving mixed-method research approaches, is required to fully understand the potential of applied theater as a tool in the context of IPV prevention.