Understanding the dramatic therapeutic play session: a contribution to pediatric nursing.

OBJECTIVES: to understand how the dramatic therapeutic play session occurs within the care of hospitalized children. METHODS: qualitative multiple case study, using theoretical references, such as symbolic interactionism and Vygotsky's theory of symbolic play. Twenty play sessions performed with six children from 3 to 10 years old were analyzed, each corresponding to one case. RESULTS: these sessions demonstrated that a dramatic therapeutic play session is a process of four interdependent and complementary steps: bonding, exploring, dramatizing, and play cessation. They also revealed the imaginary situations externalized by the child, the importance of the exploration step for which they manage the imaginary situation and catharsis, and how her higher psychological faculties are articulated during this process. FINAL CONSIDERATIONS: the results contribute to the understanding of the conduct and analysis of the dramatic therapeutic play session, reinforcing the importance of its use in pediatric nursing care practice.

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.

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.

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.

Theatre improvisation training to promote social cognition: A novel recovery-oriented intervention for youths at clinical risk for psychosis.

AIM: Few interventions address social cognition or functioning in individuals at clinical risk (CR) for psychosis. Theatre Improvisation Training to Promote Social Cognition (TIPS) is a manualized intervention based on drama therapy. We aim to describe TIPS, evaluate feasibility and acceptability, and present a preliminary investigation of outcomes in a quasi-experimental design. METHODS: Thirty-six CR participants (15-25 years) were ascertained from the Philadelphia Neurodevelopmental Cohort. Twenty-six completed the TIPS protocol: 18 weekly 2-hour group sessions led by a theatre director and actor-assistant. Participants engaged in collaborative acting and improvisation exercises. Baseline and follow-up assessments included the Clinical Assessment Interview for Negative Symptoms (CAINS), Structured Interview for Prodromal Syndromes, Global Assessment of Functioning (GAF) and Penn Computerized Neurocognitive Battery (CNB), which includes social cognitive tests. Acceptability was assessed using focus groups. Preliminary outcomes were compared to CR controls who were not enrolled in the study but completed follow-up assessments using the same methods. RESULTS: There were no significant differences in baseline demographics, psychosis symptoms, or cognition between those who did and did not complete the protocol. Overall, TIPS was considered feasible and acceptable among CR. Preliminary outcomes suggest that TIPS may be effective in improving positive and negative psychosis-spectrum symptoms and GAF, but not performance on facial emotion processing. CONCLUSIONS: TIPS is a promising and acceptable intervention that may improve symptoms and functioning in CR while providing a framework for participants to develop more empowered and confident ways of relating to others. Larger randomized controlled trials investigating TIPS efficacy are warranted.

Understanding the dramatic therapeutic play session: a contribution to pediatric nursing / Entender la sesión de juego terapéutico dramático: una contribución a la enfermería pediátrica / Compreendendo a sessão de brinquedo terapêutico dramático: contribuição para a enfermagem pediátrica

ABSTRACT Objectives: to understand how the dramatic therapeutic play session occurs within the care of hospitalized children. Methods: qualitative multiple case study, using theoretical references, such as symbolic interactionism and Vygotsky's theory of symbolic play. Twenty play sessions performed with six children from 3 to 10 years old were analyzed, each corresponding to one case. Results: these sessions demonstrated that a dramatic therapeutic play session is a process of four interdependent and complementary steps: bonding, exploring, dramatizing, and play cessation. They also revealed the imaginary situations externalized by the child, the importance of the exploration step for which they manage the imaginary situation and catharsis, and how her higher psychological faculties are articulated during this process. Final Considerations: the results contribute to the understanding of the conduct and analysis of the dramatic therapeutic play session, reinforcing the importance of its use in pediatric nursing care practice.

RESUMEN Objetivos: comprender cómo se lleva a cabo la sesión de juego terapéutico dramático en el cuidado de niños hospitalizados. Métodos: estudio de caso cualitativo múltiple, con referencias teóricas como el interaccionismo simbólico y la teoría del juego simbólico de Vygotsky. Se analizaron veinte sesiones de juguetes, realizadas con seis niños de 3 a 10 años, cada uno correspondiente a un caso. Resultados: se demostró que la sesión de juego terapéutico dramático es un proceso de cuatro pasos interdependientes y complementarios: vinculación, exploración, dramatización y detenimiento del juego. También revelaron las situaciones imaginarias externalizadas por la niña, la importancia de la etapa de exploración para la que maneja la situación imaginaria y la catarsis, y cómo se articulan sus facultades psicológicas superior durante este proceso. Consideraciones Finales: los resultados contribuyen a la comprensión de la conducta y el análisis de la sesión de juguete terapéutico, lo que refuerza la importancia de su uso en la práctica de cuidados de enfermería pediátrica.

RESUMO Objetivos: compreender como transcorre uma sessão de Brinquedo Terapêutico Dramático na assistência à criança hospitalizada. Métodos: estudo de casos múltiplos, qualitativo, sendo referenciais teóricos o Interacionismo Simbólico e a Teoria de Vygotsky sobre a brincadeira simbólica. Analisaram-se vinte sessões de brinquedo, realizadas com seis crianças de 3 a 10 anos de idade, cada uma correspondendo a um caso. Resultados: mostraram que a sessão de Brinquedo Terapêutico Dramático é um processo de quatro etapas interdependentes e complementares: Estabelecendo vínculo, Explorando, Dramatizando e Parando de brincar. Revelaram, também, as situações imaginárias exteriorizadas pela criança, a importância da etapa da exploração para que ela geste a situação imaginária e ocorra a catarse, e como se articulam suas faculdades psicológicas superiores durante esse processo. Consideraç ões Finais: os resultados trazem contribuição à compreensão da condução e análise da sessão de Brinquedo Terapêutico, reforçando a importância de sua utilização na prática assistencial em enfermagem pediátrica.

Treatment Effects in Social Cognition and Behavior following a Theater-based Intervention for Youth with Autism.

This randomized clinical trial ( www.clinicaltrials.gov ID# NCT02276534) examined the impact of a peer-mediated, theater-based social skills intervention, SENSE Theater®, on social cognition and behavior in 77 youth (ages 8-16) with high-functioning autism spectrum disorder. Analysis of Covariance models revealed that post-treatment, the experimental group (n = 44) performed significantly better than the controls (n = 33) on NEPSY theory of mind (verbal) subtest, demonstrated increased neural evidence of memory for faces, and engaged in more cooperative play and verbal interaction with novel peers. The study extends previous findings showing that SENSE Theater® contributes to improvement in social cognition and behavior.

Using forum theatre to teach communication skills within an undergraduate pharmacy curriculum: A qualitative evaluation of students' feedback.

BACKGROUND AND PURPOSE: Pharmacists need to learn communication styles which adopt a more consultative model. The objectives of this paper are to describe the use of forum theatre facilitated by actors to teach communication skills to pharmacy students and to highlight perceptions of the workshops. EDUCATIONAL ACTIVITY AND SETTING: During the actor-led forum theatre, students redirected scenes depicting pharmacist-patient consultations. Students also learned about their own communication styles and role-played consultations and interview situations with actors. Pharmacy undergraduate students enrolled in years 2, 3, and 4 answered open-ended questions online at the end of workshops. All responses were coded to identify themes. FINDINGS: Five themes emerged from 752 comments: (1) workshops were useful in facilitating communication skills development, (2) workshops encouraged reflection, (3) appreciation of feedback provided, (4) the live, interactive nature of the workshop enhanced learning, and (5) suggestions for improvement. There were requests for more varied scenarios involving different patient groups and more opportunities to participate in the role-plays. Students also requested smaller groups, which would encourage participation from those who were reticent and allow more personal feedback. SUMMARY: The use of forum theatre employing role-play, small group coaching on consultation and interview skills, and emphasizing feedback was perceived as an effective and engaging method to teach communication skills.

Integrative systematic review of psychodrama psychotherapy research: Trends and methodological implications.

BACKGROUND: Psychodrama is an experiential psychotherapy in which guided role-play is used to gain insights and work on personal and interpersonal problems and possible solutions. Despite the wealth of literature describing clinical work, psychodrama intervention research is relatively scarce compared to other psychotherapies and psychological interventions. OBJECTIVE: For this reason we implemented the integrative approach to systematic review that authorizes the combination of publications with diverse methodologies and all types of participants, interventions, comparisons, and outcomes. Our aim was to produce a comprehensive summary of psychodrama intervention research in the last decade that critically evaluates methodological issues to inform future studies. METHODS: We searched four major electronic databases (PsycINFO, PubMEd, Scopus by Elsevier, and Web of Science) for peer-reviewed articles on psychodrama interventions published in English between 1 January 2007 and 31 December 2017. The quality of qualitative and mixed methods studies was assessed on the basis of pre-established guidelines, and the risk of bias was assessed for all quantitative randomized control studies, consistent with the PRISMA protocol. FINDINGS: The database search and a hand search resulted in 31 psychodrama intervention publications. Overall, these studies examined the effects of psychodrama on more than 20 different outcomes and most studies had adult clients. The next largest group was adolescents, whereas only two studies involved children. Thus psychodrama intervention research in the last decade suggests there are promising results in all methodologies, and highlights the need to enhance methodological as well as reporting quality and to theorize and examine modality-specific mechanisms that lead to therapeutic change. Recommendations to improve methodology, transparency, and specificity in reporting future psychodrama and other psychotherapy research are discussed.

The effects of the psychodrama in instilling empathy and self-awareness: A pilot study.

This pilot study investigated the effects of psychodrama on the counseling skills (mainly empathy) and on increasing the self-awareness of 23 counseling undergraduate students. Participants attended 12 psychodrama sessions over 3 months. Data were gathered by using the Empathic Tendency Scale and a personal information form. The study used the mixed method research design, which combines qualitative and quantitative methods. The quantitative aspect of the study involved the use of pretest-posttest experimental and control group design with random assignment, while the qualitative aspect utilized the methods of case study, observation, and interview. The quantitative and qualitative results showed that psychodrama increased students' empathy, counseling skills, and self-awareness.

Psychodrama and the Treatment of Narcissistic and Borderline Patients.

Psychiatric clinicians are faced with the challenge of remaining flexible and psychotherapeutically relevant to the broadening scope of patients with severe narcissistic and borderline personality disorders. Diagnostic sophistication among mental health professionals, increased availability of psychotherapy services, and economic pressures combine to cause the public to expect cost-effective, successful, and shorter duration of treatments. These treatment challenges are particularly poignant with the treatment of those narcissistic and borderline patients who have meager capacity for insight and limited verbal skills. This article describes the use of psychodynamically oriented and informed psychodrama for the treatment of narcissistic and borderline patients.

Using Video Modeling as an Anti-bullying Intervention for Children with Autism Spectrum Disorder.

In the present study, we used a multiple baseline design across participants to assess the efficacy of a video modeling intervention to teach six children with autism spectrum disorder (ASD) to assertively respond to bullying. During baseline, the children made few appropriate responses upon viewing video clips of bullying scenarios. During the video modeling intervention, participants viewed videos of models assertively responding to three types of bullying: physical, verbal bullying, and social exclusion. Results indicated that all six children learned through video modeling to make appropriate assertive responses to bullying scenarios. Four of the six children demonstrated learning in the in situ bullying probes. The results are discussed in terms of an intervention for victims of bullying with ASD.

Investigating a theatre-based intervention for Indigenous youth with fetal alcohol spectrum disorder: Exploration d'une intervention basée sur le théâtre auprès de jeunes Autochtones atteints du syndrome d'alcoolisme fœtal.

BACKGROUND: Theatre-based interventions use artistic media to facilitate social and emotional awareness and have therapeutic benefits for persons with developmental disabilities and mental health problems. The role of these interventions with Indigenous youth who have emotional, behavioural, and cognitive sequelae related to fetal alcohol spectrum disorder (FASD) has not been explored. PURPOSE: The purpose of this study was to explore the experiences and acceptability of a theatre-based approach for facilitating social communication and engagement in youth with FASD. METHOD: Participants were three Indigenous youth with FASD. A qualitative exploration of the experiences and acceptability of the intervention was conducted via focus groups held 2 weeks post-program participation with the participants, their caregivers, and program facilitators. The transcripts were analyzed using an inductive thematic approach. FINDINGS: Our results identified perceived postintervention improvements in participants' development of self-esteem, social skills, and emotional awareness. IMPLICATIONS: A theatre-based arts intervention has the potential to support improvements in social skills for youth with FASD.

Engines of alternative objectivity: Re-articulating the nature and value of participatory mental health organisations with the Hearing Voices Movement and Stepping Out Theatre Company.

Through two case studies, the Hearing Voices Movement and Stepping Out Theatre Company, we demonstrate how successful participatory organisations can be seen as 'engines of alternative objectivity' rather than as the subjective other to objective, biomedical science. With the term 'alternative objectivity', we point to collectivisations of experience that are different to biomedical science but are nonetheless forms of objectivity. Taking inspiration from feminist theory, science studies and sociology of culture, we argue that participatory mental health organisations generate their own forms of objectivity through novel modes of collectivising experience. The Hearing Voices Movement cultivates an 'activist science' that generates an alternative objective knowledge through a commitment to experimentation, controlling, testing, recording and sharing experience. Stepping Out distinguishes itself from drama therapy by cultivating an alternative objective culture through its embrace of high production values, material culture, aesthetic standards. A crucial aspect of participatory practice is overcoming alienation, enabling people to get outside of themselves, encounter material worlds and join forces with others.

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.

Laughter is the best medicine: The Second City® improvisation as an intervention for Parkinson's disease.

BACKGROUND: Expressive therapies are increasingly incorporated into the management of Parkinson's disease (PD), although there are little objective data assessing their benefits. OBJECTIVE: Develop and study a novel community Improvisation Theater (IT) program for PD in order to improve quality of life. METHODS: A prospective, rater-blinded, modified cross-over design study of IT for PD. 22 subjects were randomized 1:1 to active-start (AS) or control-start (CS) groups, controlling for age and Hoehn and Yahr stage. Participants were recruited from the Northwestern PD and Movement Disorders Center. 60 min IT sessions were led by The Second City® faculty weekly for 12 weeks. The primary aim was to assess feasibility, determined as 70% of participants attending at least 75% of the classes. Exploratory data were obtained comparing pre- and post-intervention outcomes using Wilcoxon signed rank test for UPDRS parts I-IV, PDQ-39, and 5 neuro-QoL measures (communication, anxiety, stigma, depression, and wellbeing). RESULTS: All 22 participants completed the study. 21/22 (95%) participants attended at least 80% of the classes. All participants indicated that they would recommend the class to others with PD. 21/22 participants enjoyed the class and felt it was beneficial for their symptoms. A significant improvement pre-to-post intervention was seen with the UPDRS part II ADL measure (mean -1.5, p = 0.019). CONCLUSION: A novel improvisation program can be well-attended, enjoyable, and improve ADL measures among patients with PD of varying ages and disease severity.

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.

Psychoanalytic psychodrama in France and group elaboration of counter-transference: Therapeutic operators in play therapy.

In France, psychoanalytic psychodrama is mainly envisioned in its individual form - that is, a single patient working with a group of therapists. Its originality consists in bringing together several clinicians within a clinical experience that is shared as a group. This experience is fundamentally different from traditional individual therapies, psychotherapies or group co-led therapies. Its configuration may be confusing or overwhelming due to the large number of co-therapists involved in the setting. However, thanks to group elaboration based on the transferential-countertransferential dynamics induced by the treated patient, this potential 'cacophony' can lead to fruitful psychic development embedded in play. This is tied to the co-therapists' positioning in the transitional space shared with the patient as well as to the patient's subjective appropriation of their initiatives. By reflecting on clinical material taken from actual sessions as well as from the exchanges and elaborations occurring at their margins, this article shows how psychodrama and group come to metabolize the transferential elements, shaping the engagement of participants in the context of improvised play.

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.

Changes in anxiety following a randomized control trial of a theatre-based intervention for youth with autism spectrum disorder.

Increased anxiety and stress are frequently found in children with autism spectrum disorder and are associated with social challenges. Recently, we reported changes in social competence following peer-mediated, theatre-based intervention. The purpose of this study was to examine the impact of the intervention on reducing anxiety and stress. Participants included 30 youth with autism spectrum disorder (8-14 years old) randomly assigned to the experimental (17) or waitlist control (13) group. Pretest adjusted, between-group differences were analyzed for state-anxiety, trait-anxiety, play-based cortisol, and diurnal cortisol. Pearson correlations were conducted between anxiety, cortisol, and group play. Significant pretest-adjusted between-group differences at posttest were observed on trait-anxiety (F(1, 27) = 9.16, p = 0.005) but not state-anxiety (F(1, 27) = 0.03, p = 0.86), showing lower trait-anxiety in the experimental group. There were no between-group differences on cortisol. There was a significant negative correlation between group play and trait-anxiety (r = -0.362, p = 0.05). Playground cortisol correlated with group play, for the experimental group (r = 0.55, p = 0.03). The theatre-based, peer-mediated intervention not only contributes to improvement in social competence in youth with autism spectrum disorder but also contributes to reductions in trait-anxiety associated with more social interaction with peers. Results suggest that some degree of physiological arousal is essential for social interaction.