Drama Therapy for Children and Adolescents with Psychosocial Problems: A Systemic Review on Effects, Means, Therapeutic Attitude, and Supposed Mechanisms of Change

Abstract

Drama therapy is applied to children and adolescents with psychosocial problems. Drama therapy is an experimental form of treatment which methodologically uses drama and theatre processes to achieve psychological growth. Although in clinical practice, drama therapy has been applied successfully, little is known about how and why drama therapy contributes to a decrease in psychosocial problems. A systematic narrative review was performed to obtain more insight into this issue. Eight databases were systematically searched. Ten out of 3742 studies were included, of which there were four random controlled trails, three non-controlled trials, and three pre-and post-test design studies. We identified the results, drama therapeutic means, attitude, and mechanism of change. Positive effects were found on overall psychosocial problems, internalizing and externalizing problems, social functioning, coping and regulation processes, social identity, and cognitive development. An adaptive approach was mentioned as the therapeutic attitude. The means established contribute to a dramatic reality, which triggers the mechanisms of change. These are processes that arise during treatment and which facilitate therapeutic change. We found ten supposed mechanisms of change to be frequently used in all studies. No direct relations were found between the results, drama therapeutic attitude, means, and mechanisms of change.

Effectiveness of drama-based therapies on mental health outcomes: A systematic review and meta-analysis of controlled studies.

“…The authors found benefits for emotional, psychological, and social development in this population. Yet another systematic review examined drama therapy for children and adolescents with psychosocial problems (Berghs et al, 2022). The nine studies included in the review consisted of four RCTs, three CCTs, and three studies with a single group pre-post design.…”

“…Thus overall, the evidence for the effectiveness of drama therapy is mounting, with a clear prevalence of qualitative designs and an underrepresentation of robust RCTs. Five reviews used the recommended PRISMA guidelines and flow diagram to clearly convey their search process (Berghs et al, 2022; Bololia et al, 2022; Bourne et al, 2018; Feniger-Schaal & Orkibi, 2020; Leather & Kewley, 2019). Quality or risk of bias assessments was conducted in five reviews (Berghs et al, 2022; Bololia et al, 2022; Feniger-Schaal & Orkibi, 2020; Leather & Kewley, 2019; Ruddy & Dent-Brown, 2007).…”

“…Five reviews used the recommended PRISMA guidelines and flow diagram to clearly convey their search process (Berghs et al, 2022; Bololia et al, 2022; Bourne et al, 2018; Feniger-Schaal & Orkibi, 2020; Leather & Kewley, 2019). Quality or risk of bias assessments was conducted in five reviews (Berghs et al, 2022; Bololia et al, 2022; Feniger-Schaal & Orkibi, 2020; Leather & Kewley, 2019; Ruddy & Dent-Brown, 2007). The use of a preregistered protocol was only reported in three reviews (Bourne et al, 2018; Leather & Kewley, 2019; Ruddy & Dent-Brown, 2007).…”

Multiple intelligences theory and expressive therapies: New counselling options for secondary school students who experience anxiety

“…In the role-play, the client acts to separate themself from their anxiety problem and allows themself to externalise their anxiety, rather than internalising the anxiety. Drama therapy (ET) can reduce psychosocial problems in children and adolescents, with a reduction in depressive symptoms, (social) anxiety, post-traumatic stress, inattention (especially on hyperactivity and impulsivity), aggressive behaviour such as hostility, violent behaviour, in addition to an increase in assertiveness, a positive effect on learning behaviour and on school abilities (Berghs et al, 2022).…”

A systematic review of dramatherapy interventions used to alleviate emotional distress and support the well‐being of children and young people aged 8–18 years old

“…While they determined that dramatherapy is an effective treatment for a number of populations, 46% of their studies related to developmental disability or cognitive impairment; mental health was not a primary focus. A review of dramatherapy with CYPs experiencing a broad range of psychosocial problems has also been conducted (Berghs et al., 2022 ). While this review included some studies related to mental health, studies also related to CYPs with conditions such as Asperger's syndrome, conduct disorder and learning disability; mental health was not a primary focus.…”