Effect of drama training on self-esteem and personality strengths: A feasibility case control study of nidotherapy

BACKGROUND

Although there are many case reports and qualitative studies on the likely positive effects of drama on mental health there have been few quantitative studies with mentally ill patients.

AIMS

To assess the effect of drama training in patients receiving nidotherapy with a range of mental and personality disorders on changes in self-esteem and personality strengths over a 1-month period compared with two control groups, one with similar mental disorders and another without, who had similar assessments but no acting involvement.

METHOD

A total of 19 patients were recruited from a mental health charity with current significant mental illness (active group: n = 6) (b) a control group of patients with current mental illness who were not involved in acting (n = 5), and an additional control group with no current mental illness (n = 8) The patients involved in drama were taking part in nidotherapy, an environmental intervention. Two self-rating scales, the Rosenberg Self-Esteem Scale (RSES) and Abbreviated Personality Strengths Scale (APSS) recorded changes in self-esteem and personality strengths at base-line and after 1 month in the participants. Random effects modelling was used to analyse the data.

RESULTS

The intervention group showed positive improvement in personality strengths (p = .009) compared to the control group that had no mental illness, and also improved more than the control group with mental illness but not to a significant degree (p = .16). Self-esteem recorded with the Rosenberg scale was lower in those in the acting group at baseline compared with the other two groups (p = .088) but after acting training improved by 29% to be equivalent to the control groups.

CONCLUSIONS

Despite the limited numbers in this study, and the consequent inability to make firm conclusions about the efficacy of drama therapy as part of nidotherapy, the findings suggest that larger trials of this approach are feasible and worth exploring. .

Rapid implementation of Veterans Health Administration telehealth creative arts therapies: survey evaluation of adoption and adaptation

BACKGROUND

Creative arts therapies (CAT) are employed throughout the Veterans Health Administration (VHA) and are predominantly delivered in-person. Though telehealth delivery of CAT was used at several VHA facilities to increase services to rural Veterans, due to guidance from the Center for Disease Control and VHA that temporarily suspended or reduced in-person services, there was a large increase of CAT therapists enterprise-wide who adopted telehealth delivery. The aims of this study were to evaluate adoption and adaptation of CAT telehealth delivery and identify related barriers and facilitators.

METHODS

We deployed a survey guided by the Consolidated Framework for Implementation Research and administered it via email to all VHA CAT therapists (N = 120). Descriptive statistics were used to summarize data and responses were compared based on therapists' age, years of experience and CAT discipline. Open survey field responses were summarized, qualitatively coded, and analyzed thematically.

RESULTS

Most therapists (76%) reported adopting telehealth with 74% each delivering > 50 CAT sessions in the prior year. Therapists adapted interventions or created new ones to be delivered through telehealth. Barriers included: technical challenges, control of the virtual space, and building rapport. Facilitators included added equipment, software, and infrastructure. CAT therapists adapted their session preparation, session content, outcome expectations, and equipment. CAT therapists reported being able to reach more patients and improved access to care with telehealth compared to in person visits. Additional benefits were patient therapeutic effects from attending sessions from home, therapist convenience, and clinician growth.

CONCLUSIONS

VHA CAT therapists used their inherent creativity to problem solve difficulties and make adaptations for CAT telehealth adoption. Future studies may explore CAT telehealth sustainment and its effectiveness on clinical processes and outcomes.

A Scoping Review on the Use and Potential of School-Based Drama Therapy to Enhance Socio-emotional Skills in Early Childhood

Drama therapy incorporates play, imaginary engagement, embodiment, and perspective taking to promote interpersonal skills and affective functioning. Existing school-based drama therapy (SBDT) research has demonstrated utility with select populations; however, much of the SBDT literature has featured disparate findings. Absent from the current literature is a thorough synthesis of the benefits of SBDT for socio-emotional development in early childhood, an age cohort that may be well suited for drama therapy due to the method's theoretical and practical focus on action, symbolism, and play. A scoping review was conducted to answer the research question: What is the use and potential of SBDT to enhance socio-emotional skills in early childhood? Following a thorough database and manual search, 406 articles were identified and, after screening, 16 articles met the inclusion criteria. Based on the results, practice recommendations include the use of metaphor, distance, and life-drama connection to enhance socio-emotional skills, using dramatic play as a tool to address adverse experiences, and applying SBDT to support specific clinical populations. Policy recommendations include the use of SBDT within a public health trauma approach and the need for ecological integration of SBDT into schools. Research recommendations include the need for a broad-level articulation of a scaffolded SBDT research agenda in schools focused on socio-emotional skills and recommendations specific to methodological and reporting rigor.

Tele-Drama Therapy with Community-Dwelling Older Adults: A Field Training Project

OBJECTIVES

This paper explores a field training project of tele-drama therapy with community-dwelling older adults during COVID19. It merges three perspectives: the older participants' perspective, the students engaged in the field training, who conducted this remote therapy, and social workers.

METHODS

Interviews were conducted with 19 older adults. Focus groups were conducted with 10 drama therapy students and 4 social workers. The data were thematically analyzed.

RESULTS

Three themes emerged: the role of drama therapy methods in the therapeutic process, attitudes toward psychotherapy for older adults, and the phone as a therapeutic setting. These themes coalesced into a triangular model associating dramatherapy, tele-psychotherapy and psychotherapy with the older population. A number of obstacles were identified.

CONCLUSIONS

The field training project made a dual contribution to the older participants and the students. In addition, it promoted more positive attitudes among the students toward psychotherapy with the older population.

CLINICAL IMPLICATIONS

Tele-drama therapy methods appear to promote the therapeutic process with older adults. However, the phone session should be planned in advance in terms of time and place to ensure the participants' privacy. Field training of mental health students with older adults can promote more positive attitudes toward working with the older population.

A Pilot Remote Drama Therapy Program Using the Co-active Therapeutic Theater Model in People with Serious Mental Illness

The impact of drama therapy on mental health recovery remains poorly understood. We examined the effects of a pilot remote drama therapy program for community members living with serious mental illness. The entire intervention was delivered remotely. Participants with serious mental illness completed a 12-week drama therapy program which included an online performance open to the public. Four quantitative scales were administered pre- and post-program. A focus group was conducted 1 week after the performance. Six participants completed the program and crafted a public performance themed around hope. No significant differences were identified in the quantitative measures. Five themes were identified in the post-performance focus group. Drama therapy presents an opportunity for individuals with serious mental illness to process and share their journeys with their diagnoses and re-create a healthy sense of self with increased community awareness.

Drama Therapy Counseling as Mental Health Care of College Students

(1) Background: This study aims to apply drama therapy to a counseling group to address the mental health problems of college students in Taiwan due to the increasingly serious psychological problems that have happened in recent times. Based on the healing factors in drama therapy, we applied such therapy activities to four counseling groups composed of 12 high-risk students from Taiwan. (2) Methods: "Questionnaire-based assessment, participant self-assessment and participant attitude assessment" methods were used to evaluate the six mental health indicators of the participants in the evaluation of drama therapy's effect and the groups' pre-test and post-test (the first group and the last group). The six indicators were self-awareness, self-expression, interpersonal and communication skills, self-cognitive reconstruction ability, social role ability, and decision-making ability. Data were collected and assessed for the frequencies and percentages of each indicator item. Sets of paired-samples t-tests, independent t-tests, and two-way repeated measures ANOVAs were employed to evaluate the different designs. (3) Results: The results revealed that drama therapy could deliver significantly positive effects for and improve the six mental health indicators of the participants. Males' self-awareness and decision-making actions were more positively affected than females. (4) Conclusions: The study helps to provide a path of establishing the mental health module of drama therapy in the education sector in Taiwan.

Creative art therapy for mental illness

Creative art therapy (CAT) for severe mental illness (SMI) represents an extremely heterogenous body of literature that encompasses the use of a large variety of creative mediums (i.e. visual art, music, dance, drama, writing) in the treatment of mental disorders. The present review provides a narrative summary of the findings on the use of CAT for the selected SMI, being: schizophrenia, trauma-related disorders, major depression, and bipolar disorder. A database search of PubMed and the Cochrane Library was conducted related to the use of CAT in the treatment of mental disorders published between January 2008 and March 2019. A total of 9697 citations were identified to match the search criteria and 86 full-texts were reviewed. Although literature suggests CAT to be a potentially low-risk and high benefit intervention to minimize symptoms and maximize functioning in individuals living with SMI, the lack of methodological rigor, and inconsistency in study methods and outcome measures have prevented the advancement of CAT for use in SMI. Although creation of a single CAT regimen for all psychiatric disorders stands neither practical nor advisable, greater standardization of methods would improve evaluation of CAT interventions. Future research should elucidate biological mechanisms underlying CAT methods.

A pilot project of school-based intervention integrating drama and language awareness

BACKGROUND

  To help immigrant and refugee adolescents experiencing a severe academic delay cope with adversity, a school-based intervention combining drama workshops and language awareness activities was piloted in two classrooms.

METHOD

  A qualitative analysis of participant observations was performed and the Strength and Difficulty Questionnaire and its Impairment Supplement was administered before and after the intervention. The observations were carried out in two Montreal high schools serving an underprivileged neighbourhood of immigrants, involving two classrooms of underschooled adolescents (n = 27) and two classes of similarly underschooled adolescents chosen among other teachers interested in the intervention, who accepted to participate as a comparison group (n = 28).

RESULTS

  The adolescents shared their experiences of adversity and felt empowered by the workshops. Self-reported impairment decreased in the intervention groups.

CONCLUSION

  The protective effect of creative language activities for immigrant and refugee youth should be further investigated.