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Is psychodrama therapy evidence-based?

Therapy is a broad field for good reason: No two brains are exactly alike.

Sure, there are some generalized forms of therapy, like cognitive-behavioral therapy, that work really well for most people. But really, in order for therapy to be as effective as possible for you, there must often be a "learning period", where your therapist learns about your specific case as well as how you think. They can then tweak and change treatment in a way that works for you.

For example, some people respond to direct, even slightly aggressive communication - it helps them "snap out" of a funk, so to speak. Others, however, really don't respond to that sort of communication - they lock up, which actually hinders progress. These people need gentler, less confrontational communication to foster vulnerability.

Some people's preferred therapeutic method involves, quite literally, "acting out" in a process called psychodrama therapy. It's a form of psychotherapy that asks its patients to play the role of themselves in a sort of theatric rendering of some past trauma or ongoing relationship.

There is a lot to learn about psychodrama therapy, as well as its uses, common misconceptions, and benefits. This article will serve as a foundational introduction to psychodrama therapy.

Key Takeaways:

  • Psychodrama therapy shows promise in clinical settings, benefiting the majority of people who try it. More research is needed, but preliminary results indicate that psychodrama therapy is evidence-based.
  • Psychodrama therapy involves performing a scene that closely resembles a traumatic experience or conflict in the patient's life.
  • Psychodrama therapy, unlike drama therapy, is guided by a licensed therapist.

Psychodrama Therapy Resources on This Page:

What is psychodrama therapy?

Psychodrama Therapy Uses

Psychodrama Therapy Benefits

Psychodrama Therapy Examples

Evidence Supporting the Efficacy of Psychodrama Therapy

What is psychodrama therapy?

Psychodrama therapy is a form of mental healthcare that utilizes theater and role-playing to make progress in patients.

Typically, psychodrama therapy occurs in three steps: warm-up, action, and sharing.

Warming Up in Psychodrama Therapy

When warming up, the therapist and patient will talk first about the goals they want to accomplish during the session.

This may involve talking about things that have happened since the last session, or a continuation of the performance of the last session. The scene and setting will also be decided during this phase, and the patient may be led through warm up exercises in order to loosen up.

Action: Performing the Drama

This is the "play" itself. The patient will act as themselves during the scene, delivering lines with emotion and passion. The therapist will often act as a counterpart, such as a family member or friend.

Sometimes, psychodrama therapy is performed in groups.

Sharing: Analyzing the Drama

During the sharing phase, the patient and the therapist will discuss the performance, including the feelings and emotions that arose.

Many patients find that converting a traumatic experience or ongoing problem into a narrative helps to externalize and then analyze the feelings and underlying causes. Think of it like opening the hood of a car: it's hard to tell whats wrong with the engine from driving alone, but open the hood and start revealing the layers, and you may be able to get a sense of what's going on.

Psychodrama vs. Drama Therapy: An Important Distinction

Psychodrama therapy is led by a licensed therapist and focuses more intently on the patient's experience.

This is often confused with or interchanged with drama therapy, which does not have to be guided by a professional and often covers more broad topics and scenes.

Psychodrama Therapy Uses

The primary use of psychodrama therapy is to address trauma and conflict. By acting the scene out, a person who has been through trauma can analyze it from a new perspective and learn, through the context of narrative, where their distress is coming from and whether or not it's healthy.

Note that, for many with trauma, psychodrama therapy is not safe and suitable - acting out a traumatic experience can be paralyzing and triggering for some, so make sure you talk to a healthcare professional before attending a session.

Psychodrama Therapy Benefits

Psychodrama is not for everyone. But for some, it can be a tremendously effective way to address traumatic experiences. Laying the experience out in a theatrical setting converts it, at least in part, to an external narrative - one that can be annotated and analyzed.

Some people find psychodrama therapy fun and liberating: People whose trauma has kept them silent and reserved for a long time, for example, may find it thrilling and relieving to toss aside their reservations and, for once, command their trauma rather than letting it command them. Again, this is all done with the guidance of a licensed therapist to ensure it remains safe and productive.

Psychodrama Therapy Examples

Here's an example of psychodrama therapy at work.

Jennifer, 34, has post-traumatic stress disorder resulting from a home invasion that took place during her childhood. She witnessed her parents restrained and beaten while burglars made off with most of their savings. During the intrusion, Jennifer locked herself in a closet and stayed safe - the right move for a child of only nine - but traumatic nonetheless.

Jennifer's PTSD prevents her from ever truly relaxing. The feeling of the sanctuary of home that most of us have is absent for her: How can she relax when she knows there are threats out there and that, crucially, she may not have the courage to defend against them?

She and her therapist decide to try psychodrama therapy. They set the stage in the warm-up phase: A warm night in San Marcos, TX. Jennifer is watching TV with her parents when they hear a bump outside. Action.

During the action phase, Jennifer's therapist assumes the role of Jennifer's mother, who cries for help as the burglars enter the home. Jennifer, in turn, does what she did that night, and hides behind the chair. Jennifer feigns crying at first, which turns into real tears as the scene plays out.

During the scene, the therapist is doing mental checks every few moments to ensure that the activity is still safe and productive for Jennifer.

After the scene, Jennifer and her therapist sit back down and talk over the feelings that arose during the action. Jennifer explains that she felt totally inadequate; like she wasn't in charge of her life then, and still isn't to this day.

This gives Jennifer's therapist a starting point for the rest of the conversation, and further reveals Jennifer's roadmap to healing.

Evidence Supporting the Efficacy of Psychodrama Therapy

The short answer: yes! Longer answer: Yes, but that's not necessarily the point.

Psychodrama therapy, as well as other less common forms of therapy, have the primary benefit of being alternatives to mainstream treatment.

CBT, or cognitive-behavioral therapy, is an immensely powerful tool that has been shown in clinical settings to benefit about 75% of the people who try it. It's one of the most common forms of therapy and is often the "go-to" for therapists, at least when first starting with a new patient.

For the 25% of people who don't benefit from CBT, however, the field of therapy must provide alternatives that may be able to help them. One such alternative is psychodrama therapy.

Scientifically, psychodrama therapy has also been shown to be generally effective. While it has not been studied as rigorously as CBT, existing studies do indicate that psychodrama therapy is evidence-based and effective.

But beyond that, the best therapy is ultimately the one that works best for you. So long as it is guided or administered by a licensed therapist, any form of therapy that helps you heal and reduces distress in a healthy way, is the best kind of therapy.

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