What Is Psychodrama Therapy? 10 Techniques for Your Sessions

Psychodrama has been described as individual therapy in a group format, with action taking place around the protagonist’s multiple roles in life, such as a parent, partner, sibling, and employee.

Perhaps surprisingly, psychodrama as psychotherapy is deeply connected with psychology, sociology, and even theater, with the potential to bridge divides between individuals, groups, and communities (Cruz et al., 2018; Giacomucci, 2021).

This fascinating approach has broad applications, including treating depression, phobias, alcohol and drug use, relationships, and family issues (Nicholls, 2017).

In this article, we explore some of the psychodramatic techniques and activities that practitioners can integrate alongside their existing approaches when treating clients.

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What Is Psychodrama in Therapy?

Psychodrama began with J. L. Moreno in the 1920s and remains popular, having evolved and been reinterpreted many times since. It is a “therapeutic model widely used in Europe in private and public health settings, including hospitals, […] and mental health services, […] in the treatment of various pathologies such as schizophrenia […] and substance abuse” (Cruz et al., 2018, p. 2).

This form of psychotherapy – while preferably performed in a group setting – is focused on the individual at the center of multiple relational roles (such as being a spouse, sibling, or parent) and their difficulties and potential challenges, such as a fear of rejection or flying, or doubts regarding abilities at work (Cruz et al., 2018).

Psychodrama is often described as an individual therapy performed in a group format, homing in on the various roles or identities clients take on throughout their lives.

The approach offers clients the opportunity to explore how past experiences may have influenced their thinking, feeling, and behavior in the present and how it will shape the future by drawing “on the group’s energy and spontaneity to explore the protagonist’s situation” (Nicholls, 2017, para. 2).

Typically, psychodramatic sessions are made up of social, group, and dramatic contexts, using five instruments, including (Cruz et al., 2018):

• Protagonist
  The member of the group who provides the content for the psychodrama
• Stage
  Where the actions take place and are contained
• Auxiliary-ego(s)
  Other group members or staff
• Director
  The person facilitating the session, usually the therapist
• Audience
  The remaining members of the group who bear witness to the protagonist’s story

Each session involves three distinct phases (Cruz et al., 2018; Giacomucci, 2021):

1. Warm-up – Get the participants ready for physical action and the psychodrama.
2. Action (enactment) – Bring the protagonist’s intrapsychic or interpersonal life onto the stage.
3. Sharing – Once enactment is complete, group members de-role and share their experiences.

Psychodramatic tools provide a warm-up for the action phase or combine to “assist the protagonist in the dramatization of the conflict that needs to be solved” (Cruz et al., 2018, p. 2).

3 Examples of Psychodramatic Techniques

A recent systematic review of the literature identified 11 core psychodramatic techniques.

We include three below and others in subsequent sections (Cruz et al., 2018; Giacomucci, 2021).

Doubling

The double aims to give voice to the protagonist’s inner world by digging deeper than the visible “I” and revealing how they talk to themselves in the safety of their private world.

Doubling can be achieved by another person (the therapist or anyone in the group acting as the double) physically standing close by the protagonist, mimicking their posture, and talking as if they were them. The protagonist corrects them if the doubling is inaccurate but owns and repeats what they say when correct.

Such a technique can be particularly helpful in supporting the protagonist in integrating emotions and thinking that have previously been “split out of consciousness due to the overwhelming nature of the traumatic experience” (Giacomucci, 2021, p. 255).

Mirroring

This technique provides the protagonist with the opportunity to see themselves as others do by looking at themselves in a ‘mirror.’ The therapist asks them to take a seat and observe another group member reenact a scene while mirroring their behavior. The technique is particularly valuable when the protagonist is stuck in a role or unaware of how their behavior impacts others.

By swapping places with a member of the audience, they can gain perspective, see maladaptive relational patterns, and identify changes they have created as a result of treatment.

Role reversal

Stepping out of one’s own identity and trading places with another is considered a crucial technique in psychodrama. Seeing another’s perspective (such as the other partner in a relationship, a role model, a historical figure, or even God) can be a powerful experience.

As an approach, it can expand the protagonist’s perception and help them become unstuck from negative feelings such as guilt and shame.

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3 Best Psychodrama Interventions

The following three interventions are integral to and powerful supporting tools for psychodrama as a treatment and can be used alone or in conjunction with other techniques (Cruz et al., 2018; Giacomucci, 2021).

Initial interview

Having selected a protagonist, the next step is the initial interview with the director. While usually kept short and often performed while walking together in a circle to create physical movement, it has multiple purposes, including (Giacomucci, 2021):

• Continuing to warm up the protagonist
• Warming up the group and the director for enacting the psychodrama
• Developing trust, understanding, and connection
• Creating a contract around the goal of the enactment
• Gathering additional information regarding the presenting topic

Scene setting

Immediately after the initial interview, it is vital to choose a setting for the psychodrama and start using objects that help make it real. This marks the move into what therapists refer to as “surplus reality,” where the protagonist moves into action, warming up their body, emotions, and imagination.

The protagonist may be left to set the scene up on their own, showing how it should look while potentially accessing and sharing deep memories.

Self-presentation

At this point, the protagonist begins to show the director, auxiliary-egos, and the audience how they typically act in a given situation. This intervention establishes a starting point and the opportunity to enter the surplus reality, increasing spontaneity while reducing anxiety.

Perhaps most importantly, self-presentation is an opportunity to “externalize their own subjective reality, perspective, and experience” (Giacomucci, 2021, p. 260). The protagonist can then proceed with enactment of their past, present, or future-based psychodrama.

2 Effective Activities and Exercises

Psychodrama is as much about action as talking.

For that reason, it is essential to warm up the group and create a scene that has many of the qualities of the situation being enacted.

The following activities and exercises can help create and maintain the energy required (Giacomucci, 2021).

Spontaneous improvisation

Unlike self-presentation, the protagonist is asked to take on the role of a fictitious character. The director typically places strong demands on them, creating distance from their original psychodramatic topic.

For example, someone struggling with addiction may be asked to act out being a father protecting his family. Spontaneous improvisation can be valuable for a warm-up or as a grounding intervention after a particularly intense personal psychodrama.

Resistance interpolation

While the protagonist sets the physical scene, the director may choose to make modifications that place new role demands. The exercise may be changed in some previously unforeseen way for the protagonist, increasing spontaneity and potentially uncovering new behavioral responses and aspects of the personality.

A Look at Psychodrama in Group Therapy

Psychodrama uses a group format and tools from theater, psychology, and sociology to perform psychotherapy (Cruz et al., 2018).

While a session focuses on one individual as a protagonist, others in the group take on roles as needed. The therapist works directly with the protagonist, but the group provides supporting energies and creativity by acting out roles within their psychodrama (Nicholls, 2017).

Interestingly, once safety and cohesion within the group have been achieved, it becomes its own organism, increasing its effect on its members, and can be treated as the identified client. Research over recent years has shown group therapy to be at least as effective as individual therapy and remains a fundamental aspect of psychodrama (Giacomucci, 2021).

2 Psychodrama group activities

The following two activities, in particular, engage multiple members of the group in the enactment (Cruz et al., 2018; Giacomucci, 2021).

Sculpting

Rather than other members of the group remaining static or disengaged, they are involved in completing the scene.

The protagonist directs where they are and what they are doing. Along with doubling and role reversal, psychodramatic techniques sculpt and make concrete the perceived relationships with their family, environment, and even internal parts of the self.

Empty chair(s)

Rather than solely talking to the empty chair – as is the case with some other therapeutic approaches – this activity is used to facilitate role reversal and doubling in psychodrama.

The approach reduces the load on the protagonist, particularly useful when having a single person acting the role could be too stressful. The chair (or chairs) can remain empty or alternated between multiple group members. For example, multiple group members may take turns sitting at a chair and verbalizing positive or negative messages associated with the protagonist’s life.

3 Fascinating Books for Therapists

The following three books provide valuable insight into the theory and practice of psychodrama inside and outside the consultation room.

1. Social Work, Sociometry, and Psychodrama: Experiential Approaches for Group Therapists, Community Leaders, and Social Workers – Scott Giacomucci

Scott Giacomucci takes the reader beyond the therapeutic session to where psychodrama meets social work and community practice.

This practical book explores psychodrama and its practical application in working with individuals, groups, and communities facing trauma. Along with clinical vignettes and theory, the text includes tools for assessment and intervention.

Find the book on Amazon.

2. The Handbook of Psychodrama – Marcia Karp, Paul Holmes, and Kate Bradshaw Tauvon

This handbook offers a valuable guide for trainees and experienced mental health professionals to understand the theory and practice behind psychodrama and its relationship with other psychotherapies.

The text follows the psychodramatic approach of warm-up, action, sharing, and subsequent processing and explores how we can use them to treat clients with depression.

Find the book on Amazon.

3. Psychodrama – Jacob Levy Moreno

The book explores Moreno’s work in psychodrama, sociometry, and group psychotherapy to develop a deep understanding of its potential for helping clients face challenges in their lives through role-play.

Revisiting these original writings by the founder of psychodrama offers powerful insights into the need to include the full person in therapeutic treatment.

Find the book on Amazon.

Training Options: 5 Courses & Certifications

Psychodrama has been popular over the last few decades as a therapeutic treatment, and there are a number of psychodramatic training and accreditation schools worldwide.

• Onsite Workshops – Psychodrama Training Institute
  Students are taught the theory and practice of psychodrama, sociometry, and group psychotherapy and its application to individuals, couples, groups, and families.

Find out more on their website.

• National Psychodrama Training Center (NPTC)
  Available across the US, NPTC trains students in the theory and methods of J. L. Moreno and their application inside and outside psychotherapy.

Find out more on their website.

• London Centre for Psychodrama
  Registered with the British Psychodrama Association, this training provider offers a one-year foundational course and a three-year training certification to become a therapist.

Find out more on their website.

2 Online courses to consider

There are several online courses exploring psychodrama, including:

• Group Psychodrama
  Group Psychodrama offers several online opportunities for learning more about the theory and practice of psychodrama and potential areas and opportunities for its application.

Find out more on their website.

• Hudson Valley Psychodrama Institute (HVPI)
  HVPI provides online and in-person training in psychodrama, sociometry, sociodrama, and more, helping people uncover and build connections between individuals, groups, and communities.

Find out more on their website.

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Resources From PositivePsychology.com

We have many resources available for therapists providing psychotherapeutic support to individuals, couples, and families.

Why not download our free positive relationships pack and try out the powerful tools contained within? Some examples include:

• The Sound Relationship House Inspection
  Relationships require nurturing and regular action to promote friendship, growth, and trust. This tool is designed to help couples examine how well their relationship is functioning through the lens of the sound relationship house metaphor.
• Connecting With Others by Self-Disclosure
  Research into self-disclosure has found strong links between vulnerability and positive relationships (Laurenceau, et al., 1998). These findings support the view that the courage to be vulnerable is an essential ingredient in forming positive relationships. In this exercise, we learn how to practice self-disclosure to strengthen existing and create new connections.

Other free role-play and drama resources include:

• Assertive Message Role-Play
  Assertive messages state our needs, opinions, and ideas honestly and respectfully. This example scenario includes a role-play for practicing formulating and using assertive communication.
• Remaining Calm During Conflict
  These helpful tips for dealing with conflict can be helpful prompts for role-play.

More extensive versions of the following tools are available with a subscription to the Positive Psychology Toolkit©, but they are described briefly below:

• Passengers on the Bus group activity
  The “passengers on the bus” metaphor is a powerful group experiential exercise to help clients practice allowing distressing internal experiences (e.g., thoughts, feelings, memories, sensations, and urges) to emerge and choosing to act in line with their values in triggering situations.

The client learns that taking the pain or distress with them in a valued direction is possible instead of avoiding painful emotions or acting on their feelings. The exercise is an engaging group activity that involves role-play and intermittent debriefing of therapeutic concepts.

• Exploring Strengths Dynamics
  Strengths do not work in isolation. Instead, they work in combination with other strengths, interacting and overlapping, allowing the person to benefit maximally from their interaction (referred to as “strengths dynamics”). The process can be explored through a series of steps performed by the client, including:

Step one – Identify and list their strengths.
Step two – Analyze the interaction of their strengths.
Step three – Create a visual model.
Step four – Reflect on what they learned from the exercise.

If you’re looking for more science-based ways to help others through CBT, this collection contains 17 validated positive CBT tools for practitioners. Use them to help others overcome unhelpful thoughts and feelings and develop more positive behaviors.

A Take-Home Message

Therapists constantly strive to find the best treatment for their practices. They learn, explore, and try out various techniques to help clients overcome obstacles and become unstuck, introducing tools and techniques to help them live a more complete and fulfilling life.

Psychodrama has a history of helping clients deal with various problems across multiple settings. The effect of utilizing the power and energy of the group to support the individual as they confront their past to help their present and future selves can be profound.

For protagonists, showing vulnerability in opening up to how they handle conflict or difficult situations provides the opportunity for deep insight and growth.

For therapists, psychodrama may offer a new and different tool that can engage a group in a reflective and active treatment, identifying maladaptive relational patterns while validating changes created from the therapy.

The techniques, books, and training recommended in this article offer new tools for therapists and further hope for clients to find a new way forward in overcoming a legacy of past difficulties previously untreated.

We hope you enjoyed reading this article. For more information, don’t forget to download our three Positive CBT Exercises for free.