Psychodrama for children and adolescents: A systematic review of therapeutic effects, changes and underlying processes

In clinical practice, psychodrama is applied to children and adolescents with psychosocial problems. Psychodrama is an experiential approach grounded in theatrical methods and underlying processes of encounter, spontaneity and creativity, aimed at fostering psychological growth. Although psychodrama has been successfully applied in clinical settings, little is known about its specific therapeutic effects and changes and what in psychodrama contributes to these results. A systematic narrative review was performed to obtain more insight into therapeutic effects and changes and underlying processes. Eight databases were systematically searched, yielding 4393 studies, of which twenty-two were included. Five studies used a randomized controlled design, twelve studies a non-controlled design, and five studies applied pre-and posttest design. We identified therapeutic effects and changes, psychodrama means, attitudes, and supposed underlying processes. Positive therapeutic effects and changes were reported on overall psychosocial problems, internalizing and externalizing problems, emotional functioning, cognitions, identity, and social functioning. Thirteen categories of processes which were supposed to contribute to the therapeutic effects and changes were identified, such as process of becoming aware, gaining interpersonal experiences, gaining and modifying insight, emotional processing and acting out, (non)verbal expression, reflection, learning and applying new copings skills, and rescripting. Most studies used the warm-up, action, sharing phases of psychodrama. Some positive outcomes were inconsistent across studies. Recommendations for future research and guidelines for providing a detailed description of psychodrama intervention has been provided.