Psychodrama Therapy: How it Works & What to Expect

What Is Psychodrama Therapy?

Psychodrama helps individuals work through their thoughts, feelings, and relationships through role play. This allows participants to process their feelings and emotions, work through conflicts, find solutions, and get support. While psychodrama is often used in group therapy, it can be utilized in individual sessions as well.

Jacob Levy Moreno developed psychodrama in the 1920s. Moreno was interested in theater and acting and was curious about how dramatic performance could be used in therapy. He believed that healing from mental illness required spontaneity, which allowed people to drop their defense mechanisms and observe their condition through theatre.¹

The five elements of a psychodrama therapy group are:

• Protagonist: The protagonist is the main character in a psychodrama and is central to the role play. The therapist and other group members are there to help the protagonist explore and process their thoughts, feelings, and emotions related to the issue they are working on.
• Director: The director is typically a licensed therapist or trained facilitator. They guide the psychodrama session and support the participants as they explore their thoughts and emotions through role play and other therapeutic techniques.
• Stage: The stage is the space in which a psychodrama takes place. This could include a therapist’s office or the room in which the group is being held. The stage must be set up to maintain confidentiality to protect confidentiality and create a feeling of safety within the group.
• Auxiliary-ego(s): Auxiliary egos, sometimes called auxiliary roles, are roles played by other participants in a psychodrama. They may play a person from the protagonist’s family of origin, a supportive role, or another person in a relationship. Auxiliary egos can also be symbolic and represent emotions or other abstract constructs.
• Audience: An audience consists of the individuals who observe and participate in a psychodrama session. They observe and witness the protagonist’s process as they participate in the role play, provide safety and support, and also provide feedback and reflection.²

What Is the Goal of Psychodrama Therapy

Psychodrama aims to help individuals increase their awareness and insight into themselves and heal from distressing emotions and experiences through spontaneity and role play. This helps people gain increased insight into their situation and better cope with their emotions and thoughts while exploring new potential solutions.

What Can Psychodrama Help With?

Psychodrama works for many different mental health concerns, including mood disorders, eating disorders, and trauma. It can help participants set boundaries or solve problems, increase their ability to work through relationship conflicts, help them communicate more clearly, facilitate healing from traumatic events, and ultimately help people experience less distress and lead a more fulfilling life.

Psychodrama therapy can help with the following conditions:

• Trauma³
• Relationship problems
• Family of origin issues
• Anger management
• Low self-esteem
• Social Anxiety⁴
• Grief and loss
• Depression⁵
• Anxiety⁵

What to Expect During the Psychodrama Therapy Process

Psychodrama therapy typically takes place in a group setting, where participants reenact specific scenes from their lives. A psychodrama goes through three stages: the warm-up phase, the action phase, and the sharing phase. The therapist guides the protagonist through the scene while other group members may play supporting roles or act as an audience.

The psychodrama therapy process involves:

The Warm-up Phase

During the warm-up phase, participants engage in activities that help foster safety, trust, and rapport. This usually includes introductions to the therapist and any other participants, going over the rules for the treatment, including confidentiality, and the importance of being non-judgmental and supportive.

The therapist will take participants through ice-breaking activities, teach coping skills geared towards anxiety, like diaphragmatic breathing, and help the group set goals and intentions. Because the role-playing and emotional release that takes place in psychodrama can be so vulnerable, creating a safe and non-judgmental space is essential.

The Action Phase

In the action phase, participants will begin to set up and act out scenes. They will work together to set the stage for the scene, including obtaining any props that may be used and determining which roles participants will take.  Once the scene is set, the participants will begin role-playing the situation that the protagonist wants to work on. This can include acting out the scene through dialogue and movement while allowing for free emotional expression and feedback.

Therapeutic techniques used during the action phase include:

• Doubling: A group member doubles the protagonist’s emotions and thoughts and can sometimes help them put words to thoughts or emotions they have difficulty identifying.
• Mirroring: In mirroring, another participant listens carefully to what the protagonist says, notices their nonverbal communication, and then reflects on what they are observing. This can help the protagonist feel understood and gain additional insight.
• Role-playing: This is when the group or the individual and their therapist act out the situation that is bothering the protagonist. Participants can play the role of different people, emotions, concepts, or ideas and play out the distress or conflict that the situation creates for the protagonist.
• Role reversal: The participants will reverse roles, allowing them to take on different emotions or perspectives. They then act out the role play from these different roles, which can increase insight into what the other person might be thinking and feeling.
• Soliloquy: A soliloquy is a monologue. In psychodrama, the protagonist can talk aloud through their thoughts, feelings, memories, or anything else that comes up. This helps them explore and work through their feelings and can help them get more clear about possible solutions.
• Emotional expression: Participants are encouraged to freely and openly express their emotions as they arise. For many, this can be a very cathartic experience.
• Conflict resolution: Sometimes, conflicts will come up during the action phase. This allows for opportunities to resolve those conflicts, problem-solve, and identify coping and communication skills.

The Sharing Phase

During the sharing phase, the protagonist, other participants, observers, and the therapist all share their observations. This is when the participants can process the experiences and emotions that came up during the role play. This can include giving and receiving feedback, validating the protagonist, sharing any insights, and providing support.

Examples of Psychodrama Therapy

Here are a few examples of what psychodrama therapy could look like:

Psychodrama for Someone With Adoption Trauma

Someone with adoption trauma might utilize psychodrama to work through their emotions relating to their adoption. Other participants could play the role of their birth parents, adoptive parents, other support people, or any professionals involved in their adoption. This allows the protagonist to identify and come to terms with their adoption trauma even when they are not able to confront the people involved directly.

Psychodrama for Someone Who Lost a Parent

Psychodrama could help a person grieving the loss of a parent explore their feelings of grief and make sense of the loss. The person grieving would play the protagonist, and other participants could play siblings, other family members, the deceased parents, hospital staff, or even grief itself. By playing out the scene in the psychodrama, a person can face their emotions and work through them in a healthy way.

What Is the Role of the Director in Psychodrama?

The director is in charge of setting up and facilitating the psychodrama. They guide the process of creating a safe and supportive environment, collaborating with participants to identify the goals of the psychodrama. They assign roles to the participants, guide the group through the warm-up, and facilitate the role play.

Throughout the process, the director is responsible for monitoring participants’ emotional safety while encouraging them to be emotionally expressive and creative. As licensed and trained mental health professionals, they can watch for signs that someone may not be emotionally safe, manage any conflicts that come up, and provide feedback.

Benefits of Psychodrama Therapy

Psychodrama is a powerful tool for exploring emotions and relieving difficult feelings. Participants can gain increased insight into their experiences, increase their strengths, find healing from trauma, and develop new tools for coping and problem-solving. In a group setting, psychodrama can also help participants build support and trust.

Challenges & Considerations of Psychodrama

While psychodrama can be a creative, unique, and very effective tool, there are some considerations to watch out for. Psychodrama can be an extremely intense experience, and while this can be very healing and cathartic, an individual should consider their support system, self-care, and their personal comfort level and readiness for this type of deep work.

Be sure to work with a qualified therapist who is trained and experienced in facilitating this type of therapy. Safety and trust must be established, whether psychodrama occurs individually with a therapist or in a group.

What Is the Cost of Psychodrama Therapy?

The cost of psychodrama can vary greatly depending on the therapist’s fees, whether the sessions are group or individual, the facility, the number of sessions, and whether or not it is covered by insurance. In general, group therapy is typically less expensive than individual therapy. You will want to ask the therapist to clarify costs before beginning treatment.

Does Insurance Typically Cover Psychodrama?

Insurance coverage for psychodrama therapy varies widely. For any type of therapy to be covered, it has to be focused on the treatment of a mental health diagnosis. The best step is to consult with one’s insurance provider for details. Coverage will depend on each person’s specific plan coverage, diagnosis, and whether the therapist accepts that person’s insurance.

Is Psychodrama Therapy the Right Choice for You?

When deciding whether or not psychodrama is the right approach for you, consider your comfort with expressive therapies and group settings. In addition, think about your goals for therapy. If your primary goals are working through unresolved emotions, finding solutions to problems, or gaining more insight about yourself, psychodrama may be a great approach for you.

How to Find a Psychodrama Therapist

If you are looking for psychodrama therapy, you can check an online therapist directory or ask for recommendations from your mental health or primary care provider. Psychodrama may also be available on online group therapy platforms. If you plan to use insurance, contact your insurance company to check whether the therapist is in network with your insurance.

What to Look For in a Psychodrama Therapist

Look for a therapist who has specific qualifications and training in psychodrama. Be sure to work with someone with experience and training, and you’ll also want to consider things like location, cost, and logistics. Certified therapists are available through the American Society of Group Psychotherapy and Psychodrama (ASGPP).

Here are a few questions to ask a potential psychodrama therapist:

• How long have you been practicing psychodrama?
• What other therapeutic approaches do you use?
• How will I know if psychodrama is the right fit for me?
• What insurance plans do you take?
• How are your groups structured?
• What is the cost?

Who Can Provide Psychodrama Therapy?

Licensed mental health professionals provide Psychodrama. This includes psychologists, clinical social workers, marriage and family therapists, professional counselors, and psychiatrists. Some therapists have specialized training in drama therapy or group therapy approaches in addition to psychodrama.

Where Does Psychodrama Therapy Take Place?

Psychodrama occurs in a wide variety of different settings. This could include a mental health agency, a private therapy practice, a mental health clinic, a hospital, or an inpatient center. Some educational settings like schools and universities may offer psychodrama, as well as group homes or residential facilities.