Applications – Drama Therapy Central

February 3, 2017October 29, 2022

Social & Recreational Settings

Campers and Drama Therapy students play with a parachute at Super Summer Camp, Kansas State University.

One of my first drama therapy jobs was to create an arts access program for children with special needs at a non-profit community arts center in suburban Maryland. I integrated students with disabilities into regular drama classes and productions by helping teachers identify ways to make adaptations and accommodations that leveled the playing field. I created programming in special education classrooms for teaching social skills, self-expression, or an aspect of the curriculum. Theatre companies comprised of adolescent actors with and without disabilities created original plays dramatizing their own ideas. Some of this work could be categorized as educational drama, some as therapeutic drama, some as drama therapy, some mixed them all together.

The performing troupes were originally designed to be venues for disabled actors to explore issues of difference and to provide awareness education to non-disabled audiences. However, my actors had different ideas. They told me right off that they were sick of thinking about their disabilities because they had to deal with them “24-7.” They wanted to explore issues that were universal to adolescents like rebellion, responsibility, growing up, falling in love, being rejected, friendship and family. We created many plays together through improvisation. Each play became a metaphor for exploring their struggles, allowing them to fictionally explore and express their concerns, hopes, and dreams. Each rehearsal process became a laboratory for the development of better social skills, flexibility, responsibility, self-discipline, communication abilities, and the development of higher self-esteem.

Making Connections, a play about a video dating service, provided opportunities to explore appropriate dating behavior, first impressions, and unfair assumptions. During our improvisations, we explored all the WRONG ways to behave on a date and all the right ways. We practiced what information is appropriate to reveal to someone you just met and what is inappropriate. We role-played anxious, overprotective parents waiting for their daughter to come home from a date and laid-back, gentle ones. In the play that resulted, one couple arranges to go on a date based on viewing each other’s video interviews, but the girl doesn’t reveal that she uses a wheelchair until they meet outside the restaurant. She wants to be chosen for her personality, not rejected on the basis of her disability. Her date has to get past his expectations of what he thought she would be like. Another girl chooses a guy who, unbeknownst to her, turns out to be a foot shorter than she is. At first, she is horrified, but later learns that he’s a wonderful person, no matter what his height.

Making Connections was later turned into an educational video for the purpose of modeling social and dating behavior to young people with disabilities and their parents. It won Honorable Mention in several video/film competitions, was shown on WETA, the PBS station in Washington, DC, and for many years was marketed by Choices, Inc., a non-profit that sponsors educational videos for people with developmental disabilities. In the course of this adventure, the actors got to “film on location” and learned about acting “in the movies.” They had a chance to share their ideas and what they learned during our rehearsal process with a much larger audience. Self-esteem sky-rocketed when people who saw them on TV came up to tell them how wonderful their “movie” was and to ask for their autographs!

Parents report that the dramatic experiences their young people had in our performing companies helped them develop a greater level of independence, responsibility, and self-discipline than their peers who didn’t participate in drama. Most of my former actors are now middle-aged adults holding down full-time jobs and living independently in apartments. One job coach at a school-to-work transition program confided he could always tell which of his clients had been actors of mine: they had more self-confidence, better communication skills, and the self-discipline necessary for succeeding in the world of work.

February 3, 2017October 29, 2022

Residential Settings

Years ago, recovering substance abusers stayed in treatment for one to three years in order to learn how to live without drugs and alcohol; today three months is considered long-term treatment and 28-day programs are the norm. A drama therapist is lucky to get one session per week with clients.

I worked thirteen years in a long-term residential treatment program with recovering substance users in the Washington, DC area. A drama group of 12-14 residents ran between three and six months. In the beginning weeks, we focused on drama games and improvisation to build group trust, social skills, drama skills (although recovering substance users are already excellent actors – skills honed during their addiction), communication, and understanding, and the idea that we can learn life lessons through metaphor and action.

Later we worked on deeper psychological issues through Psychodrama and Gestalt therapy. One of my favorite success stories involves Henry, an older recovering alcoholic, who revealed during our check-in one day that he was on the verge of being kicked out of the program for “lack of motivation.” He had always participated fully and enthusiastically in drama, so I was surprised. He reported that he never talked in other groups, and he wouldn’t work on issues in individual therapy sessions with his primary therapist. When I asked him why, he said, “Well, I hardly know what my feelings are! How can I talk about them?”

“Maybe you can’t talk about them,” I offered, “because you’ve ignored them for so many years that they feel like strangers to you. How would you like to meet them?”

“Sure!” he said, “That would be great!”

He picked four group members to represent four of his feelings and sculpted them in chairs. “Fear” hunched over in his chair looking at the floor, his arms across his chest, protecting himself. “Pain” looked away, afraid to make eye contact. “Sadness” bent over into her lap and covered her face with her hands, as if crying. “Rejection” sat defiantly with his back to Henry.

Henry introduced himself to each Emotion one by one and asked them questions so he could get to know them. As he did, each Emotion came alive and spoke about how much they missed being part of his life. They expressed how deeply they cared for him and that they wanted to help him complete treatment.

It was a turning point. Henry began to talk in his other groups and in his individual sessions. He started to acknowledge his feelings, to identify and understand how they related to his behavior. He also began to take more risks in revealing secrets and shames he was carrying inside. And because he was now able to reveal them, he could let the negative ones go.

The exercise worked for him on a metaphoric level, a practical level, and a relational level. On a metaphoric level, he was able to reconnect with emotions he had “cut off” during his addiction; on a practical level, he was able to practice talking “with feeling” to another person; on a relational level, he made a deep connection with the group members he chose to play parts in his psychodrama. This then made it easier for him to trust and open up to them and fellow residents in other groups and interactions. The group members learned about their own relationships to the emotions they portrayed, as they gave voice and body to them. They felt more connected to Henry, more connected to themselves, and more connected to each other.

Henry graduated from the program six months later. He proudly and successfully made it through treatment, and members of his family were there to see him “walk across the stage.”

Members of a Drama Therapy Group at Second Genesis perform wearing half masks.

Mask work was an extremely powerful technique for these clients. Sometimes we made half-masks, painted them with designs representing their behaviors or issues, and performed a poem or created a play about “wearing masks” and “being dishonest” in life.

Sometimes we would make full, life masks, paint the outside to represent one of the metaphorical, behavioral masks they wore in life, and paint the inside to reveal what they were really feeling. Then they would imagine that the outside mask and the inside mask could come to life and speak. They wrote down the monologue or poem that came from each, and we shared them in a dramatic reading for family and friends. Often it was the most honest, revealing work they did their entire time in treatment.

One woman, who created an outside mask of bullying and intimidation, told me that after she graduated she still kept her mask on display in her home, and whenever she felt threatened and became threatening to others, she meditated on her mask to remind herself that she doesn’t need to make negative behavior choices, and, in fact, can’t if she is to remain healthy and sober.

February 3, 2017October 29, 2022

Psycho-Educational Settings

Medical and mental health professionals often find they need to provide basic self-care information to clients and their families. When this information is delivered through traditional lecture methods, a lot of information goes “in one ear and out the other,” but when presented through drama with human stories and emotions attached to the facts, the information makes sense.

Kaiser Permanente, a major HMO, for many years had professional theatre troupes in different regions of the country toured original plays on HIV/AIDS, violence prevention, and other issues to schools and community groups. Stop-Gap Theatre of Orange County, California, also tours plays that deal with important issues and involves students in workshops and discussions afterward.

SafeHome, a prevention and intervention non-profit in Kansas City, has a teen acting troupe, which each year tours a play on dating violence and sexually responsible behavior to high schools. These are but a few of the many examples of troupes making medical and mental health issues accessible in a live, dynamic format.

One of the most interesting projects in this vein came out of the Psychosocial and Behavioural Research Unit at Toronto Sunnybrook Regional Cancer Centre in Toronto, Canada. Doctors, researchers, writers, and actors came together to create a new kind of research report: a dramatized one (called an ethnodrama). They ran focus groups with women who had metastatic breast cancer, and separate focus groups made up of their family members and of their medical caregivers. The focus groups were recorded, transcribed, and used as a basis for improvisations about the experience of living with metastatic breast cancer. The resulting play Handle with Care? and a later project on prostate cancer No Big Deal? toured throughout Canada for several years. Both plays capture the confusion, frustration, and fears generated by these diseases and offer supportive suggestions of “do’s and don’ts” for patients, family, friends, and medical personnel alike.

Monica Phinney, RDT, a drama therapist in Kansas City, worked with filmmaker Robert Greene as he filmed the documentary Procession (2021). The film follows six men who experienced abuse childhood abuse perpetrated by powerful figures within the Catholic Church. Guided behind the scenes by Monica, the men write and enact scenes to explore and reframe their experiences. In one scene a man replayed a meeting with a church board, which had dismissed his claims as unrealistic lies, and was given his opportunity to say exactly what he wished he could have said to each of them. Procession is available on Netflix. The film is not an example of drama therapy, but more an example of how a drama therapist can help direct and contain an exploration of an experience safely and ethically.

February 3, 2017October 29, 2022

Older Adults

Senior Day Programs, Retirement Communities and Nursing Homes

Actors demonstrate a "new product" that will enhance ageing! — Actors demonstrate a “new product” that will enhance ageing!

Older adults have a variety of needs that can be addressed through drama therapy. Isolation and loss are big issues: some older adults have experienced physical losses due to medical conditions, cognitive losses from Alzheimer’s disease, or social losses through the deaths of friends and family members and losses from retirement from their life’s employment. The developmental issue of old age is life review as the individual looks back and evaluates what has been accomplished and learned over the course of the years (Erikson, 1997). Drama therapy can help older adults make new social connections, assist with reminiscence and meaning-making, and bring enjoyment of the present moment back to participants, even those who are losing touch with the world around them due to dementia.

Judy Holstein, RDT/BCT, was the Program Manager for a senior day program for elders in Evanston, Illinois. In her drama therapy groups, she created dramatic opportunities to re-visit enjoyable times from past and to celebrate the present. A session might involve creating humorous commercials for “products that help with an age-related issue,” or making up an original radio drama based on a favorite radio show like “The Shadow” or “Fibber McGee and Molly,” or re-enacting an important story from Jewish history, such as the Purim Story or the Passover Story.

But drama therapy is not just about the past; it can help process current events. Judy recalls when a drama group was scheduled on the day after a gunman shot and killed a number of people at a Jewish Community Center in Los Angeles. The group members were very upset at the news reports and needed to process their anger, frustration, and helplessness. A number were survivors of the Holocaust or had relatives who had died in Hitler’s concentration camps, so this example of violence was very upsetting to them. Judy and her assistant Deb Mier, RDT, led the group in brainstorming the creation of a new and improved society, which they dubbed “Earth 2 – Dreamland.” In this place, children with potential emotional problems would be identified and helped when they were young, so they wouldn’t grow up to become adults who hurt others. A council of young and old called The Care-Givers would work together to make sure that justice was served and needs were met for all. The group nominated their choices for this council, including two group members who were highly admired and respected, the Reverend Jesse Jackson, Sammy Sosa, Michael Jordan, and – to her great honor and surprise — Judy. Then they all stood together, held hands, and chanted “Let us begin!” This drama therapy ritual brought closure and relief to the group as they struggled to find meaning in an upsetting event and allowed them to continue to act as problem-solvers and care-givers.

Quality of life, an important concept in serving the needs of older adults, relates to “an individual’s personal sense of satisfaction with areas of life such as physical comfort, emotional well-being, and interpersonal connections.” (Kuhn, Origara, & Kasayka, 2000). Quality of life is particularly important in the lives of those who live in nursing homes or who are dealing with varying degrees of dementia. Drama therapy, with its emphasis on being “here and now,” on connecting with others, communicating, and making meaning together, has proven to contribute to quality of life. In 2001 a study using Dementia Care Mapping was conducted at the day program Judy Holstein managed. Six clients were observed doing a variety of activities on two different days. Residents had a “significant spike on a subscale of ‘Pleasure’ on the Affect Rating Scale and recorded the highest level of individual well-being scores during the 75-minute drama session. There was nothing to compare to these scores…except for the 30-minute music/dance session” (Kuhn, 2001).

Aging Workshop with actors about to unveil a "new product" that will enhance ageing. — Aging Workshop with actors about to unveil a “new product” that will enhance ageing.

Drama therapy is also useful with independent older adults who want to continue to grow, enhance their talents, and give back to the community. Acting has been shown to enhance the memories and cognitive abilities of older adults (Noice, Noice, Perrig-Chiello & Perrig, 1999; Noice, Noice, & Staines, 2004; Noice & Noice, 2008). Mental and physical health improvements result when participants are immersed in drama because it involves the challenging tasks of analysis, empathy, emotional integration, physical expression, and socialization, all of which jumpstart the growth of new neurons in the brain as well as growth in the number of synapses on older neurons (Cohen, 2006; Cohen, 2009; Noice, Noice, & Kramer, 2013). The physical, mental, emotional, and relational tasks involved while acting out a character encourage connections to be formed and exercises across the brain from the left to the right hemisphere and from top to bottom of the brain, providing better overall brain functioning (Cohen, 2009).

All of this can be done without requiring older actors to memorize lines. Drama can be created in a purely process, improvisational basis or plays can be devised without a script, or actors practice storytelling skills to share their experiences with younger generations.

February 3, 2017October 29, 2022

Educational Settings

Juliet and her mother Lady Capulet (from Shakespeare's "Romeo and Juliet" demonstrate better choices through role play in Conflict Resolution Workshop. — Juliet and her mother Lady Capulet role play better choices in Conflict Resolution Workshop.

Drama therapists work within the school system as counselors, using drama therapy as their treatment method with children and adolescents. In Casper, Wyoming, Linda Nelson, RDT used drama therapy to help high school students formulate and reach academic and personal goals. In elementary schools in Michigan and Illinois, Mary Fahrner, RDT, a counselor, and Linda Sheehan, RDT, a social worker, used drama therapy with elementary school children to teach social skills, explore diversity issues, and improve personal coping skills.

Drama therapists work as teachers in public schools as well. Mary Reid, RDT, created a peer conflict resolution program in a California middle school using drama to teach communication, empathy, and problem-solving skills. Over 100 peer mediations were successfully conducted each year of the program and detentions went down twenty percent. She also brought narrative drama therapy techniques into her counseling groups so students could address their personal life challenges by acting out turning points in their lives.

Conflict Resolution Workshop with Martin Luther King Quote written on the blackboard. — Conflict Resolution Workshop with MLK Quote on board.

Lanell Finneran, RDT/BCT worked in the Therapeutic Classroom in Lawrence, Kansas for close to 20 years, first as the classroom therapist and then as the lead teacher. Her students were adolescents with emotional disorders, such as school phobia, depression, schizophrenia, bi-polar disorder, and Asperger’s syndrome who couldn’t function in a regular public school classroom. Many had learning disabilities and/or medical conditions. In her classroom, however, students were able to work through their problems while keeping up with their academics. Lanell incorporated the arts and socio-emotional education into her lesson plans. She encouraged self-expression by example: reading Harry Potter books out loud in costume with detailed character voices and props, then encouraging students to join her in acting out scenes from the books.

Even social issues were addressed through drama. One boy in the Therapeutic Classroom was being scapegoated and tormented by other students on bus trips to and from school. Lanell discussed the problems and potential solutions in individual therapy sessions with all the students, stressing each person’s responsibility in solving the situation. Then she set up a sociodrama in the classroom: the bus was created using chairs and each student sat in their assigned seat. Lanell took each student out of the bus on a “walk and talk” to verbalize what they were thinking and feeling, how they played into the problem, and at least one alternative they could take to make it better. Once everyone had contributed, they acted out a bus ride using the brainstormed solutions. After this intervention, problems on the bus stopped; everyone made an effort to be more flexible and understanding with each other for the rest of the school year.

February 3, 2017October 29, 2022

Clinical Settings

The groundwork for inclusion of the creative art therapies into psychiatric hospitals in the U.S. was laid after World War I. Talk therapy and medical interventions were not very successful in helping veterans recover from what at the time was called “shell shock” (now called Post Traumatic Stress Disorder). However, the arts brought unresponsive patients back to life. In the early 20’s and 30’s inclusion of the arts in hospital programming was expanded. (Phillips, 1994).

Today drama therapists working in a psychiatric hospital or an outpatient mental health clinic might work with patients who have a wide variety of clinical diagnoses, including eating disorders, depression, schizophrenia, bi-polar disorder, addictions, or Alzheimer’s disease. Previous to our current era of short hospital stays, in-hospital drama therapy groups would often work together over long periods of time, several times a week, and could develop original plays or do long-term in-depth work. Today with shorter stays and less coverage for psychotherapeutic services, groups tend to be short-term or a single session. Drama therapists might need to utilize process-oriented interventions in which the drama work is contained within one hour. Developmental transformations can be used in this fashion. Playback Theatre can be used for one-time therapeutic interventions in some hospitals, where a trained troupe of playback actors re-enacts stories told by the patients who comprise the audience.

Anne Curtis, RDT, and Paula Patterson, RDT, two drama therapists in Florida, have worked with acutely and chronically ill patients of all ages in medical hospitals. Puppets, guided fantasies to safe healing places, music, movement, clowning, and fairy tales help children and adults stimulate their immune systems, get back in touch with their healthy selves, and feel hope. One of Anne’s favorite parts of her visits is the Healing Parade: All the mobile patients dress up in costume and parade throughout the unit past the rooms of those who are too sick to get out of bed, spreading songs, “healing energy,” and good humor. Even staff members ask for drama therapy sessions to help them deal with their stresses, frustrations, and disappointments.

February 3, 2017October 29, 2022

Community Action Settings

Drama is an unbeatable way to provide cohesion and promote understanding at the community level. There are many drama therapists who do this work.

Armand Volkas, RDT/BCT, brings together groups from cultures that have become enemies due to war and historical trauma. Using Playback Theatre, Sociodrama, and other drama therapy techniques to allow people to tell their stories, discover their human connection, build trust, open communication, and begin to heal the rifts. He has worked around the world, bringing together descendants of Jewish Holocaust survivors and the Third Reich, Japanese and Chinese over the traumas created by the rape of Nanjing, African-American and European Americans in relation to the traumas of slavery. He calls this powerful and effective work “Healing the Wounds of History.”

STAND Together is an acronym for “Spirit, Teamwork, and New Determination Together,” one of the oldest self-advocacy groups for adults with developmental disabilities in the state of Maryland. Through monthly meetings and activities, STAND Together members learn how to stand up for themselves and develop their leadership skills, speaking out about the rights of people with disabilities. I facilitated their creation of a dramatic training module for new employees of the Montgomery County ARC to ensure that residents in their group homes and programs would be treated with respect. Group home support staff, job coaches, and other service providers for people who have disabilities are often so focused on “doing their job” that they treat residents as children or as patients, rather than as adults living independently.

Through drama, we explored the basic rights of individuals with developmental disabilities and identified situations in their personal lives in which their rights had been violated or in which they had been embarrassed by insensitive caregivers. We brainstormed more appropriate ways of treatment which showed respect. The scenarios we created demonstrated examples of inappropriate and appropriate treatment. These were incorporated into the monthly ARC training for new employees, allowing the people receiving services to define the manner in which they wanted their services delivered.

Deborah Zuver, RDT/BCT, works with a program called Acting for Advocacy in North Carolina. She trains adults with intellectual and developmental disabilities how to be self-advocates through drama therapy techniques and prepares them to present self-advocacy training to peers so that they can also learn to advocate for themselves.

February 3, 2017October 29, 2022

Corrections Settings

Rehearsal of "12 Angry Lebanese" in Roumieh Prison, Lebanon — Rehearsal of “12 Angry Lebanese” in Roumieh Prison, Lebanon

Correctional facilities (prisons, forensic units, and juvenile detention centers) offer long-term opportunities for work with clients, but within systems that more often are focused on punishment than therapeutic intervention. Therapists of all kinds express frustration at their attempts to create behavioral change in institutions of this kind. However, drama therapists love the challenge of working with these clients.

Brandon Brawner, RDT, worked for many years in San Francisco prisons using video techniques. Inmates created characters and stories that expressed their concerns about their personal struggles or group issues and enacted their concerns about their personal struggles on video. Some are highly fictional: in one short film, based on the television show Star Trek, a group of prisoners is transported to the USS Enterprise to get help with anger management skills from Captain Kirk, Spock, and the rest of the crew. Other films are psychodramatic: a prisoner acts out what his journey home might be like after his release and faces the temptations of “old friends” who want to entice him back into a life of crime. Brandon also worked with ex-convicts, helping them explore their struggles to “go straight” once they are released.

There is a drama therapy program currently being run by Barbara Wiebe, RDT, at the North Texas State Hospital forensic unit in Vernon, Texas, for clients who have committed crimes but have been found not competent to stand trial because of mental illness. These clients are manifestly dangerous to themselves and others. Drama groups at NTSH can meet as often as three times per week, developing basic social interaction skills and self-expression through movement and simple drama games. They use role play, masks, performance, and very simplified Playback Theatre to work on therapeutic issues relating to anger management, substance abuse, and coping mechanisms.

Zeina Daccache directing "12 Angry Lebanese" in Roumieh Prison, Lebanon — Zeina Daccache directing “12 Angry Lebanese” in Roumieh Prison, Lebanon

In Lebanon, Zeina Daccache, RDT-BCT has worked with men in Roumieh Prison (pictured at the top of this page) and with women in a women’s prison. 12 Angry Lebanese, the Documentary is a moving film of her work in Roumieh as she worked on a production of 12 Angry Men. She followed these up with other documentaries on the women’s prison, Scherazade in Baabda, with clients who were mentally ill and in prison (The Blue Inmates), and others. These documentaries have played in commercial houses and won a number of awards at international film festivals