Key Principles

The Structure of Drama Therapy Sessions

A typical drama therapy session begins with a “Check-in” in which clients share how they are currently feeling. This provides important information to the drama therapist about how to lead the group that day, what issues are ready to be worked on, and what resistances will need to be worked past to get the group to function openly and smoothly. Next, the “Warm-up” gets everyone focused on each other and on being in the “here and now.” A warm-up also prepares muscles that may be used in activities later in the session so no one gets hurt and prepares imaginations so everyone is ready to work together creatively and safely. Each session usually has at least one major drama therapy activity that is participated in and then discussed by the group. Those who have taken on a role need to “de-role” afterwards in order to reconnect with themselves. The group ends with a closure activity: a game, a ritual, a review of the session, or a song.

The Structure of a Drama Therapy Series of Sessions

Renee Emunah (1994) has identified five phases through which most drama therapy groups progress. Her Five Phase Model parallels established wisdom from group dynamics on how successful groups form and grow. The first phase is Dramatic Play where the group gets to know each other and the therapist through playing together to develop trust, group cohesion, and basic relationship skills.

Then the group moves on to the Scenework phase where they continue playing, but begin focusing on developing a lot of the dramatic skills they will need as they continue in treatment. All humans develop basic dramatic skills at the ages of 3-5, a time when they naturally begin learning about the world around them through imitation and dramatic play. As they grow older and begin school, children are encouraged to develop their abstract reasoning skills and use them to the exclusion of hands-on forms of learning. However, drama is like riding a bike. You never forget how to do it. The Dramatic Play and Scenework phases allow clients to get back in touch with those skills and feel competent and confident using them again.

Phase Three focuses on Role Play, exploring issues through fictional means. Perhaps the group acts out a generic, fictionalize family conflict or familiar characters from a fairy tale or legend that goes through a crisis or challenge shared by group members. When the group is ready, they can move on to Phase Four: Culminating Enactments, where personal issues are acted out directly through Psychodrama or autobiographical performance.

The final phase, Dramatic Ritual, involves closure to the work of the group. This might be the sharing of a public performance that has been created by the group, the sharing of a private ritual within the group, or an evaluation session where clients can review what they’ve learned, how they’ve changed, and where they can say goodbye and thanks to the people in the group who have helped them and to whom they have become close.

Not every drama therapy group works its way through all five phases. Some groups aren’t together long enough to develop the skills and trust to reach the Culminating Enactment phase. This is especially true in this day of limited reimbursement by health insurance for mental health services which are often limited to 6-8 sessions.

Age and developmental level make a difference, too. Children often get the full benefit of emotional healing through play and fictional work alone, so there’s no need to move on to some of the later stages. Some adult groups dealing with severe trauma, anger, or who are extremely immature may not work through their trust issues enough to move on to Phase Four. That doesn’t mean that they have “failed” as a drama group; it means they needed more time to heal at an earlier emotional developmental level, perhaps because their wounds in that area were very deep.

As mentioned earlier, metaphorically, the Five Phase Model is the plate on which the Drama Therapy Pie rests. Different slices of the pie are used in different phases. Typically, Phase One incorporates drama games and improvisation. Phase Two moves into improvisation and role play. Phase Three involves more structured role play methods, such as Role Method or Sociodrama. Phase Four includes techniques such as performance, Psychodrama, and Theatre of the Oppressed forums or deeper explorations of Role Method or Developmental Transformations. Phase Five might end with ritual, games, and techniques which help bring group closure.

Concepts Common to All Drama Therapy Approaches

While drama therapy techniques may differ from therapist to therapist or from session to session, there are concepts which are common to all forms.  Transitional Space is an important component in many therapeutic and learning environments, but it is essential in drama therapy. Transitional space is the imaginary world that is created when we play or imagine together in a safe, trusting situation. It is a timeless space in which anything we can imagine can exist: dragons can be vanquished, castles can be built, raging rivers can be crossed, acceptance and love can be experienced. Transitional space is the place where change and healing can happen, because it is potential space, a magic play space, Stanislavksy’s “Magic If.” It is created jointly by the therapist and the clients playing together and believing in the possible.

Another crucial concept is using metaphor through action or Dramatic Metaphor. Behaviors, problems, and emotions can be represented metaphorically, allowing for symbolic understanding. A certain set of behaviors can be looked at as a “role,” such as the role of mother, victim, student, or hero. These roles can be played out in a dramatic situation, leading to a greater understanding of the role as helpful or harmful, safe or dangerous. An emotion can be represented with a metaphorical image: anger displayed as a volcano, an exploding bomb, or a smoldering fire. Dramatized, these images allow the client deeper insight into the qualities of the emotion and how it functions positively or negatively in his/her life.

Embodiment allows the abstract to become concrete through the client’s body. We all experience life first through our senses and our bodies, and only later, at older ages, through language and abstract thoughts. Acting out an idea or an experience allows it to become “more real.” This allows it to be dealt with in form rather than in the abstract, through feeling rather than only through thought, in the moment rather than through past memory or future projection. Embodiment allows clients to “experience” or “re-experience” in order to learn, to practice new behaviors, or to experiment with how to change old behaviors. This is particularly important for clients who are kinesthetic or visual learners (estimated to be at least two thirds of the population).

Distancing allows the therapist to change the degree to which the role being played is like you symbolically or like you actually. Children intuitively use distancing to protect themselves from shame and guilt in play by acting out characters similar to them, but not them. Pretending to be Gretel, abandoned in the forest by her mother and father, allows a child to explore her feelings of being punished by her parents or a significant adult.

Playing a role quite different from oneself often feels more comfortable than playing oneself directly. In some cases, an experience is too “close” to us for us to see our part in it. We need to take a step back (metaphorically speaking) and see the experience in a wider context: to see the forest in order to see the tree.

Sometimes a situation is too emotional or intense for a client to encounter in therapy without becoming overwhelmed emotionally. More distance, through fictionalizing a situation, using a metaphor to represent the problem, or using a technique like puppets, removes the situation a step from flesh and blood reality and can help a client work on the issues without falling apart.

On the other hand, some clients will create so much intellectual distance from an issue that they can’t get in touch with their feelings (see the story of Henry under Residential Settings in Applications). They need less fiction and more emotional involvement to be able to face the issue honestly and directly.

Certain drama therapy techniques tend to create more distance, and others tend to create less distance. For example, Psychodrama, which deals directly with the personal, nonfiction history of the client, is less distanced. Puppets, theatre games, and improvising fictional characters are more distanced. Some techniques can go either way, depending on how they are used. The performance of an autobiographical or self-revelatory play is less distanced than the performance of a play about fictional characters. Role play can be very close to oneself or distanced, depending on the role being portrayed. (A note here: as every actor knows, the emotions in any role can feel very real while the role is being portrayed!)

Dramatic Projection is akin to concrete embodiment and employs metaphor. It is the ability to take an idea or an emotion that is within the client and project it outside to be shown or acted out in the drama therapy session. A client’s difficulty asking for help (an internal problem) can be dramatized in a scene with other members of the group, with puppets, or through masks, so the problem becomes an external problem which can be seen, played with, and shared by the therapist and the group.

Incorporating the other Arts. Drama therapists use music, movement, song, dance, poetry, writing, drawing, sculpture, mask making, puppetry, and other arts with their drama therapy activities. Just as the theatre is a crossroads where all the arts come together, drama therapy allows all the arts to meet and work together, too. Starting with writing and then enacting the story or poem, or beginning with drawing and then embodying the art through movement, body sculpting, or drama is a natural way to progress. This is one reason drama therapists are required to have training in the other creative arts therapies and why many drama therapists have credentials in one of the other creative arts therapy modalities.

© Copyright Sally D. Bailey, Registered Drama Therapist. All Rights Reserved.

About

 Sally Bailey

Sally Bailey, MFA, MSW, RDT/BCT

I earned my BFA in directing, summa cum laude, at the University of Texas at Austin in 1976 and my MFA in directing and playwriting at Trinity University at the Dallas Theater Center in 1981. I worked in professional theatre for thirteen years as a technician and administrator at such places as Houston Stage Equipment, NORCOSTCO Texas Costume, Theatre Virginia, and The Shakespeare Theater at the Folger before discovering drama therapy.

After training in drama therapy in the Washington, DC area, I created the Arts Access Program (now the AccessAbility Program) at the Bethesda Academy of Performing Arts (now Imagination Stage) and served as the Arts Access Director from 1988 to 19http://www.imaginationstage.org/accessability.htm98. While there I had the opportunity to work with a wide array of children through adults who had various physical and cognitive disabilities. They taught me how to make theatre accessible to everyone.

I also worked as a drama therapist at Second Genesis, a long-term residential drug rehabilitation program in the Washington, DC area, from 1988 to 1999. For the first six years I was the “itinerant drama therapist,” traveling to all six facilities to run drama therapy groups with residents. Then after massive state funding cuts for drug treatment programs in 1994, I was able to work part- time only at Second Genesis’ Melwood House for Women and Their Children until 1998 when I took a full-time position there as an Addictions Therapist.

Other educational credentials: In 1992 I received a certificate in Gestalt therapy from the Washington Gestalt Training Institute under the training of Rudy Bauer, Ph.D., and in 1998 I received a Masters in Social Work from the University of Maryland at Baltimore.

I became a Registered Drama Therapist with the North American Drama Therapy Association in 1990 and a Board Certified Trainer in 1997. I served on the board of the NADTA: 4 years as Membership Chair (1995-1999), 2 years as President-Elect (1999-2001), 2 years as President (2001-2003), and 2 years as Education Chair (2007-2009). I also served on the Registry Committee for three years, 2 of those years as the Registry Chair (2005-2007).

Currently, I am a professor at Kansas State University in Manhattan, Kansas (yes, we are known as The Little Apple) where I am the director of the drama therapy program. I teach drama therapy courses, creative drama, and playwriting as well as direct the Barrier-Free Theatre, an integrated acting company of adults with and without disabilities, co-sponsored by City of Manhattan Parks and Recreation Department and the K-State Theatre Department.

Intensive drama therapy courses are offered at K-State every June (Current Offerings) through the Division of Continuing Education. These courses are a great way to “get your feet wet” and discover if drama therapy is the career for you. They are also a way of getting Alternative Training in Drama Therapy. In addition, K-State offers an MA in Theatre with a concentration in Drama Therapy.

I serve as the Office Manager of the Drama Therapy Fund, a non-profit 501(c)3 charitable organization founded to support the field of drama therapy in education and research through grants, awards, and scholarships.

Books: Wings to Fly: Bringing Theatre Arts to Students with Special Needs (1993), Rockville, MD: Woodbine House, currently out of print.

Dreams to Sign (2002) co-written with Lisa Agogliati, published through the U.S. Department of Education. It is available from Lisa at lagogliati@aol.com.

Barrier-Free Theatre (2010) published by Idyll Arbor, winner of the American Alliance for Theatre in Education’s 2010 Distinguished Book Award.

Becoming a Drama Therapist

Most drama therapists begin their training in theatre at the BA, MA, MFA or Ph.D. level and often work in professional or educational theatre before training in psychology and drama therapy at the MA level. In North America there are three graduate programs in drama therapy that have been approved by the North American Drama Therapy Association: New York University (NYU) in New York City, California Institute of Integral Studies (CIIS) in San Francisco, California, and Concordia University in Montreal, Canada. Students in these programs study for two years full time, taking courses in drama therapy, psychology, psychotherapy, ethics, and research, and complete 800 hours of internship using drama therapy with at least two different populations of clients.  There are 2 programs that should be approved in the next year or so: one at Antioch University in Seattle, WA and one at Lesley University in the Boston, Massachusetts area.

People who already have or are working on Masters or Ph.D. degrees in theatre or mental health, such as counseling, social work, speech pathology, or special education can pursue Alternative Training in drama therapy. Alternative Training is equivalent to the MA approved programs and allows students to create individualized programs around a specialty. This program was put in place in the late 1990’s by NADTA. It is not an easier way of becoming a drama therapist; however, it can be a more flexible way for people who have jobs and families and can’t move to the cities the current approved programs are in or for individuals who have already have earned advanced degrees.

Alternative Training must be overseen by a Board Certified Trainer (BCT). This is a Registered Drama Therapist who has been approved to mentor, guide, and train drama therapy students. The BCT helps the student plan out a yearly learning contract and serves as an academic advisor.

Registry: The Professional Credential

RDT (Registered Drama Therapist) is the credential that is nationally recognized in the United States and Canada as the professional designation for drama therapists. Registry is a peer review of education, training, and experience qualifications.

The clearest way to explain registry as a credentialing system is to compare it with the medieval guild system. If a young boy in 12th century France wanted to be a weaver, first, he would train as an Apprentice to a Master Weaver. When his training was completed and he passed his basic proficiency tests, he became a Journeyman. As a Journeyman, he worked in the field at a higher level of responsibility, pay, and respect. After a certain number of years, during which the Journeyman had gained practice and expertise, he could apply to join the Guild as a Master Weaver. The Guild members would review the Journeyman’s qualifications and either vote him into the guild as a peer or not (in which case, he would remain a Journeyman until he achieved the appropriate level of skills).

In terms of drama therapy, a student (apprentice) completes the educational and training necessary to understand how to practice drama therapy responsibly and ethically, earning either an MA in drama therapy or completing the Alternative Training Program. Then the journeyman level practitioner works for a minimum of 1,500 hours as a professional drama therapist (for the purposes of comparison, social workers typically work for 2,000 before they can apply for licensure). In addition, all potential applicants for registry must at some point have completed a minimum of 500 hours of theatre experience. The theatre experience can be educational, professional, or via community theatre. A BA or MA degree in theatre alone constitutes much more than 500 hours of theatre, so most drama therapy practitioners have already completed this requirement before they enter the field as trainees. When all of these basic, educational and professional requirements have been met, registry can be applied for.

Peer review or registry is different from certification or licensure, the professional credentials in certain other fields. Public school teachers, for example, must be certified and/or licensed within the state in which they teach. Certification guarantees school employers that the teacher applying for the job has the education and training to teach whatever subject/age the certification covers. In many states teachers must also pass a test to be certified. Teacher certification is controlled separately by each state’s Board of Education or Board of Regents. Some standards are set by the state legislature and others are set by the Board. Teacher certification is important because it protects students, employers, and, ultimately, the public.

Social workers or counselors must be licensed within the state in which they practice. Licensure guarantees potential employers and clients that the therapist has the minimum required education, training, and experience in order to adequately do his/her job. Teachers pay for their certification and must renew it every few years. Licensed social workers and counselors must do the same. Licensure for therapists is set up separately by each state through legislation passed by the state legislature and then regulated and administered by a mental health board.

Currently, registry is the only recognized professional credential for drama therapists in the United States and Canada; there is no licensure for the title “Drama Therapist.” New York State and Wisconsin have passed licensure laws that include creative arts therapists, among them drama therapists. The law in New York took a coalition of creative arts therapists and counselors twenty years of organizing and lobbying to get passed.

What is Drama Therapy?

Drama therapy applies techniques from theatre to the process of psychotherapeutic healing. Beginning in the early 20th century drama was used by occupational therapists in hospital and by social workers in community programs to teach clients social and emotional skills through performing in plays.  Later in the 70’s, these techniques were integrated with improvisation and process drama methods as the field emerged as a separate profession.

The focus in drama therapy is on helping individuals grow and heal by taking on and practicing new roles, by creating new stories, and by rehearsing new behaviors which can later be implemented in real life. Drama therapists have extended their applications beyond clinical contexts to enrich the lives of at-risk individuals, to prevent problems, and to enhance wellness of healthy people. 

Drama and therapy have been natural partners for at least the last 350 centuries. Archeological evidence suggests that early humans began to make art – paintings, sculpture, music, dance, and drama – between 45,000 and 35,000 years ago at the same time they became capable of symbolic, metaphoric thought. As part of this creative explosion, shamans incorporated the arts into their religious and healing practices. Dance and drama, in particular, were used in rites to create sympathetic and contagious magic and to embody myths and rituals. That the arts have been connected to healing and meaning-making since their origins, shows how vitally important they are to health and to civilization. In fact, recent scientific research by Gene Cohen (2005, 2009), James Pennebaker (1995), Helga and Tony Noice et al (1999, 2004, 2008), and others are proving that participation in drama and other arts enhance physical and mental health.

Drama and psychology are both the study of human behavior: you could say they are two sides of the same coin. Psychologist Philip Zimbardo, author of The Lucifer Effect, acknowledges this when he says, “Drama, psychology, and therapy share a basic goal of trying to find what is essential about human nature and try to use that knowledge to improve the quality of individual and collective life.  When drama is good, it transmits knowledge about what is essential about people and between people” (Zimbardo, 1986).  Psychology studies thoughts, emotions, and behavior; drama actively analyzes and presents the thoughts, emotions and behavior of characters for an audience to see and understand. Much of dramatic literature addresses the psychological, social, and cultural conditions of humanity and, thus, serves as a natural vehicle for actually helping real people with problems more consciously address their problems.

Just as psychotherapy uses talking to treat clients who have difficulties with their thoughts, emotions and behavior, drama therapy uses drama processes (games, improvisation, storytelling, role play) and products (puppets, masks, plays/performances) to help clients understand their thoughts and emotions better or to improve their behavior. However, unlike most types of therapy which rely purely on talking, drama therapy relies on taking action. This creates for the client an embodied, concrete experience of the issues being explored, making them easier to understand and change.

Because there are so many forms that drama, drama therapy is a very broad field, including many different approaches and techniques. The metaphor I like to use is to say there is a big “Drama Therapy Pie,” which can be cut into many smaller slices. The slices of the pie below represent only a few of the more well-known drama therapy approaches in order to provide a general idea of the variety available; it is not exhaustive.

Within the pie are two different directional continuums. The up to down continuum ranges from fictional enactments to ones which are more true-to-life. Fictional work (drama games, improvisation, role play, Sociodrama, Developmental Transformations, rituals, masks, puppets, and some types of performance) allows clients to pretend to be characters different from themselves. This can expand their role repertoires (the number of types of roles that can be accessed for use in real life) or can allow clients to explore a similar role to those they usually play under the guise of “not-me-but-someone-like-me.” Non-fictional work (Psychodrama, Playback Theatre, Theatre of the Oppressed, ethnodrama, and autobiographical performance) allow clients to explore their lives directly. Clients need to have good ego strength to be able to do non-fiction work.

The left to right continuum ranges from presentational enactments (presented for an audience) to process-oriented ones (done just for the group). Methods like Playback Theatre, Theatre of the Oppressed, and the performance of plays are presentation, while methods like drama games, improvisation, role play, Developmental Transformations, Sociodrama, and Psychodrama are process-oriented. Other methods, such as puppets, masks, rituals, can be used as part of performance or as process techniques within a therapy session.

Imagine that underneath the pie is a plate. That plate represents Renee Emunah’s Five Phase Model of Drama Therapy (1994), which guides the growth and process of a drama group from the time they start as complete strangers to the time they end their work together. Different phases pull activities from different slices of the pie.

Drama therapy is primarily conducted in groups, although there are practitioners who use it in individual, couples, or family practice. Drama therapy can be found in a wide variety of settings, used with many kinds of clients. Most clients who benefit from talk therapy can benefit from drama therapy and some populations who have difficulty verbalizing, like individuals with autistic spectrum disorders or people recovering from trauma respond well to drama therapy, too.

For some populations, the action methods of drama therapy are more effective. Recovering substance abusers are notorious for being disconnected from their feelings, for making up endless excuses (called rationalizations) for their behavior, and for “being in denial” about their addiction and addictive behaviors. Drama therapy bypasses the excuses and denial, getting right to the maladaptive behavior. Other types of groups — for instance, nonverbal clients or children – who aren’t good candidates for verbal therapy – can often participate successfully in drama, because they can show, rather than tell, how they feel.

Depending on the goals and needs of the client, the drama therapist chooses a method (or several) that will achieve the desired combination of understanding, emotional release, and learning of new behavior. 

See Key Principles and Applications for more.

© Copyright Sally D. Bailey, Registered Drama Therapist. All Rights Reserved.