Web-Page Supplement to:

Chapter 16: Drama Therapy

Sally Bailey

Revised and re-posted, September 29, 2006

Early History:

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.

Drama is another way to study and teach about human behavior–it recognizes the more artistic way of communicating about what psychology studies in a more academic fashion. Drama actively analyzes and presents the thoughts, emotions and behavior of characters for an audience to see and understand. In addition, drama addresses the wider 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.

Notes on stage work

Some adult groups dealing with severe trauma or anger or who are extremely immature may not work through their trust issues enough to move on to Stage Four. That doesn't mean that they have "failed" as a drama group; it means they needed more time to heal at one particular emotional developmental level, perhaps because their wounds in that area were very deep.

P 4: One of Anne Curtis's favorite parts of her visits is the Healing Parade: all of the mobile patients dress up in costume and parade throughout the floor to 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.

Mask work was an extremely powerful technique for these clients. Sometimes we made half-masks, painted them with designs representing their 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 inside. 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, tells me that she still keeps her mask on display in her home and whenever she feels threatened and, in turn, becomes threatening to others, she meditates 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.

Further Examples of Applications

Corrections. Some drama therapists love the challenge of working with these prisoners or offenders on probation. In addition to Baim's description of the Geese Theatre program in the UK (and John Bergman's in the USA), there are other examples:

– Brandon Brawner, another drama therapist, has worked for many years in San Francisco prisons using video techniques for drama therapy interventions. Inmates create characters and stories that express their concerns about their personal struggles or group issues and enact their stories on tape. Some are highly fictional. In one screenplay based on Star Trek, a group of prisoners are transported to the USS Enterprise to get help with anger management skills from Captain Kirk, Spock and the rest of the crew. Others are highly 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 continues his work with ex-convicts, helping them explore their struggles to "go straight" once they are released.

-- At the North Texas State Hospital forensic unit Lori Yates works long term with clients who have committed crimes, but have been found not competent to stand trial because of mental illness. They are manifestly dangerous to themselves and others. To promote responsibility and commitment, she calls her clients "actors," not "patients." In drama therapy group they must agree to abide by her rules of "No harm to self, no harm to others, use your outs" at the beginning of each session. Drama groups at NTSH can meet often as three times per week, developing basic social interaction skills and self expression through movement and simple drama games. They work use role play, masks, performance, and very simplified Playback Theatre to work on therapeutic issues relating to anger management, substance abuse, and coping mechanisms.

-- Priscilla Haynes, another drama therapist in Texas, uses drama therapy with adolescents in juvenile detention and helps them explore their options and identity through mask work.

Psychoeducational 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." Through drama methods, the information "sticks" and makes more sense because it is not presented as disembodied facts, but as issues with human stories and emotions attached. Kaiser Permanente, a major HMO chain, has professional theatre troupes in different regions of the country which tour original plays on issues like 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 afterwards.

Planned Parenthood of San Diego has a teen acting troupe which each year develops a new play on sexually responsible behavior, drug use, and life style choices which they take to their peers.Staci Block, who writes about her teen troupe in one of the articles later on in this book, also addresses teen issues through the interactive, live work created by her teen actors. These are but a few of 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! They began with focus groups of women who had metastatic breast cancer, of their family members, and of their medical care-givers. 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.

Education settings.  Some drama therapists work within the school system as counselors, using drama therapy as their treatment method with children and adolescents. Mary Reid 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 20%. 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.

In Casper, Wyoming, Linda Nelson has used drama therapy to help high school students formulate and reach academic and personal goals. In elementary schools in Michigan and Illinois, Mary Fahrner and Linda Rosenberg, a counselor and social worker, respectively, use drama therapy with elementary school children to teach social skills, to explore diversity issues, and to improve personal coping skills.

Lanell Finneran has worked in the Therapeutic Classroom in Lawrence, Kansas for ten years, first as the classroom therapist and now as the lead teacher. Her students are adolescents with emotional disorders, such as school phobia, depression, schizophrenia, and bi-polar disorder, who can't function in a normal public school classroom.  Many have learning disabilities and/or medical conditions as well. In her classroom, however, students are able to work through their problems while keeping up with their academics.  Lanell incorporates the arts and emotional education into her lesson plans. She encourages self-expression by example: reading Harry Potter books out loud in costume with detailed character voices, then encouraging students to join her.

Even social issues are addressed through drama in her classroom. Several years ago one boy who had poor social skills and poor boundaries antagonized the other students so much that they began scapegoating and tormenting him on bus trips to and from school. Lanell first processed the problems and potential solutions in individual therapy, stressing each person's responsibility in solving the situation.  Then she set up a group sociodrama in the classroom: the bus was created using chairs and each student sat in his/her assigned seat.Lanell took each student out of the bus on a "walk and talk" to verbalize what he or she was thinking and feeling, how he or she played into the problem, and at least one alternative he or she could do 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 the rest of the school year.

Senior Day Programs/Retirement Communities/Nursing Homes. Older adults have a variety of needs which can be addressed through drama therapy offered through senior day programs, retirement communities, or nursing homes. Isolation and loss are big issues: some older adults have experienced physical losses due to medical conditions or cognitive losses from Alzheimer's Disease or social losses through deaths of friends and family members and retirement from their life's employment. The developmental issue of old age is life review as the individual looks back over 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 works as the program manager for a senior day program for elders in Evanston, Illinois. In her drama therapy groups, she creates dramatic opportunities to re-visit enjoyable times past and to celebrate the present. A session might involve creating humorous commercials for "products that help with an age related issue" or creating 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 several years ago 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 in our world today was very upsetting to them. Judy and her assistant Deb Mier 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 2 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 clients, 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, on communicating and making meaning together, has proven to contribute to quality of life. A study using Dementia Care Mapping, which documents behaviors of individuals every 5 minutes in a number of different categories, was done at the day program Judy Holstein manages in 2001. 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).

Drama therapy is also useful with fully-functioning older adults who want to continue to grow, enhance their talents, and give back to the community. The act of memorizing and enacting characters has been shown to enhance memory abilities in elders (Noice, Noice, Perrig-Chiello & Perrig, 1999). Senior theatre and storytelling troupes create professional or amateur programming for their peers and younger generations (Stich, 2003).

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 full or part time. John Sullivan, author of the article on Theatre of the Oppressed, directs a drama program within a university hospital in Texas which reaches out to area residents to take them information about health issues and allow them to explore issues of aging, discrimination, and self-worth. In addition, drama is employed as an active medical research tool: Forum Theatre techniques are used to elicit information about how to better provide accessible and ethnically-sensitive services to minority communities. Asking customers what they want is a time-honored practice in consumer sales, but not in most medical delivery systems. This is a unique, creative, and effective new approach.

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 make friends, 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 (Association for Retarded Citizens) 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.

In a series of Saturday workshops we explored the basic rights of individuals with developmental disabilities, identified situations in their personal lives in which their rights had been violated or in which they had been embarrassed by insensitive care-givers, and 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.

Social and Recreational Settings. Some applications are described in the book; here are some others:

A few plays in my (Sally Baily's) early access program for children with special needs mentioned in the chapter also ended up dealing with therapeutic issues that came in through the "side door" as a result of the actors' brainstorming, improvisations, and choices. Making Connections, about a video dating service, provided a number of instances where we could 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 one couple arranges to go on a date based on viewing each others' 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 is.

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 the PBS station in Washington, DC, and is still being 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 reported to me that they believe 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 young 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.

More about becoming certified as a "registered drama therapist":

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 he 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) first 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 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.

Bibliography to the items mentioned above:

Erikson, Erik H. (1997). The Life Cycle Completed, NY: W.W. Norton.

Gray, R. & Sinding C. (2002). Standing ovation: Performing social science research about cancer. Walnut Creek, CA: Altamira Press.  (book and video).

Kuhn, D., Ortigara, A., & Kasayka, R.E. (2000). Dementia care mapping: An innovative tool to measure person-centered care. Alzheimer's Care Quarterly 1 (3), 7-15.

Kuhn, D. (2001). Personal communication to Judy Holstein.

Lewis P. & Johnson D.R. (eds.) (2000). Current approaches in drama therapy.  Springfield, IL: Charles C. Thomas Publisher.

Lewis-Williams, D. (2002). The mind in the cave: Consciousness and the origins of art. London: Thames & Hudson.

Noice, H., Noice, T, Perrig-Chiello, P. & Perrig, W. (1999). Improving memory in older adults by instructing them in professional actors' learning strategies. Applied Cognitive Psychology. (13) 315-328.

Pfeiffer, J.E. (1982). The creative explosion: An inquiry into the origins of art and religion. New York: Harper & Row.

Stich, S. S. (2003). Into the spotlight: Theatre gives seniors an outlet for self-expression, therapy, socializing and sheer fun. Time. Vol. 161 (11), March 17, Bonus Section.

Further Resources

Annotations to the books mentioned in the chapter:

Emunah, Renee. (1993). Acting for real. NY: Brunner-Mazel.

The single best overview of the field of drama therapy with a history of the field, a description of various approaches that can be used with clients, and an explanation of how drama therapy fits into psychotherapy, detailed descriptions of drama therapy activities and Emunah's overarching meta-method (The Five Stage Model) which can be used for organizing the delivery of drama therapy to clients, and wonderful case examples of real clients she has worked with in her drama therapy practice. She is the founder and director of the drama therapy program at CIIS.

Jennings, Sue. (1998). Introduction to dramatherapy: Theatre and healing: Ariadne's ball of thread. London: Jessica Kingsley Publishers.

Overview of the field of dramatherapy (the British spell it as one word) by one of the founders of the field in the United Kingdom.  Her approach stems from theatre, sociology, and anthropology and focuses on the developmental process and culture.

Jones, Phil. (1996). Drama as therapy: Theatre as living. London: Routledge.

The second best overview of the field with a perspective on the British approach to dramatherapy. Jones includes excellent case examples of drama therapy with clients and provides an international perspective with his detailed research on the history of drama therapy in Britain, Russia, and other parts of the world.

Landy, Robert J. (1994). Drama therapy: Concepts, theories and practices.  Springfield, IL: Charles C. Thomas Publisher.

Drama therapy text by the founder of the New York University Drama Therapy program.

Lewis, Penny & Johnson, David Read, eds. (2000). Current approaches in drama therapy. Springfield, IL: Charles C. Thomas Publisher.

A collection of articles from many innovators, theorists, and practitioners of various drama therapy approaches, including developmental transformations, the five stage model, role method, sociodrama, psychodrama, playback theater, and narradrama. There is a chapter on the history of drama therapy and a meta-analysis of how all the methods fit together in the field.

Sternberg, Patricia & Garcia, Nina. (2000). Sociodrama: Who's in your shoes? 2nd edition. Westport CT: Praeger. Excellent source on sociodrama, one of the most versatile and applicable drama therapy methods. Easily read and understood with specific examples of activities, how to run a session, and descriptions of places where sociodrama can be practically employed.

To learn about specific drama therapy methods, see the resources listed after the chapters about Psychodrama, Playback Theatre, Theatre of the Oppressed, Rehearsals for Growth, Self-revelatory Performance, Creating Rituals, Acting Out, Acting for Advocacy, Intergenerational Theatre, Ethics and Problem Solving in the Workplace, Geese Theatre, and more.

Sterns Book Service: 2004 West Rosen Street; Chicago, IL 60618   (Toll Free Ordering: 888-475-2665)Website:  www.sternsbooks.com

Sterns Books specializes in books on psychology and has extensive bibliographies on creative arts therapies, addictions, trauma, and special needs. If you want to locate it, they can find it for you!

Websites of publishers of Creative arts therapy books:

Brunner/Routledge (Taylor & Francis Publishing Group)  www.brunner-routledge.co.uk

Jessica Kingsley Publishers  www.jkp.com

W.W. Norton   www.wwnorton.com 

Charles C. Thomas Publisher  www.ccthomas.com


The Arts in Psychotherapy (published five times each year)

Customer Service 

6277 Sea Harbor Drive Orlando, FL 32887-4800Toll free: 877-839-7126

Email: usics@elsevier.com

Website: www.elsevier.com/wps/find/journaldescription.cws_home/833/description

Published since 1973, an international journal dedicated to the creative arts in therapy, including the fields of drama therapy, music therapy, art therapy, dance/movement therapy, poetry therapy and psychodrama.  It is available most often at university libraries, especially those which have large collections of medical, mental health, and social services periodicals.Individual subscriptions can be ordered from the above address or website. Student subscription prices exist.

Dramatherapy: The Journal of the British Association of Dramatherapists

4 Gordon Place, Withington, Manchester M20 3LDEngland

Email: A.Seymour@anna86.freeserve.co.uk

Journal of the BADth (British Association of Dramatherapy), published twice a year.

Poesis: A Journal of the Arts and Communication (published once a year)

EGS Press

128 Danforth Avenue #119

Toronto, Ontario, M4K 1N1 CANADA

Phone: 416-465-6618

Email: egspress@interlog.com

Published since 1999, an annual international journal dedicated to research in the expressive arts therapies and media &communication.


Find out more about the National Association for Drama Therapy at their website:

www.nadt.org  You can access information on the MA approved drama therapy programs and alternative training on the website. There is a complete drama therapy bibliography of books and articles on the website as well as announcements of upcoming workshops and conferences.

Membership in NADT includes a subscription to Dramascope, the quarterly newsletter, an annual membership directory, and discounts on registration fees at conferences. There is an annual national conference once each year and regional conferences. Student membership prices available to high school students, undergraduates, and graduates with copy of student ID.

NADT runs a free Dramatherapy listserve which anyone can subscribe to at the website.


For information on research in drama therapy and British dramatherapy:


Many websites on the arts and creative arts therapies can be found through Arts Lynx:


For a copy of the video Making Connections, contact Choices, Inc. at www.ChoicesIncOnline.org.Also available is the video documentary Roots and Wings which features a segment on drama therapy with adolescents who have disabilities.