Drama therapy for schizophrenia or schizophrenia-like illnesses
ABSTRACT Medication is the mainstay of treatment for schizophrenia or schizophrenia-like illnesses, but many people continue to experience symptoms in spite of medication (Johnstone 1998). In addition to medication, creative therapies, such as drama therapy may prove beneficial. Drama therapy is a form of treatment that encourages spontaneity and creativity. It can promote emotional expression, but does not necessarily require the participant to have insight into their condition or psychological-mindset.
To review the effects of drama therapy and related approaches as an adjunctive treatment for schizophrenia compared with standard care and other psychosocial interventions.
We searched the Cochrane Schizophrenia Group's Register (October 2006), hand searched reference lists, hand searched Dramatherapy (the journal of the British Association of Dramatherapists) and Arts in Psychotherapy and contacted relevant authors.
We included all randomised controlled trials that compared drama therapy, psychodrama and related approaches with standard care or other psychosocial interventions for schizophrenia.
We reliably selected, quality assessed and extracted data from the studies. We excluded data where more than 50% of participants in any group were lost to follow up. For continuous outcomes we calculated a weighted mean difference and its 95% confidence interval. For binary outcomes we calculated a fixed effects risk ratio (RR), its 95% confidence interval (CI) and a number needed to treat (NNT).
The search identified 183 references but only five studies (total n=210) met the inclusion criteria. All of the studies were on inpatient populations and compared the intervention with standard inpatient care. One study had drama therapy as the intervention, one had role-playing, one had a social drama group and two used psychodrama. Two of the included studies were Chinese and it is difficult to know whether psychodrama and indeed inpatient psychiatric care in China is comparable with the drama interventions and inpatient care in the other included studies. There were no significant findings about the value of drama interventions for keeping inpatients engaged in treatment. Due to poor reporting very little data from the five studies could be used and there were no conclusive findings about the harms or benefits of drama therapy for inpatients with schizophrenia.
Randomised studies are possible in this field. The use of drama therapy for schizophrenia and schizophrenia-like illnesses should continue to be under evaluation as its benefits, or harms, are unclear.
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ABSTRACT: Künstlerische Therapien bilden neben anderen psychosozialen Interventionen ein wichtiges Element im Rahmen multimodaler Behandlungskonzepte für Menschen mit psychischen Störungen. Der Beitrag fasst die systematisch recherchierte Evidenz zusammen und stellt die Empfehlungen dar, die im Rahmen der S3-Leitlinie „Psychosoziale Therapien bei Menschen mit schweren psychischen Störungen“ der Deutschen Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde (DGPPN) erarbeitet wurden. Die Studien zeigen, dass die zusätzliche Anwendung künstlerischer Therapien insbesondere die Negativsymptomatik bei Menschen mit schizophrenen Erkrankungen reduziert. Die aussagekräftigste Befundlage existiert dabei für die Musiktherapie. In der Behandlung schwerer depressiver Erkrankungen gibt es Hinweise, dass eine zusätzliche musiktherapeutische Intervention die depressive Symptomatik reduziert. Künstlerische Therapien werden im Rahmen der Leitlinie mit einem Empfehlungsgrad B empfohlen.Der Nervenarzt 07/2012; 83(7). DOI:10.1007/s00115-011-3472-7 · 0.86 Impact Factor
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ABSTRACT: Adolescents with acquired brain injuries suffer from social and community withdrawal that result in isolation from their peer groups. The review highlights the evidence of effectiveness of expressive art interventions in the form of theatre for populations with difficulties in physical, emotional, cognitive, or social functioning. A systematic search from 1995 to May 2007 was carried out and 10 studies were retrieved that focused on drama-based treatments and programmes used to improve aspects of social or community integration for a broad range of populations. The studies were published in English in Canada, the USA, and the UK. Current evidence supports the effectiveness of drama therapy in terms of improvements in psychological health, emotional intelligence, cognitive function, social integration, but not necessarily community integration. The findings indicate that theatre skills training might facilitate community integration in addition to social integration in adolescents with acquired brain injuries if it is formally measured as such.Research in Drama Education 11/2008; 13(3):337-352. DOI:10.1080/13569780802410699 · 0.35 Impact Factor
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ABSTRACT: Mental health-care professionals are striving to keep up to date with health interventions that are effective and beneficial to patients. The Cochrane Reviews make available a systematic and up-to-date review of a comprehensive range of health interventions. We identified a total of 28 interventions from a systematic search and review of the Cochrane Reviews for either schizophrenia, psychosis, schizoaffective, or bipolar disorder. These interventions have been graded into tables of: strong support that merits application, moderate support that warrants consideration of application, not supported, and data that is deemed inconclusive. The tables provide a comprehensive summary and classification of evidence-based practices. This information is presented in a way to enable nurses and other health-care professionals to analyze their own practices to improve mental health services and outcomes for patients. Of the 28 interventions identified in this review, four had strong support and five had moderate support meriting application. Limitations of this review are discussed.International journal of mental health nursing 09/2009; 18(4):239-49. DOI:10.1111/j.1447-0349.2009.00613.x · 2.01 Impact Factor