Drama Therapy: The Methods, the Evidence, Three Activities
Drama therapy is the deliberate use of drama and theater processes to reach a therapeutic goal, and it does not ask you to be a good actor. This guide covers the main approaches, what happens in a session, what the research does and does not show, and three low-pressure activities you can try alone or in a group.
Reviewed byMichael Callans, MSWActivity one: the role interview (about 20 minutes)
- Name a role you are playing a lot at the moment, in two or three words: the fixer, the one who holds it together, the disappointment, the new person who knows nothing.
- Give the role a physical shape. Stand or sit the way it sits. Notice where it holds tension and what it does with its hands and eyes.
- Stay in that posture and answer out loud, as the role: What do I want? What am I afraid of? What do I never let anyone see? What would I like to stop doing?
- Name the counterrole, the figure that stands opposite this one, and give it a posture and the same four answers. Keep it short.
- Step physically out of both shapes. Say your own name out loud, the date, and one plain fact about the room. This is the de-roling step.
- Write three lines: what the role said that surprised you, what the counterrole has that the role needs, and one thing you will do differently this week.
Activity two: the six-part story (about 30 minutes)
- Fold a sheet of paper into six boxes. You will make up a story that is not about you, in sketches and a few words. Drawing badly is fine and slightly helps.
- Box one: a main character, anywhere, any kind of being. Box two: the task or mission that character has.
- Box three: someone or something that can help. Box four: what stands in the way.
- Box five: how the character deals with the obstacle. Box six: what happens after that.
- Tell the story out loud, start to finish, in the third person. Then read it back as a stranger would and name the coping style it leans on: thinking, feeling, belief, imagination, other people, or the body.
- De-role: say out loud that the character is a character, then ask the one useful question. Where in my own life does this story's way of coping serve me, and where does it cost me?
Activity three: replay the scene (about 20 minutes)
- Pick a short real interaction that went badly and still bothers you. Two people, a few minutes, nothing catastrophic. Say it out loud as it happened, in the present tense.
- Mark the other person with an object or an empty seat so the space holds them rather than your head.
- Play the scene again and change exactly one thing: what you say first, where you stand, when you stop talking, or what you let yourself not answer.
- Play it a third time with a different single change. Resist making yourself win; the aim is information, not a better ending.
- Stop and step out of the space. Say your own name out loud, the date, and one plain fact about the room: this is the de-roling step. Then name which version you could actually do and what would be hard about it.
De-roling, and why it is not optional
Taking on a role is easy; coming out of one is the skill. In drama therapy the closing of every enactment includes an explicit separation of the role from the person: saying what was the role and what is you, shaking out the posture, naming the date and the room, sometimes physically leaving the spot where the scene happened.
Skipping it is what makes people feel strange for hours afterward. If you notice a role sticking after an exercise, do the separation again, slowly, out loud, and add something ordinary and physical: wash up, walk round the block, make a call about something dull. If a role will not come off at all, that is worth telling a therapist about rather than practicing alone.
Key terms in drama therapy
What a drama therapy session usually involves
- A warm-up: movement, a game, a short sensory or vocal exercise to get out of the head and into the room.
- A check-in, often done through an image, an object, a posture or a one-word role rather than a report on the week.
- The main enactment: a scene, a role, a story, a sculpt, a mask, or an improvisation that the therapist proposes and you can shape or decline.
- Repetition with variation: the same moment played again differently, which is where most of the learning sits.
- De-roling, then reflection in ordinary language: what happened, what you noticed, what it connects to.
- A closing ritual that marks the end, often deliberately dull and grounding.
A note on the evidence
Drama therapy has a long clinical tradition and a small research base. The 2019 review by Armstrong, Frydman and Wood of effectiveness research from 1945 to 2018 found benefit reported across emotional and behavioral symptoms, social skills, self-esteem, sense of self, self-expression, emotion regulation, empathy and bodily awareness, and ended by arguing for more quantitative work with validated measures. Feniger-Schaal and Orkibi's systematic review of intervention studies from 2007 to 2017 found 24 articles across diverse methodologies, called the results promising and asked for better reporting.
Read that as promising and under-tested. It is not grounds for choosing drama therapy over a treatment with a large trial base for a specific disorder, and it is a reasonable basis for trying it where talking has stalled or where the aim is to practice something rather than analyze it.
Finding a drama therapist
In the United States and Canada, look for the letters RDT after a practitioner's name, which means Registered Drama Therapist with the North American Drama Therapy Association. In the United Kingdom, look for a dramatherapist registered with the Health and Care Professions Council. Both routes require a master's level qualification and supervised clinical hours.
Then ask two questions, because the approaches differ more than the label suggests: which model do you work in, and what would a first session look like. An answer naming role method, Developmental Transformations, an integrative five-phase model, Playback Theatre or a specific blend tells you something useful. Being told it depends entirely on you, with nothing further, tells you less.
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About this tool
Drama therapy is the intentional use of drama and theater processes to work toward a therapeutic goal, which is close to the wording the North American Drama Therapy Association uses in its own definition. In practice that means working through role, story, improvisation, enactment, movement and sometimes performance rather than through conversation alone. The distinction that matters most for anyone considering it: a drama therapist is a licensed or credentialed mental health practitioner using dramatic form as the medium of the work, not a theater teacher running a feelings class. No acting ability is needed, and most of what happens in a session would look nothing like a play to an outsider.
The field grew out of several roots at once. Jacob Moreno was staging therapeutic enactment in Vienna from the 1920s and built it into psychodrama, which is the closest relative and still a separate discipline. Separately, theater practitioners in Britain and the United States began noticing in the 1950s and 1960s that improvisation and role work changed people, and started building method around it. The British Association of Dramatherapists formed in 1977, which is why the single word dramatherapy is the standard spelling in the United Kingdom, and the North American Drama Therapy Association formed in 1979. Graduate training programs followed, and the profession has been credentialed in North America since then.
Three ideas do most of the work in the room. Embodiment, projection and role, Sue Jennings's developmental sequence, describes how dramatic activity moves from the body, to play with objects outside the body, to taking on a role. Dramatic projection is the part most people feel first: a difficulty is put into a character, a story or an object, where it can be looked at from a step back. Aesthetic distance is the name for how far back that step goes, and a good drama therapist adjusts it constantly, bringing you closer when the material is too remote to matter and further away when it is too hot to touch.
Read the diagram as text
One quiet rail carries three positions, and the same solid diamond, the difficulty, sits at each of them. At the near end it is on the person themselves, bristling with ink strokes and with no room to look at it. In the middle the identical diamond sits inside a mask, which carries a brand ring, and a brand channel runs out to it and back again: you can go into the role and step out of it. At the far end the same diamond is quiet inside a small page, joined to the person only by a long dashed line. The brand marks the workable distance, which is the thing the therapist keeps adjusting. On the phone canvas the rail runs downward.
Aesthetic distance, adjusted in both directions
Conceptual contrast, not ratings
The same difficulty and the same person throughout; only the distance between them changes, and the therapist adjusts it constantly.
Held as your own, at no distance: It floods, and there is no step back from which to look at it; a scene that produces a lot of feeling and no sense afterward has not done much.
Put into a role, a story or an object, at a workable distance: Dramatic projection: the difficulty can be looked at, tried several ways and stepped out of again, which is what de-roling at the end of a session is for.
Kept far off in a remote story: It is too remote to matter, and nothing in the work reaches the person who brought it.
Robert Landy's role theory is one of the main models in North America. He cataloged the roles that recur in Western dramatic literature and used them as a map of the parts a person can play, then built the role method around three positions: the role a person is stuck in, the counterrole that stands opposite it, and the guide that can hold both. Work proceeds by naming and inhabiting a role, meeting what it excludes, and finding a figure who can mediate between them. The theoretical appeal is that it gives distress a cast of characters rather than a diagnosis, and gives the person somewhere to stand that is neither extreme.
David Read Johnson's Developmental Transformations is the other pole, and it works almost the opposite way. Instead of a fixed role to examine, the therapist and client improvise continuously inside an agreed playspace, letting scenes transform as fast as they arise, with the therapist's own body in the encounter. The aim is tolerance for the instability of lived experience rather than insight about a particular role. Alongside these sit Renee Emunah's integrative five-phase model, Narradrama, Rehearsals for Growth, and Playback Theatre, which Jonathan Fox and Jo Salas founded in 1975 and in which a teller's real story is enacted back to them on the spot by a company.
A session usually has three movements: a warm-up that gets the body and the imagination working, an enactment where the central work happens, and a closing that includes de-roling. De-roling matters more than it sounds. Stepping out of a role deliberately, naming what was the role and what is you, is how the method stays safe, and it is the piece most self-help versions drop. Sessions run individually or in groups, with the group version using witnesses, doubles and small casts in ways solo work cannot. Nothing is improvised at the client's expense: the therapist proposes a form, and declining a form is normal and expected.
Drama therapy is used across a wide range of settings and populations, including people in addiction recovery, survivors of abuse and violence, older adults, people with developmental disabilities, people in prisons and in psychiatric inpatient care, and people with chronic illness. It is often chosen when talking has stalled, when the difficulty is hard to put into words, or when a person needs to practice something new rather than discuss it. That practice element is distinctive: a session can be used to rehearse a conversation that has never managed to happen, with the chance to try it several ways and stop when it goes wrong.
The evidence base is real but thin, and anyone telling you otherwise is selling something. Armstrong, Frydman and Wood's 2019 review of drama therapy effectiveness research from 1945 to 2018 found reported benefits clustering around emotional and behavioral symptoms, social skills, self-esteem, sense of self, self-expression, emotion regulation, empathy and bodily awareness, and the authors' own conclusion was a call for more quantitative research with validated measures. Feniger-Schaal and Orkibi's systematic review of drama therapy intervention studies published between 2007 and 2017 located 24 articles across diverse methodologies, called the decade's results promising, and asked for better methodology, transparency and reporting.
What that means for a decision: drama therapy has promising signals and a long clinical tradition, but it has not been tested at the scale that lets anyone claim it outperforms, or matches, an established treatment for a specific condition. If the problem is panic, OCD, PTSD or major depression, the treatments with large trial bases should be on the table first, and drama therapy can sit alongside them or follow them. If the problem is a stuck pattern, a role that no longer fits, grief that will not speak, or a social world that has narrowed, the case for it rests on clinical reasoning rather than trial data, and that is a legitimate basis for choosing a therapy as long as it is stated plainly.
Drama therapy and psychodrama overlap enough to be confused and differ enough to matter. Psychodrama, Moreno's method, is a structured group form in which one person's real situation is staged with group members cast as the people in it, using techniques such as doubling, mirroring and role reversal, and it has its own training and certification route. Drama therapy is the broader field: it includes fictional and metaphorical material as a matter of course, it uses story, myth, mask, puppetry and performance as well as biographical enactment, and it works individually as readily as in groups. The guide at Psychodrama sets out that method in detail.
In the United States and Canada the credential to look for is Registered Drama Therapist, awarded by the North American Drama Therapy Association. It requires either a master's or doctoral degree from an accredited drama therapy program, or an equivalent degree in theater or a mental health profession plus the association's alternative training route, in both cases with supervised clinical hours and theater experience. In the United Kingdom, dramatherapists train at master's level and register with the Health and Care Professions Council, which makes the title protected by law. Ask any practitioner which credential they hold and which approach they work in, because the approaches genuinely differ.
What drama therapy is not: it is not a diagnostic procedure, it is not catharsis for its own sake, and it is not drama club with a therapist attached. A scene that produces a lot of feeling and no sense afterward has not done much. The activities on the printable below are drawn from the field but designed for self or peer use, which means they are deliberately low-intensity; the deeper work of role method or Developmental Transformations needs a trained practitioner and a relationship. If an exercise opens something you cannot close, stop, use the de-roling step, and take it to a therapist rather than pushing on alone.
References
- North American Drama Therapy Association. What is Drama Therapy? https://www.nadta.org/what-is-drama-therapy (accessed 2026).
- Landy RJ. Persona and Performance: The Meaning of Role in Drama, Therapy, and Everyday Life. New York: Guilford Press; 1993.
- Johnson DR, Emunah R, eds. Current Approaches in Drama Therapy. 3rd ed. Springfield, IL: Charles C Thomas; 2021.
- Jennings S. Introduction to Dramatherapy: Theatre and Healing. London: Jessica Kingsley Publishers; 1998.
- Lahad M. Story-making in assessment method for coping with stress: six-piece story-making and BASIC Ph. In: Jennings S, ed. Dramatherapy: Theory and Practice 2. London: Routledge; 1992.
- Armstrong CR, Frydman JS, Wood S. Prominent themes in drama therapy effectiveness research. Drama Therapy Review. 2019;5(2):173-216. doi:10.1386/dtr_00002_1
- Feniger-Schaal R, Orkibi H. Integrative systematic review of drama therapy intervention research. Psychology of Aesthetics, Creativity, and the Arts. 2020;14(1):68-80. doi:10.1037/aca0000257
Cite this source
Psychology.com. (2026, November 6). Drama Therapy. Psychology.com. https://psychology.com/tools/drama-therapy
Drama Therapy FAQ
What is drama therapy?
Drama therapy is the deliberate use of drama and theater processes to work toward a therapeutic goal. Instead of talking about a problem, you work with it through role, story, improvisation, enactment, movement and sometimes performance, guided by a credentialed practitioner. The dramatic form does two things at once: it puts the difficulty outside you where it can be examined, and it lets you practice something new rather than only discuss it. The field has several distinct models, including role method, Developmental Transformations and Playback Theatre, and they work quite differently from each other.
What happens in a drama therapy session?
A drama therapy session usually moves through a warm-up, a main enactment and a closing. The warm-up is physical and playful enough to get you out of your head. The enactment is whatever form the therapist proposes for the material at hand: taking a role, staging a scene, making a story, sculpting a relationship with objects, improvising inside an agreed playspace. Then comes de-roling, where you step out of the role on purpose, and reflection in ordinary language. You can shape or decline any form offered, and nothing is sprung on you.
Do I need acting experience for drama therapy?
No. Drama therapy does not assess performance, and a session rarely looks like theater to an outsider. Most of the work is small: a posture, a two-line exchange, a story told in six sketches, a conversation with an empty seat. People who describe themselves as having no imagination tend to do perfectly well, because the method supplies the structure. If being watched is the problem, say so at the start: individual work exists precisely for that, and a good therapist will build the distance you need rather than push you toward performing.
Is drama therapy evidence-based?
Partly, and honestly it is early. Reviews of drama therapy effectiveness research report benefits across emotional and behavioral symptoms, social skills, self-esteem, self-expression, emotion regulation, empathy and bodily awareness, and the underlying studies vary widely in design and quality. Feniger-Schaal and Orkibi found 24 intervention studies across a decade, called the results promising, and asked for better methodology and reporting. That is a promising signal and not a proven treatment. For a specific disorder with well-tested treatments, those come first; drama therapy is a reasonable choice where talking has stalled or where rehearsal is the point.
What is the difference between drama therapy and psychodrama?
Drama therapy is the broader field and psychodrama is one specific method within the same family. Psychodrama, developed by Jacob Moreno, is largely a group form: one person's real situation is staged with group members cast as the people in it, using techniques such as doubling, mirroring and role reversal, and it has its own separate training and certification. Drama therapy routinely uses fiction, metaphor, story, mask and performance as well as biographical scenes, and it works one to one as readily as in groups. Many practitioners are trained in both.
Can I try drama therapy activities on my own?
Some of them, with limits. The three activities on the printable here are designed for solo or peer use and kept deliberately low-intensity: a role interview, a six-part story, and replaying a real scene with one thing changed. Keep the de-roling step at the end of each, because separating yourself from a role is what stops the exercise following you around. What does not transfer to solo use is the deeper work: role method with a stuck identity, improvisational work on trauma, or anything you cannot reliably close. That needs a trained practitioner and a relationship.
How do I find a qualified drama therapist?
In the United States and Canada, look for Registered Drama Therapist, or RDT, a credential from the North American Drama Therapy Association that requires a master's or doctoral qualification plus supervised clinical hours and theater experience. In the United Kingdom, dramatherapists register with the Health and Care Professions Council, which makes the title legally protected. Then ask which model they work in and what a first session looks like, since role method, Developmental Transformations and an integrative five-phase approach feel genuinely different from each other. If naming feelings is the harder part, our emotion cards are a gentler place to start.