Drama Therapy: How Storytelling Can Promote Healing

If you’ve ever participated in drama or theater before, you might be familiar with the cathartic release that drama can facilitate.

Actors commonly shed tears after a performance, often accompanied by a profound sense of relief.

Fortunately, joining a theater troupe is not the only way to get this kind of cathartic release. You can also find it in drama therapy.

Drama therapy is a unique type of therapy that relies on “acting out” rather than just “talking it out,” harnessing externalization of the internal to facilitate therapeutic processing (Pendzik, 2006).

Although it might sound like a New Age creation, drama therapy is a well-established and validated form of therapy applicable to a wide range of participants with an even broader range of issues, problems, and disorders (Haen & Weber, 2005; Landy, 1994).

The evidence backing its effectiveness is compelling, as is the intuitive reasoning behind its appeal. Let’s discover more about it below.

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What Is Drama Therapy?

Drama therapy is a type of expressive arts therapy that uses theatrical techniques and concepts to bring about meaningful change. It gives clients a way to express their feelings, interact with others, and rehearse healthy behaviors.

The North American Drama Therapy Association (NADTA; n.d.a, para. 2), the foremost authority on the field of drama therapy, describes drama therapy as an approach that

can provide the content for participants to tell their stories, set goals and solve problems, express feelings, or achieve catharsis.

The history

An early book on the subject written in 1917 postulated that drama therapy worked by allowing individuals to externalize inner challenges, safely engage in them, and explore multiple facets of their personality through experimental play (Austin, 1917).

Around the same time, the psychiatrist and theater director Jacob Moreno was formulating his psychodrama technique (Langley, 2006). Psychodrama went against the grain of the current psychology, given its focus on the present and the future rather than the past (e.g., in the style of Freud and his successors).

From these early explorations in drama and therapeutic healing, what we now call drama therapy was born. NADTA was established in 1979 to organize the field and provide guidance (North American Drama Therapy Association, n.d.a).

Drama therapy vs. psychodrama therapy

It’s common to run into questions about the difference between drama therapy and psychodrama therapy, but these questions are rooted in a misunderstanding: Psychodrama is not separate from drama therapy; it is a part of drama therapy (Giacomucci & Marquit, 2020).

Psychodrama refers to the use of guided role-play, dramatic enactment, and spontaneous improvisation with an individual client to gain insights and solve personal and interpersonal problems (Giacomucci & Marquit, 2020; Orkibi & Fenger-Schaal, 2019). While it fits within the larger world of drama therapy, it is only one piece of the larger drama therapy framework.

What does a session look like?

Today, drama therapy sessions are typically organized into four separate parts (Nicholls, 2024):

1. The check-in
   The session starts with the therapist checking in with participants on how they’re feeling.
2. The warm-up
   Next, the therapist guides participants through a warm-up activity to get everyone engaged and ready to be creative
3. The main activity
   The main activity is the largest portion of the session and where the bulk of the therapeutic work happens.
4. Closing
   At closing, the therapist will facilitate a discussion of the experience and reinforce lessons or objectives from the session.

Drama therapy sessions may resemble traditional therapy but typically involve more dramatization, emotional expression, and imagination. Let’s take a look at how it works.

The Psychology Behind Drama Therapy

You might think drama therapy sounds like one of the latest fads to arouse the curiosity of therapists and patients alike, but it’s more than a fad.

It has been around for over 100 years, and it has some serious psychological underpinnings to back it up.

Theoretical foundations

Drama therapy is built on the foundations of psychodynamic theory, role theory, and narrative theory.

Drama therapy draws from psychodynamic theory in its understanding of an inner, unconscious life that influences the conscious experience of the client and can cause issues with functioning and wellbeing (Landy, 1986).

This space is where defense mechanisms operate, built to protect the person from unexpressed feelings and unmet needs; this is the same space where drama therapy can be used to heal (Landy, 1986).

Role theory contributes a central idea to drama therapy: that roles are actual and tangible forms of the self that can be engaged, expanded, and adapted to contribute to one’s wellbeing (Keisari, 2021).

Drama therapy gives clients the chance to explore and experience new roles, understand old ones, and strengthen their sense of positive identity through the integration of roles into “a unified and purposeful whole” (Keisari, 2021, para. 9).

Another foundation of drama therapy can be found in narrative theory, which holds that a person is greatly influenced by the stories they hear and the stories they tell themselves about who they are and about the world around them (The Ohio State University College of Arts and Sciences, n.d.).

Rooted in this understanding, drama therapy offers a chance to exercise more control over the dominant narrative(s) in one’s life (Beaudoin, 2005).

Key principles

In addition to the theoretical underpinnings, there are two key principles for understanding drama therapy: catharsis and dramatic reality.

Catharsis

Catharsis, a phenomenon introduced by Aristotle to describe the release and relief of spectators of Greek theater, is at the foundation of drama therapy (Moreno, 1940). It is through the active release of long-held emotions or narratives that clients can process the unprocessed, shed what they no longer need, and move on with more lightness and feelings of freedom (Kellerman, 1984).

Dramatic reality

Dramatic reality is a core concept in drama therapy. It refers to the space between day-to-day reality and imagination, where the fictional and the actual blend together, somewhere between “reality” and “fantasy” (Pendzik, 2006). This is where drama therapy lives and where the therapeutic work happens.

How to Apply Drama Therapy in Practice

The question of how to apply drama therapy is a bit of a trick question, because you cannot really “apply” drama therapy in practice. You are either a drama therapist or not. If you are, all your work with clients will be influenced by your drama background.

As long as we and our clients are involved in dramatic reality, we are doing drama therapy.

(Pendzik, 2006, p. 271)

A person with the proper training will guide their clients through a range of techniques, some traditional and some pulled from psychodrama, but always with an eye toward facilitating dramatic reality and promoting catharsis. They will employ dramatic therapy techniques to help their clients get “unstuck” from the rigid structures and schemas that cause them suffering (Barone, n.d.).

Setting

Like most other types of therapy, drama therapy can happen in any place with the space and privacy to move, dance, act, and express oneself. The typical therapeutic office can be an effective setting for drama therapy, but individual or group drama therapy may play out on a makeshift stage, in a local theater, or even in an outdoor location.

Materials

There are no specific materials required to do drama therapy, as much work can be done with nothing but one’s body. However, there are some excellent uses of materials for drama therapy purposes, including:

• Costumes
• Props
• Dolls or puppets
• Writing and journaling tools
• Sound and light equipment

Anything that can be used to set a scene, build an atmosphere, or cultivate a particular mood on stage can also be employed to great effect within drama therapy.

Ethical boundaries

In addition to the usual ethical concerns of any therapy (including emotional closeness, professional responsibility, and facilitating informed consent), there is the added complexity of working with role-play and other techniques that may involve physical contact.

The NADTA Code of Ethical Principles explains that the therapist has a duty to use physical contact only with consent and in a safe and sane manner and to maintain professional boundaries while doing so (North American Drama Therapy Association, n.d.b).

How Effective Is It? What the Research Says

Studies on drama therapy have found that, like many other types of therapy, it can be highly effective when implemented appropriately.

Research has backed up drama therapy’s effectiveness in:

• Alleviating psychosocial symptoms and aiding in internalization and externalization problems, facilitating coping and regulation, and improving social functioning (Berghs et al., 2022)
• Improving children’s social skills (Pordanjani, 2021) and reducing their social anxiety (Anari et al., 2009)
• Improving a range of psychological and behavioral mental health outcomes (Orkibi et al., 2023)

Who could benefit from this approach?

Drama therapy is used to help children and adults with a wide range of issues. Drama therapists collaborate with their clients to (GoodTherapy, 2015):

• Promote positive behavioral changes
• Improve interpersonal relationship skills
• Integrate physical and emotional wellbeing
• Achieve personal growth and self-awareness
• Improve overall quality of life

It has been used very effectively in prisons. The evidence from drama therapy and theater-based programs in correctional institutions has shown often remarkable outcomes, including:

1. Significant improvements in relationships with peers and authority figures
2. Improved interpersonal and communication skills
3. Better self-confidence
4. Improved educational outcomes (Gardner et al., 2014)

It has also been successfully applied in schools and with people diagnosed with autism spectrum disorder (ASD). Drama therapy sessions for children and young people with ASD allow participants to practice their skills, make friends, lessen their anxiety, and foster increased flexibility in thinking and behavior (Godfrey & Haythorne, 2013; McKenna, 2016; Pordanjani, 2021).

9 Techniques Drama Therapists Use

Drama therapy uses exercises rooted in theater to help participants express themselves and gain new insights about themselves and others.

There are many techniques available, but these nine core processes provide a solid overview.

The nine core processes through which drama therapy facilitates change in participants include (Jones, 1996):

1. Dramatic projection

This process allows participants to project their inner feelings and work out their issues onto a role or object.

2. Personification and impersonation

In these two different but related processes, participants can express their own personal material through role-play or onto an object.

3. Interactive audience and witnessing

This process refers to the participant, group, and/or client in the role of audience or witness.

4. Playing

This attitude is characterized by spontaneous problem-solving, in which a play space is staked out, objects are actively repurposed into new roles, and allowances are made for changes.

5. Drama-therapeutic empathy and distancing

This is the ability of the participants to engage or disengage with the material that resonates with their personal problems and inner conflicts.

6. Life–drama connection

In this process, participants analyze their personal problems or issues through dramatic projection.

7. Transformation

This inherent aspect of much of what happens in theater and in play — a shift that changes the way we think about or approach things — is built right into the structure of telling a story.

8. Embodiment

The physical expression of personal material (which can be actual or imagined) facilitates learning through the body.

9. Therapeutic performance processes

The therapeutic use of theatrical performance is used to work through the participants’ personal issues and themes.

2 Engaging Drama Therapy Activities & Exercises for Clients

If you’re interested in using drama techniques with your clients, know that delivering true drama therapy requires a thorough education and certification. It is not a specialty that can be gained through a couple of continuing education courses.

However, there are some activities that draw upon the key concepts and theories behind drama therapy that can be thoughtfully implemented with clients.

Childhood play warm-up

This warm-up activity is ideal for groups, but it can also be used with individual clients.

Start by giving your clients these directions (Leveton, 2001):

“Think of your favorite game or pastime when you were a child. Imagine yourself playing the game — what you looked like, what you sounded like, and what your surroundings were — until you can really see and feel yourself as you were then.” Give a few minutes for your clients to think and imagine.

“Now, staying at the age level you’ve just thought about, tell us your name. You may have a nickname. Remember, we don’t know how old you are or what your favorite game is.”

After participants have their imagination switched on, engage them in conversation as that child. Encourage them to embody the role of the child they were at that age.

This exercise will get participants warmed up and ready to step outside of their current, present selves and into another version.

Emotion charades

This is a great group activity to help participants get comfortable with understanding and recognizing emotions.

Start by writing down several emotions on separate slips of paper. Include emotions like joy, surprise, sadness, anger, confusion, fear, disgust, and worry. If your client is already pretty familiar with the basic emotions, try more advanced and complex emotions, like consternation, relief, tenseness, euphoria, or optimism.

Have the participants take turns choosing a slip of paper and acting out the emotion. The rest of the group will watch and guess what emotion they are acting out.

The most important part of the exercise comes after the correct guess has been made. During this portion, the therapist will guide a discussion about the experience and what facial and body cues provided information on the emotion being acted out.

How to Become a Drama Therapist

To become a drama therapist, you must first be educated and licensed to provide therapy more generally.

Depending on the country/region where they work, most drama therapists graduate with a specialized degree (generally in psychology, sociology, or social work), pass a licensing exam, and register with the proper authorities.

Prerequisites

There are no specific prerequisites to become a drama therapist aside from the specialized degree. However, coursework or experience in drama or theater is recommended to get a running start in the advanced training.

Degrees and courses

Additional specialized training must be undertaken beyond the basic degree to become a registered drama therapist (RDT). To learn more about the process of becoming an RDT, continuing education, and alternative training, visit the NADTA webpage.

Certifications

The main certification for drama therapists is awarded by NADTA. There are two options for prospective drama therapists:

1. Attend an NADTA-accredited master’s degree program in drama therapy
2. Attend a training program under the mentorship of a board-certified trainer (BCT)

The NADTA website offers a list of BCTs and more information about getting a credential.

Further Readings From PositivePsychology.com

If you’re interested in learning about other arts-focused therapies, check out our article on expressive arts therapy. If you work with kids, you may also enjoy this great piece on art therapy for kids.

If you’re more musically inclined, our piece on musical arts therapy can be a helpful guide for practicing music-focused techniques with your clients.

You may also be interested in learning about the empty chair technique to use with your clients for a taste of dramatic enactment.

If you’re looking for more science-based ways to help others enhance their wellbeing, this signature collection contains 17 validated positive psychology tools for practitioners. Use them to help others flourish and thrive.

A Take-Home Message

Drama therapy provides individuals with opportunities to heal, express themselves, share their story, and connect with others, all under the guidance of trained and qualified professionals.

Such forms of therapy have enormous potential for all who struggle and are particularly promising for those who are in greatest need of self-expression and healthy interaction.

Thanks for reading!

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ED: Updated June 2025