Studies on treatment effects of psychodrama psychotherapy

1. Studies on treatment effects of psychodrama psychotherapy

2. Speaker Michael Wieser, assistant prof. Dr. University of Klagenfurt. Bologna process coordinator Department of psychology. Austria/Europe.

3. Contents • Terms • Starting point • Aim • Sample characteristics • Method of description • Results • Summary • Conclusion

4. Terms • Psychodrama as psychotherapy is based on theories of spontaneity, creativity and action. • ICD-10: International Classification of Diseases, Version 10 of the WHO, chapter F00-99 for mental and behavioural disorders. • Meta-analysis: existing studies in treatment effectiveness are systematically compared.

5. Starting point • Accredited by the government and social insurance systems in Austria (Ottomeyer & Wieser, 1996), in Hungary (Pintér, 2001), and by the European Association of Psychotherapy (EAP; Wieser, Fontaine, Tauvon & Teszary, 2004). • In Germany there is documentation, (Burmeister, Leutz, & Diebels, n.d.) but there are problems in matching the mainstream standards in evidence-based psychotherapy.

6. Starting point • The same with the meta-analysis developed by Grawe, Donati & Bernauer (1994) in Switzerland; preliminary acceptance by Swiss Charta of Psychotherapy • Meta-analyses conducted outside German-speaking countries (Kipper, 1978; Schramski, & Harvey, 1983; Kellermann, 1987; Greenberg, Elliot, & Lietaer, 1994; Kipper & Ritchie, 2003; Elliott, Greenberg & Lietaer, 2004) point to problems with research design.

7. Aim • The aim of this presentation is to explore the kind of statistical evidence which researchers have for the effectiveness of psychodrama psychotherapy.

8. Sample characteristics • Existing studies on the effectiveness of psychodrama psychotherapy provided in the literature • Database: PsycINFO, PsyNDEX • English and German • several decades

9. Sample characteristics • Age: children, youths, adults, elderly patients • Type of mental and behavioural disorders: acute to chronic • Treatment program: in- and outpatients, prisoners • Setting: individual, couple, family, group • Length of treatment: one session, weekend,marathon, long-term

10. Sample characteristics • Comparative studies: psychodrama psychotherapy with other psychotherapeutic methods or pharmaceutical therapy • Outcome studies • Process research • Cost efficiency analyses are unknown

11. Sample characteristics • Measuring instruments: none (at least systematic self report, sociometry) to high standard tools • Drop out rate: all, should be noticed and reflected • Most of the patients must have a diagnosis (ICD-10) • Mostly psychodrama psychotherapy, not self experience • Manualized psychotherapy: mostly not • Publication: all kind • Sixty one studies included: Thirteen are randomised clinical trials, sixteen are controlled studies, thirty-two are naturalistic studies.

12. Method of description • Classification of the studies: • Randomised clinical trial: two groups of patients are chosen at random. One group is given psychotherapeutic treatment, the other, for example, has to wait. • Controlled study: psychotherapy group is compared with a non-treated group. • Naturalistic study: normal psychotherapeutic practice, single case study, systematic, and controlled by qualitative and/or quantitative methods

13. Method of description • Mostly includes “pre- and post” measures, partly follow-up • Effect size: not all necessary information is available • Statistical significant results: * = p<0.05 ** = p<0.01 *** = p<0.001 (permille) ****= p<0.0001 probability of error in percent

14. Results: F00-F09 • Organic, including symptomatic, mental disorders (ICD-10 F00-F09) To date, no studies have been reviewed.

15. Results: F10-F19 • Mental and behavioural disorders due to psychoactive substance abuse (ICD-10 F10-F19) Five studies report positive results for adults and two of them also for youths.

16. Results: F10-F19

17. Results: F10-F19

18. Results: F10-F19

19. Results: F10-F19

20. Results: F10-F19

21. Results: F20-F29 • Schizophrenia, schizotypal and delusional disorders (ICD-10 F20 - F29) Seven of eight studies have good results even with chronic schizophrenics and people with delusions who are in short term psychodrama psychotherapy.

22. Results: F20-F29

23. Results: F20-F29

24. Results: F20-F29

25. Results: F20-F29

26. Results: F20-F29

27. Results: F20-F29

28. Results: F20-F29

29. Results: F30-F39 • Mood (affective) disorders(ICD-10F30-F39) Three studies with good results have been reported in this field

30. Results: F30-F39

31. Results: F30-F39

32. Results: F40-F48 • Neurotic, stress-related and somatoform disorders(ICD-10F40 - F48) In a total of twelve studies, more positive than negative results are reported.

33. Results: F40-F48

34. Results: F40-F48

35. Results: F40-F48

36. Results: F40-F48

37. Results: F40-F48

38. Results: F40-F48

39. Results: F40-F48

40. Results: F40-F48

41. Results: F40-F48

42. Results: F40-F48

43. Results: F50-F59 • Behavioural syndromes associated with physiological disturbances and physical factors(ICD-10F50 - F59) To date, no studies have been reviewed.

44. Results: F60-F69 • Disorders of adult personality and behaviour(ICD-10F60-F69) To date, no studies have been reviewed.

45. Results: F70-F79 • Mental retardation(ICD-10F70-F79) Three studies report positive results but are more a kind of social pedagogical psychodrama.

46. Results: F70-F79

47. Results: F70-F79

48. Results: F80-F89 • Disorders of psychological development (ICD-10 F80-F89) To date, no studies have been reviewed.

49. Results: F90-F98 • Behavioural emotional disorders with onset usually occurring in childhood or adolescence(ICD-10F90-F98) Two studies report positive results with techniques related to psychodrama psychotherapy.

50. Results: F90-F98