Integrating cognitive behavioral group therapy and psychodrama for social anxiety disorder: An intervention description and an uncontrolled pilot trial

Effectiveness of cognitive behavioral group therapy, psychodrama, and their integration for treatment of social anxiety disorder: A randomized controlled trial

BACKGROUND AND OBJECTIVES

Although cognitive behavioral group therapy (CBGT) is an effective treatment for social anxiety disorder, many socially anxious patients are still symptomatic after treatment. A possible improvement for CBGT could come from the more experiential group psychotherapy, psychodrama (PD). The integration of CBGT and PD (labeled CBPT) might offer an even more effective treatment than CBGT or PD alone. With the present study, we investigated first whether three kinds of group therapy (CBGT, PD, and CBPT) are superior to a waitlist (WL). Second, we investigated whether CBPT is more effective than CBGT or PD alone.

METHODS

One hundred and forty-four social anxiety patients were randomly assigned to three active conditions or a WL. After wait, WL-participants were randomized over the active treatment conditions.

RESULTS

The results of a multilevel analysis showed that all treatments were superior to WL in reducing social anxiety complaints. Only CBGT and CBPT differed significantly from WL in reducing fear of negative evaluations. There were no significant differences between active conditions in any of the variables after treatment and after six-month follow up, neither were there significant differences in treatment dropout.

LIMITATIONS

First there is the lack of a long-term follow-up. Second, because of loss of participants, we did not reach the planned numbers in the active treatment groups in comparison to WL. Moreover, this study was not designed as a non-inferiority or equivalence trial.

CONCLUSIONS

Although the integrative CBPT showed good results, it was not more effective than the other treatments.

Role-Exchange Playing: An Exploration of Role-Playing Effects for Anti-Bullying in Immersive Virtual Environments

Role-playing is widely used in many areas, such as psychotherapy and behavior change. However, few studies have explored the possible effects of playing multiple roles in a single role-playing process. We propose a new role-playing paradigm, called role-exchange playing, in which a user plays two opposite roles successively in the same simulated event for better cognitive enhancement. We designed an experiment with this novel role-exchange playing strategy in the immersive virtual environments; and school bullying was chosen as a scenario in this case. A total of 234 middle/high school students were enrolled in the mixed-design experiment. From the user study, we found that through role-exchange, students developed more morally correct opinions about bullying, as well as increased empathy and willingness to engage in supportive behavior. They also showed increased commitment to stopping bullying others. Our role-exchange paradigm could achieve a better effect than traditional role-playing methods in situations where participants have no prior experience associated with the roles they play. Therefore, using role-exchange playing in the immersive virtual environments to educate minors can help prevent them from bullying others in the real world. Our study indicates a positive significance in moral education of teenagers. Our role-exchange playing may have the potential to be extended to such applications as counseling, therapy, and crime prevention.

Effectiveness of Drama-Based Intervention in Improving Mental Health and Well-Being: A Systematic Review and Meta-Analysis during the COVID-19 Pandemic and Post-Pandemic Period

As a creative form of psychotherapy, drama appears to assist individuals in the COVID-19 pandemic and post-pandemic period in altering crisis conditions and challenging negative perspectives. Drama-based intervention is presented as an option for addressing mental health issues in clinical and general populations by utilising various multidisciplinary sources, such as psychodrama and role playing. In this study, a systematic review and meta-analysis were employed to assess the impact of drama on mental health and well-being during the COVID-19 pandemic and post-pandemic. Four electronic databases (PubMed, Cochrane, Web of Science, and ScienceDirect) were extensively searched from December 2019 to October 2022. Quality assessment and Risk of Bias tool of the Cochrane Collaboration were performed. Using a random effect model, standardised mean difference (SMD) values and 95% confidence intervals (CI) were calculated. In the final analysis, 25 studies involving 797 participants were included. The study revealed that drama-based interventions have the potential to improve mental health (e.g., trauma-related disorders) and well-being (e.g., psychological well-being), which could position drama as an adjunctive method of mental health care. This original review offered the newer, more comprehensive recommendations for drama-based intervention based on evidence.