Professor Yeshiva University New York, New York, United States
Overview: Psychodrama techniques for schizophrenia group work members are described within the context of recovery from psychotic episodes. Psychodrama activities including warm-ups, doubling, mirroring and role-reversals are explored for enhancing cognitive and social skills. This paper is based on 15 years of research and practice in mutual aid groups for schizophrenia.Proposal text: Psychodrama as a Group Work Approach Psychodrama easily adapts to the group modality, most importantly its capacity to release mutual aid factors promoting individual and group change. (Giacomucci, 2020, Skolnik, 2018). Its holistic approach to healing targets cognitive restructuring, emotional catharsis, as well as behavioral change. Drama therapy’s place in treating patients with schizophrenia is well established albeit with important concerns. Much depends on the clinician’s skills and knowledge of the patient’s history and ability to tolerate stress. The content of hallucinations and delusions are important earmarks for clinicians who wish to introduce drama into group treatment. Violent laden delusions are typically not appropriate to recreate in a group setting, and perhaps in individual treatment as well. Delusions that cause painful memories can be avoided in the best interest of the patient and as well as group members. Clinicians are responsible for weighing the value of dramatic reenactments versus the emotional trauma they have the potential to cause. Group work’s focus on mutual aid can be a normalizing process welcomed by group members and clinicians. The diagnosis of schizophrenia or schizoaffective disorder can be especially devastating for young people in their late teens and early twenties. It can be a time when their future seems bleak as they watch friends and family members move their lives ahead and theirs seems at a standstill. There is enormous value in the belief that they have the ability to help others, resulting in the enhancement of their own self-esteem. Young people with schizophrenia may experience intense feelings of shame, feeling that something is truly terribly wrong with them now that they have this disease. Groups can counteract this terrifying idea when members share their stories and the clinician leads the members to logically refute self-proclaimed derisions. The techniques of psychodrama are welcome additions to group work mutual aid practice. Clinicians found the techniques warming up, doubling, role reversal, and mirroring to work well. These techniques are described and discussed with examples taken from the work of Miller & Mason (1999; 2012). More recently, psychodrama techniques are shown to have efficacy in reduction of anxiety, depression and psychosis with chronic schizophrenia patients (Sevi, etal., 2020). Techniques are demonstrated for participants. Throughout, the presentation stresses the importance of reducing stigma, enhancing recovery, and achieving a form of environmental justice, the right to live with respect and dignity in residential communities. In essence, a return to normality is the goal for all patients suffering from the devastation of a severe mental illness and its accompanying break from reality. ________________________________________
Learning Objectives:
1. Participants will be able to identify the challenges related to leading a mutual aid group of recently hospitalized schizophrenia patients.
2. Participants will be able to adapt the concepts and techniques of psychodrama to the skills-level of first-episode schizophrenia patients.
3. Participants will be able to connect concepts inherent in stigma reduction, and environmental justice with groupwork mutual aid practice for members recovering from psychotic episodes.