Keiller Eleanor, Tjasink Megan, Bourne Jane, Ougrin Dennis, Carr Catherine Elizabeth, Lau Jennifer Y F
Queen Mary University of London London UK.
Queen Mary University of London & Barts Health NHS Trust London UK.
JCPP Adv. 2023 Mar 1;3(3):e12145. doi: 10.1002/jcv2.12145. eCollection 2023 Sep.
Dramatherapy, a creative form of psychotherapy, may be a useful treatment for child and adolescent mental health. As there is a growing evidence base, this systematic review sought to identify, describe and evaluate dramatherapy with children and adolescents who were experiencing emotional distress (anxiety, depression and trauma) in order to inform future research in this area.
Seven databases (PsychInfo, PubMed, Scopus, Web of Science, CINAHL, EMBASE and Cochrane) were searched for peer-reviewed articles exploring dramatherapy as a treatment for child and adolescent emotional distress. Hand searches of relevant journals were also conducted. Two reviewers coded articles for eligibility and independently appraised papers using the Joanna Briggs Institute Critical Appraisal Tools. Details relating to intervention and participant characteristics were extracted and, where data were available, effect sizes on measures relating to emotional distress were calculated.
Fifteen papers were included. Studies showed that dramatherapy was often delivered in schools (46%) and clinical settings (20%) and was more frequently delivered to adolescents (53%) (>11 years) than children (26%) (8-11 years). Dramatherapy was used as a treatment for diagnostically heterogeneous groups (40%), for emotional and behavioural difficulties (33%) and following a shared, traumatic, experience (20%). Seven papers reported relevant quantitative data however, just three of these studies were controlled and none were blinded. Pre-to-post intervention effect sizes ranged from = 0.17 to > 2 yet samples were small and participant response to treatment was not always consistent. The largest effects were seen in dramatherapy employed following trauma and in clinical settings. Medium to large effects were also seen in early intervention school-based dramatherapy.
Despite promising results with regards to the treatment of child and adolescent emotional distress, the evidence base for dramatherapy is small and methodologically flawed. Larger, methodologically robust trials should test the efficacy of dramatherapy in future research.
戏剧疗法作为心理治疗的一种创新形式，可能是治疗儿童和青少年心理健康问题的有效方法。鉴于相关证据基础不断扩大，本系统评价旨在识别、描述和评估针对有情绪困扰（焦虑、抑郁和创伤）的儿童和青少年的戏剧疗法，以为该领域的未来研究提供参考。
检索了七个数据库（PsychInfo、PubMed、Scopus、Web of Science、CINAHL、EMBASE和Cochrane），以查找探讨戏剧疗法作为治疗儿童和青少年情绪困扰方法的同行评审文章。还对手头检索了相关期刊。两名评审员对文章的合格性进行编码，并使用乔安娜·布里格斯研究所的批判性评价工具独立评估论文。提取了与干预措施和参与者特征相关的详细信息，并在有数据的情况下，计算了与情绪困扰相关指标的效应量。
纳入了15篇论文。研究表明，戏剧疗法通常在学校（46%）和临床环境（20%）中实施，与儿童（26%）（8至11岁）相比，更常针对青少年（53%）（>11岁）开展。戏剧疗法被用于诊断异质性群体（40%）、情绪和行为困难（33%）以及在共同的创伤经历之后（20%）。七篇论文报告了相关的定量数据，然而，这些研究中只有三项是对照研究，且均未设盲。干预前至干预后的效应量范围为=0.17至>2，但样本量较小，参与者对治疗的反应并不总是一致。在创伤后采用的戏剧疗法以及临床环境中观察到了最大的效果。在早期干预的基于学校的戏剧疗法中也观察到了中等到较大的效果。
尽管在治疗儿童和青少年情绪困扰方面取得了有前景的结果，但戏剧疗法的证据基础薄弱且在方法上存在缺陷。在未来的研究中，应开展更大规模、方法上更严谨的试验来检验戏剧疗法的疗效。
