Maya Jesús, Pérez-Berbel Miriam, Giraldo-Arroyave Laura, Hurtado Irene
Universidad Loyola Andalucía, Sevilla, Spain.
BMC Complement Med Ther. 2025 Jul 3;25(1):232. doi: 10.1186/s12906-025-04959-y.
Psychodrama is a psychotherapy model in which action-focused techniques are used to improve the quality of life of patients. A systematic review of the psychodrama interventions published between 2018 and 2022 is carried out in order to recognize the implementation of psychodrama (population, objectives, theoretical model, modality, intensity, periodicity, duration of sessions, psychodramatic techniques, and sistematization); to analyze the methodological design for evaluating the impact of psychodrama interventions (study design and RCT); and to consider the results of the effectiveness of psychodrama.
Following the PRISMA declaration protocol, 27 indexed studies have been selected in three databases: PsycINFO, Scopus and Medline. The selected articles met the following inclusion criteria: peer-reviewed papers, written in English, empirical studies, including quantitative, qualitative, or mixed-methods research, corresponding to interventions or treatments based on psychodrama and evaluating the effectiveness of the interventions with 10 participants in pretest-posttest.
In relation to the implementation, psychodrama was applied in a group format with diverse population, especially adolescents and adults, and most of the interventions were implemented weekly (8-13 sessions) and lasted approximately two hours. Generally, these interventions were based on Morenian Psychodrama. Role reversal, doubling and mirror were the techniques most used. No manualized psychodrama treatments were reported. In relation to study design, 62% were evaluated using a quantitative design, 27% with mixed methods, and 11% with a qualitative evaluation. 26% included follow-up assessment. The number of randomized controlled trials (RCTs) is low (11%), mostly detecting quasi-experimental controlled studies (48%) and single group studies (40%). In relation to the effectiveness of psychodrama, positive and significant results were found, for example, in the reduction of post-traumatic stress levels, the empowerment of women in vulnerable situations, improvement in the quality of life and symptoms of patients with schizophrenia, or improvement in antisocial behavior in adolescents. In 40% of the studies, effect sizes were reported, which were typically medium or large. However, the sample size was small for drawing solid conclusions. 22% of the studies did not find significant changes in any dimension. No iatrogenic effects were found.
This data supports the implementation of Morenian Psychodrama in group format across a wide variety of populations, although there are no clear profiles that have a greater impact. However, the methodological design of psychodrama needs improvement: RCTs and quasi-experimental designs, larger sample sizes, follow-up evaluations, and effect size measurement. Additionally, structuring interventions and their manualization in specific populations can help establish evidence-based treatments.
心理剧是一种心理治疗模式，其中运用以行动为重点的技术来改善患者的生活质量。对2018年至2022年间发表的心理剧干预措施进行了系统综述，以了解心理剧的实施情况（人群、目标、理论模型、形式、强度、周期、疗程时长、心理剧技术和系统化）；分析评估心理剧干预措施影响的方法设计（研究设计和随机对照试验）；并考量心理剧的有效性结果。
遵循PRISMA声明协议，在三个数据库（PsycINFO、Scopus和Medline）中选取了27项索引研究。所选文章符合以下纳入标准：同行评审论文、英文撰写、实证研究，包括定量、定性或混合方法研究，对应基于心理剧的干预措施或治疗，并在前后测中有10名参与者评估干预措施的有效性。
在实施方面，心理剧以团体形式应用于不同人群，尤其是青少年和成年人，大多数干预措施每周实施（8 - 13次疗程），持续约两小时。一般来说，这些干预措施基于莫雷诺心理剧。角色反转、替身和镜像技术是最常用的技术。未报告有手册化的心理剧治疗方法。在研究设计方面，62%使用定量设计进行评估，27%采用混合方法，11%采用定性评估。26%纳入了随访评估。随机对照试验（RCT）的数量较少（11%），大多为半实验对照研究（48%）和单组研究（40%）。在心理剧的有效性方面，发现了积极且显著的结果，例如，创伤后应激水平降低、弱势处境女性的赋权、精神分裂症患者生活质量和症状的改善，或青少年反社会行为的改善。在40%的研究中报告了效应量，通常为中等或较大。然而，样本量较小，难以得出确凿结论。22%的研究在任何维度上均未发现显著变化。未发现医源性效应。
这些数据支持以团体形式在广泛人群中实施莫雷诺心理剧，尽管没有明确显示出有更大影响的特征。然而，心理剧的方法设计需要改进：随机对照试验和半实验设计、更大的样本量、随访评估以及效应量测量。此外，在特定人群中构建干预措施及其手册化有助于建立循证治疗方法。
