The active ingredients of school-based dramatherapy for children and young people with emotional distress: A deductive analysis

Dramatherapy is offered as a school-based psychological intervention to children and young people (CYPs) with emotional distress. Although evidence of effectiveness is promising, it is little-known how dramatherapy operates to effect change in this context. As such, this study sought to uncover the active ingredients of school-based dramatherapy using primary data collected from both CYPs and dramatherapists. An observational case series, involving ten CYPs and six school-based dramatherapists, was undertaken. A written account of each dramatherapy session was submitted (N = 128) and semi-structured interviews were conducted with CYPs (N = 8) and dramatherapists (N = 7) after the course of dramatherapy. Deductive thematic analysis, using a coding framework based on previous studies was used to conduct the analysis and generate active ingredients. A total of 17 active ingredients are presented. Amongst others, they included the provision of a safe space, facilitation of agency and self-expression, embodied and projective working, emotional activation and regulation and the centrality of the therapeutic relationship. The findings of this study generally align, and contribute further to, existing psychotherapy, arts therapy and dramatherapy process literature, whilst also offering insight into the developmental and context-specific features of the intervention in school settings. Whilst further research, particularly regarding mechanisms of change, is required, these findings can inform ongoing development and evaluation of dramatherapy and the refinement of training and clinical practice.