The effect of art therapy-based short-term monodrama on emotional self-awareness, perceived stress, and illness awareness in individuals wi̇th psychotic disorders

This study was conducted as a pre-test, post-test, and randomized controlled trial to evaluate the effects of the Art Therapy-Based Short-Term Monodrama Program on emotional self-awareness, perceived stress, and illness awareness (insight) levels in patients with psychotic disorders. The study sample consisted of 60 inpatients diagnosed with psychotic disorders who were receiving treatment in the acute female psychiatry clinics of a Mental Health Hospital affiliated with the Turkish Ministry of Health in Istanbul. Participants were randomly assigned to either the intervention group (30 participants) or the control group (30 participants). Data were collected using the "Information Form," "Emotional Self-Awareness Scale," "Beck Cognitive Insight Scale," and "Perceived Stress Scale." Statistical analyses were performed using SPSS 22.0, with descriptive tests such as frequency distributions, means, standard deviations, and minimum-maximum values. Hypothesis testing was conducted using a 2X2 Two-Way Repeated Measures Analysis of Variance (ANOVA). Interaction effects and main effects (Grand Mean) were calculated in ANOVA analyses. Post-hoc analyses included paired-sample t-tests for the main effect of time and independent-sample t-tests for the main effect of group. The confidence interval was set at 95% (p = .05). Significant differences were found in the Self-Reflection and Index subscale scores of the Beck Cognitive Insight Scale between the intervention and control groups over time (p < .05). Self-Reflection scores significantly increased in the intervention group after the program (p < .05), while no significant change was observed in the control group (p > .05). Self-Certainty scores decreased in the intervention group but remained unchanged in the control group. The Index subscale scores showed a significant increase in the intervention group (p < .05), whereas no significant change was found in the control group. In the Emotional Self-Awareness Scale, the Communication subscale scores significantly increased over time in the intervention group (p < .05), while no such change was observed in the control group. However, no significant changes were found in other subscales or the total score. Regarding the Perceived Stress Scale, the Inadequate Self-Efficacy Perception subscale and total scores significantly decreased in the intervention group after the program (p < .05), while no significant change was observed in the control group (p > .05). In conclusion, participation in the Art Therapy-Based Short-Term Monodrama Program led to positive changes in emotional self-awareness, illness awareness, and perceived stress levels among patients diagnosed with psychotic disorders, compared to both their pre-intervention levels and the control group. Regular implementation of such psychosocial interventions in clinical care may be beneficial in reducing stress levels, enhancing treatment and care participation, and promoting self-expression among hospitalized individuals.