An investigation of the impact of psychodrama group interventions on psychological symptoms in adults

This study aimed to examine the effects of psychodrama group interventions on psychological symptoms in adults using a mixed-methods design. The study group consisted of 20 adult participants residing in Istanbul who voluntarily agreed to take part in the research. Based on predetermined inclusion criteria, the participants were assigned to two groups: a ten-person experimental group and a ten-person control group. A quasi-experimental design with a pretest–posttest control group was employed, and both quantitative and qualitative data were collected. The experimental group participated in weekly psychodrama group sessions for 12 consecutive weeks, while the control group received no intervention during this period. Quantitative data were obtained using the Symptom Checklist-90-Revised (SCL-90-R), which assesses psychological symptom levels. The Mann-Whitney U test was used to evaluate differences between groups, and the Wilcoxon Signed-Ranks test was used to assess within-group changes. Qualitative data were gathered through systematic observation notes of psychodrama sessions and open-ended feedback form, and analyzed using thematic analysis. Quantitative findings revealed statistically significant reductions in psychological symptom levels in the experimental group following the psychodrama intervention. Posttest results indicated significant improvements in the subscales of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, paranoid ideation, and additional items. The most pronounced improvements were observed in the subscales of depression and hostility. No significant changes were detected in the subscales of phobic anxiety and psychoticism. Qualitative findings provided a deeper understanding of the internal changes participants experienced throughout the psychodrama process. Thematic analysis revealed five main themes: the need to be seen and understood, the expression of repressed emotions, setting boundaries and developing autonomy, intergenerational transmission, and emotional transformation through new roles. These themes demonstrated participants' progress in coping with loneliness, enhancing self-esteem, increasing emotional awareness, setting interpersonal boundaries, and developing empathic relationships. Participant statements such as "I realized I have the right to ask for help" and "I will embrace myself more" reflected increased self-worth and emotional expression capacities. The qualitative findings were consistent with the quantitative results observed on the SCL-90-R. The supportive and nonjudgmental structure of the group environment enabled participants to gain insight, express emotions, and experiment with new roles. Moreover, the spontaneous and creative nature of psychodrama contributed to participants' ability to challenge rigid thought patterns, transform relational dynamics, and strengthen psychological resilience. Overall, the findings suggest that psychodrama is not only effective in reducing psychological symptoms, but also supports the development of self-concept, emotional regulation skills, and interpersonal functioning. The relatively small sample size and the absence of long-term follow-up data are noted as limitations of the study. Future research is recommended to explore the long-term effects of psychodrama interventions across diverse socio-demographic groups through extended and longitudinal designs. Keywords: Psychodrama, psychological symptoms, SCL-90-R, thematic analysis, mixed methods