Developing dramatherapy approaches for all Thai adult patients with Post Traumatic Stress Disorder

Dramatherapy is a form of psychotherapy which applies the drama/theatre process to promote mental health. This thesis presents the results from a mixed-methods research study in a psychiatric setting in Thailand, which investigated the clinical benefits and specific cultural issues affecting the outcomes of dramatherapy.

The research participants were two male and two female Thai patients, aged 23-40 years old, with a diagnosis of Post Traumatic Stress Disorder (PTSD). Patients who met the inclusion criteria were invited to attend 20 individual dramatherapy sessions and complete two selfreportage questionnaires, the Post Traumatic Stress Disorder Checklist (PCL) and Thai Depression Inventory (TDI), at three different time points (before, immediately after and two months after the end of therapy). A mixed methods approach was employed to triangulate qualitative and quantitative data for case study analysis. Interpretative Phenomenological Analysis (IPA) was also applied to the case studies following semi-structured interviews.

According to the PCL and TDI scores, after receiving the dramatherapy treatment, three out of four participants showed a clear improvement in their PTSD and depression symptoms. The qualitative data from video records, arts-based/dramatherapy tools, clinical notes, therapist’s journals, and interviews also indicated that all of the participants obtained benefits in 1) “Reprocessing” of traumatic experiences and 2) “Positive Changes” in cognition, emotions, and behaviours. However, it is acknowledged that other factors, such as medication taken during the duration of therapy, the therapeutic goals, techniques, and procedures used in therapy, also affect the outcomes.

The specific cultural issues that emerged in this research were from the IPA of interviews triangulated with the data from video records, clinical notes, and therapist's journals, in which they were categorised into five main topics: 1) Thai Cultural Values and Beliefs; 2) The Style of Expression; 3) Authority in Therapeutic Relationship; 4) Family Dynamics, and 5) Dramatherapy in a Psychiatric Setting and the Multidisciplinary Team.