Integrating Psychodrama and Cognitive Therapy: An Exploratory Study

1
Integrating Psychodrama and Cognitive TherapyAn
Exploratory Study

• by Michelle N. Boury

2
The present study evaluated the effects of
participating in a group course which integrated
psychodramatic and cognitive- behavioral
techniques on changes in the number of core
beliefs, number of automatic thoughts, mood and
alleviating depression.
3
Cognitive Model

• Thoughts influence emotions and behaviors.
• Dysfunctional thoughts are frequently associated
  with psychological distress.
• Such thoughts are provoked by core beliefs.
• Core beliefs are based in early childhood and are
  the content of the cognitive structures (schema)
  within the mind.
• Early Maladaptive Schemas (EMS).

4
Cognitive Triad

• Future
•  
• Self World

5
Psychodramatic Triad

Catharsis
Intensity of Emotion
Selection of patient
Sharing
Warm-up
Action
Closure
6
Cognitive Theory of Depression

• Depressed individuals negatively misinterpret
  facts and experiences.
• The more negative thoughts the greater the
  severity of other depressive symptoms.
• Depression is maintained by negative thoughts.
• To reduced depression there needs to be a
  reduction in negative thoughts.
• Cognitive-Behavioral Therapy (CBT) evokes change
  in thoughts and underlying beliefs.

7
Research on Cognitive-Behavioral Therapy

• CBT has shown to be as effective as pharmacology,
  psychoanalysis, interpersonal and behavioral
  therapy.
• CBT has been effective in both individual and
  group settings.

8
Present Study

• Purpose
• Examine the effects of completing the Thought
  Record Form (TRF) with the integration of
  psychodramatic and Cognitive-Behavioral
  techniques.
• Examine the relationship among the variables
  derived from the TRF and depression.

9
Present Study

• Becks Model
• When an individual is depressed there is an
  increase in negative thought content about the
  self, future, and world.
• Therapy should decrease depression because of the
  awareness it brings to the negative thought
  process.

10
Present Study

• The Psychodrama Course
• Cognitive techniques
• Psychodramatic techniques
• Group setting

11
Methods

• Participants
• 40 Undergraduate and graduate students.
• 24 females and 16 males.
• Enrolled in 1 of 5 group psychodrama courses at
  West Chester University between the fall of 1997
  and the fall of 1999.
• The course was 14 weeks long, meeting once a week
  for 3 hours.

12
Instruments

• Thought Record Form
• Identifies negative thoughts evoked by a
  particular situation.
• Beck Depression Inventory II
• Self-report measure of depression.

13
Thought Record Form Variables

• Number of distressing situations.
• Number of negative moods identified.
• Average initial mood rating.
• Number of automatic thoughts.
• Number of implied core beliefs.
• Number of implied different types of core
  beliefs.
• Number of balanced thoughts.
• Number of moods reported after completion of
  balanced thoughts.
• Average new mood rating.

14
Procedure

• BDI-II were computed weekly.
• Gradual introduction of the TRF.
• TRFs were completed as weekly homework
  assignments.

15
Results

• Review of main purpose of this study
• To evaluate if the group class had any impact on
  changes in number of core beliefs, automatic
  thoughts, mood and BDI-II scores.
• To examine the correlation among various measures
  derived from the TRFs and BDI-II scores.

16
Effect of the Group Course

• More situations were mentioned in the first three
  weeks of the course than the last three weeks of
  the course.

17
Effect of the Group Course

• There was no difference in the following
  variables from the first three weeks to the last
  three weeks of the course
• The number of automatic thoughts.
• The number of core beliefs.
• BDI-II scores.
• The number of mood reported at the beginning of
  the TRF.
• The average mood rating at the beginning of the
  TRF.
• The average mood rating after writing balanced
  thoughts.

18
Effect of the Group Course

• More moods were reported in the beginning of the
  TRF than in the end for both the first and last
  three weeks of the course.
• The difference between the number of moods
  reported from the beginning of the TRF and the
  end was greater in the first three weeks of the
  course.
• There were more moods reported at the end of the
  TRF in the last three weeks than the first three
  weeks.

19
Effect of the Group Course

• The average mood rating decreased from the
  beginning of the TRF to the end, after writing
  the balanced thoughts, in both the first three
  weeks and last three weeks of the course.
• There was a greater reduction of mood rating from
  the beginning to the end of the TRF in the first
  three weeks than the last three weeks.

20
TRF Variables and BDI-II Scores

• The BDI-II correlated with the following
  variables in the first three weeks
• Number of moods in the beginning of the TRF.
• Number of automatic thoughts.
• Number of implied core beliefs.
• Number of different implied core beliefs.

21
TRF Variables and BDI-II Scores

• The BDI-II correlated with the following
  variables in the last three weeks
• Number of situations.
• Number of moods in the beginning of the TRF.
• Number of automatic thoughts.
• Number of implied core beliefs.
• Number of new moods.
• The average new mood rating.

22
Correlations Among the TRF Variables

• The number of situations were positively
  correlated with
• Number of moods in the beginning of the TRF.
• Number of automatic thoughts.
• Number of core beliefs.
• Number of different core beliefs.

23
Correlations Among the TRF Variables

• The number of moods and balanced thoughts were
  correlated with
• Number of automatic thoughts.
• Number of implied core beliefs.
• Number of different core beliefs

24
Summary and Conclusion

• BDI-II scores did not differ from the first three
  weeks to the last three weeks.
• Average mood ratings decreased as a result of
  writing balanced thoughts.
• No reduction in negative moods as a result of
  completing TRF weekly.

25
Summary and Conclusion

• Immediate positive effects of writing balanced
  thoughts.
• These effects did not generalize to other
  situations.

26
Suggestions

• Improved way of accessing mood.
• Clinical population.
• Longer term intervention.
• Larger sample size.