OBJECTIVE: Little is known about the effects of psychodrama group therapy on the level of stress, anxiety and depression of the group members, and the biological markers of stress. The aim of this study test cortisol level as a biological reflection of some mental characteristics gained by the psychodrama method in coping with stress. METHODS: Depressive patients aged between 18 and 65 years, who diagnosed with depression according to DSM-5, without psychiatric comorbidity, who do not use drugs and were available for psychodrama were enrolled into the study. These patients were evaluated using the Perceived Stress Scale, State-Trait Anxiety Inventory and Beck Depression Inventory. In order to observe the circadian rhythm of cortisol, samples were collected from the participants before lunch, before dinner and before going to sleep on the day before psychodrama and on the 0, 15th, and 30th minutes after awakening in the morning of the psychodrama day; as well as just before and after the psychodrama session. Saliva cortisol level just before the initial session of psychodrama group therapy was compared with the saliva cortisol level just after the last psychodrama session at the end of 16 weeks. RESULTS: Statistically significant difference was determined between the scores of perceived stress scale, STAI-1, STAI-2, beck depression inventory and salivary cortisol level before and after psychodrama session. There was significant decrease in both the scale scores and salivary cortisol after vs. before psychodrama. CONCLUSION: This results is important as it shows the biological aspect of clinical improvement. Further studies would provide us with better understanding of the effects of psychodrama group psychotherapy on depressive mood and biological projections by means of short-term and long-term follow-up studies.
Anxiety ; Biomarkers ; Circadian Rhythm ; Comorbidity ; Depression* ; Follow-Up Studies ; Humans ; Hydrocortisone* ; Lunch ; Meals ; Methods ; Psychodrama* ; Psychotherapy, Group ; Saliva*

In Korea, modern art therapy was developed in the 1960s and 1970s in the form of supplementary activities for patients in psychiatry. Along with the foundation of the Korean Association for Clinical Art in 1982 by psychiatric doctors, the therapy involved more various arts forms such as music, art, dance, poetry therapy, and psychodrama. More organizations with specific expertise opened such as the Korean Art Therapy Association, Korean Art Therapy Association, etc. in the 1990s and the Korea Arts Therapy Institute in 2001. As of April 2015, the members of the Korean Art Therapy Association total 15,000, including 6,200 regular members. The arts in integrative arts therapy (IAT) is an individual's creative activity which is related to his inner world, and the forms of IAT include music, drawing, dance and poetry therapy. From the aspect of phenomenology, IAT is psychophysical therapy involving the arts that helps patients recognize and perceive their experiences with an aim of at a recovery of the body and creativity from the phenomenological aspect. It is also a therapeutic activity that targets growth and development of the body and mind. Meta-analysis of the effects of art therapy with a focus on that involving music, drawing, dance movement and IAT in recent years in Korea, significant effects were observed in all factors but physical function. The biggest effect was mentality adaptation followed by activity adaptation and physiology. In the run up to the implementation of the daily flat-rate system for the health insurance reimbursement for palliative care in July 2015, the Ministry of Health and Welfare is reviewing the coverage of music therapy, drawing therapy and flower therapy, which are currently practiced by 56 hospice institutes in Korea. This is a meaningful step because the coverage of hospice and palliative care came after that of art therapy for psychiatric patients was approved in 1977. Still, there is a need clarify the therapeutic mechanism by exploring causality among the treatment media, mediation type and treatment effects. To address the issue of indiscriminately issued licenses, more efforts are needed to ensure expertise and identity of the licensed therapists through education, training and supervision.
Academies and Institutes ; Art Therapy* ; Creativity ; Education ; Flowers ; Growth and Development ; Hospices* ; Humans ; Insurance, Health, Reimbursement ; Korea ; Licensure ; Music ; Music Therapy ; Negotiating ; Organization and Administration ; Palliative Care* ; Physiology ; Psychodrama

Death and dying is an ultimate process that every human being must experience. However, in these days we do not like to think or discuss about death and dying. Actually, hatred and denial is the usual feeling when we encounter death and dying. Dying is more than a biological occurrence. It is a human, social, and spiritual event, but the spiritual dimension of patients is too often neglected. Whether death is viewed as a "wall" or as a "door" can have significantly important consequences for how we live our lives. Near death experience is one of the excellent evidences to prove that there should be spiritual component being separated from the human physical body when we experience death. People have called it soul, spirit, or nonlocal consciousness. Caregivers need to recognize and acknowledge the spiritual component of patient care. Learning about death and dying helps us encounter death in ways that are meaningful for our own lives. Among the several learning tools, utilizing cinema with its audio and visual components can be one of the most powerful learning tools in death education.
*Attitude to Death ; Caregivers/education/psychology ; Health Personnel/*education/psychology ; Humans ; Psychodrama

OBJECTIVES: This study was to evaluate the cognitive and noncognitive effects of Psychodrama on elderly dementia patients. METHODS: The psychodrama treatment group was composed of 16 elderly dementia patients and control group was matched the psychodrama group. The psychodrama group received 8 session of psychodrama therapy every week. Cognitive function and non-cognitive function of two groups were evaluated by MMSE-KC, K-BNT, Geriatric Depression Scale, Barthel Activities of Daily Living, Self-Esteem Scale before and after Psychodrama. RESULTS: Improvement of Self esteem was observed in psychodrama group. Worsening of depression was observed in control group, but psychodrama group was not observed. CONCLUSION: Psychodrama with elderly dementia can be useful to enhance Self esteem and to prevent worsening of depression
Activities of Daily Living ; Aged* ; Dementia* ; Depression ; Humans ; Psychodrama* ; Self Concept

OBJECTIVES: This study was to evaluate the cognitive and noncognitive effects of Psychodrama on elderly dementia patients. METHODS: The psychodrama treatment group was composed of 16 elderly dementia patients and control group was matched the psychodrama group. The psychodrama group received 8 session of psychodrama therapy every week. Cognitive function and non-cognitive function of two groups were evaluated by MMSE-KC, K-BNT, Geriatric Depression Scale, Barthel Activities of Daily Living, Self-Esteem Scale before and after Psychodrama. RESULTS: Improvement of Self esteem was observed in psychodrama group. Worsening of depression was observed in control group, but psychodrama group was not observed. CONCLUSION: Psychodrama with elderly dementia can be useful to enhance Self esteem and to prevent worsening of depression
Activities of Daily Living ; Aged* ; Dementia* ; Depression ; Humans ; Psychodrama* ; Self Concept

The aim of this article is to understand group psychotherapy. In group psychotherapy, psychoanalytic theory and cognitive-behavioral theory have been accepted as perennial effective therapeutic modalities. But nowadays, all theories give the group psychotherapy vitality and liveness as a therapeutic modality in practical setting. The orders of the group psychotherapy that current therapists prefer according to their theoretical background are as follows: psychodynamic/psychoanalytic, group as a whole/systems, transactional analysis/gestalt/redecision, interpersonal/interactional, cognitive/behavioral, object relations, group analysis, psychodrama, existential/humanistic, and self psychology. The practice of group psychotherapy includes four therapy group, encounter group, training group, and education group or self-help group. Therapy group has the goal of symptom relief and personality reconstruction for patients. Encounter group has the goal of self growth and self realization for non-patients. Training group has the goal of training in human relationship and self maturation for mental health personnels. Self help group has the goal of education and support for patient families and patients. Group psychotherapy has been accepted as a therapeutic modality that are equally effective as individual psychotherapy although group psychotherapy has been derived from individual psychotherapy. Recently, individual psychotherapy has been less practiced yearly because of the pressure of economic difficulties of medical insurance in developed countries. Therefore, the importance of group psychotherapy with its therapeutic effectiveness and cost-efficiency is uprising.
Developed Countries ; Education ; Humans ; Insurance ; Mental Health ; Object Attachment ; Psychoanalytic Theory ; Psychodrama ; Psychotherapy ; Psychotherapy, Group* ; Self Psychology ; Self-Help Groups ; Sensitivity Training Groups

Recently, the Korean psychiatrists has faced to the difficult situation because of the separation of medical practice and pharmaceutical dispensing and the revision of mental health law. In this situation, this article was written for the desirable development and application of group psychotherapy in Korea in the basis of the history of foreign group psychotherapy. Introduction is composed of definition of group psychotherapy, reasons why the group psychotherapy is not applied so actively in psychiatric area, the present of group psychotherapy, therapeutic effect, and therapeutic outcome. Main subjects are the history of foreign group psychotherapy, the prospect of group psychotherapy, and Korean group psychotherapy. Group psychotherapy has been formally accepted as one of therapeutic modalities that must be as equally effective as individual psychotherapy even if group psychotherapy derives from individual psychotherapy. Those days, in psychiatric clinic in Korea psychophamacotherapy and brief symptom oriented therapy have been applied mainly due to the economic principle of medical environment and insurance policy. And psychiatrists apply psychotherapeutic modalities in there less and less. The importance of group psychotherapy should be emphasized one of holistic and humanistic therapy which provides the field of encounter for therapists and patients. As Community Mental Health Service in Korea are expanding and the separation of medical practice and pharmaceutical dispensing is being performed. The group psychotherapy and psychodrama should be perceived as a much more effective and efficient therapeutic modality in the settings of inpatient and outpatient clinics.
Ambulatory Care Facilities ; Humans ; Inpatients ; Insurance ; Jurisprudence ; Korea ; Mental Health ; Mental Health Services ; Psychiatry ; Psychodrama ; Psychotherapy ; Psychotherapy, Group*

OBJECTIVES: This study is designed to develop a large group phychodrama for light delin-quent adolescents (hereinafter called as "Psychodrama") thereby determining therapeutic factors for dealing with them. METHODS: The study was conducted in the program of Seoul Metropolitan Youth Centre called "the class of love" during the period of July through December, 1998. The subjects consisted of a total of 827 young delinquents (759 boys and 68 girls, with the average age of 15.9 years old). To develop "this psychodrama", after we composed of therapeutic team centered by psychiatrists, we prepared from January to June, 1998 by practicing psychodrama with delinquent adolescents and by analyzing the results. "This psychodrama" has three basic steps: (1) warming-up (small group me-eting), (2) action (situation drama and main drama), (3) sharing. A survey of treatments, from a pool of participating adolescents, based on evaluation sheets and 13 therapeutic factors scale followed every session of this psychodrama. RESULTS: "This psychodrama" was helpful for 47.4%, interesting for 49.2%, not helpful for 12.1% and not interesting for 16%. In the whole group of subjects, the important therapeutic factors were existential factor, universality, identification with the therapist and the instillation of hope in the order of rank. When categorized in four different groups (audience, participants in situation drama, auxiliary egos, participants in sharing) the 4 groups displayed different results to one another. First, the therapeutic factors of audience were similar to that of the whole group. Second, participants in situation drama showed a higher catharsis than others. Third, auxiliary egos were leading in the guidance of members and therapists. Fourth, participants in sharing displayed higher group cohesiveness. CONCLUSION: As it is getting harder to find program's suitable for the treatment of increasing number of delinquents due to limited budget and experts, this psychodrama could be more cost-effective than any other measures.
Adolescent* ; Budgets ; Catharsis ; Drama ; Ego ; Female ; Hope ; Humans ; Psychiatry ; Psychodrama* ; Seoul

OBJECTIVES: A group therapy includes various types: group psychotherapy, psychodrama, activity therapy including occupational therapy as well as recreation therapy, art therapy of drawing, music, dancing and drama. It has long been in use for in-patients, and became more trendy at day hospitals and community mental health centers after the enactment of a mental health law. It was surprising that a few researches have been made in the field, including a basic fact finding and that a few Korean psychiatrists have been inclined toward it. Meanwhile, we finished a research work on: how a group therapy has been conducted so far, its current status across the country, possibly the best way to heal, and deal with, psychiatric patients. METHODS: The 1997 annual report by Korean Neuropsychiatric Association, has been available for random sampling in the following categories: training hospital, general hospital, psychiatric hospital, clinic with admissions, clinic without admissions, day hospital, community mental health center. Telephone polls were conducted on contents of frequency and status of a group therapy available with psychodrama, main therapists, co-therapists, duration & times of therapy, size of group therapy recipients etc. RESULTS: The group therapy is broken down into the order of percentage; Art therapy(30.9%), Activity therapy(28.4%), Group psychotherapy(27.2%), Others(24.1%), Large group therapy(23.2%), with the psychodrama(10.9) least of all. Against in-patients(61.6%), the group psychotherapy shows its greatest diagnosis for a combined gorup(51.4%), and finds its biggest type in a general group(83.2%), Against in-patients(65.3%), the psychodrama diagnosis is mostly conducted for a combined group (69.4%). For a main therapist, the group psychotherapy is taken care of by boardmen(31.1%), and social workers(29.5%), while psychodrama by psychiatric boardmen(36.1%), and social workers(36.1%). On the other hand, for a co-therapist, the group psychotherapy is done by nurse(40.8%), while psychodrama by social workers(25.9%), and volunteers(23.5%). At a time most group psychotherapies takes some 60 minutes, psychodrama 120 minutes. Group therapies take place each once a week. Its participation amounts to 26.0(+/-17.8) for a psychodrama, and to 11.0(+/-5.8) for a group psychotherapy. Clinics with admission rooms(83.6%), exceedingly enjoy more group therapy than ones without (2.2%). CONCLUSION: The group therapy is run at most hospitals as the main part of a psychiatric treatment. However, the job has been undertaken on a small scale by outpatient clinics as well as psychiatric boardmen. Therefore, more attention is urged toward a group therapy, its professional training, plus its more brisk business at outpatient clinics.
Ambulatory Care Facilities ; Art Therapy ; Commerce ; Community Mental Health Centers ; Dancing ; Diagnosis ; Drama ; Hand ; Hospitals, Community ; Hospitals, General ; Hospitals, Psychiatric ; Humans ; Jurisprudence ; Korea* ; Mental Health ; Music ; Occupational Therapy ; Psychiatry ; Psychodrama ; Psychotherapy ; Psychotherapy, Group* ; Recreation Therapy ; Telephone

As an alternative to group psychotherapy, worked out by Dr. Moreno, the psychodrama is being carried on mainly for a large group of inpatients at 40-50% of the country's psychiatric and training hospitals. The authors have developed a Korean psychodrama model for a group mental health having following characteristics:(1) a one-time treatment, (2) open-group therapy, and (3) structured, large group approach. Korean psychodrama model was proved to be a low cost, highly effective approach in that patients could be dealt with en masse to quite a satisfactory degree: at the same time Korean psychodrama model is easily accessible for any psychiatric doctor or trainee in dealing with a patient. In addition, Korean psychodrama model is highly conducive to experiencing and training related people in psychotherapeutic practice as this model has shown up 79.4% approval rate among patients after treatment. Due to the recent crunch in medical insurance financing, psychotherapy is changing from individual long-term type to a more time-limited type. Despite the mental health law passed in 1995, from the human psychotherapy standpoint, the worsening economic situation has made it difficult for a psychiatrist to deal with patient on a one-to-one basis. As a result, the burden of most psychiatrists, is snowballing day by day. In this context psychodrama seems to be a promising, reliable alternative to group psychotherapy, both medically and economically. It will be a treatment modality for years to come.
Humans ; Inpatients* ; Insurance ; Jurisprudence ; Mental Health ; Psychiatry ; Psychodrama* ; Psychotherapy ; Psychotherapy, Group