Luigi Dotti, PsyD. - Italy

Psychodramatic Method in Children Psychotherapy

(presented at IAGP International Conference in Jerusalem - august 2000)

I have been concerned with psychodrama almost for 20 years, particularly with group psychotherapy with adults and children .
I started with adults, it was rather easy: long tradition and solid methodology in this field were there, and still they are there.
It was more difficult to transpose psychodramatic methods to children for the following reasons:

It is not always possible to dramatize in the groups of children

the severity of the clinical diagnostic picture doesn't always allow to act within the classical psychodrama setting

very young children have not fully developed the cognitive structures to proficiently use the techniques requiring capabilities of perceptual decentralization (e.g. role reversal) or to introspect (e.g. double - soliloquy)

On the other hand, expressive methodologies (as Art Therapy and music therapy) and relational psychomotricity (by Lapierre and Aucouturier) whose potentialities I was discovering, while resulting pleasant to the children, did not give me a satisfactory theoretical reference background.

While classical psychodramatic method cannot automatically be applied to children, it is yet true that it is possible to use both psychodrama and theater paradigm in playful situations, in symbolic play and in the activities proposed to the children as a pretext and an opportunity to experiment aggressiveness, fusionality, fears, and fantasies.

With time I realized that the psychological and relational functions activated by psychodramatic techniques are really therapeutic, more than the application of psychodramatic method in itself. In other words, it is more important that children may experience a wide range of relational functions than to take part in an infantile psychodrama.

In the psychodramatic theory there is a strong relation between psychodramatic technique and psychological or relational function, but the two levels do not coincide. For instance the Doubling in psychodrama activates the funtion of double in the protagonist; in other words "gives voice" to his thoughts and his sentiments and makes him feel understood in his subjectivitiy. In the same way a good mother, in tune with her newborn, certainly activates the function of double ("puts into words the sentiments, the fears and the wishes of the child"), even though she does not use the psychodramatic technique of the double.

Among the functions activated by psychodramatic techniques some take on a central role in child development. Beside the function of double already mentioned, the followings are particularly relevant:

the function of mirroring, which develops the consciousness of external perception, of being seen from the outside, "I see you this way..";

the function of role reversal, which allows to experience the point of wiew of the other, perceptual decentralization;

the function of role playing, which allows the experimentation of new roles in relation to complementary roles and counter roles (strength-weakness, activity-passivity, etc.);

the function of reflecting, which facilitates to find oneself in the other, the positive identification, confirming parts of oneself in the relation with the other;

the function of encounter, giving access to reciprocity and intimacy.


I am now going to briefly describe some aspects of the psychodramatic method which are present in the management of child psychotherapy groups.

1 the presence of a conductor-director, taking on the funtion of warrant of the setting, ruling the sequence of the activities and who above all underscores the passage from moments of reality (what is here and now of the group) to moments of semi-reality (as if..)

2 The intentional alternation of activities in semi-reality (symbolic play, dramatization, as if..) and activities in the real here and now of the group. With children it is extremely important to emphasize and to ritualize the passing from one level to the other. In this way children learn to alternate action and reflection, ego actor and ego observer.

3 intentional activation of the psychological and relational functions, we have talked about above (doubling, mirroring, reflecting, role playing , role reversal, encounter).

4 to give value to the group both as locus and medium of relationship, and as audience participating a drama, witnessing a way of living and of self proposing of the single child. In that second meaning the group-audience is inserted within the ritual theatrical framework or in the metaphor of theater as an ensemble of sights, pertaing psychodrama.

The theatrical context allows to dignify the protagonist and his story, through the ritual that alternates the observer role and the acting role. The child learns taking the risk of being a protagonist; he also experiences the necessity of sometimes playing a supporting role and to observe and give value to other protagonists.
In this way the dynamics omnipotence/helplessness is experimented and integrated in the course of the action through the roles of actor and observer.

5 Active and intentional experimentation of a wide range of roles and counter roles. For the subject Counter Role is a product of reality that is independent, non modifiable according to wishes.
The experience of playing a role and later of playing the complementary role is very important especially for children used to have in their family weak adult conter roles, so they experience themselves as omnipotent.
The body counter roles (body double, holding, body mirror) are particularly significant in this respect, putting the child in the condition to devise a new response or a new role to a situation which cannot easily be avoided with old behavioral strategies.
In the children groups it is possible to see "statu nascendi" the dynamics of spontaneity-creativity that Moreno studied in his first experiences of the theater of spontaneity.
The child faces the challenge of the new roles proposed in interactions by activating his spontaneity more easly than the adult as he confronts himself with a narrow range of internal crystalized roles (cultural conserves).

6 The presence of Auxiliary Egoes with the function of supporting and of mirroring the protagonist in the moments of reality and with the function of physical place of projections of the transfert in the moments of semi-reality.
In this context the adult has a mirroring function for the children.
He can play various roles (also fragile, childish, bad, etc,) but he always remains an adult with the ability to assume adult roles (containment, normativeness, confidence, authority, etc,).
At the same time the children experiment that they can be little and big, fragile and strong; they also understand that it is possible to come out from rigid roles to explore new role possibilities. An adult playing with a child becomes a kind of mobile intermediary object, connecting the child to the adult and also approaching the child to the feared parts of the same adult and of the other internal adult figures.


The groups are run in Institutions of the NATIONAL HEALTH SERVICE of Italy and there is no payment by parents, except in the form of a contribution to the service (ticket).
The referral of the children is from colleagues psychologists and child neuropsychiatrists, working in different services (Child Development, Handicap, Center for Epilepsy, Child Neuropsychiatry Department, Family Counseling Service).
The colleague who sends the case stays as the point of reference for the family and is the reference of the totality of the care project, including the child psychotherapeutic intervention.
Each year two groups are activated: one group for children aged 4-6 and the other one for children aged 7-9. The maximal number of children for group is 7.
In each group there are one director and two Auxiliary Egoes. We try to act that in each group both male and female adults are present.
The times of child psychotherapy groups follow the school timetables of the children, so that the interruptions of the psychotherapy coincides with school holydays.
Each group has a weekly session either of one hour or one hour and half depending on the number of children present.
The experience is proposed to the children as an yearly course, full from september to june and with possible resumption september next.
We work barefoot in a space covered with soft plastic material, with pillows, foam cubes, pelouches and various expressive materials at our disposal.

The contract with the children envisages some basic rules openly exposed right from the starting of the psychotherapy:

Once in the room the children cannot go out until the session ends

Space is divided into space of preparation (where shoes are put on and where are the props) and space of action (coinciding with activity in semi-reality)

The rule of intersubjectivity holds good: everyone has the right to be what he is and to express it without being judged.

the director and the Auxiliary Egoes are responsible for the instructions and for the group as a whole when they are in the space (physical and contextual) of reality; they may play specific roles during the activities that take place in the space of semi-reality.

In this context the adult has a mirroring function for the children; he can play various roles (also fragile, childish, bad, etc.) but he always remains an adult with the ability to assume adult roles (containment, normativeness, confidence, authority, etc.).
At the same time the children experiment that they can be little and big, fragile and strong; they also understand that it is possible to come out from rigid roles to explore new role possibilities.
An adult playing with a child becomes a kind of mobile intermediary object, connecting the child to the adult and also approaching the child to the feared parts of the same adult and of the other internal adult figures.


The parents of the children in parallel are organized in groups meeting periodically with the directors to communicate problems, verify developments and changes in the children and above all to favour an exchange-comparison-encounter with the other parents.

This "mirroring group" is extremely important, as it favorises identifications, stimulates realistic hopes, gives boundaries to illusions or feelings of omnipotence, it supports the educational role, containing the feeling of impotence.

With time I noticed that this group of parents tends to consitute itself as "informal group" durign the waiting time outside the sessions with their children. Together or in subgroup, the parents take the opportunity to go and have a coffee, a walk and first of all to confront themselves, sharing experiences, in some sort of self-help group. Very often significant bonds are created, that constitute a resource for reciprocal support "when needed" in the space outside the group.

In some cases, not frequently, the parents group can be conducted by using psychodramatic techniques. In these cases the parents have the opportunity to understand more deeply their relationship with their children. The dramatization of some problematic or difficult situations allows the parents to share emotions, to verbalize problems, and to find new ways to face their children.

In conclusion I whould like to stress a common element between children and parents groups.
The conductors in the parents groups take on a function of mirror similar to what happens in the children groups.
In fact the conductors, on the one hand, play childish roles in their activity with the children (they work in sport dress, barefoot, they play with children very different and particular roles); on the other hand they play adult roles in the groups of the parents (formal dress, expert role, etc.).

In this way the parents discover, by mirroring the conductor, the possibillity to play a wide range of roles with children, without loosing the parental role and, in a wider acception, the adult role.

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2001 Luigi Dotti