Table 3.

Results of analysis of drama intervention studies.

Studies	Interventions	Processes and mechanisms	Depression outcomes, measures, and scale	Quality assess and design
Keisari and Palgi, 2017	Life review of major life crossroads integrated with drama therapy techniques led by drama therapist and social worker used dramatic roles, embodiment, enactment, witnessing; n = 55 (27 intervention, 28 control). Group intervention 90 min; 1x week; 12 weeks	Increased self-acceptance, meaning making, relationships with group members, capacity for self-reflection and the integrity and coherence of one's life story. Social processes such as social recognition, learning from others, and being able to help others that are central to life review were amplified through use of processes of dramatic projection, embodiment, enactment, witnessing, and the life-drama connection.	GDS: [F(1, 53) D 12.9, p < 0.001], Significant improvement reported in depressive symptoms	PEDro 9/11 QE
Kontos et al., 2017	Improvisational play, humor, empathy, song, dance, and music facilitated by trained elder clowns; n = 23. Individual intervention 10 min; 2x week; 12 weeks	Reciprocal play, affective relationality, joy, con-constructed imagination, and acceptance of sadness as non-pathological all regarded as contributing to positive affect in participants.	Qual interviews, ethnographic observations of video recorded clown- resident interactions, and practice reflections	COREQ 21/32 QS
Sajnani et al., 2018	Use of projective devices, psycho-dramatic, techniques drawn from Therapeutic Spiral Method (TSM), and sociodrama. Group and individual intervention n = 4 Average 45 min; 1 X week	Reinforcing participants' strengths, dramatic projection prompts social interaction and facilitates perspective through externalization of inner conflicts.	Collaborative discourse analysis	COREQ 19/32 CDA
Wilkinson et al., 1998	Sesame method of DT led by drama therapist included use of metaphor, movement, enactment. n = 16 (9 intervention, 7 control). Group intervention 105 min; 1x week; 12 weeks	Stimulation of memory, encourages role flexibility, and reinforces past coping strategies. Metaphor encourages organization of self-expression. Enactment of scenes increases orientation to past and present, self-understanding, and acceptance, meaningful personal relationships.	CSDD Qualitative data involving observation and informal interviews. No significant differences reported between intervention and control group with exception of indication of deterioration in area of depression due to rise of depressive symptom in one participant	PEDro 8/11 QE/ QS

Key: CSDD, Cornell Scale for Depression in Dementia; GDS, Geriatric Depression Scale.

Intervention coding: * intervention delivered by a trained, registered and/ or certified drama therapist; # intervention delivered by other professional; and + unclear.

Design codes: CDA, collaborative discourse analysis; COD, crossover design; CS, case study; LA, longitudinal study; OS, observational study; PE, pre-experimental; PPGD, prospective, parallel-group design; PPT, pre and post-test; PS, pilot study; PT, pragmatic trial; QE, quasi experimental; QS, qualitative study; RCT, randomized control trial; RCS, retrospective cohort study; SSR, single subject research.