Investigating the role of drama-based strategies in addressing psychological trauma: a systematic review

Background: Drama-based techniques have been increasingly implemented with trauma-exposed populations. However, the evidence base remains conceptually and methodologically heterogeneous, with substantial variation in how trauma is defined, how interventions are described, and which trauma-related outcomes are assessed.Objective: This review aimed to synthesise empirical studies examining drama-based interventions for individuals exposed to trauma. The review describes the characteristics of drama-based interventions, the types of trauma addressed, the pattern and range of trauma-related psychological outcomes assessed, and the methodological quality and certainty of the available evidence.Methods: A search was conducted across Scopus, PsycINFO, MEDLINE, and Web of Science Core Collection databases on 29 October 2025. Studies published in English within the past 20 years were eligible if they examined a drama-based intervention in a trauma-exposed population and reported trauma-related psychological outcomes. Methodological quality was appraised using the Mixed Methods Appraisal Tool and certainty of evidence was assessed using GRADE.Results: Twenty-six studies met inclusion criteria out of 1,461 screened papers. Interventions were grouped as psychodrama, dramatherapy, applied theatre, other drama-based psychotherapeutic interventions, and other. The most commonly examined outcomes were depression, anxiety, and PTSD symptoms. Across intervention types, some studies reported improvements in trauma-related and broader psychological outcomes. However, findings were mixed and frequently constrained by small samples, uncontrolled designs, heterogeneous outcome measurement, limited intervention reporting and inconsistent use of terminology. Certainty of evidence was rated as very low.Conclusions: Drama-based interventions show preliminary potential for supporting trauma-exposed populations, but the evidence base remains limited by substantial heterogeneity and low methodological quality. More rigorous study designs, clearer reporting of intervention content and delivery, and greater consistency in outcome assessment are needed to strengthen the evidence base and clarify how drama-based strategies may contribute to trauma-related mental health care.