Psychodrama Methods for Palliative Care Teaching

In Palliative care, we have used Psychodrama to help Doctors, Hospital Staff and Caregivers in dealing with in communication with relatives, differences with other staff, and in breaking bad news to patients.

Some have problems of grief and work-life-balance.

A doctor in one of the programs admitted for example, he experiences “fear” of meeting incurable cancer patients during home care. He didn’t know, how to make contact, what to say, how to manage the whole situation himself. He was hesitantly explaining the matter, believing this problem might be just his own, and suspected no other participating doctor might feel like him. Through psychodramatic role play, we explored the subject, in order to find solutions and greater connection between patient and doctor.

Psychodrama’s foremost method is the protagonist role play. Such training of Medical Doctors in Palliative Care can be on all subjects with special communication needs and problems like

a) breaking bad news, b) overcoming collusion, c) bereavement counselling, and – d) the needs of caretakers themselves.

There are many approaches and methods which can be used for palliative care training:

a. Normal role play: Performing the situation again, finding out what happened

b. Role reversal: putting oneself in the place of the other to get a different perspective

c. Protagonist play: Interact on an interpersonal level as protagonist with all other persons involved (with support from other training group members). But the protagonist will play each and every role and get different perspectives (see b) even trying out other situations (“surplus reality”).

d. Inner Psychodrama: The protagonist gets a view of all his inner attitudes, skills, needs and shortcomings, to find new solutions and other related methods

e. Act Storming: The protagonist takes on the patient’s role (or relative) while other group members try  to find new solutions to the case, which the protagonist might not yet have tried.

This gives a triple effect: 1.) the protagonist experiences a longer role reversal,

2.) the group tries out more possibilities – which can be fun – and the protagonist can decide, what will
be helpful

3.) If all solutions are not new to the protagonist, he at least can feel, he has done his level best.

f. Vignette: Have a short overview on a case or problem in someone personified by the protagonist with help of group members, but without role play (for those more reflective and shy to act).

g. Constellation Work: Consider the whole constellation and let others act freely and improvise.

h. Group play: Let the group create and act out a script on the problem, which can be worked on

See here for details