Investigators conducted a database search across Scopus, PsycINFO, MEDLINE and Web of Science Core Collection on 29 October 2025. They applied eligibility criteria limited to English-language reports from the prior 20 years that evaluated a drama-based intervention in trauma-exposed populations and reported trauma-related psychological outcomes. From 1,461 screened records the review team included 26 studies. The review used the Mixed Methods Appraisal Tool to appraise methodological quality and applied GRADE to assess certainty of evidence. These are the study team’s reported search and appraisal methods; the source did not provide additional screening flow details or supplementary search parameters in the abstract.
The review grouped included interventions into five categories: psychodrama, dramatherapy, applied theatre, other drama-based psychotherapeutic interventions, and a residual ‘other’ category. Intervention descriptions varied widely across studies. Some reports identified psychodrama or dramatherapy explicitly; others used applied theatre or broader, non-standardised labels. The study team observed inconsistent use of terminology and limited reporting of core content and delivery parameters across trials. The source did not report a unified taxonomy or standardised intervention protocol applicable across the included literature.
Across the 26 included studies the most commonly examined outcomes were PTSD symptoms, depression, and anxiety. Several studies measured broader psychological wellbeing as an outcome as well. The review found that some studies reported improvements in trauma-related symptoms and in general psychological outcomes following drama-based interventions. However, results were mixed between and within intervention types. Outcome measurement approaches were heterogeneous: investigators used differing scales and outcome definitions, which constrained direct comparison. The abstract did not provide a study-by-study outcome table or the specific instruments employed, so readers must consult the full text for detailed measurement tools and effect estimates.
The review team appraised methodological quality using the Mixed Methods Appraisal Tool and rated certainty of evidence using GRADE. Data indicated important limitations across the evidence base. Small sample sizes and uncontrolled designs were common. Heterogeneity appeared in how trauma exposure was defined, how interventions were described, and which outcomes were assessed. Intervention reporting frequently lacked sufficient detail on content, dose, facilitator training, and delivery fidelity. Because of these limitations the authors rated overall certainty of the evidence as very low. The abstract did not present pooled effect sizes or meta-analytic statistics; it stated certainty and quality judgements without numeric synthesis in the abstract.
The authors noted several consistent gaps that limit interpretation of current findings. First, inconsistent terminology across psychodrama, dramatherapy and applied theatre made synthesis difficult; the field lacks standard descriptors. Second, inadequate reporting of intervention content and delivery—such as session structure, facilitator qualifications, or adherence monitoring—prevented replication and assessment of active components. Third, heterogeneous outcome measurement and inconsistent selection of trauma-related endpoints complicated comparison across studies. Fourth, small samples and a high prevalence of uncontrolled designs constrained causal inference. The review concluded that drama-based approaches show preliminary potential to support trauma-exposed populations but that the evidence base remains constrained by substantial heterogeneity and low methodological quality.
The authors recommended future research priorities that include more rigorous study designs (for example, controlled trials), clearer and standardised reporting of intervention content and delivery, and greater consistency in outcome selection and measurement. The abstract did not specify a timeline for future trials, nor did it provide details on funding sources, trial registries, or specific protocol templates. Readers seeking those specifics should consult the full article.
Limitations reported in the abstract included the narrow search language (English) and the 20-year publication window applied by the review team. The authors also emphasised that the GRADE assessment resulted in a very low certainty rating, reflecting pervasive methodological issues across the included studies. These concrete limitations close the abstract’s account; the source did not provide additional regulatory milestones or definitive clinical recommendations within the abstract.