The Effect of Psychodrama-Based Group Work

The Effect of Psychodrama-Based Group Work on Postpartum Women's Depression and Forgiveness Tendencies: A Randomised Controlled Study

Aims This study examined the effect of psychodrama-based group work on postpartum women's tendencies toward depression and forgiveness.

Methods This study used a pretest-posttest-follow-up randomised controlled experimental method. The study sample consisted of 23 postpartum mothers (11 experimental and 12 control) whose babies were receiving treatment in the neonatal intensive care unit between April and June 2025. While psychodrama-based group intervention was applied to the experimental group, no intervention was performed in the control group. Data were collected using a personal information form, Postnatal Depression Screening Scale, and Forgiveness Scale.

Results In the study, it was found that the mean forgiveness scores in the final test and follow-up measurements of the postpartum women in the experimental group were statistically significantly higher compared to the control group (p<0.05). In the final test and follow-up measurements, the mean postpartum depression scores of the women in the experimental group were found to be statistically significantly lower than those of the mothers in the control group (p<0.05).

Conclusions Psychodrama-based group work increased forgiveness tendencies and reduced depression levels in postpartum women. In this regard, it is recommended that psychodrama sessions be conducted for postpartum women.

Study Overview

• Status: Completed
• Conditions: Psychoeducation; Psychiatric Nursing; Forgiveness; Puerperal Depression; Depression Disorder
• Intervention / Treatment: Other: psychodrama-based group intervention; Other: Control

Detailed Description

The neonatal period is a critical stage of development in the first 28 days after birth, during which the baby adapts physiologically and biologically to the external environment. Owing to issues such as prematurity, low birth weight, congenital anomalies, and respiratory distress, some babies require advanced medical support, highlighting the vital importance of the Neonatal Intensive Care Unit (NICU). During this process, mothers experience intense psychological stress due to factors such as uncertainty about the baby's health, limited physical contact, a highly technological environment, and the postponement of maternal roles, which leads to the emergence of negative emotions, such as guilt, inadequacy, hopelessness, helplessness, and anxiety, thereby making the postpartum period more emotionally fragile. These negative emotions also weaken the psychological resilience of postpartum mothers and constitute a significant risk factor, especially for the development of postpartum depression. Studies in the literature indicate that mothers experiencing postpartum depression negatively affect their breastfeeding behaviors, adaptation to the postpartum period, ability to cope with challenges, quality of life, and overall mental, physical, and social health. The concept of forgiveness, which facilitates relief from pain and distress caused by intense negative emotions that intensify during the postpartum period, is defined as an important psychological component in overcoming depression, anxiety, relationship conflicts, and crises in a healthy manner. Forgiveness has been reported to make a significant contribution, particularly in reducing depressive symptoms. Forgiveness has been shown to have positive effects in alleviating psychological distress, protecting and improving health, and has been found to be beneficial in the treatment of various mental disorders. One such approach is psychodrama. Psychodrama has been used in the field of nursing since the 1960s and has found a place in clinical practice. Psychodrama is an effective and important psychotherapy method in terms of increasing peer support, finding a model for identification, experiencing positive relationships, seeing different approaches to relationships, and experiencing different roles. An increase in the number of psychiatric nurses with knowledge and skills in psychodrama will add a scientific and artistic dimension to the field of nursing, creating a special level of advancement in the quality of care provided by nurses through interactions with people. In this context, considering the critical role of women in shaping the future of society, this study evaluated the effects of a psychodrama-based group intervention aimed at supporting the psychological well-being of mothers during the postpartum period, reducing depressive symptoms, and strengthening tendencies toward forgiveness.

• Study Type: Interventional
• Enrollment (Actual): 23
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Bergama
    • Izmir, Bergama, Turkey (Türkiye), 35700
      • Bergama Necla Mithat Öztüre State Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age between 18-55 years or (until menopause)
• Having the mental capacity and sufficient communication skills to follow the research instructions, being literate.
• Having an infant receiving treatment in the neonatal intensive care unit.

Exclusion Criteria:

• Having a condition that impairs communication
• Having a diagnosed mental illness.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: psychodrama-based group intervention; Participants will receive an 8-session psychodrama-based group intervention.	Other: psychodrama-based group intervention; For postpartum mothers in the experimental group, a psychodrama-based group intervention was carried out face-to-face, with one session per week, each lasting 120 minutes, for a total of 8 sessions (over 8 weeks).; Other: Control; no intervention was performed in the control group
No Intervention: Control; Throughout the study, the psychodrama-based group intervention was applied only to the experimental group, and no intervention was performed in the control group

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postpartum Depression Screening Scale	Evaluation of the change in the total score of the Postpartum Depression Screening Scale. The minimum score obtained from the scale was 35, and the maximum score was 175. Higher scores indicate higher levels of postpartum depression.	Baseline (pretest), 8 weeks (posttest) and one month after the posttest

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Forgiveness Scale	Forgiveness Scale, developed by Ersanlı and Batık, designed to measure individuals' levels of self-forgiveness and forgiveness of others. The scale is scored from "strongly disagree" to "strongly agree," with higher scores indicating higher levels of forgiveness.	Baseline (pretest), 8 weeks (posttest) and one month after the posttest

Collaborators and Investigators

• Sponsor: Ömer USLU
• Investigators: Principal Investigator: Merve Şahin, PhD, RN, Bergama Necla Mithat Öztüre State Hospital

Study record dates

Study Major Dates

• Study Start (Actual): April 2, 2025
• Primary Completion (Actual): June 29, 2025
• Study Completion (Actual): June 30, 2025

Study Registration Dates

• First Submitted: December 13, 2025
• First Submitted That Met QC Criteria: December 13, 2025
• First Posted (Estimated): December 26, 2025

Study Record Updates

• Last Update Posted (Actual): January 6, 2026
• Last Update Submitted That Met QC Criteria: January 2, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: depression; psychiatric nursing; forgiveness; psychodrama; puerperal
• Additional Relevant MeSH Terms: Urogenital Diseases; Mental Disorders; Female Urogenital Diseases and Pregnancy Complications; Pregnancy Complications; Behavioral Symptoms; Mood Disorders; Puerperal Disorders; Depressive Disorder; Behavior; Depression; Depression, Postpartum
• Other Study ID Numbers: MERVE-RCT-2025-PAD

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data (IPD) from this study will not be shared due to ethical and institutional restrictions. The dataset includes sensitive health information from postpartum women, and the informed consent process did not include permission for public data sharing. Therefore, in accordance with privacy regulations and ethical committee requirements, IPD will not be made available to other researchers

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No