A Positive Psychodrama Intervention to Improve Psychological Well-Being in University Students

Psychological well-being has been conceptualized as the realization of one's potential, the ability to establish meaningful relationships, the capacity to utilize environmental opportunities in line with personal goals, self-direction, and the development of positive self-esteem. Within contemporary educational frameworks, student development is supported not only through instructional services but also through student personal development services, which contribute to identity formation. Psychodrama, as an action-oriented group intervention, aims to enhance psychological well-being through techniques such as enactment, cognitive processing, catharsis, surplus reality, mirroring, confrontation, empathy development, and role flexibility. Previous studies have demonstrated the application of psychodrama across various domains, including reducing anxiety, alleviating hopelessness, enhancing self-esteem, improving communication and social skills, addressing crises and addiction, coping with depressive symptoms and chronic illness, and supporting mental health.

The present study aims to evaluate the effectiveness of psychodrama as a psychoeducational intervention on psychological well-being, self-esteem, self-compassion, empathy, and affective awareness among undergraduate nursing students in Turkey. The study will be conducted with students enrolled in a nursing faculty, specifically those who have taken the pediatric nursing theoretical course and are preparing to begin their clinical practicum.

This study is designed as a randomized controlled trial. Participants will be recruited from second- and third-year nursing students and will be informed about the study prior to voluntary participation. Eligible participants will be randomly assigned to either an experimental group or a control group (maximum of 20 participants per group). The experimental group will participate in a structured psychodrama program consisting of 10 sessions, conducted twice weekly, each session lasting approximately two hours. The sessions will be facilitated by a certified psychodramatist and a co-therapist under supervision. The control group will receive no intervention.

Data will be collected at three time points: baseline (pre-test), post-intervention, and a 2-month follow-up. In the pre-, post-, and follow-up assessments, the Positive and Negative Affect Schedule (PANAS), PERMA Profiler, Basic Empathy Scale (BES), Rosenberg Self-Esteem Scale, Self-Compassion Scale (SCS), Emotional Contagion Scale (ECS), and the HEXACO Personality Inventory will be administered.

The instruments used in this study also include a sociodemographic questionnaire (11 items). In addition, qualitative data will be collected through post-session interviews with participants in the psychodrama group to explore their experiences.

Based on existing empirical evidence and the limited number of studies conducted with nursing students, particularly in pediatric nursing contexts, this study aims to contribute to the literature by examining the effects of psychodrama group interventions on developmental outcomes, self-compassion, self-esteem, well-being, affective awareness, and empathy levels among nursing students.

It is hypothesized that there will be statistically significant differences between the experimental and control groups in terms of these outcome variables (H1). Furthermore, it is expected that the positive effects of the psychodrama intervention on these variables will be sustained over time, indicating long-term effectiveness (H2). Beyond hypothesis testing, the findings are anticipated to provide practical implications for the design and implementation of psychodrama-based interventions in academic settings.

Study Overview

• Status: Completed
• Conditions: Nursing Education; Well Being; Empathy; Self Esteem; Self Compassion; Psychotherapy, Group; Pediatric Nursing; Nursing Student
• Intervention / Treatment: Behavioral: Psychodrama group therapy

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Ümraniye
    • Istanbul, Ümraniye, Turkey (Türkiye), 34760
      • Erenköy Mental and Nervous Diseases Training and Research Hospital, University of Health Sciences, Istanbul, Turkey

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Being an undergraduate nursing student enrolled in the Department of Medical and Surgical Sciences.
• Providing voluntary informed consent after being informed about the aims and procedures of the study.
• Signing the group contract

Exclusion Criteria:

• Personally knowing the group leader or co-leader.
• Reporting inability to participate in all assessment phases (T1: Pre-test, T2: Post-test, T3: Follow-up test).
• Self-reporting the use of psychiatric medication or currently receiving clinical psychiatric treatment.
• Indicating that the scheduled session days and times are not suitable (these participants are assigned to the control group after providing informed consent).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention group; The experimental group comprises 20 students who attend 10 weekly psychodrama sessions, each lasting approximately 120-150 minutes. The sessions are conducted by a certified psychodramatist under the supervision of an accredited trainer. Outcome measures are administered at baseline (pre-test), immediately post-intervention, and at a 2-month follow-up. In the pre-, post-, and follow-up assessments, the Positive and Negative Affect Schedule (PANAS), PERMA Profiler, Basic Empathy Scale (BES), Rosenberg Self-Esteem Scale, Self-Compassion Scale (SCS), Emotional Contagion Scale (ECS), and the HEXACO Personality Inventory are used.	Behavioral: Psychodrama group therapy; The intervention consisted of a structured, manualized psychodrama program delivered in a group format. The program included 10 sessions conducted weekly, each lasting approximately 120-150 minutes. Sessions were facilitated by a certified psychodramatist under the supervision of an accredited psychodrama trainer. The intervention incorporated core psychodrama techniques such as role-playing, role reversal, mirroring, doubling, and enactment to enhance emotional expression, empathy, and self-awareness. The program followed a standardized session structure including warm-up, action, and sharing phases, ensuring consistency across sessions.
No Intervention: Control Group; The control group comprises 20 students and does not receive any intervention during the study period. Outcome measures are administered at the same time points as in the experimental group, including baseline (pre-test), post-test, and a 2-month follow-up. In the pre-, post-, and follow-up assessments, the Positive and Negative Affect Schedule (PANAS), PERMA Profiler, Basic Empathy Scale (BES), Rosenberg Self-Esteem Scale, Self-Compassion Scale (SCS), Emotional Contagion Scale (ECS), and the HEXACO Personality Inventory are used.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Emotional Contagion Scale (ECS)	The Emotional Contagion Scale (ECS) measures the extent to which individuals are susceptible to others' emotions. It assesses emotional responsiveness and the tendency to "catch" others' emotional states.	pre-test, post-test (10 weeks after pre-test-immediately after the intervention), and after 2 months (follow-up test)
Rosenberg Self-Esteem Scale	The Rosenberg Self-Esteem Scale is employed to measure global self-esteem. It assesses individuals' overall evaluation of their self-worth, including both positive and negative self-perceptions.	pre-test, post-test (10 weeks after pre-test-immediately after the intervention), and after 2 months (follow-up test)
PERMA Profiler	The PERMA Profiler is utilized to evaluate psychological well-being within the framework of positive psychology. It measures five core dimensions: Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment.	pre-test, post-test (10 weeks after pre-test-immediately after the intervention), and after 2 months (follow-up test)
Basic Empathy Scale (BES)	The Basic Empathy Scale (BES) is used to assess individuals' empathy levels. It evaluates both cognitive empathy (the ability to understand others' emotions) and affective empathy (the ability to share others' emotional experiences).	pre-test, post-test (10 weeks after pre-test-immediately after the intervention), and after 2 months (follow-up test)
HEXACO Personality Inventory	The HEXACO Personality Inventory is used to assess personality traits based on a six-factor model: Honesty-Humility, Emotionality, Extraversion, Agreeableness, Conscientiousness, and Openness to Experience.	pre-test, post-test (10 weeks after pre-test-immediately after the intervention), and after 2 months (follow-up test)
Positive and Negative Affect Schedule (PANAS)	The Positive and Negative Affect Schedule (PANAS) is used to assess individuals' levels of positive (e.g., enthusiasm, alertness) and negative (e.g., distress, irritability) affect. It provides a measure of emotional well-being and allows for the evaluation of changes in affective states over time.	pre-test, post-test (10 weeks after pre-test-immediately after the intervention) , and after 2 months (follow-up test)
Self-Compassion Scale (SCS)	The Self-Compassion Scale (SCS) is used to evaluate individuals' level of self-compassion. It includes components such as self-kindness, self-judgment, common humanity, and mindfulness.	pre-test, post-test (10 weeks after pre-test-immediately after the intervention), and after 2 months (follow-up test)

Collaborators and Investigators

• Sponsor: Ministry of Health, Turkey

Study record dates

Study Major Dates

• Study Start (Actual): January 25, 2024
• Primary Completion (Actual): April 25, 2024
• Study Completion (Actual): June 25, 2024

Study Registration Dates

• First Submitted: March 18, 2026
• First Submitted That Met QC Criteria: March 25, 2026
• First Posted (Actual): April 1, 2026

Study Record Updates

• Last Update Posted (Actual): April 1, 2026
• Last Update Submitted That Met QC Criteria: March 25, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: Decision No: 11, January, 2024

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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