Psychodrama Group Therapy for Breakup Distress and Relationship Adjustment: A Randomized Trial

Psychodrama Group Therapy for Unresolved Breakup Distress and Dyadic Adjustment in Current Romantic Relationships: Study Protocol for a Randomized Controlled Trial

The purpose of this randomized controlled trial is to evaluate whether a psychodrama group therapy intervention can reduce unresolved breakup distress and improve dyadic adjustment in adults currently involved in romantic relationships who have experienced a significant previous breakup.

The main questions this study aims to answer are:

• Does participation in psychodrama group therapy reduce breakup distress compared with a waiting-list control condition?
• Does participation in psychodrama group therapy improve dyadic adjustment and relationship functioning compared with a waiting-list control condition?

The researchers will compare participants receiving the psychodrama group therapy intervention with participants in a waiting-list control condition to determine whether the intervention leads to greater improvements in breakup distress, dyadic adjustment, psychological functioning, relationship quality, and sexual satisfaction.

Participants will:

• complete assessments at baseline, 16 weeks, and 42 weeks;
• participate in a 15-session weekly psychodrama group therapy program (intervention group only);
• complete questionnaires assessing breakup distress, dyadic adjustment, psychological outcomes, relationship quality, and sexual satisfaction.

Study Overview

• Status: Recruiting
• Conditions: Breakup Distress; Dyadic Adjustment
• Intervention / Treatment: Behavioral: Psychodrama Group Therapy for Unresolved Breakup Distress and Dyadic Adjustment

Detailed Description

Romantic relationship breakups are common life events that may have substantial emotional and relational consequences. While many individuals adapt successfully over time, some continue to experience unresolved breakup distress characterized by persistent emotional suffering, difficulties processing the loss, and challenges integrating the experience into their personal and relational lives. Emerging evidence suggests that unresolved distress following a previous romantic breakup may negatively affect the quality of subsequent romantic relationships, including communication, intimacy, trust, emotional regulation, and overall dyadic adjustment.

Despite increasing recognition of the psychological and relational impact of romantic breakups, there is a limited evidence base regarding interventions specifically designed to address unresolved breakup distress. Furthermore, randomized controlled trials evaluating psychodrama interventions in this context remain scarce. Psychodrama is an experiential and action-oriented psychotherapy approach developed by Jacob Levy Moreno that uses dramatization, role-playing, role reversal, and other action methods to facilitate emotional expression, interpersonal insight, and behavioral change. Through the exploration of past and present relational experiences, psychodrama may help individuals process unresolved emotions associated with previous relationships, recognize maladaptive relational patterns, and develop more adaptive ways of relating in current relationships.

The present study was designed to evaluate the effectiveness of a manualized psychodrama group therapy program for adults currently involved in romantic relationships who continue to experience unresolved distress related to a significant previous breakup. The intervention was developed based on psychodramatic theory and clinical practice and focuses on emotional processing of previous relationship losses, exploration of attachment and relational patterns, enhancement of emotional communication, strengthening of intimacy and trust, and promotion of healthier dyadic functioning in current romantic relationships.

This study employs a randomized controlled design comparing a psychodrama group therapy intervention with a waiting-list control condition. The intervention consists of 15 weekly group sessions delivered in a closed-group format by trained psychodrama practitioners. Sessions follow the traditional psychodramatic structure of warm-up, dramatization, and sharing and progressively address themes including relational history, attachment experiences, breakup distress, grief processes, self-esteem, emotional communication, jealousy, emotional security, relational repair, intimacy, and relational role reconstruction.

In addition to evaluating clinical outcomes, the study aims to contribute to the methodological development of psychodrama research by implementing a structured intervention protocol and examining both quantitative and qualitative indicators of therapeutic change. Findings from this trial may contribute to a better understanding of the role of psychodrama in addressing unresolved breakup distress and promoting healthier functioning in subsequent romantic relationships. The results may also inform the development of evidence-based interventions targeting the long-term emotional and relational consequences of romantic relationship dissolution.

• Study Type: Interventional
• Enrollment (Estimated): 42
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Filipe N Ribeiro, PhD Student; Phone Number: (+351) 915457227; Email: up202408511@edu.fpce.up.pt
• Study Contact Backup: Name: Mariana V Martins, PhD; Phone Number: (+351) 220400667; Email: mmartins@fpceu.up.pt

Study Locations

• Portugal
  • Porto District
    • Porto, Porto District, Portugal, 4200-135
      • Recruiting
      • Faculty of Psychology and Education Sciences at the University of Porto
      • Contact: Filipe N Ribeiro, PhD Student; Phone Number: (+351) 915457227; Email: up202408511@edu.fpce.up.pt
      • Contact: Mariana V Martins, PhD; Phone Number: (+351)220400667; Email: mmartins@fpce.up.pt
      • Principal Investigator: Filipe N Ribeiro, PhD Student
      • Sub-Investigator: Mariana V Martins, PhD
      • Sub-Investigator: Filipa M Vieira, PhD

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Age 18 years or older;
• Currently involved in a romantic relationship for at least 6 months;
• History of at least one significant previous romantic relationship breakup;
• Presence of breakup distress related to a previous romantic breakup and/or difficulties in current dyadic adjustment;
• Ability and willingness to provide written informed consent.

Exclusion Criteria:

• Presence of severe mental disorder that may interfere with participation in group psychotherapy;
• Severe active substance dependence;
• Current severe relational violence;
• Inability or unwillingness to provide written informed consent;
• Any clinical condition that, in the opinion of the research team, may compromise safe participation in the intervention.

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 Group Therapy; Participants assigned to this arm will receive a structured psychodrama group therapy intervention consisting of 15 weekly sessions delivered in a closed-group format. Sessions are facilitated by trained psychodrama practitioners and focus on emotional processing of unresolved breakup distress, exploration of relational and attachment patterns, emotional communication, intimacy, trust, and dyadic adjustment in current romantic relationships.	Behavioral: Psychodrama Group Therapy for Unresolved Breakup Distress and Dyadic Adjustment; A manualized psychodrama group therapy program delivered in 15 weekly sessions of approximately 90-120 minutes. The intervention is based on Morenian psychodrama principles and uses techniques such as role reversal, soliloquy, mirroring, sociometry, sculpting, and dramatization to facilitate emotional processing of previous romantic relationship losses and promote healthier functioning in current romantic relationships. The program is delivered in a closed-group format by trained psychodrama practitioners.
No Intervention: Waiting-List Control; Participants assigned to this arm will remain on a waiting list during the study period and will not receive the psychodrama intervention. They will complete all study assessments at the same time points as the intervention group and will be offered the opportunity to participate in the psychodrama program after completion of the follow-up assessments.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Breakup Distress	Assessment of breakup-related emotional distress using the Breakup Distress Scale (BDS). The BDS is a 16-item self-report measure assessing emotional distress associated with a previous romantic relationship breakup. Higher scores indicate greater breakup distress.	Baseline, 16 weeks, and 42 weeks
Change in Dyadic Adjustment	Assessment of relationship functioning using the Revised Dyadic Adjustment Scale (RDAS). The RDAS is a 14-item self-report measure evaluating overall dyadic adjustment and the dimensions of consensus, satisfaction, and cohesion within the current romantic relationship. Higher scores indicate better dyadic adjustment.	Baseline, 16 weeks, and 42 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Psychological Functioning	Assessment of psychological functioning using the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM). The CORE-OM is a 34-item self-report measure assessing subjective well-being, psychological symptoms, social functioning, and risk-related behaviors. Higher scores indicate greater psychological distress and impairment.	Baseline, 16 weeks, and 42 weeks
Change in Perceived Relationship Quality	Assessment of perceived relationship quality using the Perceived Relationship Quality Components Inventory (PRQC). The PRQC is an 18-item self-report measure assessing satisfaction, commitment, intimacy, trust, passion, and love within the current romantic relationship. Higher scores indicate better perceived relationship quality.	Baseline, 16 weeks, and 42 weeks
Change in Sexual Satisfaction	Assessment of sexual satisfaction using the Global Measure of Sexual Satisfaction (GMSEX). The GMSEX is a 5-item self-report measure assessing overall satisfaction with the sexual relationship with the current partner. Higher scores indicate greater sexual satisfaction.	Baseline, 16 weeks, and 42 weeks

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Therapeutic Change as Reported by Participants	Assessment of participants' perceived therapeutic change using the Personal Questionnaire (PQ), an individualized measure in which participants identify and rate personal problems they wish to address during therapy. Lower scores indicate improvement in identified problems.	During sessions 1-15 and at 16 weeks (intervention group only)
Helpful and Hindering Aspects of Therapy	Assessment of participants' perceptions of helpful and unhelpful aspects of each therapy session using the Helpful Aspects of Therapy (HAT) questionnaire.	After each intervention session 1-15 (intervention group only)
Participant Experience of Therapeutic Change	Assessment of participants' experiences of change during therapy using the Client Change Interview (CCI), a semi-structured interview exploring perceived changes, contributing factors, and helpful or unhelpful aspects of treatment.	16 weeks and 42 weeks (intervention group only)

Collaborators and Investigators

• Sponsor: Universidade do Porto
• Investigators: Study Director: Mariana V Martins, PhD, Faculty of Psychology and Education Sciences at the University of Porto; Study Chair: Filipa M Vieira, PhD, Faculty of Psychology and Education Sciences at the University of Porto; Principal Investigator: Filipe N Ribeiro, PhD Student, Faculty of Psychology and Education Sciences at the University of Porto

Study record dates

Study Major Dates

• Study Start (Actual): September 23, 2025
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): May 1, 2027

Study Registration Dates

• First Submitted: June 14, 2026
• First Submitted That Met QC Criteria: June 14, 2026
• First Posted (Actual): June 18, 2026

Study Record Updates

• Last Update Posted (Actual): June 18, 2026
• Last Update Submitted That Met QC Criteria: June 14, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: group psychotherapy; Psychodrama; Breakup Distress; Dyadic Adjustment
• Other Study ID Numbers: Ref.ª 2025-02-01b (CdE FPCEUP)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared due to the sensitive nature of the information collected and the need to protect participant confidentiality and privacy in accordance with ethical and data protection requirements.

Drug and device information, study documents

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