Expression Circle Group: Incorporating Psychodrama Toward Empowering Sexual Assault Survivors
Keywords:
sexual assault survivors, PTSD, psychodrama, empowerment, restorative justiceAbstract
It is well-established in clinical practice and through various research studies that sexual
assault survivors can suffer from chronic posttraumatic stress disorder (PTSD) symptoms.
Numerous interventions have been developed to assist those who struggle with PTSD post–
sexual assault; however, no modalities have been developed that incorporate a combination
of restorative justice disclosures toward increasing survivor empowerment with elements of
psychodrama reenactment. This feasibility study explores a person-centered small-group
interaction that allowed survivors and volunteer male ‘‘allies’’ to work together through
unresolved painful emotions utilizing elements of psychodrama. The allies agreed to
support women ‘‘survivors’’ who reported a history of past sexual assault through their
participation as listeners of the survivors’ disclosures during a one-time encounter called an
‘‘expression circle’’ group meeting facilitated with a psychodrama therapist. Our study used
a pretest and posttest design that measured survivors’ responses (n.9), each of whom was
referred by their community counseling providers to the meeting. Measurements included
instruments that focused on empowerment, distress, and PTSD. Findings suggest that
survivors reported significant increases in empowerment scores, decreased guilt, and
reduced distress scores at posttest. By better understanding the impact of innovative
techniques that include a psychodrama structure, these preliminary findings may contribute
to further group alternatives available to practitioners treating sexual assault.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Avinger, K., & Jones, R. (2007). Group treatment of sexually abused adolescent girls:
A review of outcome studies. The American Journal of Family Therapy, 35, 315–
https://doi.org/10.1080/01926180600969702
Psychodrama Empowering Sexual Assault Survivors 35
Downloaded from http://meridian.allenpress.com/jpsgp/article-pdf/69/1/21/3293780/i0731-1273-69-1-21.pdf by Scott Giacomucci on 28 November 2023
Casson, J. (2004). Drama, psychotherapy and psychosis drama therapy and
psychodrama with people who hear voices. Routledge.
East, J. F., & Roll, S. J. (2015). Women, poverty, and trauma: An empowerment
practice approach. Social Work, 60(4), 279–286. https://doi.org/10.1093/sw/
swv030
Foa, E. B. (2000). Psychosocial treatment of posttraumatic stress disorder. Journal of
Clinical Psychiatry, 61(5), S49–S51.
Fong, J. (2006). Psychodrama as a preventive measure: Teenage girls confronting
violence. Journal of Group Psychotherapy, Psychodrama, & Sociometry, 59(3), 99–
https://doi.org/10.3200/jgpp.59.3.99-108
Haswell, M. R., Kavanagh, D., Tsey, K., Reilly, L., Cadet-James, Y., Laliberte, A., &
Doran, C. (2010). Psychometric validation of the growth and empowerment
measure (GEM) applied with indigenous Australians. Australian & New
Zealand Journal of Psychiatry, 44(9), 791–799. https://doi.org/10.3109/
2010.482919
Havens, L. (1980). Explorations in the uses of languages in psychotherapy. Journal of
Contemporary Psychoanalysis, 16, 53–67.
Herman, J. L. (1998). Recovery from psychological trauma. Psychiatry and Clinical
Neurosciences, 52(S1), S98–S103. https://doi.org/10.1046/j.1440-1819.1998.
s5s145
Herman, J. L. (2003). The mental health of crime victims: Impact of legal
intervention. Journal of Traumatic Stress, 16(2), 159–166.
Kasturirangan, A., Krishnan, S., & Riger, S. (2004). The impact of culture and
minority status on women’s experience of domestic violence. Trauma, Violence,
& Abuse, 5(4), 318–332. https://doi.org/10.1177/1524838004269487
Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S.-
L.T., Walters, E. E., & Zaslavsky, A. (2002). Short screening scales to monitor
population prevalences and trends in nonspecific psychological distress.
Psychological Medicine, 32(6), 959–976.
Kipper, D. (1998). Psychodrama and trauma implications for future interventions of
psychodramatic role-playing modalities. International Journal of Action
Methods, 51, 113–120.
Mardi, N., Arefi, M., Momeni, K., & Amiri, H. (2020). The comparison of the
effectiveness of psychodrama, reminiscence and rational-emotional and
behavioral treatment on death anxiety in the elderly. Journal of Aging
Psychology, 6(2), 131–148.
Margoob, M. A., Khan, A. Y., Majid, A., Mansur, I., Gani, N., Bhat, M. F., Mushtaq,
H., Nehra, D., & Jeelani, H. (2008). Prevalence of post-traumatic stress disorder
after amputation: A preliminary study from Kashmir. Jk Practitioner, 15(1–4), 5–7.
Markowitz, S., & Fanselow, M. (2020). Exposure therapy for post-traumatic stress
disorder: Factors of limited success and possible alternative treatment. Brain
Sciences, 10(3). https://doi.org/10.3390/brainsci10030167
ZIEGLER AND DANIELS
Downloaded from http://meridian.allenpress.com/jpsgp/article-pdf/69/1/21/3293780/i0731-1273-69-1-21.pdf by Scott Giacomucci on 28 November 2023
Moreno, J. J. (1999). Ancient sources and modern applications: The creative arts in
psychodrama. The Arts in Psychotherapy, 26(2), 95–101. https://doi.org/10.1016/
S0197-4556(98)00050-1
Moreno, J. L. (1946). Psychodrama and psychotherapy. Sociometry, 9(2/3), 249–253.
Naar, R., Dorein-Michael, C., & Santhouse, R. (1998). Short-term psychodrama with
victims of sexual abuse. International Journal of Action Methods, 51(2), 75–80.
Ornstein, P. H., & Ornstein, A. (1980). Formulating interpretations in clinical
psychoanalysis. International Journal of Psycho-Analysis, 61, 203–211.
Orsillo, S. M., & Batten, S. V. (2005). Acceptance and commitment therapy in the
treatment of post-traumatic stress disorder. Behavior Modification, 29, 95–129.
https://doi.org/10.1177/0145445504270876
Perrin, M., Vandeleur, C. L., Castelao, E., Rothen, S., Glaus, J., Vollenweider, P., &
Preisig, M. (2014). Determinants of the development of post-traumatic stress
disorder, in the general population. Social Psychiatry and Psychiatric
Epidemiology, 49(3), 447–457. https://doi.org/10.1007/s00127-013-0762-3
Prins, A., Bovin, M. J., Smolenski, D. J., Marx, B. P., Kimerling, R., Jenkins-
Guarnieri, M. A., Kaloupek, D. G., Schnurr, P. P., Kaiser, A. P., Leyva, Y. E., &
Tiet, Q. Q. (2016). The primary care PTSD screen for DSM-5 (PC-PTSD-5):
Development and evaluation within a veteran primary care sample. Journal of
General Internal Medicine, 31(10), 1206–1211. https://doi.org.hpu.idm.oclc.org/
1007/s11606-016-3703-5
Pukui, M. K., Haertig, E. W., & Lee, C. A. (2002). N¯an¯a i ke kumu ¼ Look to the
source. Hui H¯anai.
Rappaport, J. (1984). Studies in empowerment: Introduction to the issue. Prevention
in Human Services, 3, 1–7.
Resnick, H., Kilpatrick, D., Dansky, B., Saunders, B., & Best, C. (1993). Prevalence of
civilian trauma and posttraumatic stress disorder in a representative national
sample of women. Journal of Consulting and Clinical Psychology, 61(6), 984–981.
Ron, Y., & Yanai, L. (2021). Empowering through psychodrama: A qualitative study
at domestic violence shelters. Frontiers in Psychology, 12, 600335. https://doi.
org/10.3389/fpsyg.2021.600335
Sherman, L. W., Strang, H., Mayo-Wilson, E., Woods, D. J., & Ariel, B. (2014). Are
restorative justice conferences effective in reducing repeat offending? Findings
from a Campbell systematic review. Journal of Quantitative Criminology, 31(1),
–24. https://doi.org/10.1007/s10940-014-9222-9
Smith, S. G., Chen, J., Basile, K. C., Gilbert, L. K., Merrick, M. T., Patel, N., & Jain, A.
(2017). The National Intimate Partner and Sexual Violence Survey (NISVS):
-2012 State Report. Centers for Disease Control and Prevention National
Center. https://www.cdc.gov/violenceprevention/pdf/NISVS
Steele, N. M., Benassi, H. P., Chesney, C. J., Nicholson, C., Fogarty, G. J., &
Australian Army Psychology Corps. (2014). Evaluating the merits of using brief
measures of PTSD or general mental health measures in two-stage PTSD
Psychodrama Empowering Sexual Assault Survivors 37
Downloaded from http://meridian.allenpress.com/jpsgp/article-pdf/69/1/21/3293780/i0731-1273-69-1-21.pdf by Scott Giacomucci on 28 November 2023
screening. Military Medicine, 179(12), 1497–1502. https://doi-org.hpu.idm.oclc.
org/10.7205/MILMED-D-14-00183
Strang, H., Sherman, L., Angel, C. M., Woods, D. J., Bennett, S., Newbury-Birch, D.,
& Inkpen, N. (2006). Victim evaluations of face-to-face restorative justice
conferences: A quasi experimental analysis. Journal of Social Issues, 62(2), 281–
https://doi.org/10.1111/j.1540-4560.2006.00451.x
Stubbs, J. (2010). Relations of domination and subordination: Challenges for
restorative justice in responding to domestic violence. UNSW Law Journal,
(3), 970–986.
Testoni, I., Ronconi, L., Biancalani, G., Zottino, A., & Wieser, M. A. (2021). My
future: Psychodrama and meditation to improve well-being through the
elaboration of traumatic loss among Italian high school students. Frontiers in
Psychology 11, 1–11. https://doi.org/10.3389/fpsyg.2020.544661
Ullman, S. E., & Townsend, S. M. (2008). What is an empowerment approach to
working with sexual assault survivors? Journal of Community Psychology, 36(3),
–312. https://doi.org/10.1002/jcop.20198
Umbreit, M. S., Coates, R. B., & Vos, B. (2004). Victim-offender mediation: Three
decades of practice and research. Conflict Resolution Quarterly, 22(1), 279–304.
van Wormer, K. (2009). Restorative justice as social justice for victims of gendered
violence: A standpoint feminist perspective. Social Work, 54(2), 107–116.
https://doi.org/10.1093/sw/54.2.107
Walker, L., & Greening R. (2010). Huikahi restorative circles: A public health
approach for reentry planning, Hein Online, 74(1), 1–11.
Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P.
P. (2013). The PTSD checklist for DSM-5 (PCL-5). National Center for PTSD.
www.ptsd.va.gov
Wright, C. V., Perez, S., & Johnson, D. M. (2010). The mediating role of
empowerment for African American women experiencing intimate partner
violence. Psychological Trauma: Theory, Research, Practice, and Policy, 2(4), 266–
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Journal of Psychodrama, Sociometry, and Group Psychotherapy

This work is licensed under a Creative Commons Attribution 4.0 International License.