From Drama-Based Interventions to Public Performance: Effects on Self-Esteem and Self-Stigma in Individuals with Mental Illness
E. Stratou, G. N. Porfyri, A. GamvroulaIntroduction
Self-stigma and low self-esteem are common in individuals with psychiatric disorders, adversely affecting their social functioning and recovery. Drama-based interventions have been proposed as an empowering approach to reduce stigma and improve psychosocial outcomes.
Objectives
To evaluate the effect of a structured drama-based intervention on self-esteem and internalized stigma in community-dwelling individuals with psychiatric disorders.
Methods
Fifteen participants with psychiatric diagnoses engaged in 24 weekly drama-based sessions (90–120 minutes each), implemented by the department’s occupational therapist in collaboration with a volunteer drama specialist at the Psychiatric Department of the General Hospital of Argos. Self-esteem and stigma were assessed pre- and post-intervention using the Rosenberg Self-Esteem Scale (RSES) and the Internalized Stigma of Mental Illness (ISMI) scale, respectively. Paired t-tests examined pre-post differences, and Cohen’s d quantified effect size. Significance was set at p < 0.05.
Results
The sample consisted of 15 individuals with psychiatric disorders, primarily male (53.3%) and aged between 41 and 59 years (66.7%). The most commonly reported diagnosis was schizophrenia (F20.0, 40%), with the majority being unmarried and unemployed. All participants were on medication and under regular psychiatric follow-up. A significant reduction was observed in the ISMI
Stigma Resistance
subscale (p = .010; d = 0.51). Although not statistically significant, additional positive trends were noted in the other ISMI subscales (Alienation, Stereotype Endorsement, Discrimination Experience, Social Withdrawal), with small effect sizes (Table 1). Self-esteem increased post-intervention on the Rosenberg Self-Esteem Scale, although this did not reach statistical significance (p = .087; d = 0.29, Table 2).
Descriptive Statistics for the ISMI Scale Before and After Intervention Table 1. Long description.