Dramatic Expressions“Acting is novel, effortful, enjoyable, multi-modal/multi-factorial, and mentally and physically stimulating.” (Noice & Noice, 2008, p 60)RESEARCH:An Arts Intervention for Older Adults Living in Subsidized Retirement Homes, Helga and Tony Noice

Population: Older adults ages 68-93 living in retirement homes Abstract: In this study, the Noices had three control groups consisting of an acting class, singing

class, and a no-treatment group. The 122 participants who completed the study had to take pre-tests and post-tests that tested the memory, verbal fluency, and problem solving. Participants then were split up into the three control groups and partook in 8 one-hour sessions.

Benefits: Acting group scored higher on immediate word recall, problem solving, verbal fluency, delayed word recall, delayed East Boston Memory Test and immediate East Boston Memory Test.

A Short-Term Intervention to Enhance Cognitive and Affective Functioning in Older AdultsHelga and Tony Noice

Population: Older adults ages 60 to 86 years old community-residing adults Abstract: In this study, 124 participants were broken down into three control groups consisting of

an acting class, a visual arts class, and a no-treatment group. They attended nine 90 minute sessions and were given a pre-test and a post-states to compare results.

Benefits: Word recall improved by 18%, Problem solving ability 55%. Indirect observations: Improvement in quality of life, socialization

The Journal of Dementia Care, Drama as therapy: bringing memories to life Diagnoses: Dementia Abstract: Paul Batson writes: “mime, storymaking, role play, movement and music all have a part

to play in empowering people with dementia so that they can live as fully as possible.” Benefits: Batson has found that in her dramatherapy program patients with dementia are able to

express themselves easier, bring alive memories from their past, express feelings, maintain focus, socialize and relate with others, and experience increased moments of well-being.

Dramatherapy, Psychodrama, and Voices, Casson J. PhD

Diagnoses : People who hear voices Study included: schizophrenia, paranoid schizophrenia, depression, paranoid, psychosis, and experiences of trauma

Abstract: This qualitative research occurred over 6 years, 1995-2001. 21 people, who heard voices and were clients of the Mental Health Services were offered individual or group sessions of drama therapy and psychodrama. This study is based on 349 individual therapy sessions and 60 group sessions. 80% of participants found drama therapy to be helpful.

Benefits: Promotes socialization, provides a relief from tension, gain insight and integration, rehearse a future, learning distance and empowerment, prevents suicide and self harm, decreases voices or makes them less aggressive/disturbing

Support:National Association for Drama Therapy

Benefits: cope with stress, problem solving, rehearsing social skillsJohn Killick (writer/teacher with Dementia Care patients) and Kate Allen (clinical psychologist)

“Dementia Positive”- Using the creative arts and expression to benefit patients with dementia Benefits: relaxation, sense of community, free to be spontaneous, enjoying others, laughter

Drama as Therapy Volume 2: Drama therapy, learning disabilities and acute mental health, Naomi Gardner-Hynd

CTRS will follow Garner-Hynd’s model for each session because it illustrates a successful framework for drama therapy practiced (Naomi Gardner-Hynd, 2010, p. 178).

Figure 9.1 Dramatherapy and the creativity cycle (Gardner-Hynd 2008).

Preparation- Warm up/games/relaxationIncubation: Main activityIllumination: Reflection and ending circleVerification: Can occur between sessions as material is processed consciously and subconsciously

Richardson 8 ProtocolPreparation:

Assess patients based on mini mental score- Dramatic Expressions Group A: (MMS: 20-30) or Dramatic Expressions Group B: (MMS: 14-19)

If there are more than 5 participants, use the dayroom otherwise the activity room will be used. Set up chairs and spaces for wheelchairs to form a circle Prepare any scene work, props, costumes, etc. that will be used in session

Richardson 8 Protocol:Session: 30-45minutes

1. Entry and greeting of patients2. Explain the benefits of drama therapy and for the patients in that session.3. Check-In: (2-5 minutes) Please see “Check-In Ideas” on next page4. “Preparation” (10 minutes) 2-3 warm-up games (Please see “Warm-Up game ideas” below)5. “Incubation”: (20minutes) 1-2 main activities (Please see “Main Activity Ideas” on the next

page)6. “Verification” Takes place in between each activity.

Group A: Ask open-ended questions regarding what they gained from that activityGroup B: Ask yes/no or multiple choice questions regarding whether or not they enjoyed the activity.

7. “Illumination” (2-5 minutes) Wrap up with group discussion. Group A: Ask open-ended questions regarding: What can you take away from this session? How have you benefited from this session? How can you use what we practiced in daily life? If you used the figurine for “check-in” pass it around again so patients can hold it when they speak.Group B: Ask patients to provide an expression (using words or body language expressions) to describe how they feel now that session is complete. If you used the figurine for “check-in” pass it around again so patients can hold it when they speak.

8. Assist patients out of room. 9. Clean any supplies or equipment used during group session by putting on gloves and wiping

them down with sani cloth wiptes provided by the hospital.

Check-In Ideas:Expressing Feelings

Group A: Ask patients to share how they are currently feeling by providing a non-verbal expression. (Ex: yawning for tired, dancing in seat for hyper, slumped over for depressed) Group B: Ask patients to express how they feel today using words and/or movements. Provide an example. (Ex: “I’m tired.” CTRS slumps in chair and closes eyes)

Figurine Doll(Figurine doll is used as a focus/object to promote comfort when beginning to open up)

Group A: CTRS passes around a figurine doll and asks the first patient “How are you today?” Once that patient expresses themself, CTRS will prompt them to pass it to the next patient and ask the same question. This continues until the figurine doll returns to the CTRS and all participants have had a turn. Group B: CTRS will pass a figurine doll around the circle asking each patient to verbalize how they feel today. More prompting may be necessary using multiple choice or yes/no questions.

Hello

Group A: CTRS will prompt patient to wave to someone across the circle and say hello. If the patient does not know their peer’s name, CTRS will prompt patient to ask them their name. All participants will be prompted to greet each other with a “How are you today?” Continue until everyone has had a turn to greet and be greeted by all participants. Group B: CTRS will prompt each patient to wave to another peer across the circle and say hello. CTRS will prompt patient to ask that peer “How are you today.” This continues until everyone in the circle has had a turn

Warm Up Game Ideas:Gibberish Dictionary

Group A only: One person makes up a word in gibberish and the person to the left of them defines the word. Next, that person makes up a gibberish word and the person to the left defines it. Continue until all have participated in providing a gibberish word and defining a word.

What could this be? CTRS chooses a random object that does not have a distinct purpose (ex: a pool noodle, a net, a disk) and explains that the object could be anything that you want it to be and give an out of the box example. For example, a black foam disk with a hole in the middle could be a pizza, a donut, a plate, a Frisbee, a spyglass, a steering wheel, a tire, etc.

Group A: CTRS gives the 1st patient an object and asks them to find another use for it. Patient then passes to a peer. This continues until all patients have had a turn.Group B: CTRS gives the 1st patient an object and asks them to find another use for it. If patients are unable to provide their own answers, CTRS will provide patient with yes/no questions or multiple choice, two choice questions.

Miming Situational ExpressionsGroup B only: Using 1 step directives ask patients to mime an expression per given situation. (Ex: “What would be your expression if your car was towed? If you found out you won the lottery? If you opened up a nice present from someone you love?

Miming RoutinesGroup A: CTRS asks patients to use their body to mime what they did in their career. Ask the other patients to guess what career they had. Then ask patient to verbalize what they did. If patient did not work, ask them to mime a household chore, they were in charge of.Group B: Using direct questions, CTRS asks each patient what their career or main life activity was. Then, using 1-step directives, CTRS asks patient to use their body to mime what that career/life activity looked like.

Infectious LaughterGroup A: Pair all patients in 2. CTRS states: “Make each other laugh without touching or speaking.”Group B: Pair up patients 2 at a time. CTRS directs Patient A to make Patient B laugh without touching them. One-step directive only.

Mirror ImageGroup A: Pair patients in groups of two. With one at a time leading, CTRS directs partners to attempt to follow each other’s movements.Group B: Pair up patients 2 at a time. Patients should be sitting next to each other. CTRS states: “Patient A face Patient B. Patient B face Patient A. Patient A, you are going to lead Patient B in

movements using your hands. Patient B, you are going to follow Patient A and move your hands just like he does.” Be sure to give patient 1 step directives.

Main Activity Ideas:

Story Creation Just like our story creation group, the patients will create a story based off a picture. However for this group we are creating very short stories answering Who, What, Where, When, and Why. You could then ask patients to act out the story or pieces of the story. When appropriate, move on to the next picture.

Group A: CTRS will ask thought provoking questions to guide patients to create a basis for a story. Then ask patients to act out story scene. CTRS will designate roles to patients.Group B: CTRS will prompt patients with direct questions to create a short story regarding the picture. If patient is unable to provide own answers, CTRS will provide patient with yes/no questions or multiple choice, two choice questions. Using 1-step directives ask patient to provide what a character in the story might think or say. Then, ask them to demonstrate how they would say it.

Mime/CharadesGroup A: Each patient, one at a time, is given a piece of paper with an action word on it. CTRS will direct the patient to act out that action word without speaking or making noise. The other patients then guess what that person is acting out.Group B: One at a time, a patient is given a piece of paper with an action word on it. CTRS will direct the patient to act out that action word without saying what it is. Other patients may guess what that person is acting out.

Gibberish DilemmasGroup A only: CTRS assigns 2 people as partners and provides them with a piece of paper with their role on it. VTRS then explains the situation. (Ex: One person is the tow truck driver the other person comes out of the store to see their car being towed.) Direct patients to act out their situations without language. They may only use gibberish.

Open ScenesGroup A only: Assign 2 people as partners and hand them a sheet of paper with two lines on it. (For example: A: I want to leave. B: Not yet. CTRS designates which patient says the first line (A) and who says the second line (B). CTRS asks patients to read their line out loud and come up with a solution to the problem by acting out the situation. CTRS asks both patients open ended and though provoking questions to prompt patients to come up with alternate ways to solve the problem.

(Other examples of scenes: A: I want to leave. B Not yet, A: That’s not what I ordered. B: Well, that’s what I heard you say, A: Can I use that? B: No. It’s mine, etc.) *To make it easier, CTRS can highlight each patient’s line so they know which of the two lines they have to say.

Hat Session

Group B only: CTRS will place a variety of hats on a table in front the patients and allow patients to choose a hat. CTRS will ask each patient direct questions such as “Why did you choose that hat?” “What would you use that hat for?” and “How would someone act who wears that hat?” If possible, have a mirror in the room to show patients how they look in their hats. If patient is unable to provide his/her own answer, CTRS will provide patient with yes/no questions or multiple choice, two choice questions.

How many scenes can we make with this prop?Group A: Pair patients into groups of 2 Patient A and Patient B. CTRS will hand patient A a prop (Ex: fake flowers). CTRS will direct the two patients to act out a short dialogue using that prop (1minute or less). Once scene is done, CTRS will direct Patient A to act out a different scene using that prop with Patient C. Patient C then uses that prop to engage in a different dialogue with Person D. This continues until all patients have performed at least two scenes.

Memory ItemsGroup B only: CTRS will give patient a household item. CTRS will ask patient to identify what that item is. Patient will then be prompted to act out how they would use that item in their own household. If patient requires further prompting, CTRS will provide patient with yes/no or two choice questions.

Scene work There are short scenes that can be found online or can be taken from plays or movies. CTRS could even write their own short scene. Scenes should be no more than one page, around 5 or so lines each and the font should be large. It may also be helpful to highlight each characters lines so that the patients can easily understand what they must say.

Group A: CTRS will pair patients into groups of two. Patients will be given a short scene between two people. Once patients have read the scene out loud, ask patients thought provoking questions. (Ex: What is happening in this scene? How do each of these characters feel? What do these characters want?) CTRS will direct patients to act out this scene again portraying the knowledge they know about the scene and the characters within the scene.

Group B (patients must be able to read out loud): One at a time, patients will be paired into groups of two. The two patients will be given a short scene to read out loud. Using 1-step directives ask the patient to read their highlighted lines when it is their turn. Once scene has been read, CTRS will summarize the scene and ask direct questions to the group regarding the scene. (Ex: How do you think those characters felt? Have you ever felt that way? Has this ever happened to you?) If patients are unable to provide their own answers, CTRS will provide patient with yes/no questions or multiple choice, two choice questions.

More drama activity ideas can be found on improv websites including:

http://improvencyclopedia.org/categories//Warm-up.html

http://fuzzyco.com/improv/games.html

Luscomb 9 Protocol

Preparation: Set up chairs to form a circle Prepare any scene work, props, costumes, etc. that will be used in session

Richardson 8 Protocol:Session: 45-60 minutes

1. Entry and greeting of patients2. Explain the benefits of drama therapy and why we do it: Problem solving, promotes

socialization, freedom of expression, and practice role for the future3. Set Ground Rules: This is freedom of expression but please keep it appropriate (Language

and gestures)4. Check-In: (2-5 minutes) Please see “Check-In Ideas” below5. “Preparation” (10 minutes) 2-3 warm-up games (Please see “Warm-Up game ideas” below)6. “Incubation”: (20minutes) 1-2 main activities (Please see “Main Activity Ideas” on the next

page)7. “Verification” Takes place in between each activity.Ask thought provoking, open-ended questions regarding what the patients gained from each activity. “Why did we do this?” “What is a lesson one could take away from this?”8. “Illumination” (2-5 minutes) Wrap up with group discussion. Ask open-ended questions regarding: What can you take away from this session? How have you benefited from this session? How can you use what we practiced in daily life? 9. Dismiss patients from session. 10. Clean any supplies or equipment used during group session by putting on gloves and wiping

them down with sani cloth wipes provided by the hospital.

Check-In Ideas:Expressing Feelings

Ask patients to share how they are currently feeling by providing a non-verbal expression. (Ex: yawning for tired, dancing in seat for hyper, slumped over for depressed)

HelloCTRS will prompt patient to wave to someone across the circle and say hello. If the patient does not know their peer’s name, CTRS will prompt patient to ask them their name. All participants will be prompted to greet each other with a “How are you today?” Continue until everyone has had a turn to greet and be greeted by all participants.

Warm Up Game Ideas:Gibberish Dictionary

One person makes up a word in gibberish and the person to the left of them defines the word. Next, that person makes up a gibberish word and the person to the left defines it. Continue until all have participated in providing a gibberish word and defining a word.

What could this be? CTRS chooses a random object that does not have a distinct purpose (ex: a pool noodle, a net, a disk) and explains that the object could be anything that you want it to be and give an out of the box example. For example, a black foam disk with a hole in the middle could be a pizza, a donut, a plate, a Frisbee, a spyglass, a steering wheel, a tire, etc. CTRS gives the 1st patient an object and asks them to find another use for it. Patient then passes to a peer. This continues until all patients have had a turn.

Miming RoutinesCTRS asks patients to use their body to mime what they did in their career. Ask the other patients to guess what career they had. Then ask patient to verbalize what they did. If patient did not work, ask them to mime a household chore, they were in charge of.

Infectious LaughterPair all patients in 2. CTRS states: “Make each other laugh without touching or speaking.”

Mirror ImagePair patients in groups of two. With one at a time leading, CTRS directs partners to attempt to follow each other’s movements.

Ba-da-daCTRS snaps a slow and steady beat with their fingers. Patients are prompted to do the same. CTRS designates one patient to come up with a word at the top of their head. Any word. The person to their right waits one “snap” and says any word that is at the top of their head. The all patient wait one “snap” and say those two words together followed by “ba-da-da.” Now it is patient’s B’s turn to say the first word. This continues around the circle with all patients snapping. Prompt the patients to stay within the beat and to say any word that comes to mind trying to focus on the word that their partner just gave them. (For example: Patient A: Shoe, “snap,” Patient B: Foot, “snap,” All Patients: Shoe-Foot- Bad-da-da)

Top 7CTRS starts off this game by choosing one patient and stating, “Patient A, give me the top 7 ______________.” (ex: things to put on a pizza, ways to ride a bike, learn to fly) Patient A must now come up with 7 ways to do that whatever comes to mind. As Patient A starts listing off, all the other patients count each one (Example: Patient A: Pepperoni All: “One!” Patient A: Cheese All: “Two!” This continues until Patient A has listed all items. Prompt the patient to list off as fast as they can without even thinking. The answers can be anything and do not have to make sense.

Main Activity Ideas:

Scene Creation Just like our story creation group, the patients will create a story based off a picture. However, for this group we are creating very short stories answering Who, What, Where, When, and Why. You could then ask patients to act out the story or pieces of the story. When appropriate, move on to the next picture. CTRS will ask thought provoking questions to guide patients to create a basis for a story. Then ask patients to act out story scene. CTRS will designate roles to patients.

Mime/Charades

Each patient, one at a time, is given a piece of paper with an action word on it. CTRS will direct the patient to act out that action word without speaking or making noise. The other patients then guess what that person is acting out.

Gibberish DilemmasCTRS assigns 2 people as partners and provides them with a piece of paper with their role on it. CTRS then explains the situation. (Ex: One person is the tow truck driver the other person comes out of the store to see their car being towed.) Direct patients to act out their situations without language. They may only use gibberish.

Open ScenesAssign 2 people as partners and hand them a sheet of paper with two lines on it. (For example: A: I want to leave. B: Not yet. CTRS designates which patient says the first line (A) and who says the second line (B). CTRS asks patients to read their line out loud and come up with a solution to the problem by acting out the situation. CTRS asks both patients open ended and though provoking questions to prompt patients to come up with alternate ways to solve the problem.

(Other examples of scenes: A: I want to leave. B Not yet, A: That’s not what I ordered. B: Well, that’s what I heard you say, A: Can I use that? B: No. It’s mine, etc.) *To make it easier, CTRS can highlight each patient’s line so they know which of the two lines they have to say.

How many scenes can we create with this prop?Pair patients into groups of 2 Patient A and Patient B. CTRS will hand patient A a prop (Ex: fake flowers). CTRS will direct the two patients to act out a short dialogue using that prop (1minute or less). Once scene is done, CTRS will direct Patient A to act out a different scene using that prop with Patient C. Patient C then uses that prop to engage in a different dialogue with Person D. This continues until all patients have performed at least two scenes.

Scene work CTRS will pair patients into groups of two. Patients will be given a short scene between two people. Once patients have read the scene out loud, ask patients thought provoking questions. (Ex: What is happening in this scene? How do each of these characters feel? What do these characters want?) CTRS will direct patients to act out this scene again portraying the knowledge they know about the scene and the characters within the scene. These are short scenes that can be found online or can be taken from plays or movies. CTRS could even write their own short scene. Scenes should be no more than one page, around 5 or so lines each and the font should be large. It may also be helpful to highlight each characters lines so that the patients can easily understand what they must say.

More drama activity ideas can be found on improv websites including:

http://improvencyclopedia.org/categories//Warm-up.html

http://fuzzyco.com/improv/games.html