Enjeux et fondements d’une évaluation qualitative des dispositifs de drama-thérapie avec adolescents en structures psychiatriques

Abstract

BackgroundThis study focuses on the methodology of qualitative evaluation of psychoanalytic therapeutic settings. It aims to elaborate a qualitative evaluation of a drama-therapy setting with teenagers. This method of evaluation of drama-therapy could offer an alternate option to randomized trials. As a matter of fact, randomized trial often generates biases in the collection of the material, especially with teenagers that are not very reliant to treatment and with whom the diagnosis is not steady. Moreover, quantitative researches do not take in account the plurality of dimensions activated by those specific group settings. ObjectiveWhat are the underlying psychological processes involved in drama-therapy sessions with teenagers? This qualitative analysis is fundamental to fully understand the complexity of those settings that mix art and therapy. Qualitative analyses of the health care treatments are important to address the question of the subjectivity of the efficiency of the treatment. Qualitative studies are however complex to conceive. MethodAfter a review of studies on this matter in the drama-therapy and clinical psychology literature, a qualitative method of evaluation of drama-therapy with teenagers is presented. Its underlying theory and protocol are explained. The goal is to create a rating grid of this health care setting. Using grounded method to analyze the clinical material of drama-therapy sessions, the author selected the significant behaviors of a psychological involvement of the teenagers in drama-therapy sessions. ResultsThis evaluation table highlights the signs of a significant psychic functioning of teenagers in this therapeutic setting. Thus, this table offers a picture of the psychological state of the patient at a specific time of his treatment. The comparison of the results to this grid for a patient at different moments of his treatment gives elements to analyze very precisely his evolution. It also gives elements to adjust the therapeutic setting to the needs he shows in sessions. A case study illustrates the findings of this method of qualitative evaluation of drama-therapy with teenagers. ConclusionsThis method offers alternate ways to think the evaluation of health care treatments, adjusting to the complexity of what we are trying to assess. It also gives new perspectives in the training of drama-therapists. Work still has to be put into the construction of this method of evaluation of drama-therapy, in particular a quantitative evaluation of the correlation between the changes of the patients, as it appears on the table and the changes in their general psychological functioning.