Developing Resilience and Anxiety Management Through the Arts (DRAMA)

Case Western Reserve University

Status: Enrolling

Conditions: Mood; Depression; Anxiety

Treatments: Behavioral: Improvisation; Behavioral: Improvisation + Wellness; Behavioral: Social Craft

Study type: Interventional

Funder types: Other

Identifiers

NCT07033052

STUDY20241298

NEA AWARD 1891861-38-22 (Other Grant/Funding Number)

Details and patient eligibility

About

The Developing Resilience and Anxiety Management Through the Arts (DRAMA) Study examines the degree to which the arts can help to address stress, anxiety, and sad mood in children and adolescents. The researchers will pair theatrical improvisation exercises with cognitive-behavioral therapy (CBT) techniques versus improvisation exercises alone versus a social craft group on reducing elevated levels of anxiety and depression.

Full description

The purpose of this study is to observe the benefits of theatrical improvisation exercises paired with cognitive-behavioral therapy (CBT) techniques versus improvisation exercises alone versus a craft control group on reducing elevated levels of anxiety and depression in children and adolescents. It is possible that improvisational techniques could reduce anxiety and depression symptoms because they involve being spontaneous and going into social situations as well as creating something larger than oneself through the group (e.g., creating a scene, working together, etc.). It is also possible that the addition of CBT techniques might lead to a further reduction in anxiety and depression. The study will compare these to a control craft group where youth work on craft projects. The researchers hypothesize that improvisation exercises paired with CBT techniques will be more effective at reducing anxiety and depression than improvisational exercises alone, which we expect will be more effective than a craft group. This improvisation course will not be implemented by licensed therapists or psychologists. Group leaders will be undergraduates, schoolteachers, and graduate students without a background in therapy or counseling (e.g., drama students, music students, etc.) As such, it is important to note that this should not be considered "therapy" or an "intervention." It should not replace intensive treatment for children or adolescents who require a higher level of treatment. Rather, it can be considered a supplementary or preventative group that can help children or adolescents manage feelings of anxiety or depression. The goal of the study is to reduce existing levels of anxiety and depression, prevent the development of new symptoms, and prevent exacerbation of symptoms.

Enrollment: 110 estimated patients

Sex: All

Ages: 8 to 17 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Between 8 and 17 years of age

• Individuals must have parental/guardian consent

• Elevated levels of anxiety or depression based on

  1. Screen for Child Anxiety Related Disorders (SCARED) score of 15 or higher, or;
  2. Revised Children's Anxiety and Depression Scale (RCADS) Depression T score of 65 or higher, or;
  3. Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) clinician severity rating of 3 on any anxiety disorder or on a mood-related disorder

Exclusion criteria

• Diagnosed with Conduct Disorder or with behavioral symptoms that would make it difficult for the child/adolescent to participate in the group or comply with directions given by the group leader (such as difficulty following instructions, difficulty staying in one's seat, defiance of adults, harming animals or people, threatening others, getting into physical fights, hyperactivity, impulsivity, difficulty waiting for one's turn, etc.)
• Autism or developmental delays
• Psychotic symptoms or active suicidality
• Active Eating Disorders that raise concerns about morbidity and therefore need to be addressed in an intervention and actively monitored
• Unsteady dosage or recently or impending changes to psychotropic medication(s)
• Non-English-speaking individuals
• Wards of the State

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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110 participants in 3 patient groups

Improvisation + Wellness

Experimental group

Description:

The Improvisation + Wellness arm will include a variety of techniques based on Cognitive Behavioral Therapy (CBT): behavior activation, mindfulness, relaxation techniques, exposure, and cognitive restructuring. The improvisation techniques will include using your truth (talk about what you know), making patterns (working with others in the group to create something that you all contribute to), yes...and (agreeing with others and building on what others contribute to activities/conversations).

Treatment:

Behavioral: Improvisation + Wellness

Improvisation

Experimental group

Description:

The improvisation alone arm involves the same improv techniques as the improv + wellness arm, but without the wellness techniques. Improv techniques include using your truth (talk about what you know), making patterns (working with others in the group to create something that you all contribute to), yes...and (agreeing with others and building on what others contribute to activities/conversations).

Treatment:

Behavioral: Improvisation

Social Craft

Active Comparator group

Description:

The social craft group involves youth connecting with other youth while completing craft projects.

Treatment:

Behavioral: Social Craft