Study of the Effectiveness of Drama Therapy in Enhancing Communication Skills of Institutionalized Children

Study of the Effectiveness of Drama Therapy in Enhancing Communication Skills of Institutionalized Children

S.D. Vidanagamage¹, A.O. Bhaumik¹, A.I. Irugalbandara²

¹Faculty of Social Science, Arts and Humanities, Lincoln University College, Malaysia

²Faculty of Education, Open University of Sri Lanka

DOI: https://dx.doi.org/10.47772/IJRISS.2024.8080359

Received: 13 August 2024; Accepted: 21 August 2024; Published: 25 September 2024

ABSTRACT

This study investigates the effectiveness of drama therapy in enhancing communication skills among institutionalized children in the Southern Province of Sri Lanka. In the global context, drama therapy is recognized as a therapeutic tool for mental well-being.  However, the application of drama therapy as a therapeutic tool in Sri Lanka is still underexplored. Institutionalized children who are exposed to trauma often show poor communication abilities. This study provides valuable insight to address this critical gap in both research and application within this context. The study utilized Qualitative methods and data was gathered through observations, in-depth interviews, and focus group discussions. The study sample consisted of 80 female children aged 12-16, in state-run children’s homes under the Department of Probation and Childcare Service in Southern Provinces. Thematic analysis was used to identify key themes: Verbal Communication Challenges, Non-Verbal Communication Challenges, Active Listening, and Engagement. Under these key themes, sub-themes were identified as Articulating, Clarity in Expressing Ideas, Body Language, and Confidence in Presentation. The results revealed a significant improvement in communication skills, including expressiveness, engagement, and social interaction. It aligns with previous research on the effectiveness of drama therapy. The study suggested integrating tailored drama therapy interventions into the child welfare framework in Sri Lanka. Incorporating drama therapy into regular therapeutic programs, and training staff to implement therapeutic intervention effectively would support the reintegration of institutionalized children into society by improving their communication skills and overall emotional well-being.

INTRODUCTION

This study explored how drama therapy can improve communication skills in institutionalized children in the Southern Province of Sri Lanka. These children often face developmental challenges due to exposure to traumatic experiences such as parental loss, abuse, neglect, or issues within the family structure. (Ginige et al.,2020; Hettiarachchi, 2021). Children affected by natural or man-made disasters cause elevated risk of language and cognitive difficulties, as well as challenges related to social interactions, emotional regulation, and behavioral development (Ariyadasa et al.,2017).

Globally, drama therapy is recognized as a therapeutic tool for various psychological and behavioral issues (Jarman, 2014).  However, in Sri Lanka, research and applying drama therapy as a creative therapeutic tool are still underexplored (Ranasinha,2019). Studies indicated that drama therapy supports in improvement of various aspects of children’s psychological health, including their self-awareness, ability to express themselves, interpersonal communication, cognitive flexibility, and decision-making skills (Chang et al., 2019

Through investigating this study bridging the gap in the literature and practices. This study evaluates the effectiveness of drama therapy on this vulnerable population for the improvement of their well-being. The results of this study will support to implementation of targeted intervention programs designed to meet the specific needs of institutionalized children in Sri Lanka.

BACKGROUND

The situation of Institutionalized Children in Sri Lanka

In Sri Lanka, institutional care plays a crucial role in ensuring the safety and well-being of children who are at risk of being separated from their families. These children encounter various challenges, such as poverty, homelessness, crime, restricted access to education, the absence of one or both parents, inadequate caregiving, parental migration, incarceration, domestic violence, marital conflict, teenage pregnancy, disabilities, chronic family illnesses, abuse, abandonment, and the effects of natural disasters, war, and conflict (Department of Probation and Child Care Services, 2017; Fernando, 2023; Ginige et al., 2020; Hettiarachchi, 2021).

Common psychological issues such as anxiety, depression, attachment disorders, and difficulties with emotional regulation as well as one of the most significant difficulties these children face is a lack of communication skills (Sandoval et al.,2020: Vasudevagan,2014). Many institutionalized children struggle with verbal and non-verbal communication, which can hinder their ability to express emotions, form relationships, and engage in social interactions (Ariyadasa & Mcintyre, 2015).

The Department of Probation and Child Care Services (DPCCS), established in 1965, oversees the protection of children in Sri Lanka. According to the Department of Probation and Child Protection Services (2017), approximately 10,632 institutionalized children have been adopted in 379 children’s institutions across Sri Lanka. (Hettiarachi, 2021). The National Policy on Alternative Care for Children emphasizes the need to develop various alternative care options and highlights the reform of all formal institutions providing home-based and out-of-home care services to children in need of protection.

Despite laws, regulations, and well-documented care plans aimed at supporting mental well-being, studies have shown that institutionalized children in Sri Lanka suffer from a variety of psychological and behavioral problems  (Ariyadasa & Mcintyre, 2015). This is largely due to a lack of resources and trained mental health professionals, the inability to implement attractive, and creative therapeutic tools such as drama therapy, and play therapy that can comfortably apply to this population, and an absence of proper guidance and mechanisms for regular review and oversight of their mental wellbeing (Karunanayake, Rathnayake, & Vimukthi, 2020; Hettiarachchi, 2021; Ranasinghe, 2019).

Application of Drama Therapy

According to the North American Drama Therapy Association (NADTA, 2018), drama therapy allows participants to release their emotions, express their inner thoughts, set goals, address challenges, and achieve emotional breakthroughs. Engaging in drama therapy allows individuals to deeply into their inner experiences, enhancing both their communication abilities and interpersonal relationships. Through this process, participants can expand their range of roles and find that their personal life roles are strengthened (Vietri, 2018). This therapeutic technique provides opportunities to express themselves, explore their emotions, build self-confidence, and enhance social integration ability through role play, storytelling, and other dramatic techniques (Chegeni & Chegeni, 2018; Danielyazdani, 2020).  Even though the effectiveness of drama therapy has been demonstrated in diverse contexts, still its application in Sri Lanka and in particular within institutions is scarce and not sufficiently researched (Ranasingha, 2019).

Accordingly, this study is carried out using drama therapy tools; role play, and storytelling to enhance communication skills of institutionalized children. Role play offers the protagonist an opportunity to gain a clearer understanding of the complementary role’s individuality. Role training creates scenarios that closely imitate real-life situations, allowing participants to develop and practice specific roles in a safe, controlled environment (Cruz, Sales, Alves, & Moita, 2018). Additionally, research shows that storytelling enhances reading skills, creativity, and cognitive abilities by encouraging children to think differently and connect words to emotions and meanings. Through storytelling, children expand their vocabulary, improve their language skills, and enhance their cognitive development by learning to organize and present ideas logically (Mokhtar et al., 2011).

SIGNIFICANCE OF THE STUDY

Drama therapy has been recognized worldwide for its ability to enhance psychological well-being and personality growth (Chegeni & Chegeni, 2018; (Ekanayaka, Wijesekara, & Gunaratna, 2021)). The application of drama therapy in Sri Lanka is still underutilized, and research in this area remains limited. This study addressed applications and practices to enhance the communication skills of institutionalized children, It addresses existing gaps clearly and identifies the efficiency of drama therapy in improving the communication skills among them.

In addition, the findings might be used to design more efficient therapeutic programs within institutional care. The study shows the effectiveness of drama therapy in improving communication skills, which is one of the major areas of concern in the childhood development of these children. Study findings can be used to incorporate existing conventional therapeutic modalities. This is especially useful for introducing novel therapeutic modalities in the framework of the institutional care system (Hettiarachchi, 2021). Thus, this study provides insight into how drama therapy can be tailored for institutionalized children who exhibit numerous psychological and behavioral issues as a result of traumas (Ginige et al., 2020).

Besides, the findings of the study influence policymaking highlighting the necessity of proper mechanisms for continuous evaluation and monitoring of mental health interventions. This empirical evidence may contribute to the improvement of the awareness of the benefits of drama therapy which can lead to training mental health professionals and the utilization of creative therapies. Lastly, this work also provides a theoretical contribution to the body of knowledge related to drama therapy as well as a practical change to the lives of children in care in Sri Lanka

Problem Statement

This research focused on bridging the gap in the application of drama therapy as one of the most effective and attractive intervention methods to improve the communication skills of institutionalized children in Sri Lanka. The main research key was “Does drama therapy enhance the communication skills of institutionalized children? This study applied drama therapy techniques such as role-play, and storytelling which are commonly used in drama therapy to enhance personal development, life skills, social skills as well as relationship skills.

Research Aim and Objectives

This study aims to investigate the effectiveness of drama therapy in enhancing communication skills among institutionalized children in the Southern Province of Sri Lanka. This investigation seeks to provide evidence-based insights that can contribute to improving the mental well-being and social integration of these children.

Specific Objectives

1. To evaluate the current state of communication skills among institutionalized children in the Southern Province of Sri Lanka.
2. To examine the specific challenges faced by institutionalized children in developing effective communication skills.
3. To assess the impact of drama therapy on enhancing verbal and non-verbal communication skills among institutionalized children.

METHODOLOGY

This study utilized qualitative research methods and collected data through in-depth interviews, focus group discussions, and observation to a deeper analysis of the effectiveness of drama therapy in enhancing communication skills among institutionalized children. The researcher and four assistant drama therapists implemented this intervention and collected data to minimize bias and ensure the findings’ validity and reliability.

Study Design

Study site and sample

The study was conducted in a State-run female children’s home functioning under the Department of Probation and Childcare Services, Southern Province of Sri Lanka. The study applied a purposive sampling method for the sample selection, accordingly 80 females aged 12-16 were selected. Among the 92 female children, 80 were selected based on significant challenges in both verbal and non-verbal communication, potential for improvement through structured interventions, and emotional and psychological readiness. The number of 12 female children was excluded due to severe behavioral and cognitive issues, medical conditions, and language barriers.

Drama Therapy Intervention Procedure

The drama therapy consisted of 16 sessions conducted over 8 weeks, with 4 sessions held each week. The 80 participants were divided into four groups, each group attending one session per week. Each session will last 4 hours. The same session content was delivered to all four groups within the same week, ensuring consistency across the intervention. The sessions followed a structured format, including Check-In, Warm-Up, Main Phase, and Closure.

Phase 1 Introduction: Conducted an awareness program for the study sample and caregivers and obtained consent from each participant and their authorized officers.

Phase 2 Pre-Test:  For the pre-test, Communication skills were assessed before the intervention through pre-prepared role play and storytelling activities to asses the baseline level of communication skills.

Phase 3 Drama Therapy Intervention: The study used role play and storytelling as core techniques of this intervention.

Each of the sessions followed a structured format (Ranasinghe, 2019). These key phases were applied for every session throughout the intervention.

1. Check-In:

Each session began with sharing their current feelings and thoughts. Various activities were used for this phase such as the Emotion card; where the participants chose a card relevant to their mood and discussed why they selected it, Guided Imagery; the therapist guided them with a visualization exercise to connect with their emotions. This phase helped set the session and allowed the therapist to identify the emotional state of the group.

2. Warm-Up:

This phase focused on activities designed to relax and prepare participants for the main activities. The therapist included simple games, breathing exercises, and movement exercises aimed at encouraging spontaneous expression and interaction.

3. Main Phase:

This is the core phase in which the study focuses on enhancing communication skills by applying drama therapy tools: Role Play and Storytelling.

Role Play: participants were involved in several dramatic activities where they enacted real-life situations or created scenarios to learn how to communicate roles. This phase enabled them to consider several views, demonstrate feelings as well as enhance both verbal and non-verbal communication skills.

Storytelling: Children were involved individually or as a group to create and narrate stories and acted as the members of the story.  storytelling helps them to learn to develop narrative skills, articulate thoughts, engage in collaborative communication, present them, develop eye contact, and maintain appropriate non-verbal communication skills.

4. Closer

Each session ended with focus group discussions for evaluating their feelings, thoughts, experiences, and challenges and difficulties they faced during the intervention. This phase was useful to identify progress in the development of verbal and non-verbal communication. It was crucial for strengthening the lessons learned and ensuring emotional stability before the session concluded.

DATA COLLECTION AND ANALYSIS

Data Collection

To collect the data, this study applied qualitative data collection methods; observations, in-depth interviews, and focus group discussions. These three primary data collection methods were supported to assure the validity and reliability of this data.

Observation:

The researcher and assistant drama therapists were closely observed throughout the sessions. They focused on participants’ engagement in activities, changes in communication patterns, behavioral changes, and their responses during these intervention sessions. Details were gathered by taking notes on both verbal and non-verbal communication, and behavioral changes.

In-Depth Interviews:

In-depth interviews were conducted to identify the changes in participants’ behavioral and communication skills. These interviews were conducted before, during, and after the intervention, with the caregivers employed under the Department of Probation and Childcare Service. Data was gathered by using audio recordings and taking notes.

Through this, the researcher gathered data on the overall improvement of the participants’ communication skills, their emotional health, and their self-reported reactions to the drama therapy sessions.

Focus group discussions:

After the end of each session, the researcher and the team conducted focus group discussions with the participants to share their thoughts, feelings, and reflections on the effects of drama therapy intervention on influencing communication behaviors. Data was gathered by using audio recordings and taking notes.

Ethical Consideration:

Ethical approval was obtained from the Department of Probation and Childcare Services in the Southern Province before commencing the research. All ethical considerations in ensuring the well-being and rights of the participants were strictly followed in this study. Before implementing this study Participants, caregivers, and all stakeholders were aware of the purpose of the study, the procedures involved, and the intervention process including the right to withdraw at any time without penalty. Informed consent was obtained from the participants and their caregivers. Also, to maintain confidentiality, the data have been anonymized for the protection of the identities of participants. None of the research activities imposed any kind of harm or distress on the participants.

In addition to obtaining ethical approval, this study was carried out in full adherence to all the rules and regulations established to protect the confidentiality, dignity, and rights of an institutionalized child. All the research activities were planned and conducted while respecting participants’ privacy and the ethical standards required by the institutes. It was carried out with the expressed highest respect levels and protection of children involved.

Conflict of Interest: The author declares no conflicts of interest regarding the publication of this paper.

Data Availability Statement

The data generated and analyzed during this study are not publicly available due to the sensitive nature of the Information involving institutionalized children. According to ethical guidelines and the approval obtained, the sharing of these data is to protect the privacy and confidentiality of the participants.

Data Analysis

This study utilized a qualitative approach to analyze data gathered through in-depth interviews, focus group discussions, and observations. The qualitative methods allowed for a deeper exploration of the participants’ experiences and helped uncover the subtle details of their communication skills within the context of the drama therapy interventions.

Thematic Analysis

Thematic analysis was utilized as the primary method for identifying, analyzing, and reporting patterns (themes) within the data (Braun & Clarke, 2006). When using this method it should be closely examined the data to identify common themes, topics, ideas, and patterns of the data collected. It allowed for a flexible and detailed examination of the qualitative data. This method helped to ensure an in-depth understanding of the qualitative data and enabled to identify uncovered underlying themes that reflected communication skills among institutionalized children.

The process of thematic analysis followed six key steps as outlined by Braun and Clarke (2006)

Familiarization with the Data: Familiarization with the Data: The researchers began thoroughly immersing themselves in the data, carefully reading and re-reading transcripts gathered from interviews, focus group discussions, and observation notes. This process allowed them to become deeply familiar with the content.

Generating Initial Codes: Generating Initial Codes: Relevant data sets were then systematically coded throughout the entire dataset. These codes were created based on recurring concepts and ideas that emerged from the participants’ responses and observed behaviors

Searching for Themes: Once the codes were generated, they were grouped into broader themes that represented overarching patterns within the data. For example, codes related to confidence, articulation, and body language were combined under the theme “Verbal and Non-Verbal Communication Challenges.”

Reviewing Themes: The identified themes were then carefully reviewed to ensure they accurately captured the data and had sufficient supporting evidence. At this point, some themes were refined, merged, or discarded depending on their relevance to the study.

Defining and Naming Themes: After refining the themes, each one was clearly defined and named to summarize the core patterns that emerged from the data. For instance, the theme “Active Listening and Engagement” was chosen to describe improvements in participants’ focus and responsiveness during interactions.

Writing the Report: Finally, the themes were organized into a cohesive narrative that directly addressed the research questions. The report included examples and summaries of participants’ responses to illustrate the themes and provide context to the findings.

RESULTS AND DISCUSSIONS

Key findings of the study based on collected data through observation, in-depth interviews, and focus group discussions are summarized according to thematic analysis.

Table 01

The study results (Table 1) highlight, that pre-tests have identified challenges faced by female children in institutional care, particularly in verbal and non-verbal communication, active listening, engagement, and presentation skills before intervention. Post-test results show the effectiveness of the drama therapy intervention in addressing these difficulties and improving their overall communication abilities.

Verbal Communication Challenges:

Before the intervention, many children struggled to express their ideas both individually and in group discussions. Articulating Thoughts and Clarity in Expressing Ideas: their thoughts were often unclear; some took a long time to express their opinions and some of them were silent. Additionally, several children appeared visibly anxious or panicked when sharing their thoughts. However, after they engaged in role-play and storytelling activities, a significant number initiated to express their thoughts more clearly (Chegeni & Chegeni, 2018). One child who had difficulty finding the words to express himself in the initial session became more fluent and confident in sharing his ideas as the session progressed.

Non-verbal communication challenges:

A significant number of children showed Non-verbal communication difficulties. Among them, passive body language, neutral facial expressions, and difficulty maintaining eye contact were observed. In the beginning phases, many children exhibited closed or passive body language. They crossed their arms and avoided expressing body movement. During and at the end of the intervention significant children engaged in different roles and activities through non-verbal communication. For example, a child who initially appeared emotionless during discussion began to use smiles and frowns to express emotion during storytelling activities. Another child who was avoiding engaging actively and tried to be silent, within the first two role play and storytelling activities, joined and engaged actively. Caregivers highlighted that she was very silent and stayed away from peers before (Chegeni & Chegeni, 2018; Mokhtar, et al. (2011).

Before the intervention, we observed that Eye contact was another significant challenge. Many children avoid direct gazing during interactions. Through role-play scenarios, children gradually improved in maintaining eye contact. A previously shy child who avoided eye contact during the pre-test began maintaining steady eye contact during group discussions and role-play performances by the intervention’s end. Some children who were socially fearful, and shy, could be able to observe gradually improve after this intervention.

Active Listening and Engagement:

During the pre-test, a significant number of children exhibited disengagement, distraction Comprehension, and response, or difficulty in understanding and responding to their peers.

Many children exhibited disengagement during the pre-test. They were observed as distracted or uninterested. After participating in interactive activities like “Follow the Leader” and collaborative storytelling, their engagement levels increased. For example, a child who previously seemed disconnected and did not participate in discussions was gradually attentive and engaged, offering thoughtful responses to others during the storytelling sessions.

Another thing we noticed during the pre-test was that some children had a hard time focusing on what we were doing. They were looking around a lot. Keeping eye contact and concentrating was so difficult. But as we continued to drama therapy with them, they gradually became better at focusing and keeping eye contact (Chegeni & Chegeni, 2018; Mokhtar, et al. (2011). One child who was always distracted was able to stay focused after the intervention. She even responded to others and engaged with them accordingly.

Many children had difficulty understanding what was happening and how to respond. But after replaying several role plays and storytelling they gradually improved active listening and interaction with peers. For example, during one game, a kid who had trouble responding to other kids started getting it more often. It was clear that her listening skills were improving.

Presentation Skills: Before the intervention participants initially showed a lack of confidence in presenting themselves, with poor verbal tracking and vocal expression.

Before the intervention, children struggled with self-confidence when speaking in front of others. After participating in multiple role-playing and storytelling activities, they demonstrated greater confidence in presenting themselves. For example, a child who had previously mumbled and avoided eye contact, after engaging in several sessions, had presentations and participated in group discussions confidently.

During the pre-test, Vocal qualities such as volume, clarity, and intonation were found to be underdeveloped. Through vocal exercises and role-playing, the children improved their vocal expression. One child who spoke too quietly for others to hear in the first session learned to project her voice by speaking clearly and with appropriate emphasis after engaging in several storytelling activities (Chegeni & Chegeni, 2018).

Among the 80 participants, 7 children demonstrated significantly lower improvement in communication skills than their peers.  Two of them had irregular attendance, and three children had conflicts with peers frequently and crying and left time to time. The other two children often left out the intervention and engaged in other work, they rejected being with the team.

However, despite the low improvement of a few participants, a significant number of children showed notable improvement in their verbal and non-verbal communication, engagement, and presentation skills. Role play and storytelling provided a structured and supportive environment to enhance essential communication skills contribute to their personal development and enhance their social interactions (Danielyazdani. 2020).

CONCLUSIONS

This study demonstrates the effectiveness of drama therapy in enhancing the communication skills of institutionalized children. The results strongly support the integration of drama therapy into personal development and mental health programs within institutional settings (Ciarrochi & Bailey, 2008). This intervention not only improves communication but also fosters social and emotional well-being. which is more useful for the reintegration of these children into society (Danielyazdani. 2020). To achieve this, this study highly recommends the essential of allocating resources, providing staff training, and developing policies that mandate the inclusion of creative therapeutic interventions in institutional care. Future research should focus on longitudinal studies to evaluate the long-term sustainability and effectiveness of drama therapy interventions for institutionalized children.

Limitations

This study focused exclusively on female children, which limits the generalizability of the findings to other gender groups.  Furthermore, The 8-week duration of the intervention may not have been sufficient to observe long-term effects. These limitations highlight the need for further research, including studies that involve male participants and longer intervention periods, to confirm and expand upon these findings.

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