The effect of drama therapy on depressive symptoms and quality of life among older adults in residential care facilities: A systematic review

Older adults in residential facilities suffer greater loneliness and social isolation. Therefore, depressive symptoms and low quality of life (QoL) are common among them. As a result of several disadvantages associated with pharmacological interventions for depression, the focus is shifting to non-pharmacological interventions. Drama therapy is one of these interventions, which entails activities like storytelling, improvisation, and role-playing. Thus, this systematic review aimed to evaluate the effect of drama therapy on depressive symptoms and the quality of life of older people in residential facilities. A systematic review of the literature was performed. Studies published between 2000 and 2023 were searched on PubMed, Web of Science, Scopus, and Google Scholar. The findings included two randomized controlled trials (RCTs) and three controlled clinical trials (CCT) that were eventually selected for meeting the eligibility criteria. A narrative synthesis revealed that three studies of moderate methodological rigor showed drama therapy and related therapeutic interventions with shared aspects with drama therapy (e.g., life review therapy with a narrative component) had moderate to large effect sizes on reducing depressive symptoms, compared to care as usual. One study that used reminiscence therapy with some overlap with aspects of drama therapy showed no significant improvement on depressive symptoms. There were mixed findings on quality of life, with two studies supporting the positive impact of drama therapy on quality of life, and one contradicting this. Although there is confirmative evidence of the positive effect of drama therapy on depressive symptoms, the evidence regarding its effect on quality of life remains inconclusive. Future research should expand sample sizes and address the blinding of participants and outcome assessors.