By "memory blues" we include all sorts of memory challenges whether they are called "Alzheimer's" or some other related dementia or acquired brain injury. Others can worry about clinical niceties while here we focus on managing these challenges and enjoying life.

By "dancing away" we include all sorts of activities which enrich lives of persons with these challenges.

Entries below are results of a thorough review of literature representing what we know about these activities. Annotated results are grouped into six categories.

You can contribute comments and contribute via email for us to add to these results. Email to: moyer.don.f@gmail.com

Sunday, May 11, 2008

Annotated Results: 3 Drama

Please add comments. Tell us about work we've missed. Add work published after we closed our review.

In your annotated additions please tell what was studied, what benefits were found, what quality of life benefits were found, and how well benefits were sustained.

Thanks. Don

3. Drama

Banks-Wallace, J. (2002). Talk that talk: storytelling and analysis rooted in African-American oral tradition. Qualitative Health Research, 12, 410-426.
This article explores the importance of storytelling in African-American oral tradition.

Basting, A.D. (2001). ‘God is a talking horse’: dementia and the performance of self. The Drama Review, 45(3), 78-94.
The article looks at the role of DT in helping persons with dementia express themselves nonverbally.

Batson, P. (1998). Drama as therapy: bringing memories to life. Journal of Dementia Care, 6, 19-21.
This article looks at drama as therapy, including mime, story making, role play, movement and music, as empowering PWD so that they can live as fully as possible. Accordingly, drama can help individuals and groups to express themselves and interact with one another creatively (p 20). Outcome measured is “quality moments,” defined as the characteristics associated with well-being in dementia care mapping (e.g., humour, alertness, responsiveness, creative self-expression, showing pleasure or enjoyment, being active and/or purposeful, initiating social contact, etc.; p 20). For example, mime is an especially effective way of enabling pts to express themselves when find it difficult to use words; stories can create a sense of accomplishment; and props can be effective in stimulating interests and holding attention. Use of drama can provide another means of stimulation that enables them to relate with others and experience increased moments of well-being.

Brooker, D.J. & Duce, L. (2000). Well-being and activity in dementia: a comparison of group reminiscence therapy, structured goal-directed activity, and unstructured time. Aging and Mental Health, 4 (4), 354-358.
A comparison of well-being levels of 25 individuals with mild to moderate dementia during three types of activity was made. The first was group reminiscence therapy (RT), the second was group activities (GA), and the third was unstructured time (UT). These activities were all part of the usual program of activities within three day hospitals where the study took place. Dementia Care Mapping results indicated that individuals experienced a greater level of relative wellbeing during RT than GA. The level of wellbeing in both RT and GA was significantly higher than in UT.

Byres, A. (1995). Beyond marks: working with people with severe memory loss. Inscape, 1, 13-18.
This article explores the use of reminiscence with people who have memory loss. Overall outcomes included increased communication/interaction and improved understanding of nonverbal forms of storytelling

Casson, J. (1994). Flying towards Neverland. Dramatherapy, 36(2/3), 2-7.
This article is a highly personal account of one psychodramatist’s excursion into the world of PWD. He examines the ways that spontaneity can be used to enhance personhood. He reflects on sensory stimulation, symbolic language, music and storytelling, through vivid case studies. The emphasis on the arts and communication in dementia care make this a seminal piece.

Dent-Brown, K. & Wang, M. (2006). The mechanism of storymaking: a grounded theory study of the 6-part story method. The Arts in Psychotherapy, 33, 316-330.
49 subjects (24 mental health clinicians and 25 users with borderline personality disorder (BPD) were asked to create and tell a fictional story, following structured guidelines, and then relate how far the story communicated something about their own lives. Using direct participant accounts, the aim of the technique was to “assist the individual to reach self-awareness and improve external and internal communication.” Results suggested those with BPD may be less likely to identify closely with their story and that storymaking may distance rather than bridge the gap, though the method could be used as a tool to pursue those “easily overwhelmed by powerful feelings.”

Gersie, A. (1991). Storymaking in bereavement: dragons fight in the meadow. London: Jessica Kingsley Publishers.
The article looks at the role of storymaking/telling for helping people deal with bereavement. It suggests that telling and making stories, as “symbolic expressive activities,” can assist people in managing their losses and sadness.

Jenny, S. & Oropeza, M. (1993). Memories in the Making: A Program of Creative Arts Expression for Alzheimer’s Patients. Alzheimer’s Association of Orange County, California: California.
This article outlines the “Memories” method of AT. Using various approaches, this program aims to support people in expressing themselves through art. The emphasis is on the process of creation, rather than the finished product, and is based on the conviction that PWD have important things to tell us, and that there is meaning in what they say and do even if it is not immediately obvious to others. It includes a step-by-step guide to using the program.

Johnson, C.M.; Lahey, P.; & Shore, A. (1992). An Exploration of Creative Arts therapeutic group work on an Alzheimer’s unit. The Arts in Psychotherapy, 19(4), 269-277.
This article includes a description of the authors’ long-term care facility, a summary of AD, exploration of the “loss of self” phenomenon, rationale for including creative arts therapies in special care unit, and a discussion of issues relative to group process and technique with AD patients. The role of arts activities in groups is discussed within a therapy-orientation model.

Killick, J. (2003). Funny and sad and friendly: A drama project in Scotland. Journal of Dementia Care, 11, 1, 24-26.
This article discusses a project utilizing drama therapy as a tool to help persons with dementia meaningfully interact and express their emotions.

Killick, J. (2000). Storytelling and Dementia. Elderly Care, 12, 2, 8-10.
This article looks at the use of storytelling, or reminiscence, in dementia care. It suggests that such activities are meaningful in the moment, regardless of “outcomes.”

Martin, R. & Stepath, S. (1993). Psychodrama and reminiscence for the geriatric psychiatric patient. Journal of Group Psychotherapy, Psychodrama & Sociometry, 45- 139-148.
This article looks at the role of psychodrama and reminiscence for seniors with psychiatric disturbances. It finds that nonverbal techniques are more effective than traditional verbal modalities in reminiscence group sessions with elderly PWD (p 145).

Mayers, K.S. (2003). Play for individuals with dementia. In Schaefer C.E. (Ed.), Play therapy with adults. New York: John Wiley & Sons.
This article looks at the use of dolls for play with PWD. It reports positive effects of dolls on the lives of seniors with dementia.

McKee, K.J.; Wilson, F.; Chung, M.C.; Hinchliff, S.; Goudie, F.; Elford, H. et al. (2005). Reminiscence, regrets and activity in older people in residential care: Associations with psychological health. British Journal of Clinical Psychology, 44, 543-562.
This cross-sectional interview-based questionnaire survey with 142 (N=142) seniors living in residential and nursing homes was used to determine current levels of reminiscence, activity participation, and psychological health, while care staff recorded the participants’ observed affect over the previous 2-week period. Multivariate analyses showed significant associations between reminiscence frequency, reminiscence enjoyment, and regrets, and psychological health outcomes, while controlling for age, dependency, self-reported health, and social well-being. While reminiscence enjoyment was associated with positive psychological health, high frequency of reminiscence and the presence of regrets were associated with negative psychological health.

Noice, H. & Noice, T. (2006). What Studies of Actors and Acting Can Tell Us About Memory and Cognitive Functioning. Current Directions in Psychological Science, 15, 14-18.
This study compared dramatic and musical forms of theater performance to investigate the neural mechanisms underlying acting with the goal to promote healthy cognitive aging. Older adults in state supported housing without higher education at risk of cognitive decline were encouraged to “actively experience” performance. While the study is not yet completed, the authors hypothesize that the findings could “add physiological support to existing behavioral evidence that bodily action and emotion response, along with semantic evidence, can enhance human memory and also help us to understand the aesthetic experience.”

Pendzik, S. (2006). On dramatic reality and its therapeutic function in drama therapy. The Arts in Psychotherapy, 33, 271-289.
This article describes the therapeutic implications of “dramatic reality” as a theory, allowing for the inner world to be expressed, validating such experience and providing a bridge to the outer world (as with narrative therapy). The author stresses how the dramatic encounter is co-created and relational, and that by “doing reality,” one may transform everyday life.

Rentz, C.A. (2002). Memories in the Making©: Outcome-based evaluation of an art program for individuals with dementing illnesses. American Journal of Alzheimer’s Disease and Other Dementias, 17(3), 175-181.
This study observed 41 seniors attending Adult Day Care and living in skilled nursing facilities participating in a weekly art program. Based on Lawton’s psychological well-being model and measuring QoL in respondents, findings report that 66% greeted and socialized; 83% had sustained attention; 80% expressed pleasure; and 78% had enhanced self-esteem. Limitations include: there wasn’t a control group, it was not longitudinal and no inter-rater reliability measures were used.

Snow, S.; Damico, M.; & Tanguay, D. (2003). Therapeutic theatre and wellbeing. The Arts in Psychotherapy, 30(2), 73-82.
This present study examined therapeutic theatre in the field of drama therapy. This paper reviews the concept as it has been articulated by several important practitioners and, subsequently, attempts to postulate a common definition. It, then, focuses on the model of therapeutic theatre implemented at the Centre for the Arts in Human Development at Concordia University in Montreal. This model incorporates qualitative methodology for the evaluation of its effectiveness. Preliminary results from this research indicate that the Centre’s approach has considerable therapeutic value for the participants, all of whom are individuals with developmental disabilities who have previously shown deficits in communication, cognition and social skills. This article documents these results, along with describing the two qualitative evaluation methods: pre- and post-performance interviews and observations made from running records taken at different intervals in the three-month long process of producing the Centre’s most recent therapeutic theatre production, based on the story of Pinocchio.

Thorgrimsen, L.; Schweitzer, P.; & Orrell, M. (2002). Evaluating Reminiscence for people with dementia: a pilot study. The Arts in Psychotherapy, 29, 93-97.
This study looked at reminiscence (R) with 11 PWD and their informal carers. The intervention was based on standardized the manual: Reminiscing with people with dementia- a Handbook for Carers (Bruce et al, 1999). While the study finds positive trends supporting anecdotal evidence that reminiscence is a valuable therapeutic intervention, the authors conclude that no firm conclusions can be reached about its effectiveness for dementia due to lack of scientifically rigorous research and poorly defined evaluative processes. The authors did note that carer perceptions are weighed twice as heavily as the PWD themselves.

Wilkinson, N.; Srikumar, S.; Shaw, K.; & Orrell, M. (1998). Drama and Movement Therapy in Dementia: a pilot study. The Arts in Psychotherapy, 25(3), 195-201.
This study focused on patients with dementia attending a psychiatric day hospital and used the Sesame method, a symbolic approach based in Jungian psychology and humanistic philosophy to access patient’s subjective experience (self-esteem) rather than improving their cognition or reducing psychiatric symptoms as measured by quantitative scales. The study criticizes the quantitative approach with its emphasis on statistical significance and deductive reasoning as unable to capture the validity derived from more descriptive and qualitative methods. Authors found "deterioration in dementia is expected but stimulating and maintaining social skills, independence, self-esteem, and self-belief through drama therapy may improve quality of life." The study notes that future groups need to match groups more carefully for age, sex, cognitive impairment, and functional dependency.

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