DRAMA THERAPY IN PSYCHIATRIC SETTINGS: A SYSTEMATIC REVIEW OF EMPIRICAL EVIDENCE AND IMPLICATIONS FOR PRACTICE IN CALABAR, NIGERIA

Abstract

Mental illness constitutes a substantial and growing burden in Nigeria, yet psychiatric services remain concentrated in a small number of orthodox biomedical interventions, with limited institutional attention to creative and expressive arts therapies. Drama therapy, understood as the intentional and systematic use of theatrical and role-based techniques to achieve psychological, emotional, and behavioural change, has accumulated a growing empirical evidence base internationally, yet remains largely unexplored within Nigerian psychiatric practice generally, and within Calabar, Cross River State, specifically. This paper presents a systematic and narrative review of empirical literature on drama therapy and related drama-based interventions (including psychodrama and applied theatre) as practised in psychiatric and mental health care settings, with the aim of establishing the strength of existing evidence and deriving implications for a Calabar-based psychiatric context. Literature was retrieved from major databases and synthesised thematically around four domains: overall treatment effectiveness, population-specific outcomes, proposed mechanisms of therapeutic change, and the state of drama-based mental health practice in sub-Saharan Africa and Nigeria. Findings indicate a moderate, statistically significant pooled effect of drama-based therapies on psychological and behavioural outcomes across diverse clinical populations, including psychosis, personality disorders, and populations with psychosocial difficulties across the lifespan, alongside a marked scarcity of controlled studies conducted within African, and specifically Nigerian, psychiatric institutions. The review argues that Calabar's rich indigenous performance heritage, combined with the presence of an established Department of Theatre and Media Studies and a teaching hospital psychiatric unit, constitutes a distinctive and underutilised opportunity for the development of a culturally grounded, evidence-informed drama therapy programme. The paper concludes with recommendations for interdisciplinary collaboration, workforce training, and the design of future primary empirical studies within Calabar's psychiatric institutions.