The Effectiveness of Psychodrama on Social Adjustment and Subjective Well-being in the Elderly

At the onset of aging, people gradually lose some of their physical, psychological and social functions. Mental health and emotional status seem to be the most important factors in predicting the level of performance of the elderly, and improving the mental and emotional state of the elderly helps them maintain their optimal social performance despite physical problems. Therefore, this study aimed to investigate the effectiveness of psychodrama on social adjustment and subjective well-being in the elderly. The research was a quasi-experimental included pre-test and post-test design with control group. The statistical population of this study was the elderly of daily nursing homes of Tehran in 2019 to 2020. Having Completed Bell’s Social Adjustment Inventory, Diner’s Life Satisfaction Scale and the Lubmirsky & Leper’s Actual happiness scale, 30 elderlies with the lowest score in each item were selected and randomly assigned into experimental and control groups (15 people in each group). The experimental group receive ten 90-minute sessions of psychodrama training, and the control group did not receive any intervention at the same time. The results of Univariate Covariance Analysis (ANCOVA) showed significant positive effect of psychodrama on the subjective well-being of the elderly, but its effect on social adjustment of the elderly was not significant. Based on the findings of this study, psychodrama could be used as an appropriate method to increase the well-being of the elderly as psychodrama allowed people through role-playing to release their thoughts, hidden motivation and emotional states such as anger, sadness and happiness. Likewise, they could expose their inner thoughts and inner demands.

References
Abbasi, B., Kimiagar, M., Shahidi, S., Shirazi, M., Sadeghniiat, K., Payab, M., & Karimi, N. (2013). Effect of magnesium supplementation on mental health in elderly subjects with insomnia: A double blind randomized clinical trial. Iranian Journal of Psychiatry and Clinicsl Psychology, 19 (1), 9-19. [Persian]
Alahyari, T., MirgholikhaniTehrani, N. (2014). Evaluation of social factors affecting depression among elderly women living in Kahrizak sanatorium. Social Science Monthly, 18(74), 28-33. [Persian]
Akhoondzadeh, G., & Akhoondzadeh, J. (2014). Effectiveness of memory recall on memory performance of elderly. Journal of Geriatric Nursing, 1 (1), 64-72. [Persian]
Alavi, M., Molavi, H., & Molavi, R. (2017) The Impact of cognitive behavioral therapy on self-esteem and quality of life of hospitalized amputee elderly patients. Nursing and Midwifery Studies, 6 (4), 162-167. [Persian]
Allemand, M., Hill, P. L., Ghaemmaghami, P., & Martin, M. (2012). Forgivingness and subjective well-being in adulthood: The moderating role of future time perspective. Journal of Research in Personality, 46(1), 32–39.
Argyle, M., & Lue, L. (2011). The happiness of extraverts. Journal of Individual Differences, 11(2), 112–121.
Aqababaee, N., Farahani, H., & Fazeli Mehr Abādi, A. (2010). Measuring Gratitude among University and Religious Students: An enquiry into the psychometric features of the Gratitude Questionnaire. Studies in Islam and Psychology, 4(6), 75-88. [Persian]
Aqapur Hasiri, F. (2o14). Psychometric properties of the Adaptation Questionnaire and its relationship with emotional intelligence of high school girls in Babol (unpublished master's thesis). Islamic Azad University, Tehran Branch Center, Tehran. [Persian]
Aytemur, Z. A., Pişmişoğlu, B., Kılınç, O., Pişmişoğlu, E., Hacıevliyagil, S. S., & Karaman, C. (2012). Intensive clinic intervention plus psychodrama in smoking cessation and effects on cessation outcome. Turkiye Klinikleri Journal of Medical Sciences, 32(3), 630–637.
Bagheri, P., Saadati, N., Fatollahzadeh, N., & Darbani, S. A. (2018). The effectiveness of group acceptance and commitment therapy on self- efficacy and social adjustment of elderly retired. Journal of Geriatric Nursing, 3(2), 103-117. [Persian]
Barghi Irani, Z., Bakhti, M., Bagiyan Agiyankulemare, M. (2015). TheEffectiveness of cognitive processing-based social skills on emotional, psychological well-being and reducing the symptoms of children with conduct disorder. Social Cognition, 4(1), 157-175. [Persian]
Bayani, A., Koocheki, A. M., & Goodarzi, H. (2010). Psychometric properties of short form of the social problem solving inventory, 7(26), 147-154. [Persian]
Bell, H. M. (1962). Adjustment Inventory Manual. Palo Alto, Calif: Consulting Psychologists Press.
Blatner, A. (2000). Foundations of psychodrama. Springer.
Bowling, A. (2011). Do older and younger people differ in their reported well-being? A national survey of adults in Britain. Family Practice, 28(2), 145–155.
 Bustos, D. M. (1994). Wings and roots. In P. Holmes, M. Karp, & M. Watson, Psychodrama since Moreno: Innovations in theory and practice. Blackwell.
 Castel, A., Liuch, C., Ribas, J., Borras, L., & Molto, E. (2017). Effects of a cognitive stimulation program on psychological well- being in a sample of elderly long-term care hospital inpatients. Journal of Aging & Mental Health, 21(1), 88-94.
Crain, W. (1985).Theories of development: Conceptsand applications (Gh.Khoynezhad & A. Rajaei.Trans.).Tehran: Roshd. [Persian]
Csikszentmihalyi, M., & Larson, R. (2014). Flow and the foundations of positive psychology. Springer.
Darvishpoor Kakhki, A., & Abed Saeedi, Z. (2013). Investigating the factors related to quality of life related to the health of the elderly in Tehran. Scientific Journal of Shahid Beheshti University of Medical Sciences, 23 (82), 8-16. [Persian]
Diener, E. (2009). Subjective well-being: The science of well-being. Springer.
Diener, E., Suh, E., & Lucas, R. E. (1999). Subjective well-being: Three decades of progress. Psychological Bulletin, 125(2), 276-302.
DiClemente, C. C., Prochaska, J. O., Fairhurst, S. K., Velicer, W. F., Velasquez, M. M., & Rossi, J. S. (1991). The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. Journal of consulting and clinical psychology, 59(2), 295.
Dorudian, Z. (2011). The Impact of Role-Playing TechniqueOn Social Adjustment and Academic Achievement in Dyscalculia Students of Tehran Province. Psychology of Exceptional Individuals, 1(2), 85-101. [Persian]
Eryilmaz, A. (2009). Ergen öznel iyi oluş ölçeğinin geliştirilmesi. Türk Eğitim Bilimleri Dergisi, 7(4), 975–989.
Faramarzi, S., Moradi, M., & Motamedi, B. (2015). Effectiveness of psychodrama with pantomime on the social adjustment of deaf female students. Audiology, 23(6), 85-91. [Persian]
Fathi Ashtiani, A., & Dastani, M. (2012). Psychological tests: personality and mental health. Tehran: Besat. [Persian]
George, N. I., & Ukpong, D. E. (2012). Adolescents’ sex differential social adjustment problems and academic performance of junior secondary school students in Uyo Metropolitan City. International Journal of Business and Social Science, 3(19), 245–251.
Gilmar, A. Jr., Costa, A. R. S., Beretta, R.C.S., & Figueiredo, G. L. A. (2020). Promoting health through psychodrama with a group of seniors attended at the social assistance reference center. Revista Brasileira De Psicodrama, 28 (1), 71-76.
Golparvar, M., Masahebi, M., Abedini, H., Adibi, Z., & Abdolu, F. (2015). Construt and Validation of Spiritual Capital and Spiritual Wellbeing Scales for senile people. Quarterly of Educational Measurement, 5(19), 130-149. [Persian]
Golmohammadian, M., Nazari, H., & Parvaneh, A. (2015). Effectiveness of group logo therapy on death anxiety and social adjustment of elderly men.Aging Psychology, 2(3), 167-175. [Persian]
Georgi, Z.  (2010). Evaluation of psychodrama in increasing the self-esteem of adolescents with divorced parents (Master's degree has not been published).  Faculty of Psychology and Educational Sciences, Shahid Beheshti University, Tehran. [Persian]
Gürgan, U. (2013). The effect of psychological counselling in a group on life orientation and loneliness levels of the university students. Educational Research and Reviews, 8(24), 2303-2312.
‏Han, K. M., Han, C., Shin, C., Jee, H. J., An, H., Yoon, H. K., & Kim, S. H. (2018). Social capital, socioeconomic status, and depression in community-living elderly. Journal of Psychiatric Research, 98, 133–140.
‏Helliwell, J. F., Layard, R., & Sachs, J. (2013). World happiness report. EarthInstitute.
Hodge, D. R., Bonifas, R. P., & Chou, R. J. A. (2010). Spirituality and older adults: Ethical guidelines to enhance service provision. Advances in Social Work, 11(1), 1–16.
Hunter, J., & Csikszentmihalyi, M. (2013). Happiness in everyday life: The uses of experience sampling. Journal of Happiness Studies, 2(4), 182–199.
Jensen, R. A. A., Kirkegaard Thomsen, D., O'Connor, M., & Mehlsen, M. Y. (2019). Age differences in life stories and neuroticism mediate age differences in subjective well‐being. Applied Cognitive Psychology, 34, 3-15.
Joshanloo, M., & Afshari, S. (2011). Big five personality traits and self-esteem as predictors of life satisfaction in Iranian Muslim university students. Journal of Happiness Studies, 12(1), 105–113. Journal Complementary Therapies in Medicine, 30, 27-67.
Joshanloo, M., & Weijers, D. (2013). A version to happiness across cultures: A review of where and why people are averse to happiness. Journal of Happiness Studies, 15(3), 717–735.
Kalkan Oğuzhanoğlu, N., Osman, O., Yaşlilik, H. (2005). The elderly, nursing homes and life voyages: A psychodrama group study. Turk Psikiyatri Derg, 16(2), 124-132.
Karataş, Z. (2014). Psikodrama Uygulamasının Üniversite Öğrencilerinin Öznel İyi Oluş ve Umutsuzlukları Üzerindeki Etkisi. Eğitim ve Bilim, 39,118 -128.
Karimi Dormani, H. (2013).  Rehabilitation of Special Groups (with emphasis on social work services). Tehran: Roshd Publications. [Persian]
Karp, M. (1998). An introduction to psychodrama. In M. Karp, P. Holmes & K. B. Tauvon, The handbook of psychodrama. London: Routledge.
Kellermann, P. F. (1987). Outcome research in classical psychodrama. Small Group Research, 18(4), 459-469.
Konopik, D. A., & Cheung, M. (2013). Psychodrama as a social work modality. Social Work, 58(1), 9- 20.
Kim, S. D., Jang, H. R., & Lee, W. K. (2005). Effects of psychodrama on the elderly patients with dementia. Journal of Korean Geriatric Psychiatry, 9 (1), 57-62.
Larsen, L., Christoffersen, M., & Vedel, A. (2020). Psychotherapy improves the well-being of elderly Danish care recipients. The Journal of Gerontopsychology and Geriatric Psychiatry, 33(2), 67–76.
Lee, S. K., & Sobal, J. (2003). Comparison of models of acculturation: The case of Korean Americans. Journal of Cross-Cultural Psychology, 34, 282-296.
Leveton, E. (2001). A clinician's guide to psychodrama. (F. Yazdkhasti, S. Jokar & S. Jokar, Trans.). Esfehan: Payam Alavi Publication. [Persain]
Liberali, R., & Grosseman, S. (2015). Use of psychodrama in medicine in Brazil: A review of the literature. Interface-Comunicação, Saúde, Educação, 19(54), 561-571.
Lyubomirsky, S., & Lepper, H. S. (1999). A mea- sure of subjective happiness: Preliminary reliability and construct validation. Social Indicators Research, 46(2), 137-156.
Moreno, Z. T., Blomkvist, L. D., & Rutzet, T. (2000). Psychodrama surplus reality and the art of healing. London and Philadelphia: Routledge.
Mohammadi, I., & Sajjadia, E. (2019). The effectiveness of resiliency training on social adjustment and purposeful life in the elderly male living in nursing homes. Aging Psychology, 5(2), 89-100. [Persian]
Newton-John, T. R. O., Mason, C., & Hunter, M. (2014). The role of resilience in adjustment and coping with chronic pain. Rehabilitation Psychology, 59(3), 360–365.
Oguzhanoglu, N. O. (2005). The elderly, nursing homes and life Voyages: A psychodrama group study. Turkish Journal of Psychiatry, 16(2), 124-132.
Park, C.L., Edmondson, D., & Lee, J. (2012). Development of self-regulation abilities as predictors of psychological adjustment across the first year of college. Journal of Adult Development, 19, 40-49.
Rada, J., Weiss, N., & Walker, Z. (2008). The old age psychiatry handbook (M. Forough, Trans.). Tehran: Arjmand Publication. [Persain]
Saadati, H., Younesi, J., Foroghan, M., & Lashani, L. (2013). Effectiveness of gestalt therapy on happiness of elderly people. Salmand: Iranian Journal of Ageing, 8 (2), 7-15. [Persian]
Safdari, R., Shams Abadi, A. R., & Pahlevany Nejad, S. (2018). Improve health of the elderly people with M-Health and Tech- nology Iranian Journal of Ageing, 13(3), 288-299.  [Persian]
Seligman, M. E. P. (2011). Flourish: A visionary new understanding of happiness and well-being. Free Press.
Siedlecki, K. L., Salthouse, T.A., Oishi, S., & Jeswani, S. (2013). The relationship between social support and subjective well-being across age. Social Indicators Research, 117(2), 561–76.
Şimşek, G., Yalçınkaya, E. Y., Ardıç, E., & Yıldırım, E. A. (2020). The effect of psychodrama on the empathy and social anxiety level in adolescents. Turkish Journal of Child and Adolescent Mental Health, 27(2), 96-101.
Somov, P.G. (2008). A psychodrama group for substance use relapse prevention training. Journal of the Arts in Psychotherapy, 35, 151-161.
 Steptoe, A., Deaton, A., & Stone, A. A. (2015(. Subjective wellbeing, health, and ageing. The Lancet, 385, 640-648.
Sumngern, C., Azeredo, Z., Subgranon, R., Sungvorawongphana, N., & Matos, E. (2010). Happiness among the elderly in communities: A study in senior clubs of Chonburi Province, Thailand. Japan Journal of Nursing Science, 7(1), 47–54.
Taghinezhad, Z., Eghlima, M., Arshi, M., & Pourhossein Hendabadi, P. (2017). Effectiveness of social skills training on social adjustment of elderly people. Archives of Rehabilitation, 18(3), 230-241. [Persian]
Yazdanbakhsh, K. (2016). Effects of life review on social adjustment of retirees' elderly persons. Aging Psychology, 1(3), 179-185. [Persian]
 Zhao, W., Ukawa, S., & Tamakoshi, A. (2018). The associations of dietary patterns with all-cause mortality and other lifestyle factors in the elderly: An agespecific prospective cohort study. Clinical Nutrition, 38(1), 288-296.