The effects of the Dramatherapeutic Self-concept Module: a multiple baseline single-case study on the effects of the Dramatherapeutic Self-esteem Module for patients with a personality disorder, who are indicated for outpatient schemafocused therapy.

Evidence-based treatment in mental health service is getting more and more
important. There is relatively little empirical evidence for arts therapies,
amongst which drama therapy. In 2015 the minister of health asked the
organization of arts therapists to build up empirical evidence for their
therapies. This study will investigate the effects en progress of drama
therapy, especially the * Dramatherapeutic Self-concept Module*, a well
documented module. This module has proved to be effective in a clinical setting
for clients with anxiety disorders. In this study, the module will be evaluated
with respect to clients with a personality disorder who will receive
schemafocused therapy in an outpatient setting.
The module is designed for enhancing self-esteem. Low self-esteem is a
transdiagnostic factor and correlates with a variety of psychological problems
and is as well part of several personality disorders. What makes this module
special, and relevant for the population of interest, is the use of
dramatherpeutic techniques. These are expected to fit well to hot cognitios
('feeling that', as opposed to cold cognitions * 'knowing that') which seem to
be extremely important in the treatment of clients with a personality disorder.

Investigating the progress of the self-esteem and well-being before, during and
after the Dramatherapeutic Self-Image module in clients with a personality
disorder who are in treament phase 1 of outpatient schema focused therapy.
Investigating which aspects of the Dramatherapeutic Self-concept Module, helped
or obstructed clients to change, in their experience.

A multiple baseline single-case experimental design will be used, in which 10
participants will be followed by means of weekly measurements, while they are
in treatment phase 1. In this phase clients are prepared for the schema focused
therapy (which takes part in phase 2) by means of psycho-education on schema
focused therapy, formulating treatment goals, etc. In the period of the
measurements, they will first participate in the psycho-education of 4 weekly
group sessions and after that, in de Dramatherapeutic Self-concept Module, both
of which interventions will take place in a closed group. There will be some
waiting time between the start of the measurements and the start of the
psycho-education, and between the psycho-education and the Dramatherapeutic
Self-concept Module. In this waiting time, the measurements are to be
continued. The period of waiting time and psycho-education will serve as
baseline. It will be a multiple baseline single-case design because different
participants will have different periods of wainting time.

De Dramatherapeutic Self-concept module is a module in which in 6 weekly
sessions of 75 minutes in a group of 6 participants will be worked on
enhancement of self-esteem. This will be done with cognitive behavioural and
dramatherapeutic interventions and some homework. The sessions will be leaded
by a experienced drama therapist who is trained in this module.

The participants will fill in the questionnaires weekly, which will take about
10 minutes, in sum 3 1*2 hours. The change interview will take about one hour.
They participate in the module which consists of 6 weekly sessions of 75
minutes, and some homework inbetween. The sessions and the homework will take
10 1/2 to 11 1/2 hours. Total time investment is 15-1 hours in 4 to 5 months.
Clients are free to praticipate in the study and they can end their
participation at any moment, without reason and without consequences for their
furter treatment.
Questionnaires will be done online by the researcher. The interviews will be
done by the researcher or her assistent, a master student psychology. They will
be trained in doing this in a safe and respectfull way.
There are no known negative effects of the Dramatherapeutic Self-concept
Module. We expect that participants will profit from the module by an
increasing self-esteem which will contribute to an increasement of well-being.