Psychodrama Group Therapy for Breakup Distress and Relationship Adjustment: A Randomized Trial

Psychodrama Group Therapy for Unresolved Breakup Distress and Dyadic Adjustment in Current Romantic Relationships: Study Protocol for a Randomized Controlled Trial

The purpose of this randomized controlled trial is to evaluate whether a psychodrama group therapy intervention can reduce unresolved breakup distress and improve dyadic adjustment in adults currently involved in romantic relationships who have experienced a significant previous breakup.

The main questions this study aims to answer are:

• Does participation in psychodrama group therapy reduce breakup distress compared with a waiting-list control condition?
• Does participation in psychodrama group therapy improve dyadic adjustment and relationship functioning compared with a waiting-list control condition?

The researchers will compare participants receiving the psychodrama group therapy intervention with participants in a waiting-list control condition to determine whether the intervention leads to greater improvements in breakup distress, dyadic adjustment, psychological functioning, relationship quality, and sexual satisfaction.

Participants will:

• complete assessments at baseline, 16 weeks, and 42 weeks;
• participate in a 15-session weekly psychodrama group therapy program (intervention group only);
• complete questionnaires assessing breakup distress, dyadic adjustment, psychological outcomes, relationship quality, and sexual satisfaction.

Romantic relationship breakups are common life events that may have substantial emotional and relational consequences. While many individuals adapt successfully over time, some continue to experience unresolved breakup distress characterized by persistent emotional suffering, difficulties processing the loss, and challenges integrating the experience into their personal and relational lives. Emerging evidence suggests that unresolved distress following a previous romantic breakup may negatively affect the quality of subsequent romantic relationships, including communication, intimacy, trust, emotional regulation, and overall dyadic adjustment.

Despite increasing recognition of the psychological and relational impact of romantic breakups, there is a limited evidence base regarding interventions specifically designed to address unresolved breakup distress. Furthermore, randomized controlled trials evaluating psychodrama interventions in this context remain scarce. Psychodrama is an experiential and action-oriented psychotherapy approach developed by Jacob Levy Moreno that uses dramatization, role-playing, role reversal, and other action methods to facilitate emotional expression, interpersonal insight, and behavioral change. Through the exploration of past and present relational experiences, psychodrama may help individuals process unresolved emotions associated with previous relationships, recognize maladaptive relational patterns, and develop more adaptive ways of relating in current relationships.

The present study was designed to evaluate the effectiveness of a manualized psychodrama group therapy program for adults currently involved in romantic relationships who continue to experience unresolved distress related to a significant previous breakup. The intervention was developed based on psychodramatic theory and clinical practice and focuses on emotional processing of previous relationship losses, exploration of attachment and relational patterns, enhancement of emotional communication, strengthening of intimacy and trust, and promotion of healthier dyadic functioning in current romantic relationships.

This study employs a randomized controlled design comparing a psychodrama group therapy intervention with a waiting-list control condition. The intervention consists of 15 weekly group sessions delivered in a closed-group format by trained psychodrama practitioners. Sessions follow the traditional psychodramatic structure of warm-up, dramatization, and sharing and progressively address themes including relational history, attachment experiences, breakup distress, grief processes, self-esteem, emotional communication, jealousy, emotional security, relational repair, intimacy, and relational role reconstruction.

In addition to evaluating clinical outcomes, the study aims to contribute to the methodological development of psychodrama research by implementing a structured intervention protocol and examining both quantitative and qualitative indicators of therapeutic change. Findings from this trial may contribute to a better understanding of the role of psychodrama in addressing unresolved breakup distress and promoting healthier functioning in subsequent romantic relationships. The results may also inform the development of evidence-based interventions targeting the long-term emotional and relational consequences of romantic relationship dissolution.

Inclusion Criteria:

• Age 18 years or older;
• Currently involved in a romantic relationship for at least 6 months;
• History of at least one significant previous romantic relationship breakup;
• Presence of breakup distress related to a previous romantic breakup and/or difficulties in current dyadic adjustment;
• Ability and willingness to provide written informed consent.

Exclusion Criteria:

• Presence of severe mental disorder that may interfere with participation in group psychotherapy;
• Severe active substance dependence;
• Current severe relational violence;
• Inability or unwillingness to provide written informed consent;
• Any clinical condition that, in the opinion of the research team, may compromise safe participation in the intervention.