Skip to main content

Development, Execution and Acceptance of a Manualized Dance/Movement Therapy Treatment Protocol for the Clinical Trial in the Treatment of Negative Symptoms and Psychosocial Functioning in Schizophrenia

American Journal of Dance Therapy volume 42, pages 150–175 (2020)Cite this article

Abstract

The use of manual-based interventions that aim to improve outcomes and that allow for replication become a research standard in recent years. Currently, the dance/movement therapy English language literature contains few if any works on specific guidelines or models to help researchers conceptualize, develop, pilot, revise and execute treatment protocols. Therefore, this manuscript describes in detail the development of manualized dance/movement therapy treatment protocol for a clinical trial on the negative symptoms and psychosocial functioning in individuals with schizophrenia. It provides a comprehensive description of the step-by-step process of the creation and implementation of the intervention manual. As such it offers a guideline to help researchers conceptualize, develop, pilot, revise and execute the treatment protocol. Feasibility and acceptance findings are included. Discussion of the importance of the use of manualized treatment protocols in dance/movement therapy research and their limitations follows.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1

References

  • Addis, M. E. (2002). Methods for disseminating research products and increasing evidence-based practice: Promises, obstacles, and future directions. Clinical Psychology: Science and Practice, 9(4), 367–378. https://doi.org/10.1093/clipsy.9.4.367.

    Article  Google Scholar 

  • Ball, K., Berch, D. B., Helmers, K. F., Jobe, J. B., Leveck, M. D., Marsiske, M., … & Advanced Cognitive Training for Independent and Vital Elderly Study Group. (2002). Effects of cognitive training interventions with older adults: A randomized controlled trial. JAMA, 288(18), 2271–2281. https://doi.org/10.1001/jama.288.18.2271

  • Barton, E. J. (2011). Movement and mindfulness: A formative evaluation of a dance/movement and yoga therapy program with participants experiencing severe mental illness. American Journal of Dance Therapy, 33(2), 157–181.

    Article  Google Scholar 

  • Bryl, K. (2012). Praca zaliczeniowa DMT na podstawie odbytej praaktyki terapeutycznej. Unpublished manuscript, Polski Instytut Psychoterapii Tańcem i Ruchem, Warszawa, Poland.

  • Bryl, K., Bradt, J., Chechnicki, A., Fisher, K., Sossin, K. M., & Goodill, S. (2018). The role of dance/movement therapy in the treatment of negative symptoms in schizophrenia: A mixed methods pilot study. Manuscript submitted for publication.

  • Cechnicki, A., & Bielańska, A. (2009). Understanding and treatment of people suffering from schizophrenia in Kraków. Archives of Psychiatry and Psychotherapy, 3, 17–25.

    Google Scholar 

  • Cohen, D. & Crabtree, B. (2006). Qualitative Research Guidelines Project. Retrieved July 2006 from http://www.qualres.org/HomeSemi-3629.html

  • Crits-Christoph, P., Beebe, K. L., & Connolly, M. B. (1990). Therapist effects in the treatment of drug dependence: Implications for conducting comparative treatment studies. NIDA Research Monograph, 104, 39–49.

    PubMed  Google Scholar 

  • Fisher, S. (1986). Development and structure of the body image (Vols. 1 & 2). Hillsdale: Lawrence-Erlbaum-Associates Publishers.

    Google Scholar 

  • Forbat, L., Black, L., & Dulgar, K. (2015). What clinicians think of manualized psychotherapy interventions: Findings from a systematic review: What therapists think of treatment manuals. Journal of Family Therapy, 37(4), 409–428. https://doi.org/10.1111/1467-6427.12036.

    Article  Google Scholar 

  • Goldstein, N. E. S., Kemp, K. A., Leff, S. S., & Lochman, J. E. (2012). Guidelines for adapting manualized interventions for new target populations: A step-wise approach using anger management as a model. Clinical Psychology: Science and Practice, 19(4), 385–401. https://doi.org/10.1111/cpsp.12011.

    Article  Google Scholar 

  • Guzek, I. (2009). Fragmentaryzacja i reintegracja. In Z. Pędzich (Ed.), Psychoterapia Tańcem i Ruchem, teoria i praktyka w terapii grupowej (pp. 68–77). Warszawa: Arteer.

    Google Scholar 

  • Henry, W. P., Strupp, H. H., Butler, S. F., Schacht, T. E., & Binder, J. L. (1993). Effects of training in time-limited dynamic psychotherapy: Changes in therapist behavior. Journal of Consulting and Clinical Psychology, 61, 434–440.

    Article  PubMed  Google Scholar 

  • Herman-Smith, R., Pearson, B., Cordiano, T. S., & Aguirre-McLaughlin, A. (2008). Addressing individual client needs in manualized treatment: Case comparisons. Clinical Case Studies, 7(5), 377–396. https://doi.org/10.1177/1534650108315867.

    Article  Google Scholar 

  • Kanas, N. (1991). Group therapy with schizophrenic patients: A short-term, homogeneous approach. International Journal of Group Psychotherapy, 41(1), 33–48.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E. (2001). Progression of therapy research and clinical application of treatment require better understanding of the change process. Clinical Psychology: Science and Practice, 8(2), 143–151. https://doi.org/10.1093/clipsy.8.2.143.

    Article  Google Scholar 

  • Kiepe, M.-S., Stöckigt, B., & Keil, T. (2012). Effects of dance therapy and ballroom dances on physical and mental illnesses: A systematic review. The Arts in Psychotherapy, 39(5), 404–411.

    Article  Google Scholar 

  • Koch, S., Kunz, T., Lykou, S., & Cruz, R. (2014). Effects of dance movement therapy and dance on health-related psychological outcomes: A meta-analysis. The Arts in Psychotherapy, 41(1), 46–64. https://doi.org/10.1016/j.aip.2013.10.004.

    Article  Google Scholar 

  • Koch, S. C. (2014). Rhythm is it: Effects of dynamic body feedback on affect and attitudes. Frontiers in Psychology, 5, 537. https://doi.org/10.3389/fpsyg.2014.00537.

    Article  PubMed  PubMed Central  Google Scholar 

  • Leder, S. (2009). Psychoterapia. In A. Bilikiewicz (Ed.), Psychiatria. Podręcznik dla studentów medycyny (pp. 556–584). Warszawa: Wydawnictwo Lekarskie PZWL.

    Google Scholar 

  • Lee, H.-J., Jang, S.-H., Lee, S.-Y., & Hwang, K.-S. (2015). Effectiveness of dance/movement therapy on affect and psychotic symptoms in patients with schizophrenia. The Arts in Psychotherapy, 45, 64–68.

    Article  Google Scholar 

  • Lehman, A. F., Lieberman, J. A., Dixon, L. B., McGlashan, T. H., Miller, A. L., Perkins, D. O., … & Steering Committee on Practice Guidelines (2004). Practice guideline for the treatment of patients with schizophrenia, second edition. The American Journal of Psychiatry, 161(2 Suppl), 1–56.

  • Leifker, F. R., Bowie, C. R., & Harvey, P. D. (2009). Determinants of everyday outcomes in schizophrenia: The influences of cognitive impairment, functional capacity, and symptoms. Schizophrenia Research, 115(1), 82–87. https://doi.org/10.1016/j.schres.2009.09.004.

    Article  PubMed  Google Scholar 

  • Liddle, P. F. (2000). Cognitive impairment in schizophrenia: Its impact on social functioning. Acta Psychiatrica Scandinavica, 101(400), 11–16. https://doi.org/10.1111/j.0065-1591.2000.007s021%5bdash%5d3.x.

    Article  Google Scholar 

  • Martin, L., Pohlmann, V., Koch, S., & Fuchs, T. (2016a). Back into life: Effects of embodied therapies with patients with schizophrenia. European Psychotherapy, 2016(2017), 179–194.

    Google Scholar 

  • Martin, L. A. L., Koch, S. C., Hirjak, D., & Fuchs, T. (2016b). Overcoming disembodiment: The effect of movement therapy on negative symptoms in schizophrenia—A multicenter randomized controlled trial. Frontiers in Psychology, 7, 483. https://doi.org/10.3389/fpsyg.2016.00483.

    Article  PubMed  PubMed Central  Google Scholar 

  • Morgenstern, J., Morgan, T. J., McCrady, B. S., Keller, D. S., & Carroll, K. M. (2001). Manual-guided cognitive-behavioral therapy training: A promising method for disseminating empirically supported substance abuse treatments to the practice community. Psychology of Addictive Behaviors, 15(2), 83–88. https://doi.org/10.1037/0893-164X.15.2.83.

    Article  PubMed  Google Scholar 

  • O’Malley, S. S., Foley, S. H., Rounsaville, B. J., & Watkins, J. T. (1988). Therapist competence and patient outcome in interpersonal psychotherapy of depression. Journal of Consulting and Clinical Psychology, 56(4), 496–501. https://doi.org/10.1037//0022-006X.56.4.496.

    Article  PubMed  Google Scholar 

  • Papdopoulos, N. (2004). Disconnection and re-engagement: Systemic reflections on dance movement therapy and the therapeutic process in chronic schizophrenia. E-Motion, 14, 14–19.

    Google Scholar 

  • Papadopoulos, N. L. R., & Röhricht, F. (2014). An investigation into the application and processes of manualised group body psychotherapy for depressive disorder in a clinical trial. Body, Movement and Dance in Psychotherapy, 9(3), 167–180. https://doi.org/10.1080/17432979.2013.847499.

    Article  Google Scholar 

  • Paquin, J. D. (2017). Delivering the treatment so that the therapy occurs: Enhancing the effectiveness of time-limited, manualized group treatments. International Journal of Group Psychotherapy, 67, 141–153. https://doi.org/10.1080/00207284.2016.1218771.

    Article  Google Scholar 

  • Pilling, S., Bebbington, P., Kuipers, E., Garety, P., Geddes, J., Orbach, G., & Morgan, C. (2002). Psychological treatments in schizophrenia: I. Meta-analysis of family intervention and cognitive behaviour therapy. Psychological Medicine, 32(5), 763–782. https://doi.org/10.1017/s0033291702005895.

    Article  PubMed  Google Scholar 

  • Priebe, S., Savill, M., Wykes, T., Bentall, R. P., Reininghaus, U., Lauber, C., … & Röhricht, F. (2016). Effectiveness of group body psychotherapy for negative symptoms of schizophrenia: multicentre randomised controlled trial. The British Journal of Psychiatry, 209(1), 54–61. https://doi.org/10.1192/bjp.bp.115.171397

  • Pylvänäinen, P. M., Muotka, J. S., & Lappalainen, R. (2015). A dance movement therapy group for depressed adult patients in a psychiatric outpatient clinic: Effects of the treatment. Frontiers in Psychology, 6, 980. https://doi.org/10.3389/fpsyg.2015.00980.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ren, J., & Xia, J. (2013). Dance therapy for schizophrenia. The Cochrane Database of Systematic Reviews, 10, CD006868.

    Google Scholar 

  • Röhricht, F. (2009). Body oriented psychotherapy. The state of the art in empirical research and evidence-based practice: A clinical perspective. Body, Movement and Dance in Psychotherapy, 4(2), 135–156. https://doi.org/10.1080/17432970902857263.

    Article  Google Scholar 

  • Röhricht, F., & Papadopoulos, N. (2010). A treatment manual: Body oriented psychological therapy for chronic schizophrenia. London: Newham Centre for Mental Health.

    Google Scholar 

  • Röhricht, F., & Priebe, S. (2006). Effect of body-oriented psychological therapy on negative symptoms in schizophrenia: A randomized controlled trial. Psychological Medicine, 36(5), 669–678. https://doi.org/10.1017/S0033291706007161.

    Article  PubMed  Google Scholar 

  • Rolvsjord, R., Gold, C., & Stige, B. (2005). Research rigour and therapeutic flexibility: Rationale for a therapy manual developed for a randomised controlled trial. Nordic Journal of Music Therapy, 14(1), 15–32. https://doi.org/10.1080/08098130509478122.

    Article  Google Scholar 

  • Rounsaville, B. J., Carroll, K. M., & Onken, L. S. (2001). A stage model of behavioral therapies research: Getting started and moving on from stage I. Clinical Psychology: Science and Practice, 8(2), 133–142. https://doi.org/10.1093/clipsy.8.2.133.

    Article  Google Scholar 

  • Scott, J. E., & Dixon, L. B. (1995). Assertive community treatment and case management for schizophrenia. Schizophrenia Bulletin, 21(4), 657–668. https://doi.org/10.1093/schbul/21.4.657.

    Article  PubMed  Google Scholar 

  • Simmons, A. M., Milnes, S. M., & Anderson, D. A. (2008). Factors influencing the utilization of empirically supported treatments for eating disorders. Eating Disorders, 16(4), 342–354. https://doi.org/10.1080/10640260802116017.

    Article  PubMed  Google Scholar 

  • Staudt, M., & Williams-Hayes, M. (2011). A state survey of child advocacy center therapists’ attitudes toward treatment manuals and evidence-based practice. Journal of Child Sexual Abuse, 20(1), 1–13. https://doi.org/10.1080/10538712.2011.539999.

    Article  PubMed  Google Scholar 

  • Sue, S., Zane, N., Nagayama Hall, G. C., & Berger, L. K. (2009). The case for cultural competency in psychotherapeutic interventions. Annual Review of Psychology, 60, 525–548.

    Article  PubMed  PubMed Central  Google Scholar 

  • Torłop, J. (2009). Nauka Jazdy. In Z. Pędzich (Ed.), Psychoterapia Tańcem i Ruchem, teoria i praktyka w terapii grupowej (pp. 51–67). Warszawa: Arteer.

    Google Scholar 

  • Turkington, D., Kingdon, D., & Weiden, P. J. (2006). Cognitive behavior therapy for schizophrenia. The American Journal of Psychiatry, 163(3), 365–373. https://doi.org/10.1176/appi.ajp.163.3.365.

    Article  PubMed  Google Scholar 

  • Velligan, D. I., & Alphs, L. D. (November 24, 2014). Negative symptoms in schizophrenia: An update on identification and treatment. Psychiatric Times. Retrieved July 20, 2017 from http://www.psychiatrictimes.com/schizophrenia/negative-symptoms-schizophrenia-update-identification-and-treatment/page/0/

  • Waltz, J., Addis, M. E., Koerner, K., & Jacobson, N. S. (1993). Testing the integrity of a psychotherapy protocol: Assessment of adherence and competence. Journal of Consulting and Clinical Psychology, 61(4), 620–630. https://doi.org/10.1037//0022-006X.61.4.620.

    Article  PubMed  Google Scholar 

  • Wilson, G. (1996). Manual-based treatments: The clinical application of research findings. Behaviour Research and Therapy, 34(4), 295–314. https://doi.org/10.1016/0005-7967(95)00084-4.

    Article  PubMed  Google Scholar 

  • World Health Organization. (2010). International classification of diseases, tenth revision, clinical modification (ICD-10-CM). Geneva: World Health Organization.

    Google Scholar 

Download references

Acknowledgements

We thank our study participants and assistance from dissertation committee, mentors, and other individuals who greatly contributed to this project. The authors acknowledge all members of the Community Mental Health Center; Polish research team members; students and staff of the Community Psychiatry Department of Jagiellonian University Collegium Medicum; and research assistants.

Funding

This study was funded by a Grant from the Marian Chace Foundation.

Author information

Authors and Affiliations

  1. Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, 1601 Cherry Street, Philadelphia, 19102, PA, USA

    Karolina Bryl & Sherry Goodill

Authors
  1. Karolina Bryl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sherry Goodill
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Karolina Bryl.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendices

Appendix 1

See Table 2

Table 2 Fidelity checklist example
Full size table

.

Appendix 2

See Table 3

Table 3 Field note example
Full size table

.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Bryl, K., Goodill, S. Development, Execution and Acceptance of a Manualized Dance/Movement Therapy Treatment Protocol for the Clinical Trial in the Treatment of Negative Symptoms and Psychosocial Functioning in Schizophrenia. Am J Dance Ther 42, 150–175 (2020). https://doi.org/10.1007/s10465-019-09312-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10465-019-09312-8

Keywords

  • Dance/movement therapy
  • Manualized treatment protocol
  • Intervention manual
  • Schizophrenia
  • Negative symptoms
  • Psychosocial functioning