Keywords

An extensive overview of sociometry has already been presented in previous chapters (see Chaps. 5 and 11). This section will focus on the practical applications of written sociometric and psychodramatic interventions in individual social work and psychotherapy contexts. Clinical social workers are increasingly tasked by providing individual psychotherapy services for clients. The provision of one-to-one clinical social work, infused with basic sociometric and psychodramatic interventions, would provide an avenue for social work’s core values to be more fully embodied in a way that differentiates clinical social work from counseling and clinical psychology. As proposed previously, Moreno’s methods engage with social group work in a synergistic union (Skolnik, 2018). This chapter proposes a similar synergistic union between clinical social work practice with individuals and the use of Moreno’s methods in individual contexts.

An overview of the social atom will be presented as an inherently person-in-environment assessment and intervention tool predating the genogram and ecomap. The role atom will be presented with its utility as a brief personality assessment rooted in role theory. The use of timelines for assessment and interventions will be briefly described as it relates to client assessment and warm-up for psychodrama. Also included in this discussion will be the utility of psychodramatic letter writing and journaling processes for contained psychodramatic work in sessions or as homework in-between sessions. The blend of the social atom, role atom, timeline, and psychodramatic letter writing provides a social worker with assessment tools that explore a client’s intrapsychic role atom and social relationships within the past, present, and future timeline of their life.

1 The Social Atom

The social atom, a fundamental instrument of sociometry, is one of the most useful assessment tools for individual work. The social atom provides a depiction of the individual within their social environment (Giacomucci, 2019). Using the social atom as an early assessment in clinical work or case work offers the social worker an efficient and revealing overview of the social life of the individual client through their eyes (Buchanan, 1984). In some cases, the social atom is able to provide more information about the state of a client’s social life than several months of interviewing them. This pen-to-paper assessment also provides the client with an opportunity for self-reflection regarding the status of their social life.

Simple instructions for creating a social atom are described below:

  1. 1.

    Using circles to represent females, triangles for males, stars for non-gender conforming persons, and squares for non-human entities or objects—draw yourself at the center of the page and your relationships to others around you.

    1. a.

      An alternative is to invite participants to use whichever shapes, symbols, or images they would like to in representing each person in their social atom. This is much less prescriptive in terms of gender and may be preferable, especially with groups focusing on LGBTQ issues.

  2. 2.

    Taking into consideration size and proximity, draw shapes to represent the significant people in your life on the page based on their closeness to you in the center and the amount of social space they take up in your life.

  3. 3.

    Shapes with dotted lines can be used to represent people or things that are meaningful but no longer alive or present.

  4. 4.

    Use different types of lines to resemble the connection between self and the other people or things on the social atom—solid line is good connection, bold line is very strong connection, dotted line is a lost connection, and a wavy line is a conflictual connection.

The social atom exercise can be used solely as an assessment tool in individual work, or as a reference point for future sessions. J.L. and Zerka Moreno suggested that each person draws their social atom monthly to assess the changes within their interpersonal relationships (Moreno, 1953; , 2014). It is also used as a validated research instrument to graph the changes in one’s social life from pretest to post-test (Treadwell, Collins, & Stein, 1992). In group work, the social atom is frequently used as a pen-to-paper warm-up exercise that moves into psychodramatic action.

In the following social atom example (see Fig. 16.1), a social worker is working individually with a seventy-year-old woman named Mary whose primary treatment concerns are depression, anxiety, and social isolation. She presents as dissociative and depressed in most sessions and sometimes has difficulty communicating. After multiple sessions, the clinician feels that they still do not have thorough information regarding the client’s social landscape. The social worker explains the social atom process and invites Mary to draw herself within the center of her social relationships, resulting in the following depiction:

Fig. 16.1
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Mary’s social atom

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From this social atom drawing, one might get curious about Mary’s sense of self considering how small she drew herself in the center compared to the others depicted. While she had not verbally disclosed that many friends had died, it became clear from her social atom that she has experienced considerable losses and ambiguous losses. The largest aspects of her social atom are her deceased mother, her husband, and her depression/anxiety, suggesting that these relationships take up the most internal space for Mary. She frequently had referred to her husband as her biggest support and had hinted that her mother may have been abusive. It is also interesting to see her placement of depression and anxiety between herself and her church friends. After more discussion, she disclosed that she felt shameful for having a mental health diagnosis and did not want her friends at church to know. Also notable on her social atom are the multiple friends that she drew as close to her but had not mentioned in previous sessions either. As a result of this assessment, the social worker was able to help Mary reach out to her existing friends for more support and explore her multiple experiences of loss in later sessions. While Mary had not verbally articulated the nature of her relationships with her multiple friends, both those alive and deceased, the simple drawing of her social atom opened the door for new clinical work (see Sect. 17.3 for a continuation of psychodramatic work with Mary).

The social atom can be adapted in creative ways to serve various functions. While one’s social atom is usually drawn by themselves, another possible intervention is to invite loved ones to draw each other’s social atoms as they perceive them. This process would be revealing for each participant, as well as the therapist to discover how participants experience each other’s social lives. The drawing of a perceived social atom could be a useful source of information for a client who is unwilling or unable to give an accurate depiction of their relationships due to minimization, denial, memory loss, a distorted sense of self or others, psychosis, or language barriers.

The social atom, once created on paper, can be externalized through the use of objects, empty chairs, or auxiliaries to create a social atom sculpture in a group. Once a social atom is externalized, the client can be instructed to explore the multiple social atom roles and relationships through the interventions of doubling, the mirror position, role reversals, and soliloquy. In moving the social atom from a written assessment into an experiential intervention, one can get unstuck from their current situations in the surplus reality of the psychodramatic process. Messages that were not, or could not, be expressed in person can be articulated in the social atom sculpture. This promotes opportunities for closure, catharsis, renegotiating relationships, insight, and integration. The next chapter will depict a series of one-to-one psychodrama sessions based on Mary and her social atom assessment.

2 The Role Atom

Moreno’s personality theory suggests that the self is composed of all of the roles one plays in their life and that a healthy personality has a wide role repertoire (1953). A detailed description of Moreno’s role theory is outlined in Sect. 4.7 of this book. This conceptualization of personality is congruent with social work’s non-pathologizing stance and easily understood by most clients. The role atom, sometimes called a role diagram, is a simple depiction of all the major roles that one holds in their life. It is drawn in the similar way that the social atom is constructed:

  1. 1.

    Using circles, draw yourself at the center of the page and other circles to represent roles that you play in your life

  2. 2.

    Taking into consideration size and proximity, draw circles to represent the significant roles in your life based on the space they take up in your life.

  3. 3.

    Shapes with dotted lines can be used to represent roles that are meaningful but no longer alive or present.

  4. 4.

    Use different types of lines to resemble the connection between self and the roles your role atom—solid line is good connection, bold line is very strong connection, dotted line is a lost connection, and a wavy line is a conflictual connection.

There are many different ways to create a role atom, the simplest being the here-and-now assessment of one’s roles. This process helps client see themselves reflected back to them through their assessment of self in the language of roles. Different modifications of the role atom include drawing role atoms from the past or future. Similar to the social atom, the role atom can be created at different points on a client’s timeline or as a treatment planning tool. A simple role atom is depicted below by a client named Andrew (see Fig. 16.2).

Fig. 16.2
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Andrew’s role atom

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The role atom can be modified in many ways based on clinical goals or clinical contexts. A social justice variant is to use the role atom to depict all of one’s layers of personal identity and their perceived relationships to each identity—gender, sexuality, race, ethnicity, language, class, religion, ancestry, age, etc. The proximity and size of identities in this modified identity role atom could be drawn based on importance to the individual, relevance to a specific experience, or even their perception of how others in society experience each identity.

The role atom process can also go a step further and be used to depict sub-roles within one role (Dayton, 2005). This modified role atom can be helpful for creating a vision that depicts the current or ideal nature of a particular role. For example, after drawing a role atom, Andrew warms up to a more in-depth exploration of their experience in the role of husband. Using the same process outlined above, the client can depict the sub-roles of their experience in the role of husband (see Fig. 16.3).

Fig. 16.3
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Sub-roles within Andrew's role of husband

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After drawing a role atom to depict the sub-roles of husband, Andrew became increasingly aware of how he and his partner currently spend the majority of their time together watching television or attending to their home when they used to spend much more time traveling, running together, or creating art. The remaining time of the session is used to explore his feelings about the changes in his marriage over time and what he would like to change going forward. The same role atom process can be used to create a vision of a future role atom based on the sub-roles of husband for Andrew.

Another adaptation of the role atom process is using adjectives to describe the nature of how one holds the role—or in the case of a future projection, how a client would like to play the role. These adjectives can be depicted as another extension of sub-roles or sub-characteristics of a specific role. The role atom is useful to get to know a new client or to help a client better see when one role has consumed most of their life. This is especially useful for clients who might be in denial about the extent of their excessive working, exercising, video game use, television use, or other compulsive behavior.

The role atom also has utility for the professional development of the social worker. Social workers are regularly called to hold various sub-roles within their professional role repertoire which can be assessed and explored through a role atom. This could be useful in multiple contexts including to depict the sub-roles of a job opening, to explore one’s relationships to the sub-roles of their social work internship position or student role, to assess and/or grade one’s performance in the sub-roles of their job, or as a future projection tool for visioning one’s ideal work life. Social workers are increasingly working in private practice or hold contracts at multiple agencies which allows them to diversify their work. The future projection role atom allows a social worker to create a vision of their ideal balance between the sub-roles of social worker—for example: psychotherapist, supervisor, trainer, writer, administrator, advocate, learner, and volunteer (see Sect. 20.3.2 for a depiction of this).

Similarly to the social atom, the role atom can be concretized through the use of objects, empty chairs, or role players. This process creates an action sculpture of one’s role atom which offers opportunities for deeper exploration and transformation. In this process, a client can engage directly with their various roles, dialog with lost roles for closure, reposition roles in new ways, and practice integrating new roles. This externalization of roles also allows one to investigate role conflicts between roles while accessing spontaneity for new solutions in the future.

3 Timeline Assessments

It is interesting to note that Moreno created life event timelines, which also included sociocultural roles, in his 1932 publication about the psychosocial assessment of prison inmates (Moreno & Whitin, 1932). The use of timelines in social work and psychotherapy is not new, nor it is a process that originated from the field of psychodrama. Nevertheless, the use of timelines has become integrated within psychodrama practice, often as a warm-up for a psychodramatic enactment or within the drama itself (Carnabucci & Ciotola, 2013; Dayton, 2005, 2014, 2015a, 2015b; Giacomucci, 2017; Mak, 2019; Wells, 2018). Timeline exercises can be adapted for a variety of clinical themes to offer specific diagnostic information for both the clinician and client. Some common uses of the pen-to-paper timeline exercise are to depict the progression of one’s addiction(s), mental illness, medical concerns, recovery, resiliency, relationships, specific personal strengths, professional development, a general life timeline, or nearly any other topic. In many cases, multiple themes are integrated into the same timeline to explore and reflect on the intersections of various themes. For example, in inpatient addictions treatment, asking participants to create a timeline including the progression of their drug addiction, co-occurring mental health issues, traumas, and losses can help illuminate the underlying nature of trauma and loss (Dayton, 2015a). In this example, instructions would be:

  1. 1.

    Draw a horizontal line on your paper; mark the left end as “0” and the right as your age today

  2. 2.

    Using one colored marker, indicate major milestones on your timeline for the progression of your addiction —such as the ages you were the first time you used a drug, when your use increased significantly, when you believe you became physically addicted, etc.

  3. 3.

    Using another colored marker, indicate any major milestones on your timeline for the progression of any co-occurring disorders you experience, such as depression, anxiety, PTSD, bipolar, ADHD, etc.

  4. 4.

    Use a third color to depict any experiences of trauma, loss, abandonment, or periods of neglect.

  5. 5.

    Take a look at the collective timeline you have created and get curious about any connections between trauma, addiction, and co-occurring disorders. What do you notice?

This process is especially helpful for clients that have experienced trauma and addiction as it helps to integrate fragmented memories, experiences, and histories (Dayton, 2015a). As an assessment tool, the timeline helps the social worker to obtain clarity on the client’s history. Once a timeline is created by the client, there are various psychodramatic tools that can be used to put the timeline into action. The social worker could use the length of the room to represent the timeline and invite the client to walk their timeline while giving voice to their experiences at various points in their personal history. Another option is to use objects or empty chairs to concretize the client at various significant points in time and to invite them to speak to their past selves. Doubling, mirroring, role reversal, soliloquy, psychodramatic journaling, psychodramatic letter writing, the social atom, and the role atom can be used to further explore any point on the timeline and promote healing. Sometimes it can be helpful to ask a client to even use images of themselves from the past to enhance their timeline.

Though only the past or present can be definitively put on one’s timeline, clients can also use the timeline to depict hoped-for future experiences. This can be a simple way of setting short-term or long-term goals related to the content of the timeline. The inclusion of future positive experiences on the trauma timeline can be an important aspect as it helps keep the process balanced with positive elements and promotes hope for clients.

Beyond its utility in individual sessions, the timeline assessment can be used as a group process that is initially created individually by participants. Then, the timeline can be put into action as a spectrogram with prompts such as “stand at the age on this timeline representing how old you were the first time you used a drug,” “stand on this timeline at an age in your life that you experienced something difficult that still feels unresolved for you,” or “stand at a future age on the timeline where you would like to explore about a vision for yourself in recovery from trauma and addiction”. With each of these prompts, participants can be instructed to share with each other about their choices, to role reverse with themselves at that age, or to speak to themselves at that age (Dayton, 2015a).

4 Psychodramatic Letter Writing and Journaling

Psychodramatic letter writing and journaling offer contained alternatives to full psychodramas and can be employed as either warm-up or closure to an experiential psychodrama in individual or group settings (Blatner, 2000; Dayton, 2005, 2015b; Giacomucci, 2020; Sacks, 1974). In this process, rather than using an auxiliary, empty chair, or object to externalize another person or entity, the client is simply asked to write a letter to someone or something in their life. A client could be invited to write a letter to a deceased loved one, to an abuser, to a role model, to themselves in the past or future, to their addiction, to their body, to the part of self that feels hopeless, to society, or even to God. It is stressed that this letter will not actually be sent to the recipient, instead the purpose of the letter writing process is for expression, catharsis, and insight. Letter writing is adaptable for nearly any topic, and the recipient of psychodramatic letters can be people who are real, imagined, or deceased, as well as entities, objects, or groups. Some common uses of psychodramatic letter writing are for expressing anger, processing grief, warming up to making amends, articulating hurt, verbalizing gratitude, and offering inspiration.

Clients can also be instructed to engage in psychodramatic letter writing through role reversal. Some common examples of this might include writing a letter to yourself from a deceased loved one for closure, a letter to yourself from someone you hurt offering forgiveness, a letter to yourself from a role model offering inspiration, or a letter to yourself today from yourself in the future. When facilitating psychodramatic letter writing with clients, it can be helpful to conceptualize the letter writing from self as having the goal of catharsis of abreaction while the letter writing in the role reversed position has the goal of catharsis of integration.

Another similar process is psychodramatic journaling which is fundamentally the psychodramatic intervention of soliloquy or a monolog in written form (Dayton, 2015b). The client is asked to role reverse with someone, something, or a part of themselves in the past, present, or future and articulate the thoughts and feelings of that role in the form of journaling. Another option is to invite the client to role reverse with a witness or “a fly on the wall” to explore their experience of a situation (Dayton, 2005). This is essentially using the psychodramatic intervention of the mirror position through psychodramatic journaling. Psychodramatic journaling can be helpful in promoting cathartic abreaction or integration. While psychodramatic letter writing is inherently directing a message between two roles or people, psychodramatic journaling is exploring the inner experience of one role or person.

Both psychodramatic letter writing and journaling are used as interventions, but they also provide the social worker with diagnostic information about the client’s experience of self and others. A more modern adaptation of these processes is through the use of vlogging or video recording instead of writing. The younger generation seems to have developed a culture where the recording and sending of short videos have become normalized (YouTube, Facebook, Snapchat, Instagram, TikTok, etc.). A clinician could invite a client to record a psychodramatic video message that they wish they could send to someone or to reverse roles with someone and record a soliloquy or message from the role of the other. This can even be utilized by clients in-between sessions as a means for expressing thoughts or feelings through recorded soliloquys that they will share with their therapist in session.

The letter writing and journaling processes can be integrated with the social atom, role atom, and timeline exercises as a way of facilitating a psychodramatic experience entirely on paper. After drawing their social atom or role atom, a client could be invited to write psychodramatic letters to and/or from the most significant people or roles on their social atom or role atom. In a similar way, the client could be invited to engage in psychodramatic journaling from the perspective of one of the people or roles on their social or role atom. When the timeline is brought into this mix of interventions, it offers an exponential increase in the number of social atoms, role atoms, psychodramatic letters, and journal entries that could be facilitated in the past, present, or future.

The psychodramatic letter writing and journaling processes help clients articulate and make sense of difficult experiences. This may be, in part, because of the left brain-oriented nature of writing and language. When traumatic memories are activated, brain scans indicate a lack of left brain activity; psychodramatic letter writing and journaling help to promote hemispherical integration in the brain (Dayton, 2005). Multiple research studies have provided evidence that various forms of therapeutic writing or journaling offer psychological, emotional, and other health benefits (Baikie & Wilhelm, 2005; Pennebaker, 1997; van der Kolk, 2014). The contained and slower-paced nature of psychodramatic letter writing and journaling make them great interventions for professionals new to psychodrama. An in-depth exploration of these written interventions can be found in Tian Dayton’s The Living Stage (2005) or NeuroPsychodrama (2015a, 2015b) books.

5 Conclusion

Social work casework and individual assessments can be enhanced through the integration of various sociometric assessment tools including the social atom and the role atom. The social atom offers clients an avenue for depicting their meaningful relationships with others, objects, and institutions while the role atom offers a process for portraying their relationship to significant roles and sub-roles as they relate to the construction of personality. The combined use of the role atom and social atom offers a holistic framework for exploring both internal parts and social environments of clients. The integration of timeline assessments in the diagnostic process offers numerous layers of exploration into clients’ histories and futures. Each of these tools is adaptable as a written assessment or experiential process when working with individual clients or in group settings. Psychodramatic letter writing and journaling offer further interventions for contained psychodramatic processes within the social atom, role atom, or timeline. These pen-to-paper tools provide new psychodrama students or less warmed up clients with a contained mechanism for beginning to integrate sociometry and psychodrama into their work.