A historical analysis of sociometry, psychodrama, and group psychotherapy is incomplete without also presenting the life of Jacob L. Moreno. While there is no disagreement about Moreno being the founder of sociometry and psychodrama, there is controversy about his claim to be the founder of group psychotherapy. At the very least, he was a pioneer of group work and group psychotherapy. His sociometric and psychodramatic approach to group work offered one of the only alternative approaches to psychoanalytic groups at the time of its conception. To understand the marginalization of Moreno’s approaches in the larger group work and social work arena, it is essential to get to know Moreno himself.

1 History of Group Psychotherapy

Within the group work arena, there is some ambivalence surrounding the development of group therapy. Many attribute the first group therapy session to Dr. Joseph Pratt who, in 1905, brought together 15 of his tuberculosis patients in Boston for an educational meeting and gradually noticed the therapeutic effects of these groups for his patients (Hadden, 2015). Pratt’s approach certainly is group work, but can we call it group therapy? Moreno argues that an educational lecture and discussion cannot by itself be classified as group psychotherapy, because first the group (group = patient) must be diagnostically assessed (1947a). Others suggest that J.L. Moreno is the father of the group psychotherapy movement which encompassed multiple group methods attributed to other individual pioneers—including Pratt’s didactic approach and Trigant Burrow’s group analysis (Meiers, 1946; Moreno, 1966; Renouvier, 1958; Thomas, 1943). It appears that the emergence of group work field was introduced by a group of pioneers.

According to Jacob Moreno (see Fig. 3.1), there have been three psychiatric revolutions. The first was led by Philippe Pinel at the turn of the eighteenth century in France with the rejection of punishment in favor of treatment for the mentally ill. Sigmund Freud led the second psychiatric revolution by shifting the conceptualization of mental illness symptomology from neurological roots to a psychological basis. Jacob L. Moreno, in a 1955 address to the American Society of Group Psychotherapy and Psychodrama (ASGPP), laid claim to group psychotherapy as the third psychiatric revolution with himself as its pioneer (Moreno, 1961, 2006; Nolte, 2014).

Fig. 3.1
figure 1

Jacob Moreno in the early 1960s. Reprinted with permission from Figusch (2014)

The terms “group therapy” and “group psychotherapy” were first formally introduced by Dr. Jacob L. Moreno in 1932 at the annual conference of the American Psychiatric Association in Philadelphia (Moreno, 1945; Moreno & Whitin, 1932). Until 1935, Moreno was the only author to use the terms “group psychotherapy” or “group therapy” (Renouvier, 1958).

1.1 Group Psychotherapy Defined

Moreno’s group therapy ideas began in 1913 with his experience organizing a group of sex workers in Vienna—“we began to see then that one individual could become a therapeutic agent of the other and the potentialities of a group psychotherapy on the reality level crystallized in our mind” (1955a, p. 22). Moreno argued that group therapy must include more than an educational lecture, a discussion, a group member sharing their story to the group, or even watching a psychodrama, though group therapy may include one or more of these (1947b). While Moreno also advocated for the use of group work outside of the psychotherapy realm, this question is restricted to that of group psychotherapy. In his Open Letter to Group Psychotherapists, Moreno states that “in individual psychotherapy the patient is a single individual. In group psychotherapy the patient is a group of individuals” (1947a, p. 16).

John Nolte, in The Philosophy, Theory, and Methods of J.L. Moreno, offers us a striking clarification regarding group psychotherapy:

Moreno’s idea of group psychotherapy meant treating the group; other group therapists remained focused on the individual, and their methods could often be better described as treating individuals in a group setting. Individual psychotherapy, Moreno pointed out, is based on the psychodynamics of the individual. The treatment of a group is based on sociodynamics that involve the interrelationships and interactions of the members of the group, not just the collection of individuals and their personal dynamics. According to Moreno, treatment of groups became possible only after the development of sociometry, which allows the group therapist to identify and characterize the constellation of relationships existing within a group. (2014, p. 122)

Group psychotherapy developed within the context of Moreno’s triadic system of sociometry, psychodrama, and group psychotherapy (Moreno, 1946). It is important to note here that many group work experts in the social work profession have also criticized social work practitioners and educators as lacking a basic understanding and competency to engage the group-as-a-whole, instead they do casework or individual therapy in a group setting (Bitel, 2014; Corcoran, 2020; Giacomucci, 2020; Gitterman, 2005; Knight, 2017; Kurland & Salmon, 2005; Shulman, 2015).

According to Carl Whitaker, Jacob L. Moreno “was probably more clearly responsible for the move from individual therapy to the understanding of interpersonal components of psychological living than any other single psychiatrist in the field” (Fox, 1987, p. ix; as cited in Gershoni, 2009). Moreno organized both the first American and International societies of group therapists and served as the first presidents of these societies—now known as the American Society of Group Psychotherapy and Psychodrama (founded in 1942) and the International Association of Group Psychotherapy (founded in 1973).

1.2 Moreno’s Controversial Personality

Moreno viewed each human as having within them a mirror of the Godhead. He aimed to realize and actualize his own expression of godlikeness, and at the same time, he was not always a saint. In some ways, his actions contributed to the isolation of sociometry and psychodrama and their lack of presence in the social work field. The clinical social work field adopted much of its foundation from psychology , psychoanalysis, and psychodynamic schools in an attempt to professionalize as early as the 1920s (Ehrenreich, 1985). Moreno’s philosophical system contradicts with psychoanalytic theory and Moreno himself was an outspoken critic of it. He believed that insight was a product of action—what he called action insight. And he believed that creativity and spontaneity were a necessity for change. He harshly criticized Freud’s talking cure. In an encounter with Freudthat possibly took place at the University of Vienna, Moreno declared:

Dr. Freud, I start where you leave off. You meet people in the artificial setting of your office. I meet them on the street and in their homes, in their natural surroundings. You analyzed their dreams; I try to give them courage to dream again. (Moreno, Moreno, & Moreno, 1964, pp. 16–17)

Taken from their context, one might have guessed that these words were uttered by a social worker in that they reflect early social work’s philosophy and practice.

Moreno’s differentiation from Freud and his followers is one of the reasons that sociometry and psychodrama have been marginalized in the larger psychotherapy field (Gershoni, 2009; Moreno, 2014). In 1934, Moreno writes of the conflict between his approaches and psychoanalysis stating “there is no controversy” between the two approaches, “I am the controversy” (Moreno, 1934, p. cviii). Gershoni (2009) indicates two primary reasons for psychodrama’s isolation in the larger group therapy field: “One was that Moreno’s ideas and methods were wildly divergent from established methods in the fields of psychiatry and psychotherapy, particularly psychoanalysis. The second was that his personality was as controversial as his ideas” (p. 298). J.L. Moreno established the ASGPP in 1942, and within a year of its founding, Samuel Slavson started the American Group Psychotherapy Association (AGPA). AGPA maintained a psychoanalytic focus and much higher professional standards even requiring doctoral degrees for membership (Moreno, 2019). The ASGPP welcomed anyone as a member and was more focused on psychodrama and the other creative arts therapies (until they formed their own associations in the 60s and 70s). Moreno and Slavson developed a rivalry which seems to be continued to this day by the ASGPP and AGPA which remain mostly segregated with their own memberships, journals, theoretical traditions, and histories (Blatner, 2005; Gershoni, 2009). Gershoni (2009) writes that there is only about a ten person overlap in membership and that each organizations’ journal includes almost no reference to each other’s publications.

While the AGPA and ASGPP continue to remain loyal to their histories, the International Association of Group Psychotherapy and Group Processes (IAGP) operates as an inclusive group work organization with an entire section devoted to psychodrama and another to group analysis. It seems that the American group organizations became divisive and differentiated themselves from each other while the IAGP and group workers around the world have done a much better job at integrating psychodrama into mainstream group work and psychotherapy as a whole.

Moreno’s personality also impacted the integration of his ideas into academia in the USA. Though he initially emerged as one of the most notable social scientists in the 1930s, his personality got in his way and in the way of the acceptance of his approaches. One of his critics writes, “his commitment to mysticism, his bombastic personal style and his megalomania drove most of his early supporters away. These features of Moreno’s persona (see Fig. 3.2) were too much for regular members of the academic community to bear” (Moreno, 2014, p. 144). Moreno published most of his work through his own publishing house (Beacon House), which may have also contributed to the absence of his work beyond the psychodrama community. Perhaps the greatest lost opportunity for integrating his methods into academia came in 1947 when Moreno was nominated by leading professors from multiple universities to head Harvard University’s new sociology department laboratory. He writes of his gratitude for the unnamed sociometrist who spoke on his behalf arguing that he would not be a good fit for the role—“I owe him everlasting gratitude for talking in my behalf as an auxiliary egoin absentia—remarked that I would hardly accept the job, that I would not fit into academic life, with its formalities and limitations” (Moreno, 2019, p. 87).

Fig. 3.2
figure 2

Jacob Moreno in action. Reprinted with permission from Figusch (2014)

2 History of Sociometry, Psychodrama, and Jacob L. Moreno

While group work was gaining momentum in the USA, J.L. Moreno ’s ideas of sociometry, psychodrama, and group psychotherapy were beginning to emerge in Vienna. In the early 1900s, as a university student, he and his friends founded the Religion of the Encounter and opened the House of the Encounter, which seems to mirror the settlement house. It is interesting to note that Jane Adam’s settlement house even included drama clubs which were the most popular groups within Hull House (Bailey, 2006). The House of the Encounter provided free support, help completing official applications, job assistance, food, housing, and legal support for refugees and immigrants flooding into Europe (Marineau, 2014; Nolte, 2014). In the evenings at the House of the Encounter, everyone gathered for a community ritual discussing the events, concerns, and problems of the day. Moreno described these mutual aid meetings as the first encounter groups and a “theater of everyday life” in his autobiography (2019, p. 211).

Moreno describes himself as a mystic prior to his education in psychiatry. He studied theology and philosophy and was deeply influenced by his spiritual experiences and beliefs. He wrote of the evolution of an understanding of God, moving from a distant I-He God in the Old Testament, to a more personal I-Thou God with Jesus in the New Testament. His religion, and one of his early anonymous publications titled Words of the Father (1921), pronounces a new philosophy of an I-I God. Moreno was declaring that everyone has the capacity of accessing and awakening the Godhead within them. To support his claim, he highlighted creativity as a quality inherent to deities across culture and history and argued that human beings also have the capacity to create. The Religion of the Encounter is the basis for Moreno’s conceptualization of human nature through an existential and spiritual framework that recognizes the dignity and worth of each individual. Moreno’s sociometry, psychodrama, and group psychotherapy developed from the philosophy that we are “cosmic beings” in addition to our biological, economical, sociological, and psychological nature (Moreno, 2012). Through this conceptualization of human nature, he avoided pathologizing approaches and worked to empower individuals and groups to heal themselves.

Later, in his work at Mittendorf refugee camp, he had proposed that a formal assessment and diagnoses would uncover the social configuration of the refugee camp as the root of its troubles and formally suggested that the camp be restructured “by means of sociometric analysis” (Marineau 2014, p. 55). Moreno’s work in Mittendorf, between 1915 and 1918, is identified as a foundational event in the establishment of sociometric theory. Coincidentally, at about the same time, Mary Richmond published her famous book “Social Diagnosis” (1917) as social work practice continued to evolve, emphasizing the social environment of the individual (Giacomucci, 2018a). Moreno originally conceptualized group therapy as the treatment of oppressed, marginalized, or excluded populations (Gershoni, 2013; Nolte, 2014)—he worked with a variety of populations including immigrants, sex workers, prisoners, and the severely mentally ill. Stimmer (2004) claims that because of the context and nature of Moreno’s work, sociometry, psychodrama, and group psychotherapy really began as social work—“Die psychodramatische Idee jedenfalls begann als Soziale Arbeit; ihre Wurzel, ihre Basis ist die Soziale Arbeit” (“In any case, the psychodramatic idea began as a social work; its root, its basis is social work”; p. 19).

Moreno’s experiments with drama and theater began in the parks of Vienna playing with the children, telling them stories, and experimenting with role-playing . In the refugee camp, he developed Theater Reciproque where refugees found relief from their harsh reality by engaging in the surplus reality of drama. Of this time, Moreno writes, “when Theater Reciproque becomes a part of the life of the community it takes on the force of a religious ritual, a ritual of healing.” (2019, p. 212) As a mystic studying medicine at the University of Vienna, Moreno seems to conceptualize the healing process from a religious perspective.

Jacob L. Moreno writes that the first psychodrama/sociodrama took place in Vienna on April Fool’s Day of 1921, at a decisive time in Austria just after World War I and the dismantling of the Austria-Hungary Empire. Dressed as the king’s jester, he called for members of the prestigious audience to come on stage and take the role of “King of the New World Order” and discuss their plans to stabilize the country. Shortly after this historical moment, Moreno organized the Theater of Spontaneity (Stegreiftheater) which enacted spontaneous scenes incorporating the audience, often using events from the local newspaper or suggested topics from the audience. Moreno intended to use the theater as a medium for social change, but in the process, observed that participation had been therapeutic for both the audience and role players (Nolte, 2014; Marineau, 2014; Moreno, 2019). He developed his vision of sociatry —or psychiatry for society (1947) which articulated his commitment to healing at the societal level: “A truly therapeutic procedure cannot have less an objective than the whole of mankind. But no adequate therapy can be prescribed as long as mankind is not a unity in some fashion and as long as its organization remains unknown.” (1934, p. 3).

In 1925, Moreno immigrated to New York City. This decision was impacted by a number of factors including a vivid dream of living in New York that he had experienced, involvement in conflicts with other Vienna theater leaders, a new invention of a recording device he was working on, and hopes for a new audience that would be more accepting of his ideas. Prior to his migration to the USA, Moreno published his first nine books anonymously, inspired by his spiritual principles which suggest that ideas could not be owned by anyone:

A name is a form of capital and links the inventions and works of an author to proprietary, priority and other legal rights. Anonymity, on the other hand, begins and ends with the assumption that a work created by an individual or a group is not the property of anyone in particular, it belongs to universality . (Moreno, 1955, p. 29).

However, as a result, many of his early ideas were taken by others. In his move from Austria to the USA, he shifted from primarily religious writing to primarily scientific publications and began to publish using his name.

Upon arrival to New York, Moreno began tirelessly working to promote his ideas offering demonstration at hospitals, churches, prisons, and schools, though he experienced many difficulties as an immigrant. At her suggestion, he married Beatrice Beecher in 1926, largely to be granted US citizenship and a license to practice medicine in New York State. In 1929, he opened Impromptu Theater at Carnegie Hall, a re-creation and adaptation of the Vienna Theater of Spontaneity. In 1932 at the APA conference in Philadelphia, he presented his sociometric research from Sing Sing Prison coining the terms “group therapy” and “group psychotherapy.” It is interesting to note that psychoanalyst Franz Alexander, who coined the term corrective emotional experience, was present at this 1932 APA meeting with Moreno and commented on the potential effectiveness of Moreno’s group method to reduce crime (Moreno & Whitin, 1932). Through his work in the early 1930s, Moreno gained the support of Dr. William Alanson White, superintendent of St. Elizabeths Hospital in Washington, DC and former APA president. While supporting Moreno in New York, White was also working with Harry S. Sullivan in DC (Marineau, 2014) who later developed an interpersonal theory of psychiatry (1953) which shows some resemblance to Moreno’s interpersonal theory of sociometry.

For an entire year in the early 1930s, Moreno lived at the New York State Training School of Girls at Hudson, New York, and worked as the Director of Research. Here, he conducted extensive sociometric assessments, tests, interventions, and research which led to the 1934 publication of one of his most famous books, Who Shall Survive?: A New Approach to the Problem of Human Interrelations. Moreno and his colleagues in Hudson were some of the first social scientists to address racism and racial tensions within communities (Moreno, 2014). By this time, he was lecturing regularly in multiple universities including Columbia University, the New School for Social Research, and New York University. Beginning in 1935, Moreno started predicting boxing match winners through the application of sociometric analysis; for the next 19 years, he never made a wrong prediction and was often in the newspapers because of it. After his short marriage to Beatrice, he married Florence Bridge in 1938. Jacob and Florence had one child, Regina Moreno, and worked together to further the field of psychodrama until their divorce some years later. Florence’s contribution to psychodrama theory was primarily on the topic of child development (Moreno & Moreno, 1944).

It was not until 1936 in Beacon, New York, that Moreno began to systematically develop and use psychodrama as a form of psychotherapy at which point, he developed a reputation for successfully treating psychosis, interpersonal problems, and marital conflicts. In 1936, Moreno opened Beacon Hill Sanitarium in New York State which was later renamed Moreno Sanitarium (see Fig. 3.3). It was here that his group therapy and psychodramatic approaches found a firm foundation and was used routinely with his clients suffering from severe mental illness. This treatment program was in many ways similar to the milieu therapy and therapeutic communities that would emerge later (Moreno, 2014).

Fig. 3.3
figure 3

Beacon Hill Sanitarium, later renamed Moreno Sanitarium in 1951. Reprinted with permission from Figusch (2014)

Moreno Sanitarium developed a reputation for treating “untreatable” psychiatric cases (Moreno, 2019). In his work with patients with psychosis and schizophrenia, rather than try to convince them that their delusions and fantasies were not real, he encouraged them to act it out on the psychodrama stage. In 1937, the Red Cross Director became interested in psychodrama, and a few years later, a psychodrama stage was built at St. Elizabeths Hospital in Washington, DC, the largest federal mental health institute in the USA. Even President Franklin D. Roosevelt expressed interest in Moreno’s ideas in the mid-1930s hoping that they could help the USA through its time crisis (Moreno, 1955).

In 1941, Zerka Toeman traveled from England to Beacon, New York, in hopes of finding effective treatment for her mentally ill sister at Moreno’s Sanitarium. Zerka quickly began working for Jacob Moreno, editing and translating his work and later contributing her own additions to sociometry and psychodrama. Later in 1949, they married. In 1941, J.L. Moreno opened the Sociometric Institute and Theater of Psychodrama (later known as the Psychodramatic Institute) in downtown New York City where he began to train other practitioners in his new model—from the late 1940s until the early 70s, six nights a week, a public psychodrama was conducted at J.L. Moreno ’s Manhattan theater (Moreno, 2014). Within a few years, dozens of psychiatric hospitals around the USA were using psychodrama in their treatment programs including multiple Veterans Administration hospitals—some of which event built dedicated psychodrama stages on their campuses.

In the USA, Moreno’s popularity increased in the 1940s and he was even considered for a department chair role at Harvard University (Moreno, 1955). American Sociologists adopted Moreno’s ideas with a passion while American psychiatry remained less interested. The American Sociological Society even created a section on sociometry in 1941 and in 1955 began publishing Moreno’sSociometry journal which had been in print since 1937 (Moreno, 2019). The Cold War and World War II sparked a greater reliance upon group therapy due to the influx of soldiers back into society. All three branches of the US military employed Moreno’s sociometry concepts along with Lewin’s group dynamic analyses to enhance the functioning of military leadership (Moreno, 2014). The US Navy became particularly interested—sociometric studies in the Navy discovered that poor group cohesion and low sociometric choices were correlated with various poor outcomes such as sick days, low morale, accidents, and disciplinary actions (Moreno, 2014). The British sent leaders of the military to study sociometry with the Morenos’ to better understand the varying death rates in various military platoons. They attempted to use used sociometry to organize groups of soldiers within the army during the war—“the whole process of induction and basic training in the British Army was restructured along the lines laid down by sociometric theory” (Moreno, 2019, p. 320). By the 1950s, Jacob Moreno and his wife Zerka Moreno had begun traveling six months of the year to provide psychodrama demonstrations around the world. The increasing popularity of psychodrama at the time is evidenced by a 1950 publication which estimated that about one-third of all mental institutions were using psychodrama as a therapy approach (Borgatta, 1950).

In the 1960s–70s, psychodrama techniques became popularized through the encounter movement, T-Groups, sensitivity training, the Human Potential Movement, and humanistic psychology. J.L Moreno’s work influenced most of the leaders of these movements who had studied with him previously, including Kurt Lewin, Abraham Maslow, Fritz Perls , Viktor Frankl, and Carl Rogers (Maslow, 1971; Moreno, 2014, 2019; Treadwell, 2016). Within these popular movements, very little credit was given to Moreno’s influence. Moreno was friendly with Kurt Lewin, who was a pioneer of group dynamics, T-Groups, action research, and founded the National Training Laboratories (NTL) which had a significant impact on the field of group dynamics and group research. Unfortunately, Lewin died suddenly in 1947 and his followers and Moreno did not get along which further marginalized psychodrama from the emerging T-Group movement and group dynamics research (Moreno, 2014).

The popular magazine Life published a 1968 article on the Human Potential Movement (Howard, 1968) which provoked Abraham Maslow, father of humanistic psychology and former APA president, to send the following letter to the editors:

Jane Howard’s article on Esalen and other new developments in education and psychology was excellent. I would however like to add one ‘‘credit where credit is due’’ footnote. Many of the techniques set forth in the article were originally invented by Dr. Jacob Moreno, who is still functioning vigorously and probably still inventing new techniques and ideas. (Maslow, 1968, p. 15)

Other authorities in the field have made similar comments as it relates to Moreno’s influence on the encounter movement, the Human Potential Movement, T-Groups, gestalt therapy, and other experiential techniques. Eric Berne, the founder of transactional analysis, comments on this dynamic which he calls the Moreno problem:

Perls, founder of the gestalt movement, shared with other ‘active’ psychotherapists the Moreno problem: the fact that nearly all known ‘active’ techniques were first tried out by Moreno in psychodrama, so that it makes it difficult to come up with an original idea in this regard. (Berne, 1970, p. 164)

Similarly, William Schultz, a pioneer in the encounter group movement, notes that “virtually all of the methods that I had proudly compiled or invented [Moreno] had more or less anticipated, in some cases forty years earlier” (as cited in Blatner, 1996, p. 181). And in his book on the history of the encounter movement, Kurt Back (1972) notes that “Moreno can claim, perhaps rightly, that he is the originator of both group therapy and encounter groups” (p. 149).

J.L. Moreno believed that the encounter movement “cannibalized” his work and impacted the reputation of psychodrama (Moreno, 2014, 2019). It was during this time that many developed concerns for the psychological safety of psychodrama techniques and encounter groups which had become more focused on confrontation (Blatner, 2000; Cooper, 1974, 1975; Giacomucci, 2018b; Posthuma & Posthuma, 1973; Yalom & Lieverman, 1971). In a large study on various types of encounter groups, researchers found 7.8–9.1% of participants reported harm related to their participant in the encounter groups (Lieberman, Yalom, & Miles, 1973).As the encounter groups (as well as T-Groups and sensitivity training groups) became more sensationalized in the late 1960s and early 1970s, academic respectability and theoretical connections dissipated leading to a loss in credibility (Spence, 2007). As the evidence-based practice movement began to take root and grow in the 1970s–90s, the encounter movement and psychodrama techniques continued to lose their popularity.

In 1974, Jacob L. Moreno died. He abstained from food and drink after a long battle with illness. Moreno’s youthful dream had come true—his methods had been adopted into the larger culture while his influence remained mostly anonymous. When his friend and colleague Lewis Yablonsky visited him just before his death, Moreno whispered in his ear, “I’ve lived a full life. I’ve done my job. It’s time for me to go on to something else” (1976, p. 284). Although his life on earth ended here, in true psychodramatic fashion, the final chapter of his autobiography describes his future projected journey beyond death—into the afterlife including encounters with God, angels, Freud, and the great philosophers (Moreno, 2019).

3 Moreno as a Social Worker and Sociatrist

Jacob Moreno ’s career reflects that of a social worker. His clinical work was with societies most oppressed and underserved communities including immigrants, refugees, prostituted women, inmates, children, and the severely mentally ill. He explicitly worked to empower these communities and develop systems and tools to help individuals help each other. Early in his career, while his colleagues were practicing psychoanalysis, he was exploring the impact of relationships, society, and the environment on individuals—he even suggested that mental illness was a result of larger social forces (1950). Similar to the social work profession which emerged from charity and settlement house movements with religious influence, Moreno’s work began with the House of the Encounter . Moreno’s community work to promote exemplifies social work’s commitment to social justice, self-determination, and empowerment (Niepenberg, 2017). Moreno even worked several years as Director of Social Research for the New York State Department of Social Welfare. The whole of his work could be seen as a career composed of an integrated blend of case work, group work, and community work—micro, mezzo, and macrosocial work. His work included the entire range of social work practice including with individuals, couples, families, groups, organizations, communities, and even leaving an impact on the larger society. One aspect of social work that makes it unique is its multidisciplinary nature; it integrates psychology, medicine, sociology, criminology, philosophy, education, policy, politics, and activism. Similar to social work, Moreno’s work included each of these fields and his methods continue to be used within each of these respective fields.

Interestingly, in 1947, Moreno predicted that a doctoral degree in sociatry will be given in the future, utilizing a synthesis of knowledge from the fields of psychiatry, medicine, psychology, education, and sociology. He writes that “The art and skill of the sociatrist will depend upon a synthesis of knowledge towards which all social and psychiatric sciences will have made their contribution” (Moreno, 1947, p. 10). In the same year, Catholic University began offering the first Doctorate in Clinical Social Work (DSW) degree, though the PhD in Social Work had been around since 1920. By the late 1990s, the DSW degree disappeared until the University of Pennsylvania reintroduced it in 2007 (Hartocollis, Cnaan, & Ledwith, 2014). If Moreno was alive today, he might argue that the DSW is the fulfillment of his prediction—the social worker is fundamentally a sociatrist, one that treats conditions arising from interrelations of individuals, families, groups, and society.

4 Sociometry and Psychodrama Since Moreno’s Death in 1974

Following J.L. Moreno ’s death , Zerka continued to spread psychodrama through her leadership, writing, and training—she is affectionately remembered by many as “the mother of psychodrama” (see Fig. 3.4). A year after J.L. Moreno ’s death, the American Board of Examiners (ABE) in sociometry, psychodrama, and group psychotherapy emerged to provide standards for certification and promote a wave of professionalism in the psychodrama field. While J.L.’s writing was hard to understand and philosophically complex, Zerka translated his methods in a way that made it easier to understand and teach. A collection of Zerka’s most popular publications was organized and republished under the title The Quintessential Zerka in 2006, making them more available to students and trainees. In her memoir, To Dream Again (2012), she mentions around two dozen countries that she repeatedly traveled to teach psychodrama.

Fig. 3.4
figure 4

Jacob and Zerka Moreno in Amsterdam in 1971. Reprinted with permission from Figusch (2014)

In the decades after Moreno’s death, the membership of the American Society of Group Psychotherapy and Psychodrama was consistently declining. Other creative arts therapists, who were previously ASGPP members, began to organize and found their own societies including the dance therapists (in 1966), art therapists (in 1969), music therapists (in 1971), drama therapists (in 1979), and the poetry therapists (in 1981). Numerous other humanistic psychologies (including gestalt therapy and transactional analysis) emerged. Concurrently, the counselors (in 1973), psychologists (in 1991), and social workers (in 1979) began to establish their own formal group work divisions or associations. Previously, the ASGPP and AGPA (in addition to AAGW until its 1955 merger with NASW) were the only group therapy organizations in the USA—with ASGPP being the only creative arts therapy organization. As such, it attracted a much broader membership of group workers, psychodramatists, and creative arts therapists until they differentiated with their own organizations.

At the same time, many mental health hospitals that had adopted psychodrama were closing due to deinstitutionalization policies. The development of new psychiatric medications led to the further medicalization of mental health treatment and a significant decline in inpatient treatment programs beginning in the late 1950s. While psychiatric hospitals closed and medicalization promoted medication-based treatments for mental illness, it also created conditions for alcoholism and addiction to be recognized as a disease and an increased number of addiction treatment programs became available. Many of these programs integrated psychodrama into their programs tracing their psychodrama lineages to the therapeutic communities, or trainers such as Virginia Satir, Sharon Wegscheider-Cruse, Tian Dayton, and others.

In the first few decades after Moreno’s death, it seems that psychodrama’s popularity significantly declined overall in the USA while increasing around the world. One of the larger influences related to psychodrama’s decline in the USA included the lack of quality research on psychodrama as the psychotherapy field moved toward medicalization and evidence-based practices. Psychodrama’s theory of change, spontaneity -creativity theory, makes it nearly impossible to manualize the psychodramatic approach, and thus, it was not eligible for review as an evidence-based practice by the American Psychological Association. As the psychodrama field progressed, it seems to have fallen short in its attempts to professionalize. In the USA, most psychodramatists are in private practice rather than university settings which limits their access to research support and research grants (Orkibi & Feniger-Schaal, 2019). Until the mid-1990s, very little had been done to address psychodrama’s potential for re-traumatizing clients. As trauma theory and trauma research progressed (Herman, 1997; van der Kolk, 1996), multiple trauma-focused and trauma-informed psychodrama approached emerged (Dayton, 1994; Giacomucci & Marquit, 2020; Hudgins & Toscani, 2013; Kane, 1992; Kellermann, 2000) but the damage to psychodrama’s reputation had already been done. A new wave of cognitive behavioral psychotherapies seemed to monopolize the psychotherapy field with a plethora of empirical research to support their approaches which seamlessly fit within the US medical system.

Although the mental health field in the USA has not embraced psychodrama in the past few decades, it is especially popular in Australia, New Zealand, Europe, Turkey, Israel, Asia, and South America (Nolte, 2014). Many countries have established psychodrama psychotherapy as a scientifically validated evidence-based practice (Orkibi &Feniger-Schaal, 2019). Though it is hard to find psychodrama in US universities, various other countries have entire graduate degree programs in sociometry and psychodrama (Giacomucci, 2019). While psychodrama’s popularity declined in the USA, it continued to increase on the international stage. The influence of culture may have been at play in these larger fluctuations as well. The countries that do have robust psychodrama communities also have cultures that place significant value on community, relationships, and expression. Individualism and the medical model in the USA appear at odds with many of Moreno’s theories.

In the past few years, it seems that both group psychotherapy and psychodrama are increasing in popularity again. The most recent meta-analysis on psychodrama psychotherapy indicates an increase in psychodrama research from 2008 to 2017 with over a quarter of studies in that decade taking place in 2017 (Orkibi & Feniger-Schaal, 2019). Between 2011 and 2013, the North-West Psychodrama Association in England republished 9 of J. L. Moreno’s most popular books which had become difficult to find since they were no longer being printed. In 2018, the American Psychological Association formally recognized group psychology and group psychotherapy as a specialty which creates the possibility of new educational programs in group psychotherapy. In 2018, the Journal of Social Work with Groups published two articles emphasizing the usefulness of J. L. Moreno ’s triadic model—psychodrama, sociometry, and group psychotherapy—for social workers who facilitate groups. The first article explores the “synergistic relationship between group work and psychodrama” while discussing “the convergence of these two approaches as well as ways they can enhance one another and service delivery when used together” (Skolnik, 2018, p. 1). The second article continues the dialogue started by Skolnik and emphasizes the power of psychodrama to renegotiate traumatic experiences (Giacomucci & Stone, 2019). The authors of the two aforementioned articles also teach the only current psychodrama courses within social work graduate programs in the USA at Yeshiva University (Sari Skolnik) and Bryn Mawr College (Scott Giacomucci) which both emerged in the 2019 Spring semester.

Moreno died in 1974 before he could finish organizing his complete autobiography. In 2019, the completed Autobiography of a Genius was published—just a year after the 100th anniversary of Moreno’s Daimon journal publication in Vienna. Social worker’s interest in the creative arts therapies continues to increase (Heinonen, Halonen, & Krahn, 2018). In 2020, the Social Work with Groups journal published a special edition titled The Creative Practitioner: An Introduction to Psychodrama, Sociometry, and Group Psychotherapy. This appears to be the first social work journal to publish a special edition on psychodrama and is a significant event in the integration of sociometry and psychodrama into the social work field. If this momentum continues, we could see a more dramatic re-emergence of sociometry and psychodrama within the social work field. At this particular point in time, there appears to be newfound interest and growing attention to Moreno’s methods in the social work field and the other mental health professions. Perhaps we are at the beginning increased integration and collaboration between psychodramatists and social workers. This book is an attempt to concretize that integration.

5 Conclusion

In our work with clients, we engage in a thorough history taking process in order to fully understand the here-and-now presentation of a client. Without this, intervention or future planning is limited. The same is true when considering the future of an organization or a field—in the case of this chapter, the future of the field of psychodrama. An understanding of Moreno’s methods is incomplete without considering the historical contexts during which his methods were developed and how the larger socio-cultural forces influenced his work, particularly in the USA where he was living and working. The history of psychodrama emerged in parallel with the history of social work. Both histories intertwine with the fields of group work, psychology, and medicine (see Fig. 3.5).

Fig. 3.5
figure 5figure 5

Parallel timelines depicting the intersections between social work, group therapy, Moreno, psychodrama, psychology, medicine, and USA history