A multiple single case design study of group therapeutic puppetry with people with severe mental illness

Therapeutic puppetry is the use of puppets to aid emotional healing. There is no published research investigating the effectiveness of therapeutic puppetry with people with severe mental illness (SMI). A pilot investigation of group therapeutic puppetry with people with SMI tested the hypotheses that this intervention results in improvements in mental wellbeing, self-esteem, and body connection. It also investigated mechanisms of change, and service user acceptability and experience. In this mixed methodology study, five single ABA design case studies were utilised, with time series data analysed using simulation modelling analysis. Qualitative data was collected via participant observation and participant interviews and analysed using thematic analysis. Three participants experienced statistically and clinically significant changes in either positive or negative directions during the intervention, with all participants describing therapeutic puppetry as powerful and beneficial. The authors conclude that therapeutic puppetry is a potentially powerful medium which could be utilised by various mental health professionals. Furthermore, service users find therapeutic puppetry acceptable and beneficial despite it being an occasionally difficult and intense experience.

► Participants can both improve and decline during group therapeutic puppetry.
► Participants found therapeutic puppetry acceptable and more consistently beneficial.
► Therapeutic puppetry may rapidly reveal unconscious traumas and conflicts.
► Twelve weeks may be insufficient length for group therapeutic puppetry.
► Therapeutic puppetry facilitates cross-discipline collaboration.