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Behind the scenes of sociodrama, with Ágnes Blaskó: Interview with Hilary Bradbury of AR+

Hilary: Ágnes thanks for meeting with me to talk about your paper. It’s called “Action research with sociodrama in a healthcare institution.” We just published it in the action research journal. Congratulations!  By the way I like the poster you use to invite people to your work.  Can you help me with the Hungarian?

Ágnes: Thank you, Hilary.  I’m happy to talk to you from my department at Budapest University of Technology and Economics. [More on Agnes background here.] The caption means “Put down the CROWN!”  It’s a pun. We are playing with the word crown  and also with corona, as in corona virus. Frankly we hadn’t yet realized just how much shedding power is a challenging message. 

Hilary: So already we get a taste of the dynamics you’re inviting your stakeholders to work with. Thank you. Now I’d love to hear a little more from the behind the scenes. Let’s start with a little bit about yourself and your commitment to sociodrama.

I call myself a sociodrama leader, trainer and methodological developer, I’m extremely committed to sociodrama. You ask me the origin of my passion. I first met it in the form of psychodrama. But I felt that this dramatic approach is much more than psychology to grapple as  it can also deal with contextual, social and societal issues. At that time I was a teacher and I begin to use it as a method in the secondary school I taught in. It came clear to me that it can be used in many fields – from teaching writing and literature to understanding complex theories, also on the teaching of international law, something I do with a professor colleague from the Faculty of Law.  Nowadays I work with the question how sociodrama can be adapted for different fields within different social contexts beyond the field of education.

Hilary: As an educator who has become really attracted to the methodology of sociodrama, what strikes you about why sociodrama is useful?

Ágnes: I always say that if someone knows /meets with this methodology and is open for it then this method will open up for them. Perhaps especially in the hands of teachers as they are the ones who need respond effectively to various situations every day. In our teacher trainings, educators quickly master action methods and apply them in remarkable ways. One of my favorite cases is of a math teacher who uses sociodrama to teach functions. The  students understood the differences between sine and cosine by role-playing the functions themselves! The most important aspect of sociodrama is that we can reveal complex systems around a variety of issues and elaborate on knowing the whole context from different, also cultural, perspectives. I worked with an Hungarian team to implement sociodrama as within the Hungarian cultural context as colleagues did likewise in their European countries. At the end of this project, we also produced a booklet about the process of sociodrama, freshly translated into English, though not available yet online. 

So let’s hear examples of sociodrama from the paper we just published. I better give a little context for people who haven’t read your paper. You’re working in a hospital with 27 anesthesiology assistants and, essentially, helping them to tackle the problem of tribalism – such as intergroup tribalism and inter-professional tribalism  – so they come to embrace what you call responsible agency. How did you get these healthcare workers interested in sociodrama to start with?

Ágnes: This research has an exciting backstory. Originally, we had an idea to improve the psychological effectiveness of simulation-based medical education using action methods. I worked on this with an anesthesiologist colleague, and we were both very committed to supporting healthcare workers because we saw how burnt out they were. So, despite our contract not covering the reach into sociodrama, we started holding sociodrama workshops anyway. These workshops were quite successful. Looking back, I see that there was also a big difference between our viewpoints: my colleague focused more on personal, psychological changes, while I was more interested in the contextual aspects. This later becomes very important for understanding how to communicate the project’s goals to a variety of stakeholders at different levels of the healthcare system. So a long process preceded the start of the work you just published. During COVID, I held “flash groups” and after their shifts, assistants would stumble out of the intensive care unit early in the morning. You could see on their eyes who had lost patients that night. It was terrible. I asked them to stay for 5 minutes, and if they felt that what was happening was not helpful, they could go home to recover. About 40 percent of them stayed. That’s when I learned how and why they stay in the group.

Let’s have an example. What did it look like to do a session with the anesthesiology assistants.  Paint a picture for us so we can imagine what you were doing

Ágnes: Imagine first that we are sitting in a circle with the anesthesiology assistants. It’s very important to understand that they are not  even familiar with sitting in a circle.  I bring, therefore,  a few different methods to bridge more comfortably. They say that “I’m not going to clown around here”; “I can’t act” etc. I meet them there with these preconceptions at the beginning. I also sit in the circle, and join in their small talk and listen very carefully. And suddenly we start up and I ask participants to exchange chairs and thereby to change their position. So, everyone moves, and then I ask them to continue the discussion, but now from the position of the colleague who was previously sitting in the chair. It is surprising, easy to do and a bit funny. I am cautious to avoid offensive interactions, so, I direct the conversation so that they articulate each other’s strengths while in the “switched” role. For example, I might help tee up an interaction by saying: “So earlier it became clear why the patient is so important to you…” or “You were able to stand up for the team so assertively earlier…” and each participant responds from the perspective of the colleague. Then we switch back and everyone can sit again on the original chair but with a new experiential understanding of each other’s perspective. It’s a good starting point of the workshop; helping to create the conditions. Since everyone has gained some strength and is warmed up to the role reversal, we can start the work. We then proceed and use dramatic methods to understand a specific problem, say inter-professional conflict. We also use tangible methods like creating statues and specifically role-playing the issue at hand, so that in pausing we make visible both the contextual factors of the problem and the human factors, such as possible emotions and thoughts. Together this helps us find the solutions that the system needs. In sociodrama, these solutions sometimes appear at a personal level, but more often at the group, institutional, or social levels. We see that as a group, we can do something when it becomes clear how we can contribute as a community.

So, this is responsible agency coming alive. I bet it’s very empowering to find that the issue which disturbs someone is not just about them. It is not just their individual fault. Yet they can also call themselves and others to take action to help bring a resolution.  It seems to me that you effectively help create a special space for these kinds of insights and steps forward together. What would you say were the major outcomes in this work you did?

Ágnes: Sometimes the most important results come back almost by chance. For example, there was a very contentious situation in the operating room that had been ongoing for years among the different professionals. In an operating room, there are at least two types of doctors, a scrub nurse, a scrub tech, and an anesthesiology assistant, in addition to the patient, so quite inter-professional. I worked exclusively with the assistants on the problem, and within a few weeks, it became apparent that a doctor noticed the change. The conflict seemed to ease, and it was realized that the cause was related to what was happening in the sociodrama workshops. The doctor started also showing interest in these workshops. This case became further proof for me of how a sociodrama group can bring about bottom-up changes that ripple through the entire institution.

Also I can mention direct effects, such as that participants learning to ask for help from each other, even though asking for help does not really fit with the self-image of an anesthesiologist or intensive care professional here. Since their superpower lies in being saviors, not in needing to be saved.

What you are describing suggest the beginnings of a deeper transformation in identity and practice with those you work with. And their doing it together allows for a whole part of the system, I call it the relational space, so that there are conditions in place for people to engage and transform together in a way that repatterns old patterns.

Now as we’re coming to the close of the of the conversation what do you think you learned yourself, for yourself, in doing sociodrama? Is your own practice improving?

Ágnes: I think one of the main challenges, and thus a learning experience for me, concerns the ethical question of how to communicate in advance so the participants can fully get that we will be working at personal, interpersonal and cultural levels. For them, this is not foreseen until they can see the value for themselves. For example, the leader is, at first, not interested in societal-level changes and may not want institutional-level change as it may be disruptive. So they might engage at first only wanting mental health support for their employees or, at best, to address specific group problems. Similarly, the group participants are initially not concerned with the institutional focus because they are focused on their own issues. So if I were to start discussing the possible levels of change at the beginning of the process, I encounter significant resistance. So how can I be transparent at the beginning of the process? My answer is, I can’t, or not easily anyway.

I’m learning solutions to this. First, I can show the model developed in the article from the start, which illustrates that participants’ perspectives will expand and their focus will broaden throughout the process. Second, I can provide continuous feedback and seek ongoing consent from participants. Specifically, I do this by indicating in each workshop that the goal of the work is to impact our broader environment. Therefore, although personal matters arise, we disseminate the results of our work as a shared output. After each workshop, having documented the topics that were discussed, and the common solutions developed at various levels, I ask participants to review these notes. I encourage corrections of what they disagree with or find too personal. This way, everyone can retrospectively control what from the events can be shared publicly and, importantly, what should be disseminated and discussed. I believe this is a good method to remain ethical in the process, balancing personal and broad scope processes.

So we’re coming to the end of our conversation. I like to end with a reflection on a particular practice that you might recommend to readers who are action researchers so they can practice a bit on their own.

Ágnes: Understand that the essence of sociodrama is role reversal. The idea of swapping seats that I gave earlier is just one example. What follows this is key, however: situations, principles, and thoughts come to the fore in relation to a common issue. This inevitably pushes us out of our own perspectives and changes our positions, and we do this together, as a community. Sociodrama is based on infinitely democratic principles, and once you master it, you can use it in various fields. Its ethos, philosophy, and even the individual steps align completely with the spirit of action research. It just comes with its own specific methodology that can support both the facilitator and the participants. So I’d say it’s definitely worth learning sociodrama!  I believe that it has a system or language with which you can help contribute to transformative change processes quite easily.

I learned this type of work myself through The Living Theater work of David Diamond in Canada. He had elaborated new methodologies from working with Augusto Boal’s Theatre of the Oppressed. I found myself inspired by these methods as they suit participative work and bring more dynamism and interactivity. As you say it’s very much in the spirit of the action research tradition. Wasn’t Jakob Moreno (father of sociodrama and network analysis) influenced by Hungarian practitioners?

Ágnes: Yes, you’re probably thinking of Moreno’s personal encounters with Ferenc Mérei, an exceptionally prominent Hungarian psychologist and educational expert of his time.  

Thank you Agnes! For bringing your rich background to the readers and practitioners of action research. This helps bring your published work alive.  Congratulations again on your work and your publication. It’s been lovely to speak to speak with you. And I wish you the very best for the future.

Ágnes: Thank you very much for the discussion I’m very happy we talked today.

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Citation and forever link to paper: Blaskó, Ágnes. (2024). Action research with sociodrama in a healthcare institution. Action Research. https://doi.org/10.1177/14767503241258875

The designer of the poster is László Frauenhoffer.