The World Alliance of Dramatherapy: History, Purpose, and the Work of

The World Alliance of Dramatherapy: History, Purpose, and the Work of Global Professional Belonging

Prof. Nisha Sajnani, Maria Sol Guerrero Gimenez, M.D., Dr. Ravindra Ranasinha, Dr. Russya Coor, Dr. Kyoo Ho Moon, Dr.Chanaphan Thammarut, Dr. Majid Amrai(Amraei), Lindsay Irwin, Francesca McInally, Dr. Yi Yang, Pedro Torres, Dr. Rinat Feniger-Schaal, Shruti Garg, Akhila Khaa, Dr. Stelios Krasanakis, Marc Alexander Willemsen.

Abstract

The World Alliance of Dramatherapy (WADth)[1] was established in 2017 as a global alliance of professional, membership-based drama therapy associations and currently comprises 17 associations representing 34 countries, with approximately 4,223 documented members. Rather than functioning as a regulatory or accrediting body, WADth was conceived as a federated platform to support international exchange, collaboration, and collective visibility for the field. This article traces the historical conditions giving rise to the Alliance, examines its mission and organisational form, and situates WADth within broader debates on professionalisation, cultural plurality and global mental health. It also reflects on the tensions and challenges that accompany efforts to build global professional belonging across uneven sociopolitical, regulatory and economic contexts. Drawing on WADth’s official mission documentation and established drama therapy scholarship, the article argues that WADth represents a distinctive model of global professional organisation, one grounded in relationality, plurality and reflexivity rather than standardisation alone, and concludes by considering implications for the future development of drama therapy as WADth enters its second decade.

Keywords: drama therapy, dramatherapy, drama-therapy, professional identity, belonging, creative arts therapies

Introduction

Drama therapy has matured as a profession across multiple cultural contexts over the past nearly 70 years. Originating from overlapping traditions in theatre practice, psychology, community arts, developmental drama and anthropology, the field has developed diverse training programmes, professional associations and research orientations across Europe, North America, Australasia, Asia, Africa and Latin America (Emunah 1994; Landy 1994; Levy and Cornejo 2003; Jeings and Holmwood 2016; Johnson and Emunah 2020; Jones 2007). Despite this growth, there had been no single locus of global organisation to systematically support cross-border collaboration, mutual recognition, and collective advocacy. The North American Drama Therapy Association (NADTA), initially founded as the National Association of Drama Therapy (US) in 1979, provided a model of multi-country representation when it became the NADTA in 2013. Efforts to coect dramatherapists across Europe date back to the 1990s and eventually crystallised into the European Federation of Dramatherapy (EFD), founded in 2013 as a federated body for collaboration in the field (Willemsen and Pitruzzella 2026). In other regions, drama therapy emerged within broader movements to professionalise the creative arts therapies, as in the Netherlands, where the Dutch Association for Expressive and Creative Therapy was founded in 1962 (Willemsen et al. 2024).

In response to the absence of a global forum, the World Alliance of Dramatherapy (WADth) was established in 2017 as a federated international platform where member associations could cooperate without surrendering autonomy or imposing uniform standards. This organisational choice speaks to a central question in the creative arts therapies: how to cultivate professional coherence while honouring cultural specificity and epistemological diversity (Sajnani, Marxen and Zarate 2012; Johnson and Emunah 2020). This article examines the history, mission and organisational form of WADth, situating it within ongoing discourses in drama therapy scholarship about professional identity, research paradigms and global practice, and reflects on the strengths and challenges of WADth as a model of global professional belonging. It has been co-authored by current representatives and allies of the WADth as a means of reflecting on the value of this international effort over the past decade.

Drama Therapy Before the Alliance: A Plural Field

The development of drama therapy as a profession did not follow a linear, centralised trajectory; rather, it emerged through multiple intersecting traditions and institutional pathways. Two of the oldest professional organisations were formed in the United Kingdom and the United States. In the US, the National Association of Drama Therapy (NADT), established in 1979, later became the North American Drama Therapy Association (NADTA) in 2013, extending representation to Canadian drama therapists following several years of Canadian representation on their Board of Directors and a vote of the membership (Butler and Gains 2020).

In other contexts, the profession has evolved through the interplay of local performance traditions, culturally rooted healing practices, community rituals, environmental catalysts, training programmes and regulatory requirements. In Sri Lanka, modern dramatherapy practice formally emerged in 2014 through structured training that integrated Buddhist psychology, indigenous performance traditions and contemporary therapeutic frameworks (Ranasinha 2013). Responding to post-war, post-tsunami and ongoing socio-political psychosocial needs, this work is grounded in culturally responsive pedagogy that honours traditional healing rituals while meeting international professional standards, thereby legitimising indigenous epistemologies within therapeutic practice (Ranasinha 2025). Dedicated training and research bodies such as the Research Institute for Dramatherapy, in collaboration with national institutions including the Sri Lanka Foundation and civil-sector partners, have translated dramatherapy from dispersed practice into certificate- and diploma-level education, supervision and applied research, embedding it within psychosocial, educational and post-conflict recovery infrastructures.

In Latin America, the professional field of dramatherapy is still consolidating, yet the region has a long history of community-based, performative and arts-based psychosocial practices rooted in popular theatre, ritual, education and collective healing. Many of these practices developed outside formal professional labels but share core principles with drama therapy, particularly embodiment, symbolic action and social transformation. Within this landscape, Chile and Argentina have been pioneering sites of formalisation. In Chile, drama therapy was institutionally introduced in 2005 through the region’s first postgraduate training programme, which became a hub for practitioners from Chile and neighbouring countries; since 2024, EDRAS Chile has provided further training focused on clinical, educational and community practice, alongside the professional association ACHIDRA, re-founded in 2024 and currently bringing together around twenty members. In Argentina, close dialogue with the Chilean experience led to the creation of a university-based postgraduate diploma at the National University of Cuyo in 2018, supported by the Faculties of Medicine, Arts and Education, and the foundation of Dramaterapia Argentina (DAr), which now includes around sixty members and provides a national organisational framework for training and professional exchange.

In the Middle East, drama therapy has developed at the intersection of long-standing cultural traditions and contemporary professional organising. In Iran, the Iranian Psychodrama and Drama Therapy Association, which began its official activities in 2002, has been central in consolidating the field nationally, with representation across nine provinces and work structured around graduate-level training and therapeutic services for children, adolescents and adults. Centres in Tehran, Khuzestan, Kerman and Rasht collectively reflect a geographically distributed and socially responsive model of practice. In Israel, drama therapy developed within YAHAT (the Israeli Association of Creative and Expressive Therapies), established in 1971. Today, approximately 400 registered drama therapists practise throughout the country, supported by two accredited MA programmes and a PhD programme, and have contributed notable research to the international field (e.g. Korde et al. 2023), reflecting both the early recognition of dramatic methods as therapeutic tools and sustained efforts to establish drama therapy as a recognised profession.

Across Asia, drama therapy has grown rapidly over the past two decades. In South Korea, development has proceeded through two main pathways: practitioners trained in the United States and United Kingdom, and local drama and psychodrama specialists adapting practice to Korean contexts. Growth has been supported by opeess to integrative and alternative therapies and by prior acceptance of other arts therapies in medical, educational and welfare systems. Drama therapy is now taught at postgraduate level in more than ten universities, with expanding undergraduate and doctoral provision, and is practised across schools, hospitals and community settings, often supported by national health and welfare voucher schemes. Contemporary practice integrates international models with locally grounded emotion-focused and movement-based approaches, alongside efforts to develop culturally responsive assessment tools and theoretical foundations (Park 2016). In Taiwan, dramatherapy emerged in the late 1980s, catalysed by Chang’s graduate study at NYU (2016) and subsequent introduction of workshops and university courses. It expanded through theatre departments, teacher-training programmes and private institutions, supported in part by national arts education policy, yet Taiwan still lacks a dedicated graduate programme and unified professional pathway. In response, Chang and colleagues called for a Taiwan Drama Therapy Association, which has since been formed in 2025, to convene practitioners and coordinate training, research and ethics appropriate to the local context.

In Southeast and East Asia, newer organisational structures continue to form. In Thailand, the Dramatherapy Thailand Association (DTTH), established by Thai-registered dramatherapists in 2021, works to develop a drama therapy database and certified training programme amid limited professional recognition and concerns about adapting UK-based training within Thai cultural contexts; early clinical research has begun to explore outcomes with Thai PTSD patients (Thammarut 2024). In China, practitioners with backgrounds in theatre, psychology and education have long experimented with psychodrama, Developmental Transformations (DvT), playback theatre and related approaches (see Johnson and Emunah 2020). Since the first Chinese drama therapy student graduated from NYU in 2016 and became certified in 2017, more than fifteen Chinese drama therapists have completed formal training in the US and UK, and in 2025 they established Drama Therapy China (DTChina), an emerging organisation dedicated to recognised, ethical practice.

In Hong Kong, drama therapy gained momentum in the 2000s as locally based practitioners returned from overseas training, established the Hong Kong Association of Drama Therapy (HKADT) and introduced the modality into community organisations, mental health services and higher education. The Master of Expressive Arts Therapy at the University of Hong Kong helped position drama/theatre within a broader expressive arts framework, while clinical placements, NGO services and school programmes increased public awareness of drama therapy’s relevance to youth mental health, trauma and community wellbeing. However, the field continues to confront the absence of a standalone degree, lack of statutory recognition and limited human resources. In response, HKADT has prioritised the development of a localised ethics code, adapted from international standards and reinterpreted for Hong Kong’s linguistic and organisational contexts.

In South Africa, where performance, ritual and embodied arts have long played a role in healing, the formal profession of drama therapy is relatively recent. In the late 1990s and early 2000s, practitioners trained abroad returned at a time of urgent need for collective healing in the aftermath of apartheid. Early professional organising secured recognition of Drama Therapy by the Health Professions Council of South Africa (HPCSA), including formal registration, examination processes and professional representation, enabling drama therapists to work in medical, educational and community settings and advocate within the national health system. The South African Association of Drama Therapists (SAAD) was established as a modality-specific professional home, while the broader arts therapies network SANATO struggled to meet the diverse needs of the professions and was eventually dissolved, in part because its activities remained uniquely accessible to a privileged white minority (Nebe 2016). Subsequent gatherings such as the 2009 Tapping the Field symposium and the 2010 Building Bridges: The Arts Therapies in Africa conference underscored the need for unified advocacy on issues such as engagement with the HPCSA, ethics and public sector recognition. Sustained efforts for locally based training led to the establishment of Drama Therapy education at Wits University in 2013, aimed at contributing to social transformation through the recruitment and development of drama therapists and applied drama practitioners (Nebe 2016). In 2019, the South African National Arts Therapies Association (SANATA) was created as a consolidated professional body for four arts therapies professions, integrating SAAD and formalising a relationship with WADth.

By the early twenty-first century, national drama therapy associations existed in multiple countries, shaped by local regulatory, educational and healthcare environments. Yet international exchange remained largely episodic and informal, occurring mainly through national conferences with limited global participation, publications and ad-hoc practitioner networks, conditions that set the stage for the formation of WADth.

The Establishment of the World Alliance of Dramatherapy

The World Alliance of Dramatherapy was formally launched in 2017 as a global alliance of professional drama therapy associations. Its stated purpose is to facilitate cooperation among associations, promote drama therapy internationally, support the exchange of information, encourage collaboration across cultures and languages, and foster international research on the state of the profession (World Alliance of Dramatherapy). At present, WADth consists of 17 professional member associations representing 34 countries with, at the time of writing, a total of 4,223 documented members (Appendix A)

It is important to note that WADth was designed as an alliance of representatives of professional associations rather than individuals and is not an accrediting or regulatory authority. Member associations retain autonomy over their own standards and governance, participating in WADth as an international platform of coection rather than a centralising institution. This structural choice reflects both pragmatic constraints, given the diversity of educational and regulatory systems globally, and ethical commitments to pluralism and relationality that align with the philosophical underpiings of dramatherapy practice. It also highlights that decisions about representation, including who is invited into such a platform, when, and on what basis, are themselves shaped by existing networks, knowledge, language and geopolitical location, and thus call for ongoing reflexive scrutiny in light of WADth’s values of inclusivity and global belonging.

The move toward a formal alliance emerged from informal conversations among senior figures in the field. Exploratory discussions took place between colleagues such as Nisha Sajnani, Stelios Krasanakis, David Read Johnson, Ingrid Lutz, Susana Pendzik and others, who reflected together on the desirability and feasibility of a global alliance and on the kinds of structures that might best support international collaboration. These exchanges helped clarify both the perceived need for a global forum and the initial criteria for membership, namely that it should be an alliance of professional membership based associations and not individuals.

Building on these preliminary conversations, Prof. Nisha Sajnani, in her capacity as past president of the North American Drama Therapy Association and Director of the Graduate Program in Drama Therapy at New York University, sent a letter inviting a more formal consideration of a World Alliance to an initial group of leaders of professional membership-based drama therapy associations, including Alyson Coleman (BADth – U.K.), Dr Joaa Jaaniste (NECTA – Australia), Prof. Jason Butler (NADTA – North America), Prof. Johaes Junker (EFD – Europe), Prof. Susana Pendzik (YAHAT–Israel) and Leané Meiring (SAAD, South Africa). After consulting with their respective organisations, each one shared a written expression of interest (Appendix B).

Viewed in hindsight, this initial invitation process can be understood as a critical moment for reflexive learning within WADth: it illustrates how global professional projects emerge from partial vantage points shaped by existing networks and uneven visibility across regions, and how subsequent developments have required the Alliance to revisit inclusivity, visibility and outreach so that its evolving membership aligns more closely with its stated commitment to global professional belonging. As the Alliance's reach expanded, particularly in the Global South and non‑Anglophone contexts, members also identified additional leaders, including Prof. Miri Park (Korea), Dr Majid Amrai (Iran), Dr Ravindra Ranasinha (Sri Lanka) and Dr Sol Guerrero (Argentina) among others.

Image 1: The first picture taken of several founding members of the World Alliance of Drama Therapy: Back (L-R) Nisha Sajnani, Salvo Pitruzella; Front (L-R) Kirsten Meyer, Joaa Jaaniste, Jason Butler, Alyson Coleman, European Consortium of Arts Therapies Education conference in Krakow, Poland, 2017).

Mission and Organisational Aims

The first meeting of the WADth was held online on October 14, 2017 to begin conversations about the mission, objectives, activities, and governance structure of the Alliance. NYU continues to play a non-voting coordination role by funding a graduate student position to support the maintenance of the website, public engagement on social media chaels, and to coordinate quarterly meetings and special initiatives. The following objectives were determined by consensus, which continues to be the primary approach to decision-making:

In addition to supporting established professional associations, WADth also functions as a forum for associations in the process of formation, offering a space for dialogue, learning and peer support as professional identities and organisational structures take shape. This has been particularly significant in contexts where dramatherapy is emerging as a recognised profession but formal associations are still being developed, including recent and ongoing processes in China, Japan, Kenya, Lebanon, Mexico, Pakistan, Philippines, Taiwan, and Turkey. In these contexts, WADth provides opportunities to engage with international peers, observe diverse models of professional organisation and reflect collectively on questions of training, ethics and representation without prescribing a singular pathway to professionalisation. In this sense, WADth operates as coective infrastructure rather than a normative authority, aligning its emphasis on dialogue, exchange and shared visibility with dramatherapy's orientation toward participatory and reflective practice.

Governance Without Centralization

One of WADth's defining features is its non-hierarchical governance model. The Alliance operates through representatives of member associations, with a rotating meeting chair and consensus-oriented decision-making. Quarterly meetings allow time for representatives to consult with their constituencies, resisting centralised control and foregrounding relational accountability. This governance approach aligns with the profession's attention to role, power dynamics and relational context in therapeutic practice, and seeks to keep power differentials, political tensions and resource inequities visible, inviting ongoing critical reflection on participation and representation.

Nonetheless, this governance model presents pragmatic challenges, including loss of shared institutional memory, language accessibility, uneven technological capacity and participation shaped by resource disparities. Attempts to establish committees, including Practice, Ethics, Advocacy and Research Committees, have therefore struggled with sustained engagement. Other challenges are discussed later in this article.

International Drama Therapy Week and Global Visibility

International Drama Therapy Week is a signature WADth initiative, held aually in the third week of October. Practitioners and member associations independently organise workshops, performances, talks, and educational events, while WADth provides a shared timeframe, hashtags (e.g. #dtweek, #dtweek2025), and online amplification. Social media metrics show increased visibility and public awareness during this campaign, with reach and content interactions multiplying between roughly ten‑ and several hundred‑fold over the course of International Drama Therapy Week. The distributed format reflects WADth’s view that global identity emerges through multiplicity, functioning as both advocacy and collective ritual.

Image 2: Representatives of the WADth meet quarterly over zoom

Research, Knowledge Production and Epistemological Plurality

WADth's commitment to promoting international research has important implications for how knowledge in dramatherapy is produced, circulated and interpreted across diverse contexts. Research traditions vary considerably across regions, shaped by differences in academic infrastructures, funding regimes, professional regulation and dominant epistemological orientations, which in turn influence both research methods and outputs and which forms of knowledge are recognised as legitimate or authoritative within particular settings.

Through its international networks, conferences and communication platforms, WADth facilitates encounters among practitioners, educators and researchers working within different research cultures. While such exchanges do not necessarily challenge established hierarchies of evidence, they create opportunities for dialogue in which practice-based, qualitative and culturally situated forms of inquiry can be articulated alongside more formal academic research. To date, WADth has used its website and social media platforms primarily for information-sharing and signposting relevant journals and published research, reflecting an emphasis on visibility rather than methodological endorsement. Systematic analyses would be needed to assess how fully epistemological plurality is realised in practice.

In 2022, WADth coordinated the first global pilot survey of drama therapy practitioners to take stock of the profession’s contemporary contours across its member associations and beyond, with findings presented at an online drama therapy conference hosted by New York University but not yet published in the academic literature.[2] Drawing responses from 421 professionals in 34 countries, of whom 83% identified as drama therapists, the survey suggested a field that is both demographically narrow and professionally diverse: most respondents were women in the ethnic majority of their countries, aged 35–65 with more than six years of practice, yet they worked across a wide range of clinical and community settings and applied drama therapy with children, adolescents and adults in roughly equal proportions. The data also highlighted striking global asymmetries, with strong representation from associations in the United Kingdom, North America, the Netherlands and Israel, and comparatively limited participation from South American, Arab and African countries, mirroring wider inequities in training provision, professional recognition and research infrastructure. At the level of practice, respondents reported treating primarily anxiety, trauma-related conditions and depression, while describing a labour landscape in which most are employed part-time, earn modest incomes relative to national contexts, and navigate hybrid roles across clinical, educational and community sectors. As an early, Alliance-led effort to map who is currently visible within organised drama therapy, where and how they work, and with which populations, the survey points to the value of WADth convening periodic formal global “state of the field” inquiries as a core contribution to research and knowledge production about the profession.

Challenges facing the World Alliance

The challenges facing WADth and its member associations operate at three interrelated levels: external sociopolitical and regulatory conditions, internal organisational dynamics within the Alliance, and broader epistemic questions about evidence, practice and professional identity.

External sociopolitical and regulatory conditions

WADth’s establishment coincides with growing international interest in arts-based and embodied approaches to social care, health promotion and community wellbeing (Sajnani and Fietje 2023). Dramatherapy practitioners increasingly work in contexts shaped by displacement, collective trauma and systemic inequities, where traditional individual psychotherapy models may be limited or inappropriate. In such arenas, dramatherapy often functions as community-based psychosocial support, emphasising collective meaning-making, imagination, action, agency and social coection. WADth offers a forum in which these practices can be articulated without being subsumed under narrowly medicalised frames, providing an important counterpoint to dominant global mental health paradigms.

At the same time, the sociopolitical and regulatory contexts within which dramatherapists live and work are highly uneven, a reality that has been a recurring topic in WADth’s quarterly meetings. In many countries, dramatherapy is not formally recognised as a profession, and practitioners operate amid political instability, economic precarity and urgent social needs. In such settings, the development of professional training, research and regulatory frameworks for arts-based therapies is often deprioritised in favour of more immediate concerns related to health, housing, employment or social conflict. This creates a structural tension between evident psychosocial needs and limited institutional support for disciplines such as dramatherapy.

The Australian context illustrates how professional recognition can fluctuate in response to policy shifts. A decade ago, dramatherapy was relatively well established: creative arts therapy Master’s programmes were offered at institutions such as the University of Melbourne and Murdoch University, including a standalone dramatherapy degree at Melbourne. These pathways lent legitimacy to the profession, and dramatherapy was regarded as comparable to other psychotherapy modalities in both remuneration and professional standing, reflected in National Disability Insurance Scheme (NDIS) pricing that positioned creative arts therapies alongside other evidence-based supports. In late 2024, however, the NDIS issued updated guidelines that effectively excluded creative arts therapies, including drama therapy, from its list of recognised evidence-based supports. While describing such therapies as “permissible,” the NDIS stated that they “do not meet the evidentiary standards required to be classified as a ‘therapy’,” ( NDIS Statement, 2024) and implemented this shift abruptly, without consultation, transparency or prior warning. Drama therapy, though not specifically named, was implicitly grouped with art and music therapies, with little recognition of its distinct theoretical and clinical foundations.

The consequences were immediate: participants experienced disruptions in care, and practitioners faced a sharp decline in professional recognition and remuneration. Therapists previously compensated in line with their qualifications were reclassified alongside general support services, resulting in both economic and symbolic devaluation. A subsequent Independent Review of Art and Music Supports, led by health economist Dr Stephen Duckett AM,[3] acknowledged “some evidence” for creative arts therapies but recommended aligning remuneration with counselling rates on the basis that these are “developing professions” that are not yet nationally regulated (Duckett Review, 2024). This partial recognition nevertheless reinforced perceptions of creative arts therapies as auxiliary rather than integral to the mental health ecosystem, highlighting broader tensions in the professional identity and belonging of drama therapists in Australia, who remain caught in cycles of validation and devaluation shaped more by bureaucratic decision-making than by the growing body of clinical evidence.

In India, sociopolitical tensions around the professionalization of Drama Therapy are closely tied to the country's evolving allied health legislative landscape. Since 2022, professionally qualified Drama Therapists have been advocating for recognition under the category of 'art therapist' within The National Commission for Allied and Healthcare Professions Act, 2021 (NCAHP) which sits within the Health Ministry. While the Ministry made provision for arts therapies under Entry 7 of the Schedule to the NCAHP, it only named art and dance movement therapy as examples. Drama Therapy, along with other modalities such as Music Therapy, Creative Arts Therapy and Expressive Arts Therapy, were inadvertently omitted as examples. This legislative gap has made formal recognition a matter of both policy and proximity as much of the advocacy depends on who one knows in positions of political influence and what metrics they would consider valuable at what time (ie: school literacy, suicide rates), which also risks the professionalization of the field becoming folded into state or legislative agendas that may not always align with orientations of individual drama therapists. Sustained visibility through conferences and public panels, where Drama Therapists and NCAHP members have spoken together on mainstream Indian public health policy (Indian Association of Dance Movement Therapy, 2025) has marked meaningful progress in this direction alongside efforts to articulate core processes rooted in its own cultural and clinical contexts, and develop local postgraduate training so that aspiring practitioners are no longer compelled to invest significant financial and personal resources in seeking degrees abroad.

In Sri Lanka, sociopolitical and regulatory challenges are particularly pronounced. Dramatherapy is not formally recognised by a governmental licensing or monitoring authority, and no statutory body exists within the public health system to regulate or accredit dramatherapists. The dominance of a biomedical psychiatric culture has further marginalised psychotherapy and arts-based approaches, often positioning them as secondary or “non-essential” within psychiatric rehabilitation settings (Ranasinha 2021). As a result, dramatherapists are largely excluded from inpatient mental health services and staff development programmes in state hospitals, despite widespread psychosocial need.

Within these regulatory constraints, practitioners have developed alternative pathways to sustain and advance the practice. Private-sector organisations, non-governmental actors, religious institutions, schools and community networks have become key sites for training, practice and outreach. Through these chaels, dramatherapy has reached outpatient populations affected by war-related trauma, natural disasters and socio-political violence (ibid). State engagement has emerged only intermittently, such as the Ministry of Health–led dramatherapy training for mental health workers in 2018, which demonstrated institutional opeess without translating into long-term professional recognition or regulatory reform. This situation exemplifies the structural tension between urgent community-level psychosocial needs and limited institutional prioritisation of arts-based therapies. While culturally responsive dramatherapy has proven adaptable in addressing trauma and psychiatric rehabilitation in Sri Lanka, its development remains dependent on informal networks, individual advocacy and short-term initiatives rather than sustained policy commitment.

Such cycles of validation and devaluation highlight broader tensions in the professional identity and sense of belonging experienced by dramatherapists worldwide, shaped less by consistent evidence appraisal than by shifting bureaucratic priorities and sociopolitical climates.

In Thailand, due to the limited recognition of the art-based approach and restrictions on the number of practitioners, dramatherapists have collaborated with other professionals, including art therapists, music therapists, and dance and movement psychotherapists. Together, they have proposed the establishment of “Creative Arts Therapy” as a recognised healthcare profession with formal professional accreditation. This proposal is currently under review by the relevant regulatory authorities.

In Hong Kong the long lacked statutory recognition and limited human resources, exacerbated by broader social and livelihood pressures, including the tightening social control under the national security law and the resulting outflow of professionals, has made it difficult to build a robust body of evidence-based, locally grounded research, leaving the field in a prolonged state of early-stage development.

Sociopolitical realities also serve as a reminder that dramatherapy is never practised in a vacuum, but develops within wider historical, economic and political contexts unfolding on a global stage. In this sense, the World Alliance of Dramatherapy has created a unique space for professional dialogue that transcends geopolitical boundaries and tensions. Members from countries without diplomatic relations or those considered to be in conflict have found in the Alliance a forum where they can meet, exchange ideas, and celebrate their shared dedication to the field. These encounters, facilitated through virtual platforms, enable coections that would be difficult or impossible to establish through other chaels. The ability to collaborate professionally with colleagues from nations otherwise deemed adversarial represents one of the Alliance's most meaningful contributions - demonstrating how a shared commitment to healing and creative expression can build bridges across even the most entrenched political divides.

Taken together, these dynamics help explain the profound diversity in how dramatherapy is organized, recognized and practiced across regions, underscoring the importance of WADth as a space for dialogue, reflection and collective professional learning. These external conditions shape not only how drama therapy is organized and practised within specific countries, but also how WADth itself must continuously strive to configure representation, participation and sustainability as a global alliance.

Internal Challenges

Against this backdrop, WADth also faces a number of internal challenges related to representation, participation, organisational continuity and resources. First, questions of representation and voice arise in relation to how member associations are formally positioned within the Alliance.

The EFD, which includes 18 countries, agreed to having a single representative from the EFD as a whole rather than having EU members join both groups. However, given their status as founding members of WADth, accommodations were made for BADTh and YAHAT to have representation at both the EFD and WADth. Questions have been raised about whether this was justified and whether this decision should be revisited. The leadership of the EFD and WADth have needed to remain vigilant of this complexity as it reflects broader concerns about whose voices are heard and whose are not.

Related concerns surface around the rotation of representatives within the Alliance. While this ongoing renewal is a significant strength, bringing new perspectives, energies, and voices into the collective, it also carries costs in terms of continuity and institutional memory. Given that WADth meets formally only four times a year, some discussions necessarily unfold in fragmented ways, are taken up by different people at different moments, or remain partially developed before being interrupted by changes in representation. This rhythm can at times limit the depth with which complex issues are explored, even as it reflects the Alliance’s commitment to opeess, shared leadership, and distributed ownership.

These questions of representation are further complicated by the uneven organisational development of member associations. One of the challenges facing the World Alliance of Dramatherapy is the significant variation in organizational development and professional establishment among its member countries. Member organizations range from emerging groups with small memberships still working toward initial professional recognition, to well-established associations with hundreds of registered practitioners and formal accreditation structures already in place. This diversity means that the priorities, resources, and immediate concerns of member organizations can differ considerably, where a newer organization may be focused on gaining legitimacy and building foundational training programs, a more established one may be addressing questions of specialization, research standards, or regulatory frameworks. While navigating these differences requires careful attention to the distinct needs of organizations at various stages of development, this diversity also creates opportunities for mutual learning, with more established organizations able to offer guidance, share lessons from their own developmental trajectories, and provide inspiration to those in earlier stages of professional recognition.

For example, the Chilean association has at times been unable to maintain a representative within the Alliance due to internal restructuring processes, while in Argentina sustained participation has depended largely on the availability of a single English-speaking representative, reflecting broader linguistic and structural challenges within the field. These challenges underscore the complexities of global coordination without centralization, yet they also reflect WADth's ethical stance of prioritizing mutual recognition and shared ownership across differently positioned associations.

A second domain of tension concerns the boundaries of the Alliance and the definition of who 'counts' as a dramatherapist or a drama therapy association. As drama therapy intersects with adjacent fields such as community and applied theatre, education and social practice, WADth must negotiate membership criteria without foreclosing engagement from countries where professional identity, regulation and representation are still emerging. These tensions are not anomalies but are inherent to global professional organisations across differences. Our stance has been that WADth's value lies not in resolving them unilaterally, but in holding them as sites of ongoing negotiation, dialogue and reflexive practice.

A third internal tension lies in balancing efforts to articulate a shared scope of practice alongside ethical and training guidelines, developments that could meaningfully advance the profession, while maintaining a genuine commitment to pluralism. A clear example of this tension is embodied even in the spelling of the profession: Dramatherapy (U.K., E.U.), Dramaterapia (Argentina and Chile), Drama Therapy (North America), and Drama-Therapy (India). Beyond terminology, this challenge also involves ensuring that definitions of dramatherapy are not implicitly imposed by Western contexts where the profession has been most formally organised, but remain open to culturally situated forms of practice and professional formation. At the same time, this opeess raises a further complexity: how to recognize and legitimize diverse local practices and knowledge systems without losing the academic rigour, ethical standards, and professional coherence that have been developed within more established training and research traditions. This balance is particularly delicate in regions where access to training, literature, and international dialogue is uneven due to linguistic, economic, and geopolitical constraints, and where new forms of practice often emerge under conditions very different from those in which dominant models were originally formulated.

These definitional questions are not merely semantic; in contexts such as India they have become part of conscious efforts to adapt and localise the profession. In 2019, a significant conversation took place as drama therapists and allied professionals collaborated for the first time to create a successful two-day symposium at NIMHANS hospital, Bangalore. What began as a peer group of drama therapists, is now an 18 members association, registered under the Karnataka Societies Registration Act. Members, who were trained in the ‘West’ eventually chose to use a hyphenated spelling of ‘drama-therapy’, as a way to symbolize DTI’s continuous striving towards adapting ‘drama’ and ‘therapy’ to the diverse Indian context. Currently, Drama-Therapy India (DTI) is a nationwide initiative focused on increasing awareness, improving access to inclusive mental health support, and contributing to the broader health systems in India by centering drama-therapy processes. Through collaboration, research, education, and advocacy, DTI serves as a collective working to grow the understanding and application of drama-therapy throughout the country,

[Image 3]: The initial meeting to discuss the formation of a drama therapy organization in India which took place during a Symposium at NIMHANS, Bangalore, 2019. L-R: Back row: Prof. Nisha Sajnani, Mahnoor Yar Khan, Prof. Parasuram Ramamoorthi, Kashma Goyal, Pallavi Chander, Mike Clarke. Front row: Anshuma Kshetrapal, Dr. Maitri Gopalakrishna, Anupriya Meenakshi Banerjee, Noor Sengupta, Vikramjeet Sinha.[4]

A fourth internal tension concerns how best to support an international congress. In light of a small global membership, unequal currencies, travel-related costs, and global warming, WADth agreed not to compete with other professional events, but instead to invite WADth representatives to one another’s aual conferences and, where possible, to co‑produce gatherings. Since its founding, WADth has collaborated with the EFD twice to produce a global congress (Amersfoort 2023 and Riga 2025). More recently, however, meetings have highlighted the need to decentralise this practice and work toward more distributed opportunities to convene in coection with existing conferences outside the E.U.

[Image 4]: Representatives of the World Alliance of Dramatherapy during a plenary panel at the EFD Conference in Riga, Latvia. L-R: Prof. Nisha Sajnani (co-chair), Johaes Junker (co-chair), Maria Sol Guerrero Gimenez, M.D., Dr. Rinat Feniger-Schaal, Adam Stevens, Dr. Russya Coor, Dr. Chanaphan Thammarut, Anamarija Vuić (then student coordinator of WADth)

Broader ontological and epistemological uncertainties

Finally, WADth's work is conditioned by material and infrastructural constraints, including language, digital access, financial resources and environmental uncertainty. Language differences, uneven digital infrastructure and disparities in resources shape patterns of participation across regions. Reliance on institutional coordination and volunteer labour further raises questions about sustainability, continuity and equitable representation within the Alliance.

For example, during the COVID‑19 pandemic, drama therapists were compelled to shift practice into fully digitized and hybrid spaces in the absence of institutional infrastructure or formal regulatory guidance. Research conducted in Sri Lanka, demonstrated how digital platforms functioned as liminal therapeutic “studios,” simultaneously extending access and generating new ethical dilemmas around privacy, data security, embodiment, consent and the holding of therapeutic relationships within domestic spaces (Ranasinha, 2025). These experiences echoed insights from practitioners across countries (Keisari et al. 2023) and foreground epistemological challenges concerning what constitutes presence, dramatic reality and containment when bodily co‑presence is disrupted yet relational depth and symbolic play remain active. They also reveal how such hybrid practices intensified the positioning of drama therapists as practitioners working between systems: between formal health services and informal community networks, technological mediation and embodied practice, and global professional discourses and locally grounded cultural realities.

Conclusion: Why the World Alliance of Dramatherapy Matters Now

Tracing the emergence of WADth against the backdrop of diverse national and regional histories shows that global professional organisation in dramatherapy caot be separated from uneven regulatory regimes, linguistic landscapes, colonial legacies and material conditions. The Alliance has developed in dialogue with associations that range from long‑established bodies with formal accreditation structures to newly formed groups working toward initial recognition, and has had to navigate questions of representation, membership boundaries and scope of practice without defaulting to a single normative template. Its federated, non‑hierarchical governance model, with rotating chairs and consensus‑oriented decision‑making, seeks to keep questions of voice, power and institutional memory visible, even as it encounters practical challenges related to continuity, participation and resource disparities.

At the same time, WADth’s commitment to pluralism is expressed not only in governance but also in its approach to definitional and epistemological tensions. The coexistence of different spellings of the profession, varied training pathways and locally rooted practices underscores that dramatherapy is not a fixed entity to be exported, but a set of evolving, contextually situated processes. Efforts to articulate shared ethical guidelines, scopes of practice and research priorities therefore unfold alongside an insistence that local knowledge systems, Indigenous healing traditions and community‑based arts practices must be recognised rather than subsumed. In this sense, WADth functions less as an authority that resolves disputes than as a relational platform that holds them as sites of ongoing negotiation, reflection and learning.

The challenges facing the Alliance and its members including fluctuating professional recognition, fragile regulatory environments, linguistic and technological barriers, climate and travel constraints, and broader ontological and epistemological uncertainties, are not incidental but constitutive of global dramatherapy practice. Case examples from Australia, Sri Lanka, Thailand, Hong Kong, Latin America, South Africa and elsewhere illustrate cycles of validation and devaluation, the marginalisation of arts‑based therapies within biomedical systems, and the resourcefulness of practitioners who build alternative infrastructures through community networks, education and advocacy. Within this landscape, WADth offers coective tissue: a space where associations can share strategies, articulate tensions and support one another in navigating evidence regimes, policy shifts and sociopolitical crises that affect their work.

It is in this sense that the Alliance matters now. As dramatherapists respond to displacement, collective trauma, systemic inequities and environmental uncertainty, WADth provides a forum in which their practices can be understood not as peripheral or auxiliary, but as central to broader conversations about mental health, social care and community wellbeing. By enabling representatives from countries with divergent or strained geopolitical relations to collaborate around a shared commitment to healing and creative expression, the Alliance demonstrates how professional belonging can become a vehicle for solidarity across borders. Its emphasis on relationality, plurality and reflexivity offers an alternative to purely standardising models of global mental health, suggesting that coherence in the profession may emerge from sustained dialogue and mutual recognition rather than from uniform protocols alone.

Looking ahead, WADth’s second decade presents opportunities to deepen this role. Strengthening participatory governance structures, expanding multilingual and digitally accessible platforms, mapping global research and practice more systematically, and co‑creating gatherings that are responsive to climate and economic realities could enhance the Alliance’s capacity to support its members. At the same time, maintaining vigilance about representation, knowledge hierarchies and the risk of reproducing existing power imbalances will remain essential if WADth is to honour its commitment to global professional belonging. In holding together diversity of practice, shared ethical concerns and a collective desire for recognition, the World Alliance of Dramatherapy offers a distinctive model of how a profession can organise itself globally: not by erasing difference, but by centring it as the very ground of its work.

References

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Acknowledgements

We would like to thank the following alumni from the NYU Program in Drama Therapy who, in their capacity as research assistants, each served two-year terms as coordinators of the WADth while they were students: Opher Shamir, Monica Lopez Gamboa, Akhila Khaa, and Anamarija Vuić. Each coordinator sustained the continuity of the Alliance by responding to inquiries, maintaining the website and social media platforms, scheduling quarterly meetings, record keeping, and organizing the aual international drama therapy week, under the supervision of Prof. Nisha Sajnani. We also thank Kirsten Meyer who, while she was representing ANZACATA, contributed to the 2022 survey of the field together with Rinat Feniger-Schaal, Anamarija Vuic, Akhila Khaa, and Nisha Sajnani.

[1] The WADth acknowledges variation in how Drama Therapy is spelled and uses the preferred spelling of formal names of associations with variation where needed and in accordance with publication style guides.

[2] This pilot survey was approved by the Institutional Review Board at New York University (IRB-FY2019-3041)

[3] AM stands for Member of the Order of Australia

[4] This photograph was intentionally taken in a vintage, hyper-formal portrait style to reflect the absolute seriousness of this playful endeavor.

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