Open Access

ARTICLE

From Fragmentation to Integration: A Multi-Site Pilot Study of Psychodrama in Chinese University Mental Health Systems

Xiaohui Wang^1,#, Aiqin Liu^2,#, Zechun Ma^3,#, Nien-Hwa Lai^4,*, Rui Ding^5,*
1 School of Social Work, China University of Labor Relations, Beijing, China
2 Mental Health Education Center, Beijing Institute of Graphic Communication, Beijing, China
3 College of Humanities and Urban-Rural Development, Beijing University of Agriculture, Beijing, China
4 Nien-Hwa Lai, Zhiying Counseling Room, Osaka, Japan
5 Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
* Corresponding Author: Nien-Hwa Lai. Email: ; Rui Ding. Email:
# Xiaohui Wang, Aiqin Liu and Zechun Ma contribute equally to this paper

International Journal of Mental Health Promotion https://doi.org/10.32604/ijmhp.2026.078910

Received 10 January 2026; Accepted 11 March 2026; Published online 08 April 2026

Abstract

Objectives: Chinese higher education faces rising depression rates amidst fragmented campus mental health services. This pilot study examined the feasibility and preliminary outcomes of implementing a standardized psychodrama program across multiple university sites. Methods: This single-arm study was conducted across three Beijing universities from September 2024 to January 2025. A total of 27 undergraduates completed an 8-week psychodrama intervention program comprising weekly 2.5-h sessions. A unified protocol was ensured through centralized facilitator training and cross-site supervision. Depressive symptoms were assessed using the Beck Depression Inventory-II at baseline, post-intervention, 3-month, and 6-month follow-ups. Retention rates were 93.8% at post-intervention and 84.4% at both follow-up assessments. Results: Significant reductions in Beck Depression Inventory II (BDI-II) scores were observed from baseline to post-intervention and follow-ups, with scores decreasing from a baseline median of 13.00 [9.50–21.50] (mean ± Standard Deviation = 14.67 ± 8.73) to 5.00 [3.50–10.50] (7.11 ± 5.87) at post-intervention (p_adj < 0.001, r = 0.817). Friedman tests confirmed significant temporal declines across all sites (p < 0.05). At the individual level, 37.0% of participants achieved a ≥50% BDI-II reduction at post-intervention, and 29.6% at 6-month follow-up. Improvement to minimal depression (BDI-II ≤ 13 from baseline ≥14) was achieved by 33.3% at post-intervention and 22.2% at 6 months. Conclusions: This study demonstrated the feasibility of a standardized, multi-site psychodrama framework in Chinese university settings and provided preliminary evidence of symptom reduction from baseline to post-intervention, with reductions sustained through 6-month follow-up. These findings support further controlled trials to evaluate efficacy and sustainability.

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Keywords

Psychodrama; multi-site study; depression; college students; mental health system

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