Role Playing

Description of the Strategy

Role playing emerged as a form of behavioral assessment in the late 1970s. At the time, it was presented as the best means to estimate a patient's assertiveness skills in naturalistic settings. In a role play, an individual practices an observable behavior in the presence of a therapist as a means of assessment or intervention. In role play assessments, the aim is to determine the individual's skill level when engaging in the target behavior. In an intervention, a role play provides an opportunity for behavioral rehearsal and feedback to shape behavior in the desired direction.

As an assessment tool, role plays have the benefits of being brief and easy to implement, and they require few resources. Role playing eventually became popular as a form of intervention, primarily to enhance social skills in depressed and schizophrenic patients. The role play format provides a rich opportunity for patients to practice new methods of interaction. It allows an individual to repeatedly engage in new strategies of interpersonal behavior in the presence of a therapist, who can provide immediate feedback. Depending on the problem it is designed to address, role play may also serve as a formal exposure to cues that trigger anger, anxiety, or drug cravings.

Role playing, when used as an intervention, relies on a process of ongoing observation and feedback to help a client gradually shape his or her behavior. When role playing is used as an assessment tool, the client may be asked to respond to a simulated situation, often involving a confederate or actor, that parallels an area in which skills are anticipated to be somewhat deficient. For example, a role play assessment for a person with alcoholism might present a scenario in which the participant is being offered a drink by a friend and the participant is expected to employ drink-refusal skills.

At first, the target person may report that role playing feels artificial and awkward. However, after completing a few role plays with the therapist, clients usually become increasingly comfortable engaging in the role and accepting feedback. To encourage participants to become as engaged as possible, the therapist must give negative feedback in a gentle and sensitive manner and be sure to comment on any improvements the client makes in each iteration of the role play. Typically, a good rule of thumb is to precede each critical comment with a complimentary comment on some aspect of the role play that was successfully accomplished.

Videotaping allows a client to review his or her performance in a role play; however, more immediate, ongoing feedback from the clinician is also helpful, because specific suggestions for alternative behaviors can be made, providing excellent feedback. A comparison of pretreatment and posttreatment videotapes of client role plays may provide valuable feedback [Page 494]about treatment gains. Role reversal is a technique that may be helpful when a patients finds a scenario particularly difficult. In this technique, the therapist plays the patient, and the patient plays the role of the other person in the scene. This approach allows the therapist to model appropriate behavior while allowing the patient to act out his or her expectations of how the other person might react. The therapist then has the opportunity to address the patient's potentially distorted or extreme expectations, and the patient may be more able to understand the other person's perspective on the situation.

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