Humour in group psychotherapy

The use of humor in serious mental illness: a review

There is now a relatively good understanding of the broad range of direct and indirect effects of humor and laughter on perceptions, attitudes, judgments and emotions, which can potentially benefit the physical and psychological state. This article presents a review and discussion of the use of humor and laughter in treating people with serious mental illness, distinguishing between clinical papers on individual and group psychotherapy, and empirical research reports describing humor and laughter interventions. In spite of the exponential growth of the field over the last 30 years, I conclude that empirical studies are still lacking, the studies that do exist have major methodological shortcomings, and the field is in dire need of further investigation.

Postincident review of aggression and violence in mental health settings

Management of violence and aggression remains a challenge to mental health care practitioners. It has been acknowledged that for a small number of incidents involving aggression, use of restraint will continue to be a method of containing potentially dangerous situations. The impact of being involved in these procedures remains under researched, but there is growing acknowledgment that some form of post incident review should take place after restraint use. As part of a larger study, a survey design was used to evaluate whether staff (n = 30) and inpatients (n = 30) had found post incident review helpful after incidents involving restraint. Ninety-seven percent of staff, and 94% of patient participants agreed this approach was useful. This article presents the findings of this survey and discusses the complex factors that should be considered when reviewing the aftermath of restraint for staff and inpatients in acute mental health settings.

[Humor therapy in the depressed elderly: results of an empirical study]

BACKGROUND

Positive effects of humor on older patients with depressive symptoms have been repeatedly reported. Empirical evidence, however, is rare. We investigated the effects of a standardized humor therapy group in a clinical context especially for older depressed patients.

PATIENTS AND METHODS

For this purpose, an experimental group with treatment (52 patients participating in the humor group) was compared to a control group with no specific treatment (38 patients); all 90 participants had clinical depressive symptoms according to ICD-10 classification. Questionnaires (among them GDS, SF-12, State-Trait Cheerfulness Inventory, Satisfaction with Life Scale) were administered at two time points (pre- and post-treatment).

RESULTS

From pre- to post-measurement, significant improvements could be shown only in the experimental group for resilience and satisfaction with life (p<0.05). Analyses of the subgroups with at least medium to severe depression showed further significant effects for cheerfulness, seriousness, bad mood, and satisfaction with life (p<0.05). These severely affected patients seemed to profit best from humor therapy.

CONCLUSION

Our results indicate the efficacy of this specific therapeutic intervention for older depressed patients.

Humour therapy in patients with late-life depression or Alzheimer's disease: a pilot study

BACKGROUND

Of the disabling disorders of the elderly, depression is the most common affective disorder and Alzheimer's disease (AD) the most common neurodegenerative disorder. Pharmacological treatment strategies for these disorders are often accompanied with severe side effects. Therefore non-pharmacological treatment strategies are of great importance. The aim of the present study was to investigate the impact of humour therapy on quality of life in patients with depression or AD.

METHODS

Twenty patients with late-life depression and 20 patients with AD were evaluated. Ten patients in each group underwent a humour therapy group (HT) once in two weeks for 60 min in addition to standard pharmacotherapy, which was given as usual to the other group as standard therapy (ST). All patients completed a psychometric test battery at admission and before discharge from the clinic.

RESULTS

The quality of life scores improved both in HT and ST groups for depressive patients but not for patients with AD irrespective of the therapy group. Depressive patients receiving HT showed the highest quality of life after treatment. In addition, patients with depression in both therapy groups showed improvements in mood, depression score, and instrumental activities of daily living.

CONCLUSIONS

Although there was no significant effect of humour therapy comparing with standard therapy on quality of life, these findings suggest that humour therapy can provide an additional therapeutic tool. Further studies with higher frequently humour groups are required in order to investigate the impact of humour therapy in gerontopsychiatric treatment.

The impact of humor on patients with cancer

Using the Stetler model, in-depth literature reviews were performed that demonstrated a positive correlation between humor and comfort levels in patients with cancer. Humor frequently was used for relaxation and as a coping mechanism that aided in promoting general wellness. The literature indicated that various types of humorous material lessened anxiety and discomfort, which allowed for patients' concerns and fears to be discussed openly. The literature also showed that humor had a positive effect on the immune system. Improvements in pain thresholds and elevations in natural killer cell activity consistently appeared in quantitative experimental studies. In addition, measurements of specific neuroendocrine and stress hormone levels revealed biochemical changes that suggested improved physical stress responses and increased feelings of well-being after humorous interventions. This article has implications for nurses because humor can be an effective intervention that impacts the health and well-being of patients with cancer.

Humor as the focal point of treatment for forensic psychiatric patients

Framed as a qualitative case study based on constructivist notions, the research being reported evaluates the Humor Group, a unique treatment modality evoking therapeutic change by engaging male forensic psychiatric patients and nursing students in humorous activities. The group's meaning for patient health was investigated by cross-analyzing data collected from patient and student questionnaires, in-depth patient interviews, and naturalistic observations made by the researcher during the group's 4-year tenure. The Humor Group structure and format are offered as guides for undertaking similar attempts to rein in humor's healing potential in other settings and with other populations.

Humor in therapy: the case for training therapists in its uses and risks

Formal humor training for therapists is proposed as an elective part of their academic curriculum. The paucity of rigorous empirical research on the effectiveness of this historically controversial form of clinical intervention is exceeded only by the absence of any training for those practitioners interested in applying humor techniques. A representative sample of its many advocates' recommendations to incorporate humor in the practice of psychological therapies is reviewed. Therapeutic humor is defined, the role of therapists' personal qualities is discussed, and possible reasons for the profession's past resistance to promoting humor in therapy are described. Research perspectives for the evaluation of humor training are presented with illustrative examples of important empirical questions. In addition to its potential salubrious effects on clients, therapeutic humor might have the positive side effect of preventing or minimizing professional burnout in therapists. This potentially major psychotherapeutic resource, highly praised by some, remains insufficiently evaluated and essentially untapped.

Promoting enjoyment and self-belief through work rehabilitation

There has been a resurgence of interest in work rehabilitation in recent years. A variety of service models are in operation in a number of countries, all, to varying degrees, assisting mental-health clients achieve an optimum level of employment participation. However, little research has been conducted to examine how (and if) such schemes are structured to promote psycosocial rehabilitation. To explore such issues, the author carried out a pilot case study of a work-rehabilitation organization in Lincolnshire, United Kingdom. Two of the main themes, that emerged during the study, Hedonic Experiences and Self-Efficacy, are discussed in this article.

The Role of Faculty in Teaching Leadership Studies

The question of whether leadership can be taught has received much attention in the literature. While many authors believe that it can be taught, other disagree. Leadership is a process which is different from the term leader. In that regard, faculty can teach leadership as a process but they may not be able to provide their students with positions as leaders. The purpose of this article is to discuss the role of faculty in teaching leadership studies. The focus will be on why to teach leadership, when to teach leadership, what to teach about leadership, and how to teach it. Since leadership is a process, students are better served if they learn how this process works and use it in their daily interactions with others. Important leadership behaviors can be learned and practiced early on in life. They can be learned from parents, teachers, peers or significant others. Leadership skills may be successfully taught and learned by using the interactive approach. Thus, through instructional integrity, intellectual humility, relevant equality, critical thinking, specific class structure, and self-directed humor, faculty may create the appropriate climate for teaching leadership skills.

Laughing and health: a study using Parse's research method

The purpose of this research was to uncover a structure of the lived experience of laughing and health using Parse's research method. Twenty men and women over 65 years of age volunteered to participate in the study. The structure of the lived experience of laughing and health was found to be a potent buoyant vitality sparked through mirthful engagements, prompting an unburdening delight deflecting disheartenments while emerging with blissful contentment. Recommendations for further research and practice are suggested.

Therapeutic use of humor to improve social support in an institutionalized schizophrenic inpatient community

We attempted to use passive communal laughter to improve social support within a chronic schizophrenic inpatient population. Two identical wards were compared on classical measures of social support (emotional and functional), social network (size and dispersion), satisfaction, and the nature of the social relationships (source). The experimental group was exposed to video projection of humorous movies four times daily for 3 months, and the control group to video projections of other, assorted movies at the same rate. In the experimental ward a significant improvement was manifest in the category of "distinct individuals supporting each patient." The difference may have been due to an improvement in the relationship with the staff. No improvement was found on any of the other measures. We concluded that the positive atmosphere that humor creates affects the therapeutic alliance between staff and patients but does not affect other social networks because of the regressed nature of the schizophrenics' social relationships.

The experience of laughter: a phenomenological study

The purpose of this research was to uncover a structural definition of laughing in persons over 65. The structural definition that arises from this study is: laughing is a buoyant immersion in the presence of unanticipated glimpsings prompting harmonious integrity which surfaces anew through contemplative visioning. This definition is congruent with some of the current literature and practices related to laughter and health. It corresponds to the principles of Parse's human becoming theory and thus expands understanding of human experiences related to structuring meaning, living in relation to others, and viewing the familiar in a new light.

Humor in counseling and psychotherapy: a 20-year retrospective

This article briefly annotates the development of research and theorizing on the use of humor in psychotherapy. Beginning in 1970 and continuing through 1990, the main literature was cursorily scanned. A total of 67 sources are offered for bibliographic use. Sadly, tangential forms of humor such as fun, mirth, frivolity, songs, jokes, puns, witticisms, and other forms of humor are not as readily addressed or investigated.

getting the joke: interpreting humor in group therapy

1. Jokes, humor and laughter imply a defense against other feelings or a relief with palliative effects. 2. Jokes are vehicles of humor and may be placed on a negative-positive continuum. Placement on the continuum depends on the content and context elements such as timing, place, and the individuals involved (teller and receiver). 3. If the joke surfaces before the content and process have been presented or made clear, the joke may be the first key to the exploration of underlying issues. 4. Viewing humor and jokes as another form of emotional expression with motivation can supply a clue to group psychopathology and the group process.