Recently, I found a research article that reminded me of my wild teenage days. Yes, I was a tough one--- stubborn, defiant, and moody. Difficult? Sure. Typical? Maybe. But my style of resistance was a different brand. While many parents earnestly try to curb their teens’ risky behavior, mine had the opposite problem. On Friday nights, I insisted on wedging myself between them, watching reruns of The Love Boat. Saturdays were no better, as I locked myself in my bedroom and labored away at math homework. Any attempt at encouraging me to socialize was met with excuses, angry tears, hyperventilation, or some combination thereof. I was painfully socially phobic. Optimistic that I would outgrow this “phase,” my father joked that I should join a group for shy teens---except, probably none of us would talk.
Little did I know, my dad was onto something. Group Cognitive-behavioral therapy (GCBT) is, in fact, indicated for those who struggle with Social Anxiety Disorder (SAD). Within the context of a working group, clients are exposed to social stimuli as they learn to restructure their thoughts and build their interpersonal self-efficacy. A recent metanalysis of GCBT studies suggests that this modality has a moderate but significant advantage over control groups. However, other studies have proposed that more than a third of SAD clients don’t benefit from cognitive-behavioral treatments, be it in an individual or group format.
Where might there be a disconnect? Some researchers have noted that GCBT focuses on lessening negative emotions rather than enhancing positive ones. A new type of group work, known as Comedic Improv Therapy, adds elements of humor and play to the GCBT process. Potentially, this infusion of laughter and spontaneity is the missing link.
CIT borrows activities from improvisational comedy groups but merges these with cognitive-behavioral processing. Group cohesiveness, play, humor, and social exposure are the key curative factors. Therapists need not be comedy experts, but they are encouraged to participate in improv sessions before leading a CIT group. However, as in a traditional group, the therapist must be skillful at pausing and processing at just the right moments.
Why humor and play? As mentioned earlier, sometimes it isn’t enough to minimize the negatives. The emotions evoked by CIT activities cultivate a positive and enjoyable social experience. And laughter? Imagine a client who is fiercely afraid of public humiliation. Through improv activities, being laughed at takes on a new meaning. Furthermore, by practicing play and spontaneity, clients develop greater creativity in managing social situations, which can be applied outside of the group.
Full disclosure: I felt like my high school self when I first learned about CIT---racing heart, sweaty palms, and spiraling thoughts saying, That sounds terrifying! I’d make a fool of myself. Just as in other groups, it might be helpful to pre-screen members to determine if the group is a good fit. On the other hand, as counselors, we hope to gently nudge clients beyond their levels of comfort. For the 13% of us who are “clinically shy,” a dose of humor (and some CBT in a supportive atmosphere) might do the trick.
Phillips Sheesley, A., Pfeffer, M., & Barish, B. (2016). Comedic improv therapy for the treatment of social anxiety disorder. Journal of Creativity in Mental Health, 11(2), 157-169. doi:10.1080/15401383.2016.1182880
Christine Hennigan Paone is a counselor in training at Monmouth University as well as an aspiring counselor educator. Her research interests include creativity in counseling, multicultural career counseling, and pedagogy.