The use of humor in cognitive-behavioral therapy with outpatient depressed male adolescents

Although research has established the efficacy of cognitive-behavioral therapy (CBT) for depression and has generally supported the use of humor in psychotherapy, there have been no reports on the use of humor in CBT for depressed adolescents. By integrating theory, research, and expert opinion, this study explores the use of humor in therapy for this population. The dissertation focuses on male, outpatient adolescents because they represent a population traditionally resistant to therapy.;A review of the areas of humor, CBT for depression, and therapy for adolescents is presented. It appears that humor can serve several therapeutic functions. First, humor can challenge existing cognitive schema and change perspective (particularly important in CBT). Second, humor may help build the therapeutic relationship (especially important with male adolescents). Finally, humor enhances emotional arousal (particularly important with clients with depression). However, the use of humor in therapy can be counterproductive if the vulnerabilities of the client are not appropriately considered.;Next, 191 members of the Association for Advancement of Behavior Therapy (AABT) who work with adolescents were surveyed and a subset interviewed. Results indicated that respondents believe in the importance of humor to a greater degree than they actually use it as a therapeutic technique. Those with training experiences that included humor as an intervention endorsed its therapeutic applicability more than those without, but the difference was not statistically significant. Respondents indicated the most important reasons to use humor were cognitive restructuring, enhancing the relationship, and combating the resistance of difficult clients.;Respondents endorsed two types of humor as most appropriate and frequently used: (a) pointing out absurdity, and (b) using the "human condition" to reframe problems. They also reported most frequent use of humor for (a) exaggerating, minimizing, or relativizing a problem's importance, and (b) making fun of themselves. Certain subgroups of therapists endorsed humor use more, including those who work in private practice and community clinics.;It is concluded that humor can be of value in CBT with depressed male adolescents. It is argued that humor enhances a typically difficult-to-establish and necessary therapeutic relationship. If carefully applied, humor facilitates cognitive, emotive and behavioral change.