The presence of humor during therapy sessions is associated with improved outcomes, according to a new study published in The American Journal of Psychotherapy.

“Humor is present in virtually every human relationship, and also inside psychotherapy sessions. Clients make humorous statements about their situation, and also about their therapeutic process,” said study author and psychiatrist Christophe Panichelli.

“Famous psychotherapists used humor with their clients and published an abundant literature to describe the risks and benefits of this particular psychotherapeutic tool. But when I searched for clinical studies about the relationship between humor and psychotherapy effectiveness, I only found one study about this topic (Ventis et al. 2001), an interesting study conducted in behavioral therapy for clients with arachnophobia.”

“No other diagnoses were included, and therefore it is not possible to generalize its results to a real-life population of clients with other clinical problems,” Panichelli explained. “We wanted to complete the available data by following W.E. Deming’s advice: ‘In God we trust; all others must bring data.'”

In the study, 110 psychiatric clients along with their therapists completed surveys regarding humor during individual outpatient psychotherapy sessions. The clients had attended at least 10 sessions. The research included both men and women with a variety of diagnoses.

The researchers found that the use of humor during psychotherapy sessions was linked to higher ratings of therapeutic effectiveness. Clients who reported more occurrences of humor during therapy also tended to report greater pleasure in participating in therapy sessions and report a stronger therapeutic alliance.

“Besides other well-known psychotherapeutic ingredients like therapeutic alliance or reframing the client’s view of the world, humor is possibly another interaction between client and therapist that fosters therapy effectiveness,” Panichelli told PsyPost.

The study — like all research — includes some limitations. The study found the well-known negative association between humor and depression: if clients are more depressed, their production and enjoyment of humor lowers. But it failed to find evidence that humor was associated with client’s lowering of depressive symptoms. This is probably due to missing information in the first-session Hamilton Depression Rating Scale.

“Our results show that approximately 15% of the variability of humor is linked to the variability of therapy effectiveness, but our study protocol does not indicate the direction of causality,” Panichelli explained.

“If humorous interactions are enhanced by a positive therapy effectiveness, the presence of humor indicates that therapy is already reaching some of its goals. If therapy effectiveness is fostered by humorous events inside the sessions, therapists could include more humorous interventions in therapy.”

“Like others psychotherapeutic tools, humor can heal but it can also harm,” Panichelli added. “The alliance with the clients must be preserved. Before — and while — using humor, therapists must succeed to transmit their empathy to the clients by showing them that they profoundly understand and respect why the clinical situation induces client’s suffering (Panichelli 2013).”

The study, “Humor Associated With Positive Outcomes in Individual Psychotherapy“, was authored by Christophe Panichelli, Adelin Albert, Anne-Françoise Donneau, Salvatore D’Amore, Jean-Marc Triffaux, and Marc Ansseau.