Humor and Engagement with Children and Adolescents

Abstract

For more than three decades, clinical literature has consistently suggested that engagement and retention of children and teens in mental health care poses numerous difficulties for clinicians. In addition to many potential economic, geographic, and social barriers to treatment engagement, young people present unique challenges. Children and adolescents rarely self-refer and are typically brought to treatment by family members. This coercive aspect to therapy entry militates against forging strong treatment alliances and threatens effective engagement. Developmental differences between young people and adults mitigate the use of techniques frequently employed and endorsed in the treatment of more mature clients. Humor is a powerful clinical tool and features prominently in the clinical literature with adult clients. Therapists can strategically use humor to reinforce critical principles, deliver metaphors, and challenge dysfunctional beliefs and behaviors in session. The use of humor with young clients is fraught with concerns. Younger clients often lack the maturity and abstract reasoning capacity to understand the subtleties of humor and therapists risk insulting and alienating them by utilizing humor as an engagement tool. This chapter focuses on using humor in treatment engagement with young people, pointing out both the potential risks and benefits, of humor-based interventions and suggesting methods for effective engagement with children and teens using humor. Guidelines for assessing client readiness for humor in treatment and methods for effectively employing humorous techniques and interventions are discussed. At the heart of this discussion is the adage, “It’s only funny if everyone laughs.”