St. Catherine University St. Catherine University

SOPHIA SOPHIA

Master of Social Work Clinical Research Papers School of Social Work

5-2013

Seriously Funny: The Clinical Role of Humor in the Grief Process Seriously Funny: The Clinical Role of Humor in the Grief Process

Jessie Rae Rayle St. Catherine University

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Recommended Citation Recommended Citation Rayle, Jessie Rae. (2013). Seriously Funny: The Clinical Role of Humor in the Grief Process. Retrieved from Sophia, the St. Catherine University repository website: https://sophia.stkate.edu/msw_papers/251

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RunningHead:HUMORANDGRIEF

SeriouslyFunny:TheClinicalRoleof

HumorintheGriefProcess

by

JessieRaeRayle,BFAMay,2013

MSWClinicalResearchPaper

PresentedtotheFacultyoftheSchoolofSocialWork

St.CatherineUniversityandtheUniversityofSt.ThomasSt.Paul,Minnesota

inPartialfulfillmentoftheRequirementsfortheDegreeof

MasterofSocialWork

CommitteeMembers:CollinHollidge,Ph.D.,(Chair)ElizabethRezek,LICSWKristiJohnson,LICSW

TheClinicalResearchProjectisagraduationrequirementforMSWstudentsatSt.CatherineUniversity/UniversityofSt.ThomasSchoolofSocialWorkinSt.Paul,Minnesotaandis

conductedwithinanine‐monthtimeframetodemonstratefacilitywithbasicsocialresearchmethods.Studentsmustindependentlyconceptualizearesearchproblem,formulatearesearchdesignthatisapprovedbyaresearchcommitteeandtheuniversityInstitutionalReviewBoard,implementtheproject,andpubliclypresentthefindingsofthestudy.Thisprojectisneithera

Master’sthesisnoradissertation.

HUMORANDGRIEF 2

Abstract

Withtheintroductionoflaughtergroupsandlaughteryogatosuchdistinguished

medicalfacilitiesastheMayoClinicandCancerTreatmentCenters,theuseofhumor

asatherapeutictoolisbeginningtoemerge.Thisstudyaimstogainan

understandingofwhatmotivatestherapist’stousehumorwhileworkingwith

grievingclientsthroughaqualitativeapproach.Fourlicensedtherapistswere

interviewedonthetopicsoftheoreticalorientation,intentionaluseofhumorwith

grievingclients,theclinicalrisksandbenefitsofusinghumorandthetherapist’s

personalpreferencesofhumor.Themajorthemesfoundinthisstudyweretherole

thathumorplaysincreatingalliances,measuringsafety,assessingtheclientandself

care.Thisstudyconcludedthathumorcouldplayaverysignificantroleinthegrief

processbyimprovingthetherapeuticalliance,assessingtheclient’srecoveryand

actingasatoolforself‐careonthepartofthetherapist.

HUMORANDGRIEF 3

Acknowledgements

Iwouldliketothankmyfamily,Fahzah,Mahzah,Thithter,andLoveyfor

makinghumoranessentialpartofmydailylifeandalwayslaughingatmyrecycled

jokes!

Iwouldalsoliketothankmychair,ColinHollidge,andmyCommittee

members,FrankiRezekandKristiJohnson.Yourabilitytoreschedulethingsis

amazing!

HUMORANDGRIEF 4

TableofContents

Introduction...............................................................5

LiteratureReview..........................................................7

Methodology.............................................................16

ConceptualFramework...................................................20

Findings..................................................................23

Discussion................................................................33

References...............................................................38

AppendixA...............................................................42

AppendixB...............................................................43

HUMORANDGRIEF 5

Introduction

“PerhapsIknowbestwhyitismanalonewholaughs;

healonesufferssodeeplythathehadtoinventlaughter.“

FriedrichNietzsche

Peopleoftenspeakoflaughingsohardtheycry,butneverofcryingsohard

theylaugh.Manypeopledon’tthinkabouthumorousthingswheninastateof

despairyet,accordingtoNormanCousins,thatisexactlywhatweshouldbedoing.

NormanCousinsissitedinalmosteverycurrentresearcharticleasamajorcatalyst

inmovinghumor’seffectsonmedicalpatientstoamorerespectedandnotedlevel.

Inhisarticle,“AnatomyofanIllness”,Cousins(1976)describeshisjourneyof

healinghimselffromAnkylosingSpondylitisthroughtheuseofhumorandlaughter.

PerhapsevenmorefamousthanCousinswasHollywood’sfavoritedoctor,Patch

Adams,whousedhisclowningabilitiestobringhumorandamorehumanisticpoint

ofviewtothedeliveryofcareamonghispatients.Infact,hehastakengroupsof

“clowns”tohospitals,orphanages,prisonsandnursinghomesaroundtheglobein

hopesofimprovingthelivesofsufferingpeople(Adams,2000).Althoughbothof

thesemenhavemadeheadlinesthroughtheiruseofhumorinpractice,therehave

alsobeennumerousscientificstudiescompletedthatclaimthereismoretruthto

theterm,“Laughteristhebestmedicine”thanonemaythink.Manystudiesinthe

areaofhumorfinditcausespositiveemotionalstatesalongwithcreatinglower

levelsofdistressandanger(Martin,2007;Papa&Litz,2011);andasitwouldbe,

highlevelsofangeranddistressaresymptomscommonlyfoundinagrieving

HUMORANDGRIEF 6

person(Utz,Caserta,andLund,2011;Bonanno&Keltner,1997).

Griefisastatethatalmosteverypersoncomestoknowatsomepointinhisor

herlife,beitthroughthedeathofalovedone,thelossofanidentityordiagnosisof

aterminalillness.TheclinicalworldhasbeenworkingwithElisabethKubler‐

Ross’sfivestagesofgriefsince1970,butthesestageswereoriginallyintendedto

describestagesadyingpersonmaygothrough,notagrievingfamily.While

Kubler’smodelwasagoodstart,cliniciansarenowlookingforalternatewaysto

workwithgrievingclientsinamoreholisticandhumanisticapproach(Konigsberg,

2011).Thissearchforamoreholisticapproachtogriefopensanewframeof

thinkinginrelationtohumorinthegriefprocess.Infact,astudydonewith

widowedadultsfoundexperiencinghumorandlaughterwasstronglyassociated

withlowergriefanddepression(Lund,Utz,CasertaandVries,2009);andwhile

theremaybeminimalresearchonthiscorrelation,cliniciansseemtobeinterested

intheuseofhumorintheirpractice.

Withtheintroductionoflaughteryoga,laughtertherapyandotherhumor‐

basedpracticesinplacesliketheMayoClinicandCancerTreatmentCenters,humor

isalsomakingitswayintothesocialworkworld.Sincesocialworkersworkwith

grievingclientsunderstandingtheroleofhumorasacurativeagentmaybeauseful

tool.Thisqualitativestudyaimstoanswerthequestion;whatistheroleofhumor

inthegriefprocessasunderstoodbylicensedtherapists?

HUMORANDGRIEF 7

LiteratureReview

Thefollowingliteraturereviewfocusesongriefandhumorasseparate

entities.Itthenreportsonresearchlinkingthetwoinordertobestunderstandthe

possiblerolethathumorcould/doesplayinthegriefprocess.

Grief

“Griefisanaturalresponsetoloss.It’stheemotionalsufferingyoufeelwhen

somethingorsomeoneyouloveistakenaway”(Smith,2012).Althoughthis

definitionmayseemverysimpleforthoseexperiencinggrief,itencompassesallthat

griefisandcanbe,whenapersonlosestheirhealth,receivesamentalhealth

diagnosis,orlosesalovedone.Intheyear2011,over2.5millionpeoplediedinthe

UnitedStatesalone(CDC,2011).Eachofthosedeathsleftnumerousfamily

membersand/orfriendstowadethroughtheemotionsfromthelossoftheirloved

ones.Althoughtheyallexperiencesgrieffromsimilarlosses;itcanbestatedwith

muchconfidencethateachpersonwentthroughadifferentandindividualizedgrief

process.Becausepeopledealwithgriefindramaticallydifferentways,twodifferent

categoriesofgriefhavebeenestablishedtobetterassistinthetreatmentofthose

sufferingfromgrief;NormalGriefandComplicatedGrief,alsocalledPathological

Grief(Papa&Litz,2011;Lichtenthal,Cruess&Prigerson,2004;Boelen&Bout,

2008).

NormalGriefisusuallyaccompaniedbysymptomsthatcanincludesadness,

HUMORANDGRIEF 8

longing,guilt,andanger(Papa&Litz,2011).Thesesymptomsareusuallyat

heightenedlevelsforthefirst2‐4monthsafteraloss,butthegrievinggradually

regainthecapacityforinterestsandrelationships;eventuallyreturningtoanew

normal(Tomita&Kitamura,2002;Papa&Lite,2011).Mostpeoplewhoare

dealingwithbereavementandlosswillexperienceNormalGrief,whileonly10‐15%

ofthispopulationstruggleswithComplicatedGrief(Lichtenthal,etal.,2004).

ComplicatedGrief,orPathologicalGrief,hassimilarsymptomstonormalgrief

butcomplicatedgriefdiffersinthetimethatittakesthegrievingpersontoreturnto

a“normal”routine.Ifsomeoneissufferingfromcomplicatedgriefheorshewill

continuetohavepersistentmourning,yearning,emotionalpain,andwithdrawal

(Papa&Lite,2011).ComplicatedGriefcanbesodebilitatingthatithasbeen

proposedasaclinicaldiagnosisintheupcomingDSM‐V(Boelen&Bout,2008;Papa

&Lite,2011;Lichtenthal,etal.,2004).

PhysicalandPsychologicalEffectofGrief.Aspreviouslydiscussed,notwo

peopledealwithgriefinthesameway,yettherearesimilarphysicaland

psychologicaleffectsthatcanmanifestfromasignificantloss.Sadness,anxiety,

helplessness,irritabilityandloweredself‐esteemarejustafewofthepsychological

symptomsofgriefreportedinCasarett,Kutner,andAbrahm’s(2001)consensus

paperwhichdescribesaclinician’sroleinbothnormalandcomplicatedgrief.

Casarettetal.(2001)goesontoexplaintheimportanceofnormalizingthese

reactionsinordertoallowapersontomovethroughthemourningprocess(p.210).

Thephysicalsymptomsofgriefcanrangefromfatigue,sleepproblems,chest

HUMORANDGRIEF 9

pains,headachestogastrointestinaldistress(Casarettet.al,2001;Jeffreys,2005;

Banonno&Kaltman,2001).BanonnoandKaltman(2001)alsodiscusspastresearch

focusedoneffectsofgriefontheimmunesystem.Theyreportonnumerousstudies

thathaveconcludeda“compromise”inagrievingperson’simmunesystem(p.720),

thoughitisconclusivelystatedthatmorestudiesneedtobeconductedtomakea

concreteconnectionbetweenthegriefandtheimmunesystem.Jeffreys(2005)

emphasizestheimportanceofacareprovidertoidentifythephysicalsymptomsof

griefinordertobettertreatthegrievingclient.Jeffreys(2005)alsosuggests

“advisinggoodsleepinghabits,physicalrelaxation,physicalexerciseandspecially

designatedtime‐outsfromactivegrieving”(p.49).

GriefTherapy.Foryearsgriefhasbeendissectedbynumerousresearchers

fromElisabethKubler‐Ross’famousfivestagesofgrief,tomorerecentstudiesof

RobertNeimeryerwhofocusesonmeaningreconstructionafterasignificantloss

(Jeffreys,2005).Therearemanydifferentbreak‐downsofphases,tasksand

processestobetterhandlegrief,yetaccordingtoLichtenthal,Cruess&Prigerson

(2004),whoconductedacriticalreviewofclinicalinterventionsforgrief,“the

proposedstagetheoriesofgriefhavenotfoundevidencesupportingtheresolution

ofgriefbyclearlycutstages”(p.643).Infact,thereisyettobeaspecificgrief

therapythathasproventoeffectivelytreatalltypesofgrief.

Inameta‐analysisdonebyNeimeyerandCurrier(2009)involvingthereview

of61outcomestudies,including48peer‐reviewedarticles,itwasfoundthat

generalpsychotherapywasmoreeffectivewhencomparedtogrief‐focusedtherapy.

HUMORANDGRIEF 10

Theaffectsofnon‐randomizedgrieftherapydidyieldahighlevelofeffectiveness

immediatelyfollowingtherapy(.5effectsize),buttheeffectsizedroppedtoalmost

zeroonlyeightmonthsfollowingtreatment.Psychotherapyontheotherhand,

stayedthesamelevel(.8effectsize)fromthelastdayoftreatmenttoeightmonths

aftertreatmentwascompleted.ThoughtheNiemeyerandCurrier(2009)studywas

verycomprehensive,itdidnottakeintoconsiderationotherformsoftherapythat

mayhavegreaterorlessereffects.

Inameta‐analysisbyPapaandLite(2011),whichprimarilyfocusedon

NormalandComplicatedGrief,asimilarconclusiontoNeimeyerandCurrier(2009)

wasfound.Afterreviewingnumerousstudies,PapaandLite(2011)foundno

empiricalsupportforusing“griefwork”toassistwithapersongoingthrough

NormalGrieftoreturntopre‐bereavementfunctioning(p235).Howeverwhen

focusedonComplicatedGrief,itwasconcludedthatExposureTherapyand

CognitiveBehaviorTherapy(CBT)togetherwasmostsuccessfulwhencomparedto

stand‐alonegrieftreatment.PapaandLite(2011)alsodiscussedthenotionthatan

earlyinterventionmayendupbeinginappropriateandconsequentlyworsen

symptomsdowntheroad(p230).

Becausethereisalackofempiricalevidencetofavoraspecificgrief‐focused

therapy,itcanbeconcludedthatitisnecessaryforfutureresearchtocontinue

exploringtheoutcomeofdifferenttypesoftherapytobesthelpthosesufferingwith

grief.

Humor

HUMORANDGRIEF 11

Apersoncanusemanytypesofhumorintheirdailylivestoincludesatire,

political,low‐brow,gallowsandintellectual.Thesetypesofhumorallhaveone

thingincommon;noteveryonewilllaughatthem.Becausenoteveryonefindsthe

samejokesorsituationsfunny,itmaybedifficulttocategorizewhatwillcause

laughterandwhatwillpossiblyoffend(Hayworth,1928).Thequesttofindonetype

ofhumorthatismoreeffectiveatproducinglaughterthananotherhas

demonstratedtobeadifficultandendlesspathbymanyresearchers(Smuts,2009).

However,ithasbeendeterminedthattherearecategoricallytwotypesoflaughter,

DuchenneLaughter,laughterwhichisstimulusdrivenandemotionallyconnected

(ie,ajoke,funnysituationand/orjoy),andnon‐DuchenneLaughter,self‐generated

andemotionlesslaughter(Mora,2008).Smuts(2009)alsoexplainsphthonic

laughter–laughterfrommaliceorenvy.Thoughitmaycomefromadarkplace,

phthoniclaughterisalsoaformofDuchennelaughter.Agroupmaysharethistype

oflaughteriftheysharethesamesupposedassumptionsthatwouldbeconsidered

offensiveorinappropriatebyanotherpersonorgroup.Smuts(2009)alsoexplains

thathumorcanbeusedasaneffectivewaytobringupadifficultsubjectorpoint

outfaultthatmayotherwisebedifficulttoaddress.

PhysicalEffectsofHumor.AccordingtoRodA.Martin’s,ThePsychologyof

Humor(2007),physicalhealthisa“complexconcept”;thereforeitisdifficultto

attributehumor,another“complexconcept”,asareasonorcontributortoan

increasedlevelofphysicalhealth(p.313).InNormanCousinsarticle,“Anatomyof

HUMORANDGRIEF 12

anIllness”,Cousins(1976)describeshisjourneyofhealinghimselffromAnkylosing

Spondylitis,throughtheuseofhumorandDuchennelaughter.Heclaimedthat10

minutesofDuchennelaughtercouldgivehim2hoursofpainfreesleep.Bennett

andLengacher’s(2006)meta‐analysisalsosupportsCousin’s(1976)claimthat

thereisadefiniteconnectionbetweentheuseofhumorandself‐reportedphysical

health.BennettandLengacher(2006)reviewednumerousstudiesthatfound

exposuretoahumorousvideocanincreaseaperson’sSIgA(ameasurablepartof

theimmunesystemfoundinsaliva)levelsoftheirimmunesystem(p.160).Thus

supportingthefactthathumorcanplayaroleinaperson’sphysicalhealth,but

becauseofpossiblemethodologicalissuesinthestudies,moreresearchisrequired

tomakethisadefinitivestatement.

Justlikegrieftherapy,manyresearchershaveconcludedthatthereisnot

enoughevidencetoprovethatanincreaseinphysicalhealthcanhappensolely

throughtheuseofhumor.Afteracriticalreviewofpublishedresearchonthetopic

ofhumorandhealth,Martin(2001)alternatelyconcludedthatthereareonlyafew

significantcorrelationsthatcanbemadebetweenhumorandphysicalhealth.

Martin(2001)alsostatesthatthereistoomuchconflictingresearchontheeffectsof

humorandlaughteronphysicalhealthforanotablerelationshiptobeassumed.

ThoughmanyresearchersagreewithMartin,Mora(2011)arguesthatlaughter,the

resultofhumor,hasyettoproveanyadversephysicaleffectsonthebody(Mora,

2011).

PsychologicalEffectsofHumor.Oneareathatalloftheliteratureagreed

HUMORANDGRIEF 13

uponwasthepositiveaffectsthathumorandlaughterseemstohaveon

psychologicaloutcomes.ThoughMarin(2001)waswearytoclaimphysiological

benefits,hedidstatethatlaughterwasfoundtocausepositiveemotionalstatesin

themajorityoftheresearchreviewed.ThisconclusionisechoedinBennettand

Lengacher’s(2006)findings,whichfoundhigherscoresontheCopingHumorScale

(CHS)and/ortheSituationalHumorResponseQuestionnaire(SHRQ)inparticipants

whohadlowerlevelsofloneliness,depressionandstress.Thisresearchwas

supportedbyDanzer,DaleandKlion’s(1990)studyontheeffectsofhumorstimuli

oninduceddepression.Danzeretal.(1990)discoveredthatagroupofstudents

whowatchedadepressingvideofollowedbyahumorousvideo,returnedtotheir

pre‐experimentalbaselinewhilethosewhodidnotviewahumorousvideoafterthe

depressingvideodidnotreturntotheirbaseline.LastlyastudybyWanzer,Sparks,

&Frymier,(2009)interviewed205olderadultsandfoundthatthosewhoused

humoronaregularbasisreportedgreatercopingefficacyandahigheroverall

satisfactionwithlife.Theseresearchconclusionscouldpossiblyleadafuture

researchertomakeassumptionsaboutthepositiverolethathumorandlaughter

mayhaveinthegriefprocess.

EffectsofHumorinBereavement.Lund,Utz,Caserta&DeVries(2008),in

theirstudyof292recentlywidowedmenandwomeninvestigatednotonlythe

effectsofhumor,butalsotheimportancetheparticipantsputonhavingasenseof

humor.Theoutcomeprovedtosupportpastconclusions;theparticipantswho

werefoundtobemakingthemostpositivebereavementadjustmentswerethe

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participantswhowerealsoexperiencinghumorandlaughterintheirlives(Lundet

al.,2008).Theoutcomeofthisstudygivesconcreteevidenceforgriefcounselors

promotingnotonlytheuse,butalsotheimportanceofhumorinthegriefprocess

(Lundetal.2008).AccordingtotheresearchstudybyKeltnerandBonanno(1997),

itwasfoundthatDuchennelaughterpredictedalowerlevelofgriefseverity.The

previouslydiscussedbenefitsandexplanationsofhumorandlaughterpainteda

broadpictureofthepsychologicalbenefitsofhumor,butthisresearch,focusing

specificallyonthegriefprocess,seemstojustifyhumor’sroleinthegrieving

process.

Humor­basedTreatments.Humortherapyisjustoneofthemodalitiesthat

ispromotingtheuseofhumorasaneffectivetherapeutictool.Thepopularityof

laughteryogahasbeenincreasingintheUnitedStatessinceitsconceptioninIndia

in1995(Martin,2007).Astudyof70womendiagnosedwithdepressionwereput

throughbothexerciseandlaughteryoga;itwasconcludedthatlaughteryogahad

thesameeffectsasexercisedidonimprovingdepressionandincreasinglife

satisfaction(Shahidi,Mojtahed,Modabbernia,Mojtahed,Shafiabady,Delavar&

Honari,2010).Anotherstudyoflaughteryogafoundanimmediateimprovementof

moodandanimprovementinthesubject’slong‐termanxietyafter10sessionsof

laughteryoga(Dolgoff‐Kaspar,Baldwin,Johnson,Edling,&Sethi,2012).

Franzini(2001)conductedameta‐analysisreviewofresearchontheuseof

humorintherapy.Thereviewwassothoroughthathecreatedathree‐pagelistof

pastresearchandtheoriststhatsupportedthebenefitsofusinghumorin

HUMORANDGRIEF 15

psychotherapy.AccordingtoFanzini(2001)thepastresearchhasfoundhumor

benefitstheclinicaltreatmentinamyriadofwaystoinclude;reducingdiscomfort

anxiety,servingasacatharticrelease,makingtherapysessionsmorememorable,

anddisplaygenuineemotion(p189).Ontheconversesideofpromotinghumor,

Fanzini(2001)alsocreatedalistofcautionsinusinghumorinpsychotherapy,

whichincludedconcernsthatfocusedon;patientsassumptionthatthetherapistis

“makingfun”,thepatientmayfeelattacked,usinghumortohideconflict,and

possiblecountertransferenceproblems(p192).Martin(2007)alsodiscussedthe

useofhumorinpsychotherapyandstated,“humorhasbeenarecommendedand

usefultoolinindividualtherapy,counselingandgrouptherapy”(p337).Becauseof

theserecommendationsMartin(2007)statesthathumorcaneitherbeusedasa

“therapeutictechnique”ora“communicationskill”(p337).

HUMORANDGRIEF 16

Methodology

Afterathoroughreviewoftheliteratureongriefandhumor,theresearch

questionforthisstudyinvestigatedtherolehumorplaysinthegriefrecovery

process.Theanswertothisresearchquestionwasdiscoveredthroughaqualitative

studyusingexploratorymethodologytobetterinvestigatethespecificwaysin

whichsocialworkersusehumorwithgrievingclients.

Sample

Theparticipantsofthisstudywereobtainedthroughapurposivestrategyby

creatingasnowballsamplingoflicensedtherapistswhohadidentifiedthemselves

asusinghumorwithgrievingclients.Thisallowedforamorein‐depthlookatthe

rolehumorcouldplay,asopposedtointerviewingparticipantswhodidnotuse

humor.Thesampleforthisstudywascomposedoflicensedtherapistsinthestate

ofMinnesotawhowereactivelyworkingwithgrievingclientsatthetimeoftheir

interview.Therewerefourparticipantsinthesamplewhofitthepreviouslystated

qualifications.Theseparticipantshadself‐identifiedasusinghumorintheircurrent

practice.One(25%)oftheparticipantswasworkingwithgrievingclientsinagroup

settingandthree(75%)oftheparticipantswereworkingwithclientsonan

individualbasis.

DataCollection

Thedataforthisqualitativeresearchstudywasgatheredthroughasemi‐

HUMORANDGRIEF 17

structuredinterview(SeeAppendixA),allowingforprobingquestionstobe

includedtobestfitthereal‐timescenario.AfterapprovalfromtheUniversityofSt.

ThomasIRB,anemailwassentouttopossibleparticipantsexplainingthepurpose

ofthestudyandpossiblerisks/benefitsofparticipating.Thisemailaskedthatthe

recipientconsiderparticipationaswellasrequestingtheypassalongthis

informationtosomeonethatmayfittheparticipationcriteriaforthisstudy.

Interestedparticipantswerethenaskedtoemailtheresearchertoconfirmtheir

eligibility.Afterminimalresponse,afollow‐upemailwassenttopromoteresponse.

Afteraparticipantreplied,afollowupemailwiththeinterviewquestionsand

consentform(SeeAppendixB)wassentandaphonecallwasmadetoschedulethe

interviewtime,dateandlocation.Theinterviewslastedapproximately45minutes

andfocusedontheinterviewee’suseofhumorwithgrievingclients.Priorto

recordingtheinterviews,theresearcherconfirmedtheparticipanthadreadthe

consentformandinterviewquestions,andgavetheparticipantanopportunityto

askquestionsorclarifyanyoftheprocessinformation.Theresearcherthen

recordedtheinterviewonadigitalrecordingdeviceanddownloadedthefiletoher

computeruponcompletion.Theparticipantwasalsoremindedthattheycoulddrop

outofthisprojectatanytimeforanyreason.

Measurement

Themeasurementinstrumentusedbythisresearcherwasasemi‐structured

interview.Theresearcherofthestudycreatedeightprimaryquestionsbasedonthe

reviewedliteratureandguidancefromtheresearchchairandcommitteemembers.

HUMORANDGRIEF 18

Thesequestionsincludedthefollowingtopics;thetypeoftherapythatispreferred

bytheparticipantwhenworkingwithagrievingclient,theparticipant’sintentional

orunintentionaluseofhumorwithinpreferredtherapy,thehinderingand/or

beneficialaspectsofhumorincounselingclientswithgrievanceissues,typesof

humorthatincreaseordecreaserecoveryandaspecifictypeofhumorthatthe

participantleanstowards.

DataAnalysis

Beinganexploratorystudy,thedatafromthesemi‐structuredinterviewswas

analyzedthroughcontentanalysis.Byusingcontentanalysistheauthorofthestudy

identifiedthemesandpatternssolelybasedontheinterviewsconductedforthis

researchproject.Aftertheverbalinterviewrecordingsweretranscribed,the

authorofthestudyscouredthewrittentranscriptionsforrepetitivewordsand/or

excerpts,whichwerethenturnedintocodesandgivenmeaningthroughanalyzing

commonalitiesandcomparisonstopreviousliterature.Finallythesecodes

translatedintothemainthemesoftheresearch.Theconclusivethemesofthe

interviewsmadeupthefindingsofthisresearchprojectandwerethenappliedto

futureuseandstudieswiththepurposeofdefininghumor’sroleinthegriefprocess.

ProtectionofHumanParticipants

Inordertomaintainconfidentiality,theauthorofthisstudycreatedaconsent

formbasedonSt.CatherineUniversity/UniversityofSt.Thomasconsentform

templateandchecklist.Itfocusedonbackgroundinformation,thespecificresearch

proceduresandrisks,explainedtheconfidentialityandalsoinformedthe

HUMORANDGRIEF 19

participantsthattheinterviewwillbeaudiorecordedandtranscribed.Thisconsent

formandresearchquestionwasdistributedtoeachparticipantpriortothe

interview.Theparticipantssignedtheconsentformpriortostartingtheinterview.

Theinitialinterviewrecordingswerekeptonamemorystickandkeptlockedfile

cabinetthehomeoftheinterviewer.Thewrittentranscriptionsoftheverbal

interviewswerealsocompletedbytheinterviewerandkeptonthesamethumb

driveastheinterviewrecordings.Therecordingsandtranscriptionswerenot

labeledwiththenames,nordidtheyincludeanyidentifyinginformationofthe

interviewees.Boththeinterviewrecordingsandthetranscriptionfileswillbe

destroyednolaterthanMay25th,2013.

HUMORANDGRIEF 20

ConceptualFramework

HumorandGriefarefoundatoppositeendsofthespectrumwhenconsidering

thestereotypicaldisplayedemotionsofeach.Becauseofthisobviousdifference,

thisresearchprojectwillbeexaminedthroughPersonCenteredTheory.Thisbroad

theoryencompassestheentirespectrumfromgrieftohumor.

PersonCenteredTheory

PersonCenteredTheoryprizestherelationshipbetweenthetherapistand

clientinorderfortheclienttoachievepsychologicalwellbeing(Pattersonand

Joseph,2007).CarlRogers,whodevelopedtheframeworkforPersonCentered

Theoryinthe1950’s,statedthisabouthistheorywell:

“Aspersonsareempatheticallyheard,itbecomespossibleforthemtolisten

moreaccuratelytotheflowofinnerexperiencings.Butasaperson

understandsandprizesself,theselfbecomesmorecongruentwiththe

experiencings.Thepersonthusbecomesmorereal,moregenuine.These

tendencies,thereciprocalofthetherapist'sattitudes,enablethepersontobe

amoreeffectivegrowth‐enhancerforhimselforherself.”

Inordertoachievepsychologicalwell‐beingandbecomea“fullyfunctioning

person”,Rogerssuggeststhreequalitiesthatatherapistmustnurtureinorderto

betterservehisorherclientbasedinPersonCenteredTheory(Truscott,2010).

Thefirstofwhichisgenuineness,orcongruence.Itisimportantforthetherapistto

notonlybegenuineinhisorherreactionsandemotionsinvolvingtheclient,but

alsopayattentionandbeopentohisorherownexperiencesoutsideoftheclient’s.

HUMORANDGRIEF 21

Thepurposeforthisgenuinenessistopromoteboththeclientandthetherapistto

beinthemomentofthesessionandthereforebothbe“emotionallypresentand

available”(p.74).

ThesecondqualitythatatherapistmustnurturewhileusingPersonCentered

Theoryis“unconditionalpositiveregard”.Thischaracteristicisessentialfor

buildingtrustinthetherapeuticrelationshipthroughanever‐presentaccepting

attitudetowardtheemotionsandthoughtsoftheclientinthepresentmoment.Itis

importanthowevertonotbegintousethistorewardgoodbehaviororthoughtwith

positiveregard.Thiscouldcreateanunhealthyrelationshipbasedontryingto

pleasethetherapistinsteadoftrustingthatthetherapistwillaccepttheclientatall

times(Truscott,2010).

Lastly,atherapistmustpractice“empathicunderstanding”.Bystrivingto

understandtheclient’sperspectiveandexperienceoftheworld,thetherapistwill

betterunderstandandbettercommunicatewiththeclient.Itisn’tenoughjustto

understandempatheticallybutalsotoensurethattheclientfeelsthetherapistis

empathetictohisorhersituation(Truscott,2010).Allthreeofthecharacteristics

arevitaltoalltherapist’sabilitytohelptheclientmovetoafullyfunctioningperson.

Personcenteredtheorystatesthataclientshouldbeempoweredand

encouragedtoactasa“fullyfunctioningperson”whois“organismicallycongruent”

(PattersonandJoseph,2007).Poland’s(1971)findingsseemtocomplement

Roger’stheoryperfectly.AccordingtoPoland(1971),notonlyhashumorbeen

foundtobeusefulindevelopinginsight,butithasalsobeenassociatedwiththe

markofagoodtherapeuticalliance.Thusunderstandingtheimportanceofthe

HUMORANDGRIEF 22

therapeuticallianceandhowtohelpaclientcreateacongruentselfthroughPerson

CenteredTheorywillhelptoevaluatehowtheparticipantsinthisstudyusehumor

whenworkingwithgrievingclients.Asthisresearchdissectstheroleofhumorin

thegriefprocess,itwillbeimportanttorememberthathumorisnotalineartool,

butaconstantlygrowinganddevelopingtraitforboththeclientandthetherapist.

HUMORANDGRIEF 23

Findings

Thisresearchprojectfocusedontheuseofhumorinthegriefprocessand,

aftertheinterviewingprocess,numerousapplicablethemessurfaced.Four

participantswereinterviewedinthisproject;eachparticipanthadidentifiedusing

humorintheirworkwithclientspriortoparticipatinginthisresearchproject.All

fourparticipantswereworkingwithgrievingclientsonaregularbasisandthe

causeoftheirclient’sgriefrangedfromlossofalovedone,diagnosisofmental

health,lossofhousing,tolossofphysicalhealth.Theinterviewquestionsfocused

ontheparticipant’stheoreticalorientationwhenworkingwithgriefwhichwas

operationalizedbythequestion,“Whattheoreticalorientationdoyouusewhen

workingwithgrievingclientsandwhy”,thetherapist’sintentionaluseofhumor,

whichwasoperationalizedbythequestion,“Doyouusehumorintentionallyinthe

therapeuticprocess?Inwhatpart/way”,andthebenefitsandrisksofusinghumor

withgrievingclients,whichwasoperationalizedbyfourquestions;“Doyouavoid

usinghumor?Inwhatpart/way”,“Tellmeaboutatimethatyouhaveusedhumor

andfoundittobebeneficialtoaclient’srecovery”,“Tellmeaboutatimethata

clienthasusedhumorandfounditbeneficialtotheirrecovery”and“Inwhat

situationsistheclientmost/leastlikelytousehumor”.Threemajorthemesarose

fromthesequestions;positiveusesofhumorwithgrievingclients,humorasatool,

andparticipant’suseofhumorinself‐care.

Eachparticipantstatedthathe/sheusedadifferenttheoreticalorientation,

strengthsperspective,person‐centered,mindfulnessbasedandnarrative

HUMORANDGRIEF 24

transformationaltherapy,whenworkingwithgrievingclients.Althoughallfour

participantsusedadifferenttheoreticallens,eachthemeuncoveredinthisstudy

washighlightedineveryparticipant’sinterview.

PositiveuseofHumorwithgrievingclients

Eachoftheparticipantsstatedtheyintentionallyusedhumorinthe

therapeuticprocesswhenworkingwithgrievingclients,yetallmentioned

numeroustimesthatthetherapistshouldtaketheclient’sleadwhenconsidering

thetypeandtimingofhumor.Allparticipantscouldidentifyrisksofusinghumor

withclientsthataregrievinginanunhealthymannerand/orclientsdiagnosedwith

anti‐socialpersonalitydisorders;yet,allagreedthatthebenefitsoutweighedthe

risksifusedinanappropriateandsensitiveway.Manybenefitsofusinghumor

aroseduringtheinterviews;twoofthemostprominentbenefitswerebuildingan

allianceandthe“safety”oftherelationship.

BuildinganAlliance.Alloftheparticipantsstatedthattheuseofhumor

helpstobuildahealthyworkingalliancewiththeirgrievingclients.Twoofthe

participantsusedsimilarverbiageaboutallianceswhilediscussingtheiruseof

humorwithaclient.Thefirstdiscussedthealliancethatiscreatedthroughtrusting

thetherapistbyusinghumor:

HUMORANDGRIEF 25

“Sototheextentthepersoncaneitherappreciatehumororevenusehumor,it

issayingtothetherapistthattheytrustthem,otherwiseIdon’tthinkthatthey

wouldengageinit.SoIusethatasamarkofthetherapeuticalliance.”

Thesecondparticipantdiscussedthecreationofanalliancebyestablishingpersonal

groundthroughtheuseofhumor:

“SoIreallywantedtobethoughtfulaboutok,‘lateronwhenyou’reawayfrom

hereandtheseemotionsareatthesurface,Iwantyoutobeawareofthat.

Whatareyougoingtodo?’Andhesaid,‘Idon’tknow’andIsaid,‘Youknow

whatworksformeisice­cream.’Andwelaughedandthenwetalkedaboutit,

whatflavoroficecreamwelike.Noweverytimeheseesmeandheleaves,he

says,‘don’tworryIgoticecreaminthefreezer.’Anditcreatesanallianceand

personalground,anditalsohelpswhenhecomesbackintosessionanditcould

bereallydifficultagainlike,tokindofnormalizeit.”

Thefollowingparticipantsdidnotusetheterm“alliance”,butbothdiscussedthe

conceptofmakingaconnectioninordertojoinwiththeclientatanappropriate

level.Bothstatedthathumorcouldbeacatalystforastrongertherapeuticalliance.

“Yourbeinggenuineandeveryonecomeswithasenseofhumor,and

sometimesIthinkthatflexibilitythatwehavetomeetthemwheretheyareand

beingacceptingofthatandnotshamingandbeingabletoconnectwiththem

throughhumorandespeciallywhentheycomewiththat[grief].”

HUMORANDGRIEF 26

“Shewasabletorelaxandabletolaughandsowebonded...thatwasjust

partofourrapportbuildingingeneralwasherformaluseofhumorasa

copingskillandsowewouldjokeaboutsomeofthestuffwiththatandIthink

itremindedusofthefactthatwehadthingsincommonbecauseIdon’twantto

beinthereandhavesomebodyfeellikeIamabovethemandIthinkitbreaks

downthatbarrierbecausehumorcan,unlessthereisreallyactiveMH

symptomsthataregoingon.Ithinkhumorisawaytojustgenerallyjoinwith

people.”

Safety.Thesecondmostprominentbenefitofusinghumorwithgrieving

clientswas“safety”.Participantswereaskedaboutthebenefitsofusinghumorand

theresponsesallstated,atsomepoint,thathumoreithercreatedoraccurately

testedthesafetyoftherelationship.Thewordsafetycameupnumeroustimesin

theinterviewprocesswitheachclient.Thusbringingsafetyintothethemesof

usinghumorinthegriefprocess.

Twoparticipantsstatedthatwhentheclientuseshumoritcouldbeawayfor

himorhertocreatesafetyinthesituation:

“Ithinkthathumorisawayofnormalizingsituationswhichmakeusfeel

uncomfortableinmanyaspects,soIwouldsaythatitisconsistenttoseehumor

asdeescalatingsituationsorcreatinganalternativeviewthatallowsustofeel

saferandthat’swhyIthinkhumorissoimportantinthetherapeuticrealm,

becausemorethananything,therapyshouldbeasafeenvironment.”

HUMORANDGRIEF 27

“Ithinkit’sattachment,Idon’tthinktheyeverlearnedthatsafetypiece.They

neverhadhumorintheirhomeortheywereneglectedorneedsweren’tmet

emotionallysotheyneverlearnedhowtouseit[humor]appropriately.”

Otherparticipantsdiscussedusinghumortocreateasafespacefortalkingabout

difficultsituations.

“That’ssomethingItalkaboutwithhumorandpainmanagement,sometimes

talkingandjokingaboutitgivesthemalittlemoredistancefromit,soitmakes

italittlemoresafetotalkabout.”

“Ithinkit’sasafetything.Ithinkitcanbesafe.It’sasaferplacetogobackto.”

“Sometimesherlaughingaboutsomething,aboutsomeincidentthatIfeelit’s

saferformetokindofjoininandreflectbackonherjoy,andsoIguess,Imean

that’sprobablythesafestwaytodoit.”

Humorasatool

Accordingtoallfourparticipantstheuseofhumorwithgrievingclientscan

beausefultherapeutictoolnotonlytoassesstheclient’sstageofgrief,butalsoto

reframethegriefandgiveanalternateperspectiveoftheclient’sloss.Allfourofthe

participantssharedtheideathathumorcanbeusedasatherapeutictool.Ofthe

manytoolsavailabletotheparticipants,humorcanbeaveryapplicabletoolwhen

workingwithgrievingclients.

HUMORANDGRIEF 28

Assess.Aspreviouslystated,eachparticipantagreedthattherearetimes

whenhumorwouldnotbeausefultool.Oneparticipantexplainedhowtoassessif

theuseofhumorbytheclientishealthy:

“Inaword,unhealthyhumorisnotfunny...ifyoudon’tseehumorinit,Imean

itdoesn’thavetobehilarious,butifyoudon’tseehumorinitthenthereis

somethingwrongwithit.IjusttellthepersonthatIamconfused,IsayIam

notsureandIdon’tpushthemonitbutIsaywellIamalittleconfusedandI

amnotsurewhatthatindicatesorwhatthatthreadsbackto,butwecancome

backtothatlater.”

Thisparticipantcontinuedtoexplainthenegativeeffectsonspecifictypesof

grievingclients;

“Detachedindividuals,thereisthatkindofnervouslaughter“thetitters”asI

refertothemas.Thenthere’stheindividualsintheenmeshed;ifthere’sany

kindoflaughteritusuallyalsoproducessomenegativeaffectaswell,Ireferto

thataswailingflaughts.”

Twoparticipantsidentifiedaclient’sabilitytousehumorasagaugeofthe

client’srecoveryprocess.

“AfewsessionslaterIintroducedmetaphorsandsomehumorandhewas

actuallyable,aboutthreemonthsorso,torespondtothe­hesawsome

elementsofitthatcontainedsomehumorthathehadneverbeenabletotalk

aboutitbecauseifhelightenedtheloadaboutthat,itmeantthathetookhis

HUMORANDGRIEF 29

brotherofftheissueofresponsibility...beforethathewasn’twillingto

consider.Soitisaveryincrementalprocessanditwashelpfulandhewasable

tousehumor”

“Ithinkitshouldbepartofanassessmentlike,whenwasthelasttimeyou

laughed?”

Reframe.Thesecondwaythathumorisusedasatoolisintheclient’sability

orwillingnesstoreframeasituation.Threeoftheparticipantsdiscussedhumoras

atooltoreframetheclient’sgriefandhelptheclienttomoveforwardintheprocess.

“Shebroughtthatintothetherapysession,wetalkedaboutitandshewas

finallyabletounderstandthatlaughterisariverthatcontinuestomove

forwardandlaughingisnotnecessarilydisrespectforthepersonbutinasense

honoringtheindividual.ItsaysIcanputmyfeetinthesewatersandmove

forward”

“Iwillseeifwhetherornottheyarewillingtoconsideralternative

interpretationstothings.Iftheyarewillingtoconsideralternativeperspectives

tothings.”

“Hecomesinandhe’slaughingaboutit,andhesays,“NowIcouldsithereand

lietoyou,butyouknow”,Ithinkhecalledmesergeantorsomething,“Yourjust

goingtocallmeoutsothisiswhatIhavedone.”Sonowheisabletobehonest

aboutitandmysenseisheisn’tcomfortablebeingdirectsoheuseshisown

humortohelphimbehonest.”

HUMORANDGRIEF 30

“Ihaveseenhumoractuallydeescalatesomeverytensesituationsthatcould

haveescalatedtophysicalconflictandthensuddenlysomebodysayssomething

anditisfunnyandtheotherpersonstartslaughingandyoucanjustseethe

tension...sothat’swhatIwantclientstoseeabouthumorinthegriefprocess

thatitisawayofdeescalatingthingsandcreatingspacetoviewitdifferently.”

Theparticipantswerealsoaskedaclarifyingquestionastowhyand/or

whentheyusehumorasatoolforreframing;

“Thepointofusinghumoristogivethemadifferentvantagepointofview

withintheparadigm.That’sthewholepointImeanifIweretoboilitdown

that’swhatitsallabouttogetthepersontolookatsomethinginanewway”

“Iuseitwhentheclientisfeelingprettyheavyintheroom.And...tohelpthe

clientnormalizethesituationthatisgoingon”

“Ifwearelaughing,wearehere.Ourmindisn’tsomeplaceelse.”

“Laughterisjustonewaytokeepusinthepresentmoment.”

UseofHumorforSelf­Care

Whenaskedwhattypeofhumoreachclientused,theconversationsall

turnedintotheparticipant’shistoryofusinghumor.Allstatedthattheywere

broughtupwithhumorasacopingskillintheirfamilies.Whenaskedaboutgallows

humor,theuseofdarksarcasticandsometimesgrotesquehumorinorderto

HUMORANDGRIEF 31

“maintainone’ssanity”(Martin,2007,p.48),threeoftheparticipantsstatedthat

theyuseitasacopingskill,butonlyinaprofessionalmanner.Eachparticipant

expressedutilizinghumorasaninterventionforself‐careindifferentways.Two

participantsstatedthattheyfeltithelpedthemtohaveahealthierrelationshipwith

theirclientsandthosearoundthem.Asoneparticipantstated:

“Ithinkthatinmentalhealthifwearegoingtobehealthycliniciansand

healthyworkers;ifwearenotdoingthatinanappropriatewayoutsideofthis,

partofyourpersonality,ifyournotacknowledgingthat,itsgoingtofilterinto

yourworkwithyourclients.”

Anotherparticipantagreedwiththisnotionbystating:

“Wehadtofindawaytolaughaboutotherthings,justtokindofholdthatall

together.Youcanhave‘both­and’.”

Threeparticipantsspokeaboutthepositiverolethatlaughterandhumorplaysin

theirlives.Eachofthethreeparticipantsmadethefollowingquotesthatsuggestthe

importanceoflaughterandtheparticipant’sopinionsoftheirpersonaluseof

humor:

“IguessIhavealwayslikedtohaveasenseofhumorandbesilly.PlusIwas

alreadyalaughteryogaleader,soIjustknewweneededtolaugheverydayto

staypresentandfocusedandfocusonwhatwasgoingright.”

“It’sjutaskillthatyoudevelopandIkindofhavedoneitmywholelife,andits

whoIam,it’sasense,kindofintuitive.”

HUMORANDGRIEF 32

“Imeanlaughterisapartoflifeandlaughteristhebestmedicine.Peopledon’t

dieyouknowwhenpeoplesay“Idiedlaughing’Idon’tthinkyoudiefrom

laughingIthinkyoudiewhenyoudon’t.”

HUMORANDGRIEF 33

Discussion

Summary

Thisstudysetouttoexploretheroleofhumorinthegriefprocessas

describedbylicensedtherapistscurrentlyworkingwithgrievingclientsinagroup

orindividualsetting.Threemainthemesemergedfromthedata;positiveusesof

humorwithgrievingclients,humorasatool,andparticipant’suseofhumorinself‐

care.Amongthesethemeswastheoverallconclusionthatnotonlyistherearolefor

humorwhenworkingwithgrievingclients,buttheintentionalusebyeither

therapistorclientcouldhaveagreatimpactonthetherapeuticprocess.Though

manyofthesethemesdidnotaligndirectlywiththosestudiedintheliterature

review,strongcorrelationscanbemadebetweenthetwo.

ComparisontoLiteratureFindings

Eachparticipantexplainedthatbuildingandmaintainingatherapeutic

alliancethroughtheuseofhumorcouldbeabenefittotheclient’sabilitytomove

throughgrief.Alloftheparticipantsalsoagreedthatusinghumorcouldconnect,

buildtrust,andnormalizetherelationshipbetweenclientandtherapist.This

supportsMcCallum,PiperandOgrodniczuk’s(2002)researchthatfocusedonthe

dropoutrateswithcomplicatedgriefclients.Theauthorsfoundthatagoodalliance

andcohesionwasastrongholdforaclientstayintherapy(McCallum,Piper,

OgrodniczukandJoyce,2002).Itcouldthenbeconcludedthatifhumorhelpsto

HUMORANDGRIEF 34

buildanalliancewhenworkingwithgrievingclients,thentheuseofhumorshould

beseenaspositiveandusefultherapeutictool.Thoughtheexactverbiageof

“alliance”wasnotfoundintheliteraturereview,itwasfoundbyMartin(2007)that

humorisausefultoolandcaneitherbeusedasa“therapeutictechnique”or

“communicationskill”(p.337).Itshouldbenotedthattherehasbeenresearchon

humor’sroleinbuildinganallianceanditwasreportedbyPoland(1971)thatthe

useofhumorisagoodmeasureofthetherapeuticalliance.Poland’sclaimalso

alignswiththisresearchproject’sfindingsthattheuseofhumorcanhelpconstruct

theimportanttherapeuticingredientof“safety.”Numeroustimestheparticipants

talkedaboutclientsusinghumorinordertocreatesafetyinthesituation;

participantsusedthewords,“normalize,deescalating,andattachment”.Allofthese

themeswerefoundand/orinferredinFanzini’s(2001)meta‐analysisreviewof

researchontheuseofhumorintherapy.

Whenusinghumorasatherapeutictool,thisresearchfoundthatitwas

mostlyusedtogaugetheclient’srecoveryprogress.Themostcommonthemethat

thisresearchandthefindingsoftheliteraturereviewfound,weretheclient’slower

levelsofgriefsymptoms.Inpreviousresearch(Lundetal.2008;Keltnerand

Bonanno,1997),itwasfoundthatgrievingclients,whousedhumor,either

unintentionallyorintentionally,reportedlowerlevelsofgrief.Whilethisresearch

projectandthosereviewedwerecongruentinoverallthemes,thisresearchproject

alsofoundthatmostparticipantsexplainedthedecreaseinlevelsofgriefwhena

clientwasabletoreachadifferentperspectiveoftheirgrief.

HUMORANDGRIEF 35

Thisresearchalsouncoveredthethemeofself‐careonpartofthetherapist.

Itwasconcludedfromthisprojectthathumorisavitaltoolforallparticipantsinthe

roleofself‐careinordertoworkbetterwithboththeclientandcoworkers.Though

itshouldbenotedthatthisfindingwasnotsupportedbythereviewedresearch.

Theparticipantsdiscussedusinghumorthroughouttheirlives,andspokewellof

thebenefitsithasprovided.Participantsalsostatedthattheyuseddifferenttypes

ofhumor,butallcouldagreethatitwasanimportantaspectoftheworktheydoas

therapists.

LimitationsOfProject

Therewerenumerouslimitationsofthisproject,thefirstbeingthesmall

samplesize.Althoughmanyinvitationswereemailed,onlyfourrespondents

followedthroughwiththeinterview.Thislimitationmayhavebeenbecauseofthe

researcher’srecruitmentmethod.Becausethisresearchusedasnow‐ballsample,

theresearchermayhavebeenincorrectinherassumptionsthattheinitialemails

wouldcontinuetobepassedontopotentialparticipants.Alsoduetothesmall

samplesize,itisdifficulttogeneralizethefindingsofthisparticularproject.

Thisresearchprojectwasdesignedwithqualitativequestioningandthe

researchersinterpretationofthedatacollected.Thiscanbealimitationnotonly

becauseoftheresearchesunknownbiasesbutalsotheparticipant’sinterpretation

ofthequestions.Thislimitationwasunavoidableinthisparticularresearch;

HUMORANDGRIEF 36

however,futureresearchmaylookatthistopicthroughaquantitativelensinorder

toavoidtheselimitations.

Anotherlimitationofthisresearchwastheparticipant’sroleinthetherapy

process;thisstudylookedsolelyatthetherapist’sopinionsandprocesseswhen

usinghumorinthegriefprocess.Itwouldbebeneficialtoquestioneitherina

qualitativeorquantitativestudy,theclient’sviewpointontheroleofhumorinthe

griefprocess.Thistypeofstudymayuncoversimilarthemesthatcouldthenbe

appliedtofuturestudies.

ContributionstoSocialWork

Thelikelihoodthatasocialworkerwillworkwithagrievingclientisalmost

guaranteed;thereforeknowingwhattoolstohaveatone’sdisposalisanimportant

factorinaclient’ssuccessintherapy.Ensuringthatastrongtherapeuticallianceis

builtisimperativetotheclient’shealthandwell‐being.Socialworkersarealso

constantlyassessingclient’srecovery;thisprojecthasproventhathumorhasthe

potentialtobeagaugeintherecoveryandprogressintherapy.Associalworkers

continuetotakeonmoretherapeuticrolesinsociety,itwillbeimperativethatthey

practicehealthyself‐care.Thisresearchprojecthasalsoshownthathumorcanbe

animperativeroleinthestresslevelsandself‐careritualsofsocialworkers.

Therewerealsothemesintheliteraturethatdidnotsurfaceinthe

participant’sinterviews.Itshouldbenotedthatsocialworkersalsoworkwith

HUMORANDGRIEF 37

clientswithphysicalailmentsthatmayprecipitatementalhealth.Accordingtothe

literaturediscussed,itwouldbenefitsocialworkerstoconsiderintroducinghumor

intotheirpracticewithsuchclients,asthepossiblephysicalbenefitsofhumorhas

proventopromoterecoveryinsomestudies.

Anotherimportantaspectforsocialworkerstotakeintoconsiderationisthat

eachclientisuniqueinhisorherownuseofhumor.ItisessentialthataSocial

Workerallowtheclienttoleadtheuseandtypeofhumor,inordertoavoid

offendingorbreakingthetherapeuticalliance.

SuggestionstoFutureResearch

Itisthehopethatthisresearchprojecthassparkedaninterestofcurrent

and/orfuturesocialsworkertolookmoredeeplyintotheroleofhumorinthegrief

process.Aqualitativestudyoftheclient’sthoughtsontheroleofhumorinthegrief

processwouldbebeneficialtoaugmentcurrentresearchonthetherapist’sviews.

Therewerefewstudiescompletedthatdiscussedthedailyuseofhumorasan

individualandthepossiblebenefitsorrisks.Itwouldbenefiteachpersonworking

withgrievingclientsintherapytohaveamorewell‐roundedviewpointofthistopic

would.

HUMORANDGRIEF 38

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AppendixA

InterviewQuestions

1. What theoretical orientation do you use when working with grieving clients and why?

2. Do you use humor intentionally in the therapeutic process? In what part/way?

3. Do you avoid using humor? In what part/way?

4. Tell me about a time that you have used humor and found it to be beneficial to a client’s recovery.

5. Tell me about a time that a client has used humor and found it beneficial to their recovery.

6. In what situations is the client most/least likely to use humor?

7. What type of humor, sarcasm, cartoons, self-deprecating, have you found to be the most useful/detrimental in your self-care as a therapist?

HUMORANDGRIEF 43

AppendixB

HUMORANDGRIEF 44

HUMORANDGRIEF 45