Therapeutic Use of Improvisational Theatre References

Therapeutic Use of Improvisational Theatre References

References for Improv,  Anxiety and Depression

  1. 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.

Comedic improv therapy, a group therapy model inspired by the practice of improv comedy, provides a novel treatment for social anxiety disorder by harnessing the following therapeutic elements: (a) group cohesiveness, (b) play, (c) exposure, and (d) humor. This article outlines the theoretical basis for this creative treatment and discusses important considerations for the practical application of this mode of therapy, such as the combination of comedic improv therapy with other modes of therapy. Lastly, this article describes an existing clinical program called Improv for Anxiety that integrates comedic improv therapy with group cognitive behavioral therapy for the treatment of social anxiety disorder.


  1. Krueger, K. R., Murphy, J. W., & Bink, A. B. (2017). Thera-prov: a pilot study of improv used to treat anxiety and depression. Journal of Mental Health, 1-6.

Aims: We developed a short-term, group intervention that used improv exercises in a therapeutic manner to treat psychiatric patients.

Methods: We evaluated the feasibility, acceptability, and five clinical outcomes (depressive symptoms, anxious symptoms, self-esteem, perfectionism, and satisfaction with social roles) of this intervention in an outpatient setting. Participants were 32 patients with symptoms of anxiety and depression and who had variable exposure to psychiatric treatment.

Results: In paired samples t-tests, participants demonstrated reduced symptoms of anxiety (t(31) = 4.67, p < 0.001) and depression (t(31) = 3.78, p = 0.001), and improved self-esteem (t(31)= −3.31, p = 0.002) following the intervention. There was a trend towards reduction of perfectionism (t(31) = 1.77, p = 0.087), but no substantial change in rated satisfaction with social roles. Effect sizes were medium for a reduction in symptoms of depression and anxiety.

Conclusions: The results of this study indicate that a brief intervention based on improv exercises may provide a strong and efficient treatment for patients with anxiety and depression.

  1. Morse, Lucy A., Linda Xiong, Vanessa Ramirez-Zohfeld, Seltzer Anne, Becca Barish, and Lee A. Lindquist. “Humor doesn’t retire Improvisation as a health-promoting intervention for older adults.” Archives of gerontology and geriatrics 75 (2018): 1-5.

As our population ages and aging in place continues to remain a priority of older adults, identifying novel ways to promote the wellbeing of older adults and reduce isolation is of the utmost importance. The Second City is a Chicago-based comedy improvisation organization that provides training in improvisation. One of their training courses, Humor Doesnt Retire, specifically teaches adults 55 and over, on improvisation. This study sought to explore the experiences of older adults enrolled in Humor Doesn’t Retire, and to characterize any benefits that older adult participants perceived following participation in the comedy improvisation course. Qualitative analysis was used to identify and describe common themes that emerged in a survey of open-ended questions regarding the benefits of the improvisation course on outlook and mood as well as behavior changes. Results for perceived benefits showed main themes of increased positivity, an increased sense of comfort and ease with the unexpected, a sense of self-development and self-awareness, and a feeling of acceptance by their social group. Participants reported that these changes fed into their behaviors, and resulted in enhanced problem-solving abilities, greater facility in social situations, and the tangible outcome of an expanded and closer-knit social circle. As the first study in our knowledge to examine the effect of improvisation comedy on healthy older adults, this exploratory analysis has suggested that improvisation comedy may be a mechanism by which to combat several geriatric syndromes, including depression, stress, and isolation − all of which are detrimental to older adults.

Use of Improv in developing therapeutic skills

  1. Romanelli, A., Tishby, O., & Moran, G. S. (2017). “Coming home to myself”: A qualitative analysis of therapists’ experience and interventions following training in theater improvisation skills. The Arts in Psychotherapy, 53, 12-22.

This pilot study examines the effects of theater improvisation skills training on therapists’ perceptions of therapy and their subsequent clinical interventions. This paper presents the qualitative arm of a larger mixed-methods study of therapists who participated in a 3-month theater improvisational skills course, given at a clinical graduate program in social work in a major university in Israel. Seventeen-course graduates were interviewed regarding the training and its effects on their clinical work. Qualitative analysis shows that following the course participants experienced higher levels of therapeutic presence in terms of use of intuition, awareness in the here-and-now, and mindfulness. In addition, reports of increased levels of animation, boldness, and self-disclosure are discussed in relation to therapeutic charisma and therapeutic impact. Results suggest that training in theater improvisation skills constitutes an important addition to traditional training in relationship skills in psychotherapy. Implications for therapist training are also discussed.

  1. Romanelli, A., & Berger, R. (2018). The ninja therapist: Theater improvisation tools for the (daring) clinician. The Arts in Psychotherapy, 60, 26-31.

This article presents a new typology of improvisational concepts that can be used to widen the therapists’ perspective and interventions. Utilizing the metaphor of the therapist as a “ninja” and the importance of a spontaneous co-created encounter, this paper offers a taxonomy of improvisational tendencies (initiator/reactor, fast/slow), together with a classification of two possible relational moves: horizontal or vertical offers. This terminology can help therapists increase cooperation, creativity, flexibility, and vitality in the therapeutic process. It can also aid clinicians and supervisors in better understand and work through impasses and resistance. Clinical examples illustrate the taxonomy and its uses in therapy. Recommendations for practice and training are presented.

  1. Wiener, D. J. (2018). Benefits of Theatrical Improvisation in the Training of Psychotherapists. In Psychotherapy, Literature and the Visual and Performing Arts (pp. 131-150). Palgrave Macmillan, Cham.

Following his introduction to theatrical improvisation as a hobby, the author began applying theater games to his therapy practice with couples and families, finding these techniques useful for both assessment and intervention in clinical practice. Drawing upon the author’s 25 years of relevant experience in training therapists, this chapter presents both anecdotal and empirical support for several beneficial effects on therapists’ personal and professional lives gained by practicing theatrical improvisation during their training. These effects include increased appropriate risk-taking, enhanced therapeutic presence, greater present-centered awareness, greater use of appropriate self-disclosure, access to intuition, heightened attention to power/status cues and maneuvers, and the intensification of therapeutic charisma. Specific methods are described and pragmatic guidelines are offered for the effective improvisational training and supervision of therapists.