Humor in Psychotherapy
Curt and Katie chat about the benefits and challenges of using humor in the therapy room. We look at the research exploring how humor is used, potential risks, and best practices. We work to infuse humor, even as we take our therapeutic humor pretty seriously. This is a continuing education podcourse.
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In this podcast episode we talk about how therapists can best work within treatment teams
Anecdotal evidence suggests that humor can have positive effects on therapeutic relationship development and as a skill that can be used for interventions. Concerns that humor may be used incorrectly or be potentially harmful make many clinicians wary of utilizing humor in therapy and empirical research is in its infancy about how it can be used effectively. This podcast episode explores the themes of therapeutic humor, which populations might present with different humor styles, and cultural considerations when using humor.
What are the beneficial uses of humor in therapy?
- Authenticity versus rigidity
- Serious versus humorous interactions
- Irreverence in DBT
- Humor must come from within your own personality, it is not something that is teachable
- Within the relationship and the therapeutic alliance, humor can increase connection
- Using humor as a therapist can address power imbalances
- Opportunities to challenge beliefs and shift behavior with a lighter touch
- Diffusing situations, gallows humor, and moving on from challenging situations
What are the risks of using humor in therapy?
“If I have a client that really appreciates my humor, I have to remind myself ‘No, this is not just fun, this is therapy.’ And therapy can be fun. But also there’s…a job to do. We can’t just trade jokes that are mildly touching on therapeutic themes. We actually have to…dig a little deeper.” – Katie Vernoy, LMFT
- When clients don’t understand the humor, it can cause iatrogenic harm
- Confusion on the intent of humor
- Confusion regarding the connection fostered by humor (i.e., could be seen as seduction)
- Humor can be a distraction or a way to deflect from the therapeutic work
- Humor can be seen as reinforcing power imbalances, especially when the client sees the humor as an insult, criticism, or the therapist putting the client down
- Clients may not be able to give feedback on their reactions to humor
- Self-deprecating or self-pitying humor is not recommended in therapy
What is in the research on using humor in therapy?
- Not a lot of research
- Research on humor in therapy is usually done with western therapists and clients
- It is important to understand the different cultural impacts on humor
- There is research on the 7 stages and themes of humor within therapy
- Assessing the use of banter in therapy
- Identifying whether aggressive humor can improve outcomes in therapy
- Misapplication of humor as confrontation versus using it for facilitation
How can therapists use humor effectively in therapy?
“If manualized treatments are kind of the skeleton of what we do, then the muscles and the skin and the hair and all of the ways that it’s dressed up, that’s the art of therapy.” – Curt Widhalm, LMFT
- Assess jokes and humorous interactions from the lens of it being for the benefit of the client
- Focus on “reading the room,” so you’re not using humor inappropriately
- Connecting and affirming your understanding of the client’s experience
- Balancing activities in session (business time versus fun time)
- Using humor as a diagnostic tool
- Addressing ruptures or potential ruptures caused by humor
Receive Continuing Education for this Episode of the Modern Therapist’s Survival Guide
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References mentioned in this continuing education podcast:
Brooks, A. B., Herrmann, P. L., & Andreas, S. (2022). The use of banter in psychotherapy: A systematic literature review. Counselling and Psychotherapy Research, 21(3), 570-586.
Gibson, N., & Tantam, D. (2018). The Best Medicine? Psychotherapists’ Experience Of The Impact Of Humour On The Process Of Psychotherapy. Existential Analysis: Journal of the Society for Existential Analysis, 29(1), 64–76.
Knox, S., Butler, M. C., Kaiser, D. J., Knowlton, G., & Hill, C. E. (2017). Something to laugh about: Humor as a characteristic of effective therapists. In L. G. Castonguay & C. E. Hill (Eds.), How and why are some therapists better than others?: Understanding therapist effects (pp. 285–305). American Psychological Association. https://doi.org/10.1037/0000034-016
Norcross J.C. & Lambert, M.J. Psychotherapy relationships that work III. Psychotherapy (Chic). 2018 Dec;55(4):303-315. doi: 10.1037/pst0000193. PMID: 30335448.
Smith, K. (2018, February 16). No laughing matter?. Counseling Today. https://ct.counseling.org/2015/05/no-laughing-matter/
Yonatan-Leus, R., Tishby, O., Shefler, G. & Wiseman, H. (2018) Therapists’ honesty, humor styles, playfulness, and creativity as outcome predictors: A retrospective study of the therapist effect, Psychotherapy Research, 28:5, 793-802, DOI: 10.1080/10503307.2017.1292067
*The full reference list can be found in the course on our learning platform.
Here is what happened when we put “give me seven CBT questions in a dad joke format that would help me with my depression” into ChatGPT:
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Who we are:
Curt Widhalm, LMFT
Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com
Katie Vernoy, LMFT
Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com
A Quick Note:
Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.
Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.
Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
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Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano https://groomsymusic.com/
Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):
Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).
You’re listening to the Modern Therapist’s Survival Guide where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm and Katie Vernoy.
Curt Widhalm 0:15
Hey, modern therapists, we’re so excited to offer the opportunity for one unit of continuing education for this podcast episode. Once you’ve listened to this episode, to get CE credit, you just need to go to moderntherapistcommunity.com, register for your free profile, purchase this course, pass the post test and complete the evaluation. Once that’s all completed, you’ll get a CE certificate in your profile, or you can download it for your records. For a current list of our CE approvals, check out moderntherapistcommunity.com.
Katie Vernoy 0:47
Once again, hop over to moderntherapistcommunity.com for one CE once you’ve listened.
Curt Widhalm 0:54
Welcome back modern therapists. This is the Modern Therapist’s Survival Guide. I’m Curt Widhalm, with Katie Vernoy. And this is the podcast for therapists about things that we do in our practice, the ways that we relate to our clients. And the ways that we are. Katie, and I’ve talked a lot about Person of the Therapist over the course of this podcast, this is one of the CE eligible podcasts. So look at how you can earn CEs for listening to us and hopefully, having a very joyful hour here. But as I’m hoping many of you who’ve looked at the title of this podcast, we haven’t named it yet at the time of recording, but just humor in therapy sorts of things, who are longtime listeners, you know that I start a lot of our podcasts with some sort of irreverent sort of thing that makes Katie laugh, and she finds most of what I say at least marginally funny. Yes, so in the spirit of that and keeping therapy jokes here, Katie, do you know why the airplane went to therapy?
Katie Vernoy 2:06
To get off the ground?
Curt Widhalm 2:08
Because it had too much baggage.
Katie Vernoy 2:11
Curt Widhalm 2:17
Now, I know that I’m marginally funny. I know that a lot of our listeners like sharing dad jokes with me. I like sharing dad jokes with them and anybody else because that’s just the way that I roll.
Katie Vernoy 2:32
Yes, I definitely my eyes are definitely rolling.
Curt Widhalm 2:38
But I know that you also consider yourself humorous at times, and we’ve discussed…
Katie Vernoy 2:45
Oh, I think I’m hilarious, I am hilarious. I’m way funnier than you.
Curt Widhalm 2:52
We have our styles is really what I’m talking about. But when did you really recognize that you could attempt being funny in sessions with clients?
Katie Vernoy 3:05
When did I figure out I could be funny in session?
Curt Widhalm 3:09
That you could attempt.
Katie Vernoy 3:11
I could attempt because you’re you’re not going to admit that I’m actually funny.
Curt Widhalm 3:15
I have not been a therapy client of yours. So…
Katie Vernoy 3:17
Oh, got it. Got it. So I think probably once I got a little bit more comfortable with what it meant to be a therapist, I think initially, I was pretty rigid or, you know, not rigid, maybe that’s a bad word. But I think it’s I was more formal, trying to be professional at the very beginning. But a lot of what I did initially was in milieu settings. It was there was a lot of time just being with clients. And so the humor just came, everybody thinks I’m hilarious. So it just happened. And then I realized it kind of worked.
Curt Widhalm 3:54
So I think the, what you’re describing, especially what I’ve noticed for a lot of people who might be coming into the field, like, straight out of their undergrads, straight into grad school from there is that there’s Alright, we are professionals, and we need to be serious about things and I must put on therapy face in order to be taken seriously. And…
Katie Vernoy 4:15
Oh, yeah. And the blank slate was like a thing when I was was kind of growing up in the profession. I couldn’t like put my personality in the room, like that would be so wrong.
Curt Widhalm 4:25
So this is actually a part of the field that has some evidence base to it. Now, some of the research on this says that there’s not enough research to actually have many meta analyses on the use of humor in therapy. And there’s a bunch of limitations on doing this. But when it comes to actual therapeutic things that make therapy go better. It’s often listed as humor, authentic therapist, and deliberate practice as being the three things that helped client outcomes more than anything else. So, you know, listeners of the show, we’ve talked about deliberate practice and that kind of stuff before, we’ve talked about authenticity before. And some of the research really does look at humor as being part of our authentic self. That, you know, anybody who’s ever like, if I have to teach you how to be funny, maybe just being funny is not part of your DNA.
Katie Vernoy 5:31
Well, I this was imagining, like creating a humor based therapy, evidence based practice, which was like, here’s how you craft a dad joke.
Curt Widhalm 5:40
Well, and so, you know, some of this really is maybe the way that we look at our field being resistant to some of like the chat bots and stuff is like, I don’t know that you can type into ChatGPT, like, give me seven CBT questions in a dad joke format that would help me with my depression, like, maybe this is a way of going…
Katie Vernoy 6:04
We totally have to try it. That’s it after we finish recording, I’m going to ChatGPT and saying that because that would be hilarious.
Curt Widhalm 6:14
This is something where humor as a psychotherapeutic tool, and a mechanism of change has been recognized and discussed in a few different evidence based treatments. One is DBT uses a lot of irreverence, mindfulness based therapies, going back into like the 80s, Block et all, Franzini et all, and, or Franzini 2001, Knox et all 2017. Although the technique doesn’t naturally come to all therapists, and therefore talking about it as a tool, makes it really hard to teach. And therefore, it does bring up host of risks. Most notably…
Katie Vernoy 6:57
So, wait, wait, wait, I just, I just want to, I want to say something right there. So you can only use humor in therapy, if you’re actually funny.
Curt Widhalm 7:05
If it’s part of your personality, like this is where you can have kind of your own quirks towards humor it but it has to be authentic. It’s not something like…
Katie Vernoy 7:17
Curt Widhalm 7:17
…you’re, you’re going to go and have your own kind of comedic therapy style, if it doesn’t fit for you. You know, if you’re more of an Amy Schumer type therapist, you don’t want to go and have like, Dennis Miller type humor. Like you’re going to need it not need it to be authentic to you. Many people would expect, you know, all right, Curt is a phenomenal dad joke teller, and based on the ways that a lot of people reach out to me on my instagram and send me different messages, I know that people see that as authentically being be and will send me both more dad jokes to us as well as just kind of like, Dude, you’re not funny.
Katie Vernoy 8:09
Well, this is this is the repel and the seduce of getting the people that are good to work with you. Right?
Curt Widhalm 8:19
Katie Vernoy 8:20
Dad jokes, they aren’t going to come into your practice.
Curt Widhalm 8:22
Well, I mean, even as an example of this, I had a client recently returned back from an overnight camp that ended up missing a session and so young, young little clients and came back in. Yeah, tell me tell me about, you know, the last couple of weeks, and the client was like, Well, I went to summer camp. And I was like, Did they let you come back? And the kid just like, reaches up and gives me the slowest high five. And he says, I’m glad to see that your humor is exactly the same way as I left you. So there is something within that relationship. And this is part of being able to be authentic and develop that relationship over time that we’re really talking about is being part of that therapeutic alliance that can help people come into therapy, be able to have some utility to it. So, there’s definitely still going to be some intentionality. You know, I don’t start off every, you know, session was just kind of like, Alright, so, where’s crowd from tonight? Like, you know, it’s not like a stand up set sort of thing. But as Knox et all 2017 are talking about that, there is this double edged sword that the consumers of therapy can misunderstand humor, and this is not something where you can just come in, you know, guns ablazing. As far as the way that you might bring your humor in. It is something that needs to develop over time. Because what it does is it introduces the risks of iatrogenic harm. I love this term. Iatrogenic is harm…
Katie Vernoy 10:16
Curt Widhalm 10:17
…harm caused by medical intervention or in our case, therapeutic intervention.
Katie Vernoy 10:24
Oh, wow. So, humor can be iatrogenic harm?
Curt Widhalm 10:29
Katie Vernoy 10:31
That’s really, really intense for a funny podcast.
Curt Widhalm 10:35
Because what this can do is it can take therapy clients into a state of psychic equivalence, which is basically described as, because I feel it strongly, I believe it’s real. And so if they overreact while they’re under increased effective arousal, it can lead to them misinterpreting humor.
Katie Vernoy 10:56
Got it. So don’t just make a joke to make a joke, like read the room.
Curt Widhalm 11:02
Yes, and have the room develop together. So maybe the best way that I’ve seen this spell out is Gibson and Tantam had a 2018 article, this is a pretty small group of therapists that they interviewed. And this is really maybe the place to dive into this the most. So they interviewed some therapists. And they also found that the data seems to show that there’s both positive and negative impacts of humor in the process of psychotherapy. And that humor is a multi-sided phenomenon, whose elements are interconnected. And as such, it’s really tricky to discern underlying patterns that relate to the causality of impacts in the process. Now, a lot of the research on humor here only looks at Western therapists. And because this is in the infancy of the research into this, there’s a lot of cultural aspects that humor kind of runs into some limitations. What’s funny, in some cultures isn’t funny in others. It could even be offensive in some cultures. So, you know, if you’re thinking that you’re funny, like, you know, me, and you’re working with clients, who responds to, you know, uncomfortable situations by just kind of indirectly laughing or giggling or covering up a smile with their hand, that is not reinforcing that you’re actually funny, that might just be a cultural response. And that’s not permission to just keep going on and doing whatever it is that you’re doing. So you have to understand, even within cultural aspects, what might be funny to you might literally not be funny to entire cultures.
Katie Vernoy 12:56
Curt Widhalm 12:57
Gibson and Tantam looked at there being kind of a seven step process when it comes to the uses of humor, at least as it deals with Western therapists working with Western clients. And the first step of it is just humor, whatever that might be, yeah. But they had some things that fall into kind of the overall superordinate themes. And within those some sub themes and the way that this ends up coming out. So I’m gonna go through the themes first. And then we’re going to talk about this kind of step by step because I love the way that they look at this as being part of a good therapeutic alliance and a good therapeutic approach to being able to work. So some of the superordinate themes is just the energy and depth that can end up happening in sessions, you know, whether there’s very low energy coming from a client, that ends up being something that just kind of needs a shift in, in the relationship. And sometimes it also allows for getting into a deeper discussion around what clients are talking about, you know, some of those just like, Oh, I’m just gonna talk very lightly and briefly about this one little thing, and then I’m gonna dance away. And so what Gibson and Tantam ended up looking at is that within the energy and depth super ordinate theme, that using humor has a positive effect when it can lead to further exploration. For example, with those clients who are just kind of like, I’m just gonna lightly touch on this and move away. This is where therapists utterances like, you know, is it just me or whatever you talk about that you just kind of quickly move on to the next thing. Is that something where I’m just listening way too slowly to what happened right there or is that something that’s actually happening?
Katie Vernoy 15:01
So using it as a way to lightly confront.
Curt Widhalm 15:06
Yes. And that way it makes it more about what is happening relationally. And I have heard, you know, from a number of people before in the dating sphere that, you know, what is it about funny people that’s attractive? You know, this is this is not based in any research sort of thing. This is just kind of anecdotal research that I’ve done. But I’ve heard people in a number of ways describe that humor is the ultimate connecting emotion, it is something that if I’m person A, Katie you’re person B here, that if I can think of something that you would find as a shift in expectations, that that shows how connected I am to you, and understanding not only what you would find to be expected, but what you would find is a positive response to something unexpected. But that is one of the deepest connecting emotions that two people can have. And that’s why people like me, are so attractive to so many people.
Katie Vernoy 16:09
You keep telling yourself that.
Curt Widhalm 16:19
You know, letting letting everybody else catch up to their feelings about me right here. But also, within this energy and depth theme, that humor can lead to catalyze and giving energy to clients in session, especially if there’s clients that might be very low energy to talking about things might be very resistant to talking about things. That I’m reminded of a client that I worked with years ago, that she would come into sessions as a teenager, and I would have whatever briefing emailed to me by the parents before sessions would happen. And I know that there was something that would be a terrible week and then start the sessions, you know, some version of alright, you know, how was your week? Tell me what went on? And I would get some sort of answer just like, fine. Okay, whatever, you know, there’s just very low energy not wanting to talk about things. And I would say, you know, well, as per our agreements, I will let you know whenever I know something from your parents ahead of sessions. And I know that you seemingly had kind of a terrible week. So you just want to keep lying about this, or are you? And this happened, you know, several weeks in a row. And so it just kind of got to a point where one session rather than starting it with the same way I just started with, Okay, lie to me. And the client just, client just goes, I had a wonderful week. And I go, do you want to talk about it? And she goes, Well, my parents probably told you about X, Y, and Z. And so it’s just kind of something that helped to start off the sessions with a little bit more energy. It was something that in the therapeutic dance that the two of us had, it made it to where it energized the beginning of sessions that made it easier to talk about things.
Katie Vernoy 18:23
I think it also it sounds like was was connecting, right? It was I see you, I’m playing along with you. And I’m not upset about it.
Curt Widhalm 18:32
Yeah, and so we’re gonna get to that here in just a moment. But you’re right, it totally is something where, once again, it’s that I see you and seemingly know you well enough to be able to, in a safe way shift what the expectations of what’s going to happen next. On the negative sub themes under energy and depths, humor can be a way that conceals and deflects away from the therapeutic work. And this can be where it’s distracting. And oftentimes, you know, I have to tell people like No, no, I have to be the, the responsible one here and limit the number of jokes that I’m telling. So that way, we can actually do the amount of work because you know, the ego that we have to just continue to connect. It can serve as a distraction sometimes.
Katie Vernoy 19:26
Oh, yeah, no, I have the same thing where if I if I have a client that really appreciates my humor, I have to remind myself No, this is not just fun. This is therapy and therapy can be fun. But it also there’s like, a job to do. We can’t just trade jokes that are mildly touching on therapeutic themes. We actually have to, you know, dig a little deeper.
Curt Widhalm 19:50
So some of the research that I’ve worked on this is also the humor that is used by clients and in particular, trauma survivors, people with substances abuse issues and people with borderline personality disorder can also use a lot of humor to kind of deflect away some responsibility or some desires to end up having to work on things. And even within clients, this can end up being a double edged sword. Some of the clients who use this really well are able to use humor as kind of a good coping mechanism. But if you’ve worked with anybody from one of these categories very early on in their treatment, where they’re still in kind of that defensive, dark humor sort of thing, that that is something where it allows for his speaking to the truth, without necessarily having to do any of the emotional work around it. And so that is something where it can serve as a distracting energy and kind of pulling the energy away from what needs to actually be worked on there.
Katie Vernoy 20:53
When I think about the client’s humor, whether it’s deflecting or those types of things, I feel like there’s a place where you join with it, and then you try to shift it versus just seeing it as a distraction or as a deflection. What do you what do you think about that? Because to me, I feel like if I immediately go and try to move away from their humor, or or call them on it, I think I feel like it’s too, too jarring, too abrasive.
Curt Widhalm 21:22
And this is the part where what we’re attempting to do in this particular conversation and encourage people to look at themselves in this way is, yeah, even the difference between a good joke and a bad joke is timing. Is the same thing that within a therapeutic session, the timing of an intervention, the timing of being able to do something, as you’re describing has to deal with, when and how something is used. So what you’re describing is totally correct, that this is something very early on, where it’s maybe something where you take note of it, but later, maybe mid sessions in your treatment plan is where you might want to confront those things a little bit more directly. In the next superordinate theme, as described by Gibson and Tantam is the therapeutic relationship and on the positive sub themes, establishing and strengthening relationships. And that’s kind of what we described earlier as knowing what other people might find humorous. They also found a sub theme that this redresses power imbalances, that if it’s something where you were seen as more of a human, because you find things humorous, in the same way that I do that it makes it feel like I can be a little bit more authentic myself as a client, in order to be able to have a relationship with you. And by just being able to say, you know, I’m not just in therapist face, and being very, super serious about things that we’re able to do this in a way that makes it feel like more on a playful balance. And it’s something where the other side of that the negative sub theme is that when humor is used incorrectly, it can actually establish or reinforce power imbalances, especially if it’s seen as the therapist putting down a client.
Katie Vernoy 23:30
Ooh, yeah, that sounds pretty, pretty bad. And, to me, I feel like that would be a no brainer, like you don’t put the client down. But I mean, I could imagine that this is what I think where the cultural differences could come up. And this is where the elements of not reading the room could come up. Where something that you thought is funny. It’s a quote unquote, gentle confrontation, using humor is actually felt by the client as my, my therapist is insulting me and making fun of me.
Curt Widhalm 24:04
Well, I mean, let’s ask a question that if people are going through the transcripts of this and taking this completely out of context: have you ever put down a client?
Katie Vernoy 24:17
I think probably if there was in without context without the relationship being understood, yeah, sure.
Curt Widhalm 24:29
And a lot of that hesitation that even in being able to answer that question is I think a lot more of us have probably done that than any of us care to admit. And the reason that we don’t want to admit that is it’s so context dependent. It’s like nobody in any sort of educator role when it comes to therapists is like, “You know what’s a good intervention? Go and mock your clients. Like, just unleash on them, make fun of them over and over again until they just want to give up whatever their presenting problems are.”
Katie Vernoy 25:04
Yeah, I think that probably is pretty standard. I think it’s something where I feel like so much caution is needed. And such a strong relationship is needed to be able to do anything that might be considered mocking a client that. Yeah, fair point. Thank you, sir.
Curt Widhalm 25:25
Now, this is something where yeah, I’ll admit, kind of like you, the context of some situations does require a lot more explanation when it comes to “You said what in session?” And you know, there’s just kind of that, like, I find myself in this situation all the time, where it’s like, completely out of context here’s something that I may or may not have said to a client, and people are like, Oh, shit, shit, my therapist says. You know, I think that that’s a hashtag that I see come up on social media every so often where it’s like, that is just missing all of the other context of it, and why so much of this is about the therapeutic relationship in and of itself. Now, the other negative part of the therapeutic relationship here, the other negative sub theme that they identified is that this can be something that is perceived as seduction.
Katie Vernoy 26:25
Seduction, okay, how does that work?
Curt Widhalm 26:29
This is from their article, from the data, the impact of humor seemed to generate greater energy in the sessions and also made the other more appealing, including sexual attraction to be with. Some participants, this is therapist side described feeling seduced by their clients, others admitted to I’m paraphrasing here, were acting seductively with our clients. So this is maybe some language that was used around some of the sexual nature. And given its primitive beginnings, the sexual tension or excitement involved with humor, may well have been difficult to speak about with these participants. So the negative side of this is that when we start relating, we start getting permission to talk with our clients about things that are humorous, that this can very negatively move into making sexual jokes. And there might be some sort of attempts by either the therapist or by the client, to negatively establish and strengthen the relationship through the use of sexual discussions in a humorous way.
Katie Vernoy 27:40
I think this would be especially problematic potentially, for folks where sex is part of the presenting issues, or like it’s being talked about a lot, I think that there could be that potential for it to get very comfortable and potentially confusing for the client. I mean, obviously, sex therapists, I’m sure have a very clear training around how to do this, it’s very boundaried and appropriate, and blah, blah, blah. But for those of us who are not sex therapists, and sex comes up and we use humor a lot, I think it could be something where we can get, we can walk across a line pretty easily, that we don’t think about. And so I think it’s, I think that’s an important point. And something that all of us should really pay attention to. Because being authentic doesn’t mean being your whole whole self.
Curt Widhalm 28:30
And I’m thinking of some of the sex therapists that we’ve talked with on the show, you know, Tom Murray comes to mind. I’m connected with him on social media, he was very fun to have on our podcast, we’ll include a link to that episode in our show notes here. But I know whether it was in the episode, or some of the things that I’ve seen him post online that, you know, when it comes to sex, and sex therapy type things like, there has to be an ability to laugh at just kind of some of the funny things that happened during sex. How that’s brought up needs to be, and this is where I think the statement that I’m going to use is one that every therapist has heard multiple times. But even this is not really done in the right way, but are not talked about deeply enough. But the statement is for the benefit of the client, and I think that that’s something where, especially when it comes to humor, and many of the unfortunately very not funny professors that are out there in talking about this kind of stuff, or a lot of the very not funny supervisors out there that don’t teach like, Alright, here’s, here’s the nuance and the balance and the back and forth that makes the therapeutic relationship okay to be able to make this kind of a joke there. You know, there’s a there’s a difference, especially if we’re talking about sex and sex therapy, there’s a difference to be like, yeah, then the dog came in and started licking, you know, places that weren’t supposed to, but… All right. That is an unexpected funny situation that’s different than a sexual humor joke that is directed from the therapist to the client about potentially something sexual happening between the two of them.
Katie Vernoy 30:17
Yeah, I mean, there’s certainly the sexual boundaries that. Yeah, professional therapy doesn’t include sex, or sex jokes about your relationship with your client.
Curt Widhalm 30:31
Now, the last superordinate theme here is psychological and behavioral shifts. And according to Gibson and Tantam, there are only positive sub themes here. And this is to get through resolution and incongruency. Resolution: They identified the sub themes as it challenges and shifts beliefs, perceptions, and behavior. This is something where would you have clients really describe like a series of events? And it’s like, you see all of the pieces there, and the clients haven’t quite seen, like, what did you think was gonna happen? Now that you see what the consequences are? That it’s you being able to lay things out like that. The next sub theme that they talk about is it helps cope with and move on from difficult things in life. And this is kind of some of that gallows humor that can kind of develop some times where it’s like, okay, that’s a thing that happened that night, now that I’m out of it, I can laugh about it, or I can just kind of put things into a place where it’s just like, the danger isn’t there anymore, I can choose to laugh about it, or I can choose to continue to be hung up on it.
Katie Vernoy 31:45
And I think there’s that element of using that to potentially even as far as session management, to shift from being able to really process, cope, do all the things kind of in the the mid middle part of the session, and then using light humor, and potentially gallows humor to kind of come towards the end of the session to lighten the mood to move to move within the session that way.
Curt Widhalm 32:12
And the last piece of this also just kind of within this is the sub theme of helping to accept limitations. And so not only what has happened in the past, but what is kind of happening around me, happening in the future as far as here as a client, I’m able to just kind of sit in this space that makes it to where, all right going forward, I can only laugh about the absurdity of the situations that I’m faced with. So I also want to focus on a particular kind of humor that was identified by Brooks et all this is 2022, banter in psychotherapy, relationship to treatment type therapeutic alliance and therapeutic outcome. Journal of Clinical Psychology 2023. So, you know, this is fresh off the press, and very much…
Katie Vernoy 33:08
Curt Widhalm 33:09
So exciting. They define it in reference Brooks et all “banter is defined as the playful and friendly exchange of teasing remarks.” And further going to such reputable sources as the Oxford Dictionary. Most teasing is mocking and not only fun by definition. As they referenced Keltner et all point out, merely slight variations in the choice of utterance and mode of presentation are enough for teasing to end in more disturbing effects such as humiliation and even harassment. So they are speaking to once again this double edged sword about humor and the kind of where it’s like know who you are, know your audience, read the room, and this kind of stuff. But particularly with banter, this is going back and forth with clients in these situations. So this is an agreed upon sort of behavioral exchange rather than it just being kind of a irreverent comment or a well timed pun or dad joke that makes it to where it’s not just an unexpected and unwilling audience but something that both people engage in together. Is this something that you ever do with clients where it’s just kind of like you kind of throw barbs just back at each other, but it’s an on a unstated agreed upon sort of way that the two of you are relating.
Katie Vernoy 34:32
I feel like that’s most of how I do therapy. I mean, it depends on the client. I think there’s there’s definitely folks where this is this is how we operate and I and then I start joking, like okay, well, we actually have to do therapy now. And so I think there’s that element of of, you know, I am an attachment based therapist, this is how I operate. So yeah, absolutely. I use banter, but I think there are times and with certain clients it is Is the agreed upon how do we lighten the situation? How do we connect? And then there’s that element of okay, what are we not talking about? And how do we actually get into the work, where I feel like I as a therapist, I have to then step back into it. Even though it’s fun, even though it’s connecting, even though there’s all those pieces, I feel like I can over utilize banter, I think.
Curt Widhalm 35:27
And, you know, there’s the amount that you do it, and just kind of even the ways that it can be done. And what I like about this study, and all of the studies that it references is, some of this looks at things over really long periods of time. One study by Yonatan-Leus et all found that aggressive humor styles could predict positive therapy outcomes. And aggressive humorous styles might include things like humor, or teasing or putting them down. Also, you know, kind of self enhancing, cheering oneself up using humor. And earlier what I pointed out just how many people are just in love with me, because of what I can do as far as shifting explanations and, you know, leaving pause and space for a lot of just that adoration. That’s an example of kind of this cheering oneself up sort of way. Where this can be overdone, though, is some of the self defeating, you know, making fun of oneself or allowing others to do too much of that, where it becomes kind of personal, those don’t predict the therapist’s effectiveness very well at all. But in this study…
Katie Vernoy 36:39
Can you give an example of that?
Curt Widhalm 36:41
I don’t want to because that is something that is just not part of my style, I’m not mean vicious kind of person, but it would be, you know, maybe mocking oneself down to a point of almost pity, where it’s like, it feels bad, because people are, you know, that woe is me so much sort of thing.
Katie Vernoy 37:02
Got it, okay, I was just trying to figure out what it was.
Curt Widhalm 37:04
Think of, you know, whatever your opinions are of the example that I’m going to use here, but Rodney Dangerfield does this in kind of a positive way, you know, things things so tough for me sort of thing, and that is humorous to some people. It’s a little dated at this kind of point. But I think it’s a reference that most of the audience should at least kind of know what I was talking about. But if there wasn’t that kind of…
Katie Vernoy 37:29
Curt Widhalm 37:30
Yeah, but if there wasn’t kind of that humor, like, Alright, I’m playfully mocking myself, but it just felt like, Oh, I’m just, you know, things are just so bad for me, you know, how bad things are for me, you know, blah, blah, blah, that where it’s just like, it’s depressing, even if the attempt to do it is funny. And so not being funny there makes it to where it doesn’t actually help clients. But the study by Yonatan-Leus et all, they collected outcome measures at five points and the humor style of the therapist was collected five years after treatment ended. And this is what backs up that the clients experience of the therapists humor ends up being something that had some slight predictive validity as far as the client outcomes there. So this is something that very does much speak to the authenticity of the relationship used appropriately. Maybe to reinforce this in the way that some clients have talked about this, this is something where, you know, it’s the way that clients feel felt by therapists that they’ll often report on much later, you know, I remember, Katie being like a great person, she understood me, she was able to kind of help me laugh about my situation kind of things. That might be something that’s as effective towards reaching therapeutic goals as even some of the specific interventions that are being taught.
Katie Vernoy 38:56
I think that’s, that’s really interesting. I think, to me, when I think about some of the clients who humor was very central, and with clients where humor was not really used at all, there’s definitely different folks that are gonna respond differently to different things. But when I’m able to use banter, when I’m able to potentially even dig a little bit deeper, and it’s, and it’s mutual, or it’s acceptable within the relationship, it does feel like those relationships last longer, those relationships are more impactful. And, you know, like, I don’t have the five year after treatment check in but I do get referrals from those folks long beyond when they they complete their own treatment. So to me I it’s that feels really true, but I also think about the folks that that just doesn’t work for and so I don’t know where we’re heading next. But that just was what came into my mind. There are definitely folks where banter was not appropriate, humor was not appropriate at all, like they were just in a space where they couldn’t really take it in. And sometimes I could navigate it and sometimes it was definitely, it was a misstep and some of those clients I lost.
Curt Widhalm 40:08
One of the things that Brooks et all looked at was the, the category of banter that was used. And they looked at this across three different therapeutic theories, psychoanalytic therapy, psychodynamic therapy, and cognitive-behavioral therapy. And they looked at this as far as how it’s categorically used, whether it was used as confrontation, facilitation or defense mechanisms. And what you’re speaking to here is the misapplication of trying to use humor, for example, as a confrontation, when really what you’re trying to do is as a facilitation that misapplication of it is really where some of those instances can go awry.
Katie Vernoy 40:55
Well explain the difference between Well, I understand what confrontation is what is using humor as facilitation?
Curt Widhalm 41:03
So facilitation can really be differentiated by helping to move therapy along. It’s kind of when a client gets stuck on things, it’s not necessarily directly confronting what they’re saying. For example, a client who might be exhibiting a lot of overdoses that landed in the emergency room, a lot of passive suicidality that leads to a lot of precarious accidents. But a confrontation type approach might be, you really need to address this, a facilitation type thing might be, you know, if we look at this another way, maybe you’re just really bad at killing yourself. That ends up being something that helps you.
Katie Vernoy 41:49
That’s got to be the right client, though.
Curt Widhalm 41:51
Right. And so that’s got to be something where it’s being done to facilitate looking at what is happening in a very different way without necessarily confronting the client kind of head on in that direction. And then defense mechanisms are kind of, you know, the traditional defense mechanisms sorts of things. So looking at the frequency that this happens, the psychoanalytic therapists tend to use all three of these pretty equally, confrontation, facilitation, defense mechanisms. Both psychodynamic therapy and cognitive behavioral therapy show a lot more increase in the use of this as a facilitation technique used in therapy. That is something to kind of reframe the situation to look at things differently. And that might be something where, just by the very nature of psychoanalytic therapy being a little bit more non directive or reserved when it comes to this as especially as compared to something like CBT. But CBT was nearly twice as often in the number of instances of this as a facilitation use as a therapeutic mechanism. So part of you know, where I want to maybe turn, the last part of this conversation around is really like making this a little bit more of a discussion here in talking about this in terms of, you know, some of the considerations that we have, and especially, you know, we’ve talked a little bit about the cultural impacts that this might have, but you’ve met a number of therapists in your career. Some of them, I’m just going to make some really rash assumptions here. Some of them you find funny, some of them you find like, there is no humor in this person, whatsoever. So just kind of, you know, as as you’re…
Katie Vernoy 41:51
I would agree with that.
Curt Widhalm 43:54
As you’re taking this a little bit here, how would you talk about the ability to use humor with other therapists? And why don’t you find that educators or supervisors lean into this more, especially if some of the research base is like You know what? Humor does work as far as helping clients.
Katie Vernoy 44:18
My experience of some therapists and humans in general, folks out in the world, they take themselves very seriously, they take the work very seriously. And they have a hard time holding kind of the both/and: I can be very serious, I can be very passionate and I can hold this lightly and be irreverent and make jokes and, and, and do the thing, right that do the thing that is humor. And so I think for me, even looking at the Gottman’s and some of the things that make relationships good, right, like using humor and repair it is one of the things that I realized that my husband and I do really, really well. So we’ve got, you know, good Goldstar for that. And I think that there’s a lot of folks, even when I try to talk with them about that, in session, they just can’t think about like, how do I, how do I be? How can I be funny? How can I actually use humor. And even though I thought it was kind of funny that you were being very structured about what humor was, and what type of humor to use in therapy, I think some people need that, to be able to recognize that a lot of people are funny in small ways. And so being able to look at observational humor, being able to look at even just that, knowing that little bit of like, you’re seeing what I’m seeing, right. And we’re gonna see this in the same way. I think being able to take the concept of humor down to a deep knowing, a holding lightly, a slight irreverence around the work. I think a lot of folks could get there, not everybody, but a lot of folks could get there. But I think being able to potentially even see it as authenticity may be the way that you bring it to therapists. I know I kind of went around on a journey there. But to me, I feel like it’s that, that element of giving yourself permission to use your own insight and perception. And bring that into the room with your own personality. Like to me that’s, that’s the closest I could get that would be like, Hey, this is how most people could bring a little bit of humor into the room. I think dad jokes, you got to have that ability, right? I mean, not everybody is the dad joke expert that you are. Like, I try to respond to your dad jokes on Facebook. And sometimes I can get a good one. But most of the time, I’m just like, oh my god, I can’t think of anything that would be funny to shoot back at Curt. And so I feel like, if if that were the expectation, I’d be like, Yeah, I can’t be funny in session, I can’t do dad jokes. Whereas I know that my, my therapy clients, and I do a lot of laughing because I just see the world in an interesting way. I also have an interesting way of speaking. You always you and I always joke about how I pull together sentences even. And so to me, I feel like allowing myself to be real in the room has its humor here and there. But the real challenge, I think, is the dangers that can come from it when when someone can’t read the room, or someone assumes that what they find funny, the person in front of them would also find funny. I think the risks there are really scary, especially for folks, you know, especially when you’re training folks early in their career.
Curt Widhalm 47:49
And I think the, you know, there’s just a lot about how easy is it to teach somebody to be funny? Like, can you teach somebody to have a sense of humor. You know, there’s the idiosyncratic pieces of things. But, you know, if you are not a funny person, if you’re working with somebody who’s not a funny person, if they have the personality of a piece of broccoli, then they’re just going to, if they don’t lean into that, if that’s not the style that they’re going to do, then it’s not going to be necessarily flame that keeps the therapeutic relationship warm. It’s just going to be a bunch of sparks shooting off in different directions.
Katie Vernoy 48:35
That made me think of the it’s one of the Borat movies where he’s being taught how to do I think knock knock jokes or jokes. Do you remember this?
Curt Widhalm 48:47
Katie Vernoy 48:47
He just kept saying things in the wrong order. It was, it was funny because of how bad it was. But yeah, it was like trying to teach a basic joke. And he was not, he was not complying with the rules.
Curt Widhalm 49:00
So I’m looking at an article from counseling today by Kathleen Smith. This is from 2015 called No Laughing Matter. And I liked the this even starts out with a little bit of a joke here. So a client comes in for the first counseling session and has a carrot sticking up their nose and a banana in his left ear. “Help,” the client cries. Can you tell me what’s wrong with me? Simple, the counselor says calmly, “You’re not eating properly.”
Katie Vernoy 49:27
Curt Widhalm 49:32
Now, the article goes on to talk about the counseling profession, the therapeutic profession’s quest to be taken seriously. And I think that this is maybe even where a lot of like the manualized treatment sort of stuff ends up just feeling like here’s things that are stripped down to their bare bones that ends up being where the art of therapy is how this stuff is delivered, and some of us living more authentically in the way that we deliver this, you know, I’ve often used like, if manualized treatments are kind of the skeleton of what we do, then the muscles and the skin and the hair and all of the ways that it’s dressed up, that’s the art of therapy. And that’s what comes down to the clinician being able to deliver this stuff. Some of us are funny, some of us in our profession are pieces of broccoli, and trying to make it to where we’re all doing the exact same thing, if I have to teach you how to be funny, and you’re not necessarily a funny person, then that’s going to make it to where what you deliver in therapy is just going to be sad and pathetic. And you know, there’s enough of me in this world, if I was going to teach you to be me, you’re going to give us both a bad name doing this. So this has to be authentic to who you are. And, you know, it’s kind of that thing where it’s like, if you have to explain the joke, then it’s not really that funny. So, in getting to that place where there is humor, some of the people that Kathleen Smith did interview here talked about some ways that both for therapists but also assigning humor to clients as kind of a therapeutic shift in things might be just like, assigning humor homework, and somebody that she interviewed named Gladding, might suggest that they read or watch something that involves laughter for clients. Sometimes it might be scheduling time to be silly. And you know, there’s times where, you know, especially working with younger kids, like I’ll set up sessions to where like, Alright, here’s business time, this is where we actually sit down, and we work on learning skills. And we’ll follow that up with silly times, like well actually schedule just silly time within the sessions. And just being able to then bring it back into the moment of like, how do you feel when you’re able to do both productive things and make time to have fun. You know, there’s also being able to use humor as a diagnostic tool. In this article, somebody interviewed, Borden that you can look at how a client uses humor could be sarcasm or cynicism, to be self protective. And then there might also just be, you know, looking at things like using humor to change perspective. In the 2006 article, Goldin, Bordan, Gladding and Daniel Araoz recommended having their clients describe their their life through the eyes of a cartoonist, and just being able to really kind of emphasize and over do some of the things. But kind of the last points that I want to make here is, not only is this about what you and the clients find humor, but when we’re talking about culture within this, we also have to talk about the culture of intergenerational differences and the ways that different generations relate to humor. And this is from an article by Fram and Reed in 2018 that specifically talks about professionalism without authenticity, and humanity doesn’t build trust with clients from Millennial and Gen Z generations. And this is a lot in the way that those generations tend to relate to mental health and tend to relate in the world in a way that looks for honesty and transparency in every aspect of their life, including, you know, social media, but also in the ways that they interact with people IRL. I do that in just to annoy a lot of my teenage clients just to be like, I get how annoying that is, for me to say this stuff out loud. And then I then I say, whatever the lingo of the day is, like slay and then I dab and like…
Katie Vernoy 53:57
Curt Widhalm 53:58
But they go on to say that infusing humor and an appropriate self deprecation tends to appeal like, Oh, here’s my limitations. You know, here’s, you know, something that I wish that I was really good at. And, you know, I’m still a beginner in this too, that helps to make that therapeutic relationship stronger. And it makes therapists seem more authentically vulnerable, and allows for the better use of personal anecdotes and self disclosure to generate conversations and build a social connection with their clients.
Katie Vernoy 54:37
I think the thing that I think about here is, I think you can be funny even if you have to explain the joke. If you’re authentic and talking about how out of touch you are, you’re making fun of yourself with the joke that you just made that wasn’t funny. So I think being a big a Gen Xer at recognizing that my humor is way different and I’m not going to slay or whatever, I do know that if I can make fun of myself for not being funny, that adds to the humor, so so even if you’re not funny, I think you can still kind of be funny. If you’re willing to be humble.
Curt Widhalm 55:16
You know, I find myself in like some of the law and ethics courses that I teach when it especially when it comes down to like documentation and what people should write, they will sometimes be like, you know, alright, just write the facts, you know, be Columbo, like, if you don’t know who that is, go, go ask your grandparents, like build, build some stronger family relationships by going and asking your grandparents about this throwaway joke in the middle of a law and ethics workshop. But this also comes to the way that this extends beyond the therapy sessions, and even in the ways that we put ourselves out online, particularly in social media as we try to relate to millennials and Gen Z. And about making even online therapist humor something that is warm and inviting. And a little bit of we have difficulties too but in a way that doesn’t put down clients or the profession. Know your audience, folks, and know that your audience is going to look at things too.
Katie Vernoy 56:24
And we did an episode on how your social media might make you look. So we’ll link to that in the show notes.
Curt Widhalm 56:31
So actually, one of the recommendations in all of this is sometimes when humor doesn’t go well in sessions. Like your other people, not me, I’ve never run into this myself, but other people might make a joke in session where it’s just flat, like, nobody is laughing.
Katie Vernoy 56:54
It’s a lead balloon.
Curt Widhalm 56:56
Yeah, I’ve, I’m aware of this as a phenomenon that other people have described with me. But if…
Katie Vernoy 57:03
You have no idea, there’s no way that you’ve ever had a joke, just completely fall flat.
Curt Widhalm 57:08
My lived experience in this is pretty close to zero. So my academic understanding is when you make an attempt at humor, and it’s not found funny, it’s an opportunity to actually check in with your clients about what just happened. And being able to work through the ruptures in the relationship. And this is actually seeking out feedback. Even if you are hilarious, you’re still not at a stand up club, like this is not something where, you know, the entirety of my sessions is just kind of this like, irreverence, like, you know, Mighty Boosh episode or whatever skit show episodes that you might watch, like, I actually do take my serious parts seriously, and the funny parts of my session seriously as well. But when when those ruptures do happen, it’s important to actually talk about them as far as, hey, you know, we are joking around in here, how is this experience for you that you’re, you know, sometimes using humor, and I feel like we get a little bit off track, you know, sometimes I use it and I push us off track, like, are we actually here, succeeding and working on what we’re trying to do here? So that way, the clients are able to still work on their therapeutic goals, it’s just kind of that how it’s happening, ends up being something that you’re really able to talk about. So you know that yell of advice is like, when in doubt, talk about the therapy. But also, when you’re having maybe a little too much fun in therapy, you should also still talk about the therapy.
Katie Vernoy 58:51
There’s the talking about the therapy. I think there’s also when you make a joke that really hits wrong, that that’s harmful, potentially, I think there’s that element of being able to immediately assess it: seems like your reaction wasn’t what I was expecting. I, I was trying to be silly. Sounds like it may not have hit right. Let’s talk about that. Like I think it’s, it’s the therapy, but it’s also that what I did wasn’t therapeutic. And so it’s being able to then go to that space of repair and apology and all that stuff. And I think there may be a whole other episode on what do you do when you mess up in therapy? Because I think some folks get very worried if I admit to wrongdoing, am I going to be liable? Is my client going to sue me or they’re going to do an ethics complaint or a board complaint? And I think when we say something that’s funny to us and completely short sighted and harmful to the client, we have to we have to take take ownership and switch gears. With some clients that could be making a joke about how I how bad the joke was, with other clients, it might be a complete change of gear. And let’s talk about what just happened there because I really messed up.
Curt Widhalm 1:00:10
And if this is something where you’re wanting to incorporate more aspects of this into your therapeutic work, maybe don’t just go straight to like telling jokes, but you know, start with amusing anecdotes, you know, maybe a meandering parable about something that has kind of some irreverence to it. But you don’t, you don’t need to go like 100% different than where you initially might have presented to clients. But it’s also, you know, opportunities where I’m thinking of Jax Anderson, who encourages, you know, clients to check out some of her therapeutic YouTube videos is it set kind of an expectation of what it’s like to work, even before some of the kids come in and work with her that allows for some of that relationship and expectation to know what’s happening from the very beginning. You can find our show notes over at mtsgpodcast.com. And you can purchase this course with the directions at the beginning and the end of the episode. If you liked this long form content, please consider supporting us in other ways, including becoming a patron and seeing some of our behind the scenes sort of stuff when we prepare for these episodes or supporting us through Buy Me a Coffee, and join us on our Facebook group, The Modern Therapists Group or follow us on any of our social media. And until next time, I’m Curt Widhalm, with Katie Vernoy.
Katie Vernoy 1:01:44
Just a quick reminder, if you’d like one unit of continuing education for listening to this episode, go to moderntherapistcommunity.com, purchase this course and pass the post test. A CE certificate will appear in your profile once you’ve successfully completed the steps.
Curt Widhalm 1:01:59
Once again, that’s moderntherapistcommunity.com.
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