Improvisational Theater Reduces Social Anxiety in Adolescents

Background:

Since social anxiety disorder is a common and impairing mental disorder that typically begins in adolescence with persistence into adulthood (Öst, 1987), early intervention can have meaningful short- and long-term benefits (Albano, 1996).

Given that accessing standard treatment is difficult and sometimes unattractive to some persons with social anxiety, alternative treatments that are less stigmatizing and easier to access are needed. Some evidence suggests that, for social anxiety disorder, exposure therapy on its own is as effective as exposure therapy combined with cognitive therapy, and group therapy is as effective as individual therapy (Powers, Sigmarsson, & Emmelkamp, 2008). Taken together, school-based group exposure interventions have promise for addressing social anxiety.

This study examined the impact of a school-based 10-week multi-site improvisational theater course for groups of middle and high school students in a Midwestern city. This project investigates whether adolescents participating in an improvisational class will experience improved confidence in social behavior and reduced symptoms of social phobia.

Methods:

            Surveys were collected on weeks one (n=174) and ten (n=112) of the improvisational theater program across eight classes at five urban public schools. The final pre- and post-test surveys included three established measures to assess social skills, social phobia, and hope, as well six other program-specific items. On the posttest survey, we also measured self-reported engagement in the program.

Results:

Analysis of paired tests (n=81) showed that Social Skills scores significantly improved from Week 1 to Week 10, and agreement with the statement, “I am comfortable performing for others” also significantly improved (see Table 1). Additionally, the more engaged students (those who reported they were “very” or “extremely” engaged in the program; 58.1%) showed significant improvement in hope, and a marginally significant improvement in social anxiety (see Table 2).

Only 46.5% of students surveyed at week 1 completed the survey at week 10. Students present only for week 1 scored significantly higher on social phobia than students present for both surveys (see Table 3), suggesting that social phobia may play a role in attendance. Fifty-six percent of students absent at week 10 screened positive for social phobia at week 1, compared with 40% who were present for both weeks.

Among students who screened positive for social phobia at week 1 and returned week 10 (n=32), there was a significant reduction in social phobia scores, t(30) = 3.49, p=.002. Additionally, 10 of these 32 no longer screened positive at week 10.

Implications:

This improvisational theater program led middle and high school students to become more confident in their social skills and to feel more comfortable performing for others. For students who were very engaged, there was an added benefit of increased hope and optimism, and decreased symptoms of social phobia. Finally, for students attending the tenth week, social phobia symptoms were substantially decreased. These findings suggest that group-based improvisational theater is a promising intervention to reduce social phobia in adolescents.