Send in the Clowns

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Written by Julia Stier


Medical clowning may sound like an oxymoron, but the School of Dramatic Arts at the University of Southern California is proving that this unique form of art therapy may be just what the doctor ordered. Through the power of fun and imagination, medical clowns are working to bring laughter and relief to patients and their families all around Los Angeles. 

@ This Stage’s Julia Stier spoke with Rebecca Mellinger, who serves as the Program Coordinator and runs development for the medical clowning program at USC. She shares why this centuries-old practice (though relatively new in the states) works, the qualities that make a good clown, and how Los Angeles artists can train for this rewarding profession.


Stier: What is medical clowning, and why does it work?

Mellinger: In medical clowning we use classic clowning modalities such as humor, imagination, play, and nonverbal communication to improve the health outcomes for populations suffering from various illnesses and diseases, as well as helping improve a patient’s experience of what ails them. So that could be physically, psychologically, and behaviorally. There are a ton of actual physical benefits and physiological benefits of medical clowning –decreasing blood pressure, increasing respiration – but what we’re really working to do is decrease anxiety through laughter and play, as well as bring patients, caregivers, and doctors together in a way that doesn’t include just speaking about what their issue is, but rather changing the conversation and focusing on what is healthy about the person and highlighting that and bringing that out during a time where they might unfortunately forget that that’s still there.

What training did you receive in medical clowning?

The School of Dramatic Arts at USC is the first training program in the United States on medical clowning. What it includes is a one-semester course in basic clowning techniques within a classroom setting so that our clowns can be the most vulnerable and get all the training and skills necessary. That training includes various artistic training, as well as medical training. We’ll bring in doctors and physicians and psychologists to discuss the best practices to include when working with these patients. Then, students that wish to continue will go on to the advanced practicum, which includes clowning for six months in the hospital once a week, at first with our professional, professor medical clowns. Then they switch over, and get an undergraduate student clown partner. They clown with them while our professional professors watch and give notes. After that year study, the clowns can then practice at our partner hospitals, which include the Los Angeles County Hospital, Norris Comprehensive Cancer Center, and Children’s Hospital Los Angeles.

You don’t even really have to have clowning techniques, you just have to be open to listening and to being silly. I want to dispel the idea that you have to be a comedian to be a clown. What we’re doing is empowering the patients and letting them decide what’s funny and what they want to do. We are agents of their own humor. So it’s really not bringing in our humor and putting that onto them, that actually has the opposite effect and doesn’t give them control in a situation where that’s something that they need and crave.


What makes a good clown?

I really think it’s just the ability to give up what they think is funny and have the ability to solely focus on each patient and give them the space to create and imagine and to be an agent of their own creativity. We’re there to just be color in a hospital environment that’s void of color, and support whatever the patient desires, and to really be that middle ground to bring families together.

How does the patient benefit, and how do you benefit?  

There was an infant that was in the ICU, and the mother was very much distressed. The child couldn’t stop crying, and the mother clearly hadn’t slept in a very long time. We came in and used music and sang to this child, and immediately the child stopped crying. The doctor said that the child’s heart rate had dropped, and that the child was regulating a lot better. The mother had a chance to sit down and just watch the child. It’s most rewarding to see that change, to be the person in that environment that can bring a creative and positive spirit into the hospital. If you can bring a smile to somebody’s face who’s experiencing a significant amount of trauma, you’re going to get a lot from it. It’s a tough profession, too. You’re witnessing a lot of illness, but I think that overall it’s extremely positive.


How can Los Angeles actors get involved?

Starting in January, we have a three-week training program for actors – those that have previously had some clown experience or just general physical comedy, or musical experience. We take their artistic training and apply it to a medical setting. [The training] will include studio intensives for the first two weeks, and then shadowing Zachary Steele – who’s the program director and a professional medical clown – followed by post-shift discussions. Then we will pair them up with a partner, and watch and mentor them as they clown at hospitals. What they’ll need is to complete about 10 to 15 hours of practicum in the hospital outside of these three weeks as well to get the certificate. 


Can you tell us a bit about the clinical trial that you’re running to prove the benefits of medical clowning?

We partnered with the USC Keck School of Medicine Institute for Integrative Health and the School of Social Work, and we’re studying the effects of medical clown interventions on anxiety and perceived pain levels in pediatric patients undergoing venous blood draw at the Los Angeles County Medical Center. We are starting data collection in January, and we should have a full research paper by next May. 

Interview edited for clarity and length.

Learn about the USC School of Dramatic Arts Institute for Theatre & Social Change and their work regarding medical clowning here.

Julia Stier

Julia Stier

Julia Stier is an LA-based actress and playwright, and holds a BA in Theatre and minor in Cinematic Arts from the University of Southern California. Her work has appeared onstage in both LA and New York, and she has written for numerous publications, including Larchmont Chronicle, LA Parent, and the national magazine, Italian America. Julia is a member of the acting company at Hero Theatre.