A pilot randomized controlled trial of distance laughter therapy for mothers’ level of depression, anxiety, and parental stress during the COVID-19 pandemic

Abstract

The COVID-19 pandemic has led to substantial lifestyle changes worldwide, contributing to heightened psychological stressors such as depression and anxiety. The demands of parental care have also intensified, increasing the risk of caregiver burnout and potential child maltreatment. This study aimed to evaluate the efficacy and feasibility of implementing distance laughter therapy for mothers caring for young children during the pandemic, with a focus on mitigating depression, anxiety, and parental stress. Utilizing a pilot randomized controlled design, 22 participants were divided into two groups—experimental and control groups—and underwent four virtual sessions over two weeks. The experimental group engaged in distance laughter therapy, a technique designed to stimulate self-induced laughter, while the control group viewed a 50-minute entertainment TV show. Both groups experienced a significant decrease in depression and anxiety; however, only the experimental group experienced a significant reduction in parental stress. Nonetheless, the differences in outcomes between the groups were not statistically significant. Participants who engaged in distance laughter therapy reported positive changes across physical, emotional, social, self-perception, and stress-coping domains in exit interviews. Therefore, laughter therapy has an additional benefit of reducing parental stress, which may be particularly useful for mothers primarily responsible for childcare during the pandemic. Future research should investigate the effects of laughter on broader populations and settings and quantify the actual amount of laughter generated.