title: The Therapy Beneath the Fun: Medical Clowning During Invasive Examinations on Children.
abstract: OBJECTIVE
  The qualitative research presented here is part of a larger project on the significance of medical clowning during invasive examinations in children in the Department of Gastroenterology and the Center for the Sexually Abused in a hospital in Israel. It investigated what makes up the essence of medical clowning, what skills and techniques are used by medical clowns, and whether their work contains therapeutic elements.
  
  
  METHODS
  A total of 9 children undergoing invasive examinations and 9 of their accompanying parents participated in semistructured interviews, which were analyzed using a thematic analysis methodology assisted by an Atlas-ti software program.
  
  
  RESULTS
  The interviews revealed that the medical clowning intervention during invasive examinations was essentially therapeutic, with the clown using theatrical and clowning tools to incorporate therapeutic elements such as empowerment, reversal of role, reframing, and building a therapeutic alliance. In addition, during the invasive examinations, the medical clowning followed the model of brief crisis intervention therapy.
  
  
  CONCLUSIONS
  The study advances the need to incorporate medical clowns as an integral part of medical teams performing invasive procedures and to include clowns in all stages of the hospital visit when children undergo invasive examinations.
authors.affiliation: The Baruch Padeh Medical Center, Poriya, Israel University of Haifa, Israel shoshiofir@gmail.com.
authors.forename: Shoshi
authors.initials: S
authors.lastname: Ofir
authors.affiliation: University of Haifa, Israel The Hebrew University of Jerusalem, Israel.
authors.forename: Dafna
authors.initials: D
authors.lastname: Tener
authors.affiliation: University of Haifa, Israel.
authors.forename: Rachel
authors.initials: R
authors.lastname: Lev-Wiesel
authors.affiliation: The Baruch Padeh Medical Center, Poriya, Israel Hagalil Faculty of Medicine, Bar-Ilan University.
authors.forename: Avi
authors.initials: A
authors.lastname: On
authors.affiliation: The Baruch Padeh Medical Center, Poriya, Israel University of Haifa, Israel Hagalil Faculty of Medicine, Bar-Ilan University.
authors.forename: Nessia
authors.initials: N
authors.lastname: Lang-Franco
mesh_terms: D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007557:Israel; D007845:Laughter / Q000523:psychology*; D027641:Laughter Therapy / Q000379:methods* / Q000523:psychology*; D008297:Male; D010808:Physical Examination / Q000379:methods*; D016896:Treatment Outcome
keywords: child sexual abuse; invasive examination; medical clowning; pediatrics; therapy