When a Smile Becomes a Connection: Clown Therapy at RSA Arzaga – An Experience of Human Connection, Emotions and New Ways of Being Close

A smile, an unexpected laugh, a knowing glance: sometimes the simplest gestures can create precious opportunities for connection and human interaction. It is from this very awareness that Smile Therapy was born: an activity that uses the universal language of humour, play and artistic improvisation to support the emotional wellbeing of people experiencing situations of vulnerability.

For many years, the Fondazione Dottor Sorriso ETS has brought its experience primarily to paediatric hospital settings, where its professional clowns work alongside children, families and healthcare staff, helping to make the experience of care more reassuring and welcoming.

In 2025, the Foundation chose to explore a new area of intervention: older people living in residential care homes. In collaboration with the Consorzio Italiano per la Ricerca in Medicina, a pilot study was launched to assess the effects of clown therapy on older people living in residential care.

Residenza per Anziani Arzaga in Milan was selected as the setting for this pilot project, marking the beginning of a collaboration that created an important opportunity to bring together the worlds of research, care and artistic expression.

The pilot programme ran from February to October 2026 and involved a group of residents whose cognitive abilities were sufficiently preserved to enable them to participate in the home’s cultural and socio-educational activities and to express their preferences independently.

The sessions were led by a group of clowns with diverse backgrounds and experience in education, the arts, creative practice and clown therapy. Before the project began, they took part in specific training, delivered with the contribution of the Foundation and RSA Arzaga’s professionals, to gain a better understanding of the characteristics and needs of the older people involved.

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Over the course of the project, the sessions created moments of play, improvisation, music, smiles and spontaneous interaction.

Beyond the scientific findings of the study, which are still awaiting evaluation, the experience proved particularly enriching for the clowns themselves, both on a human level and in terms of their artistic exploration.

But it was precisely during this experience that an important reflection emerged.

As they visited the different units of the Residence, the clowns also met residents with more significant physical and cognitive impairments, who were often unable to take part in the usual recreational and social activities. Through a glance, a gesture or a more explicit request, these residents expressed their desire for attention, closeness and human connection.

These encounters opened up a new perspective: bringing Smile Therapy to those who, precisely because of their greater vulnerability, have fewer opportunities to take part in community life.

In these contexts, clown therapy can take on an even deeper meaning. The aim is not necessarily to make someone laugh, but to create a genuine connection, one that can adapt to each person’s pace, abilities and ways of communicating. A familiar melody, a simple game, a funny expression or simply an attentive presence can become ways of connecting with someone even when words become more difficult.

Smile Therapy does not replace medical care or care and educational interventions. Rather, it is intended as a complementary activity aimed at promoting psychological wellbeing, emotional expression and the quality of human relationships.

Above all, the experience at RSA Arzaga reminds us that the need for human connection, attention and the feeling of being recognised does not diminish with advancing age or increasing frailty.

It is from this awareness that the desire to continue the journey we have begun takes shape, envisioning a new phase of the project that also includes our most vulnerable residents, so that a smile can reach those who find it most difficult to take part in everyday opportunities for connection. Because a smile cannot erase difficulties, but it can transform, even if only for a moment, the way we experience them. And sometimes, even before making someone laugh, the most precious gift is simply making them feel seen, heard and welcomed.