"Most of my patients think I'm crazy and should be locked up, but I'm willing to make a fool of myself if it keeps them motivated."

When it comes to helping teens overcome spinal cord injuries, Cheryl Linden uses every tool in her kit, but her technique of choice is humor.

Linden, MS, OTR/L, MS, LPC, is a counselor and occupational therapist in the adolescent spinal cord injury program at Shepherd Center in Atlanta.

"Therapy sessions are hard," Linden said. "The kids will cry and the parents are upset . . . I use humor all the time to relax and lighten up the situation. I find it helpful in dealing with the adjustment."

Because Linden knows that patients can't do therapy all the time, staff and patients make time on Fridays for fun activities and sports, playing games or watching movies.

Cheryl Linden, in character as Kitty Litter, entertains Santa (Dr. David Apple) and patients during a holiday program. Linden is a counselor and occupational therapist in the adolescent spinal cord injury program at Shepherd Center.

She makes bets with patients during occupational therapy sessions to get them to try harder, and as a result has eaten pickled pigs feet and dog biscuits. On "Pay back the therapist day," Linden and the staff will do the exercises or silly things the teens direct them to do. Pie-throwing contests are a favorite activity at the spring carnival.

"Most of my patients think I'm crazy and should be locked up, but I'm willing to make a fool of myself if it keeps them motivated," she said.

In the face of tragic circumstances, other therapists might find the use of humor a bit daunting, but Linden is a professional. In her limited spare time, she performs standup comedy at The Punch Line, Eddie's Attic and other clubs around the South.

"Believe it or not I was a very quiet, shy kid, but I always wanted to try stand-up comedy, so I took a class from a local mime, Jeff Justice," she said. That taught her how to find, write and perform her own material.

Like comedians Gilda Radner, Lily Tomlin and others, Linden finds it easier to perform in character. Some of her favorites are Kitty Litter, a flamboyant, slightly trashy, not-too-bright woman who thinks she's the queen of everything; an elderly grandmother, and a little girl named Penny who's always getting into trouble.

Stand-up comedy led Linden to take a course in improvisation and start her own group, Quantum Theater, which played in Buckhead for a while.

"It turns out I'm really good at improv and I like it because you get to play off other people," she said. "You'll never see me boo anyone off stage, because I know that putting yourself out there takes guts."

Linden's heavy work schedule leaves little time for comedy performances at the moment, but she dreams of creating a one-woman show with her characters.

At present, she's preparing a farewell salute (roast) for retiring medical director Dr. David Apple. "He's seen me perform at center functions, so he's probably a little worried," she said with a laugh.

"People might think that it's contradictory to be a counselor and a comedian, but I think the two go hand in hand," Linden said. "The fear of going on stage and the fear of doing rehab is very similar, and my training in improv helps me think quickly on my feet and think outside the box."

She also uses humor when she teaches. "Who wants to listen to boring lectures for four hours? Humor makes things stick better," she added.

When patients and their families are going through trauma, it's easy to lose sight that there's life beyond therapy.

"When you can lighten up, it helps them lighten up, as well," she said.