It can be really exciting to come across research offering insight into new techniques . . .
. . . particularly when the method allows us to reach more people than we usually can.
A team of researchers out of the Center for Primary Health Care Research, Lund University, Sweden, led by Jan Sundquist, MD, PhD, wanted to compare the outcome of mindfulness-based group therapy against that of individual-based cognitive therapy (CBT).
They conducted an 8-week randomized controlled trial that included 215 patients (between the ages of 20-64) who exhibited symptoms of depression, anxiety, or stress.
Participants were randomly assigned to either the group mindfulness treatment or the individual CBT treatment and attended weekly sessions.
Both before and after the trial, participants self-reported their symptoms using the Patient Health Questionnaire, the Hospital Anxiety and Depression Scale, and the Montgomery-Asberg Depression Rating Scale.
It came as a surprise to the researchers when, at the end of the trial, both groups reported a significant decrease in symptoms.
And while there weren’t any significant between-group differences, this work does suggest that group mindfulness might be just as useful as individual CBT.
So what could this mean for practitioners?
Well, it might be possible to start considering group mindfulness treatment as a viable alternative to individual therapy.
But we still have to be careful before we assume that this is the way to reach more people just as effectively as one-on-one practice. I also would be interested in a 12 month follow-up.
However, when taken as a whole, the benefits here are two-fold: patients can take advantage of (more affordable) group sessions, and practitioners can make more of an impact by treating groups rather than only doing individual therapy.
If you’d like to find out more, this new study was published on November 27, 2014 and is available online through The British Journal of Psychiatry.
But for now, which patients have you seen respond to mindfulness therapy? If you have used it, do you conduct group sessions as well? Please let me know by commenting below.
I did some poking around and found a link to the article on Medscape for Nurses.
I am interested in learning more specifically about what the “Mindfulness Group Therapy” entailed as referred to in the study. I went to the 2014 issue of the Journal of British Psychiatry to locate the article and could not find it.
It does seem that therapy can help. Whether is is a group therapy, or individual therapy, I think that discussing your problems or issues is helpful. I have to thank all the therapists put there who are concerned for people’s well-being, what they do is important!
Thank you, Silas! I am going to graduate and be licensed as a counselor at the end of this year. Sometimes there are very bad views of counselors. Thank you for seeing those of us who are in this profession with our whole hearts.
Thank You for all the time you spend educating anyone interested in mental health and all the new developments (in 43 years since I first sought psychiatric services at age 19). You are an amzing human being, woman, educator and healer.
All my best in your very important work!
Barbara
How do we find such a course in our area? thanks
Good information here. Thank you for shrinag, and helping others through online therapy for anxiety. You book sounds very helpful! I may have to read it. =)
I have found that a group mindfulness course is useful to capture those people who would not consider coming to 1:1 ‘therapy’. Participants in my 6 week group course found huge benefits to their anxiety levels, confidence, relationships, mood, creativity. These people were able to ‘explore’ mindfulness and not feel daunted or stereotyped by coming to ‘therapy’.
Thanks Ruth for stimulating such interesting discussion! I was surprised at the findings, although agree that any technique which provides a means to focus the mind would be likely to produce a similar result. In my own experience, both group and individual experiences are beneficial, self- regulation is more challenging for me in the relationally rich group field, which extends my tolerance for awareness of self/ other boundary distinctions, whilst one to one work is appropriate & necessary to heal deep trauma. Looking forward to running a mindfulness yoga course for a group of Carers in 2015, where some of this will be relevant.
I think that good group work can be very powerful because it is exponentially Relational and to some degree we are always helping people to have more secure attachments. However, in my own personal experience in groups, my nervous system can easily be overwhelmed (I imagine this is so for many others as well). So I think a combination of individual and group work can be effective. I use mindfulness to help clients study their inner experience (Hakomi). Wouldn’t it be great to learn enough about our clients and for them to know what works best for them.
I have not worked with any patient with mindfulness therapy.
Hello, I have been using mindfulness the last 4 years in groups of people with such different issues as depression, grief, anxiety, chronicle pain and much more. Fore some of the group members it has been a totally transformable experience others have got some new understanding and the courage to go different ways in their life. So indeed it works for the participants no matter if it is proven or not. For me nothing is neither/nor it is always AND, because my professional and personal experience have been proving to me that there is not any one and only solution, there are different or supplementary methods at a given time to a given person. And the one to chose which methods is best is the one who tries it. You are welcome to read my blogs about this topic on my webside
I have spent some time reading your wonderful blog. I’m 62 now but the first trauma at age 5 caused a disconnect from everyone which i have struggled my entire life with though got past some of the toughest parts. At age 59, my daughter beat me over 50 minutes high on crack…all to steal 20.00. I suffered a TBI, spinal damage and…..I have a wonderful psychologist, she is a blessing. I read and search for my own answers much of the time. Mindfulness I am attempting to learn on my own. I do believe it will be the key for me.
I absolutely enjoy your blog, so much great information and a big Thank You!!!
Barbara
I am running, conjointly with a mindful teacher of the Thich Nhat Hanh School, a weekly group for people dealing with anxiety, stress and depression. Every participant is referred by a health care professional for mental health issues. No screening is dome and it is an open group held in a institute outside the hospital.
The attendance is about of 20 to 30 persons. It is running now for its 3rd year with only good results. (I am thinking here for all the screenings done before letting a mentally ill person join such a group. Such screening has proven obsolete in my experience)
We want to develop a questionnaire on the satisfaction of the participants ant of the referring HCP. Any suggestion from anyone?
It is for now a service oriented group. Its popularity makes us continue it.
I am very glad to hear about the Swedish Study on its efficacy.
Thanks Ruth for giving us such an information.
Suzanne
I am a child and family therapist at a residential facility that provides services to kids aged 4-12. I have been doing yoga/meditation/mindfulness groups with these kids for about 7 months. When I try to do individual work with kids that involves mindfulness techniques (meditation, relaxation techniques) they lose interest quickly and don’t respond as well. When I do my groups, it involves up to 14 children and we are on a dorm. They respond well to the group dynamic and seem to be calmer afterwards. I usually do a quick meditation at the end and they are very relaxed. I think seeing one another participate in the group and not having the focus be on just them helps with their anxiety and allows for healing to occur.
For the past 4 years I have been facilitating a mindfulness group for women with cancer at the Women’s Cancer Resource Center in Oakland, CA. The group is open, meets each Saturday from 10:30 to 12:00 and averages ten women each time. I lead a 30 minute guided meditation interspersed with periods of silence. I may incorporate some practice into the guided meditation…body scan, loving kindness, forgiveness, gratitude, but the emphasis is on being grounded in the body in loving awareness (Jack Kornfield). This is followed by a period of sharing which centers on their intention from the previous week.
Some of the members have been coming for 4 years. Three have died during that time, and our presence and support during this experience has been profound for all of us. Several of the longer attendees have a daily practice which is a wonderful inspiration for the others.
I am not a licensed therapist, but feel this experience is a strong endorsement for mindfulness group “therapy.” It is one if not the most fulfilling things in my life.
There was an interesting study published in the Proceedings of the National Academy of Science (PNAS) in 2013 that reviewed the capacity of CBT to regulate participants’ emotions under stress. The findings indicate that CBT strategies for emotional regulation work in experimental conditions but fails when subjects are stressed. Perhaps mindfulness skills are more rebust in real life “field conditions”. See: “Cognitive emtion regulation fails the stress test:, PNAS< 2013, 110 (37)15139-15144.
kind regards,
Chrsi
I have done both individual CBT and also mindful neuroscience based coaching, I have also run groups that emphasized coaching, mindfulness and cognitive neuroscience integrated into a model I created and use. I found the group coaching to be quicker and more powerful in general than individual.
I have participated in individual counseling and group (art therapy) sessions for many (30) years because of childhood trauma. The group work allowed me to hear parts of my own story through others and was a supported environment early in my personal journey of recovery. There is a time and place for both approaches. Isolation is definitely a problem; in a group I am one of “many”. Individual sessions give space to my particular upsets.
I am much more recent to meditation and somatic release. The abuse was severe and I still have trouble with self regulation when I am overwhelmed with life’s stresses.
CBT seems to appeal to certain individuals, and to them CBT is IT. Mindfulness (is really Heartfulness–toward oneself and others). Heartfulness seems to appeal to empathetic people and those who INTEND to be loving.
Hi Ruth,
I’m very intreagued by this research. I am a therapist in private practice and right now only do 1:1 work, but would love to do group therapy as well. My impression, however, is that people paying privately typically aren’t as interested in group therapy.
Have you found this to be so?
Cheers,
Julia Kristina
I use mindfulness in my domestic violence groups (women offenders) and with my clients, and almost without exception, they self-report positive results, especially when they take the practice home with them for self practice. And most definitely, mindfulness aids in uncovering deeper issues that can enliven our group discussion, and help individual clients resolve inner conflicts more effectively – and more gently.
I use Mindfulness often with patients who present with anxiety issues. I am in an outpatient clinic and primarily see individuals. While I think groups can be effective and powerful, they are difficult to utilize because of billing issues with insurance. I do consider Mindfulness to be an important CBT as it focuses on patients learning to calm their body which is the first step to using active relaxation.
Has anyone considered the efficacy of group singing?
Wouldn’t it work better if there were mugs of coffee or hot cocoa and a cheery fire? I remember the singing around the campfire feeling from my childhood at camp. When it’s an evening event with a fire, every face has a measure of privacy and grace. If art goes back half a million years as recent finds in Java suggest, then fire, singing, art…painting are deep in our history for good reason.
I know there is a lot of derision attached to cumbaya but it connects the left and right hemispheres, language and the heartfelt side so easily.
I think there is a reason singing in church helps connect a community and it should help reconnect a person.
Maybe this has been done and had a sinister twist that keeps it at bay or maybe it is still being done but financial constraints and places to have bonfires are hard to come by.
Jill Bolton in her TED talk makes the strong point that our brains are divided…we have these kluge-like assemblages that benefit from a rich and aesthetic healing. Oliver Sacks has brilliant insights into music.
I also like the stories of people helping others. I have a lot more motivation when I can see a way to make someone else happy.
Interesting topic for discussion. In many ways, I think Mindfulness IS a CBT technique. It’s definitely a way of refocusing the mind and looking at the world from a fresh perspective again and again. That being said, I also like what Mario noted about the impact of a “group”. There are great rewards and efficacy when people come together for shared experiences. Whether that takes the form of a book group, hiking group, or a Mindfulness group, coming together has the double benefit of breaking down isolation (a common component of depression and anxiety) and building a sense of connection, shared purpose, and meaning. Please note that I am a huge advocate for Mindfulness itself and am part of my own mindfulness group, but it would be interesting to add a regular therapy group or alternative weekly group (to the study) to see if there is a similar impact. Finally, like so many things, I strongly suggest the BOTH-AND approach to mental health and well being. A combination of individual Psychotherapy/CBT and a Mindfulness group, and maybe even an apple a day too, will “keep the doctor away”. Thanks.
I am an Addiction Educator.
I encourage all my clients to attend Al-Anon meetings on a regular basis.
The non-shaming atmosphere encourages sharing and healing.
The sense of COMMUNITY is incredibly powerful.
I am a grateful member of alanon for 15years.
i find no other(cheeper) way to be heard without the burden of fixing
I practice speaking my truth and listening to others stories and hold them in a
very special way, with respect.
My experience is, from clients who have attended mindfulness classes, that mindfulness may uncover deeper underlying causes, which will then later have to be adressed in individual therapy.
I agree.
I use a combination of both mindfulness techniques especially in reduction of stress and anxiety and having recurrent flashbacks. The mindfulness seems to really work, especially with those who have complex trauma. CBT works great for later stages of healing, and also with addiction and the cognitive distortions in self-harm with trauma survivors.
I agree and let’s get the word out! Therapists used CBT with me on and off for 20 years, yet at 42 I was still struggling with the same things. Fast forward to SE and mindfulness work or 2 years and therapist felt ocd and gad were secondary to PTSD, developmental – and now with the mindfulness and SE techniques, I have made such progress and probably would benefit from CBT work now.
With group work, I fear overwhelm – I would soak up all the group’s stories and energies and be drained after already having to be social at work I typically need to stay away from that and isolate. Would group therapy be beneficial to introverts? Not shy people, I can tell my story easily and hear others, but I fear I would be drained to exhaustion from social interaction. Thoughts?
I have recent experience in a weekend encounter group where trauma’s were shared. I was unable to tolerate the stories and emotions. It was a horrible experience for me to hear so many trauma’s in a short period of time. The leader was unable to attune to me.
However, I am having success in a weekly support group with younger women, mostly Latina. As I continue to heal, mindfulness is my rock. Knowing that I can connect to my breath. Understanding individual self regulation is the same for a group. A psychotherapist, counselor, leader must have that timing in order to provide safety thru connection.
When a group of people come together for a common purpose such as healing, there is a possibility for a much greater holding. However, some will intially feel too exposed in a group setting and so a one to one setting will be more helpfu.