Mindfulness in Counseling: 8 Best Techniques & Interventions

Mindfulness in therapyIn the last few decades, there has been a growing interest in mindfulness among health care professionals.

The importance of mindfulness in the healing process has been described among physicians, nurse practitioners, behavioral, and mental health experts (Epstein, 1999).

Mindfulness asks the practitioner to focus deliberate attention on the present experience in a way that is nonjudgmental and non-striving. This concept has been integrated into counseling practices in both formal and informal ways, with promising results.

Mindfulness is a state that helps individuals become more aware of physical, mental, and emotional conditions without judgment. It has become increasingly popular in the healthcare industry and is employed in schools, businesses, and even the military (Chiesa & Malinowski, 2011).

Before you continue, we thought you might like to download our three Mindfulness Exercises for free. These science-based, comprehensive exercises will help you cultivate a sense of inner peace throughout your daily life and give you the tools to enhance the mindfulness of your clients, students, or employees.

Mindfulness in Counseling Explained

Mindfulness is a critical building block to facilitating change in emotional and mental health. Because it includes concepts such as awareness, attention, and consciousness, mindfulness interventions have consistently been associated with various measures of emotional wellbeing (Greeson, 2009).

While there is no universal definition of “mindfulness,” Jon Kabat-Zinn (1990, p. 4) describes it as “paying attention in a particular way: on purpose, in the present moment, and non-judgementally.”

Mindfulness skills have been found to increase self-focused attention and change the characteristics of attention so it is less biased, more flexible, and nonreactive (Caldwell, 2011).

These changes in attention can prepare clients for different stages of the counseling process and make them more receptive to changing distorted beliefs, maladaptive behaviors, and negative social reactions.

The practice of mindfulness has been successfully used in the last 30 to 40 years to treat a range of mental health disorders, including depression, anxiety, substance abuse, eating disorders, attention deficit disorders, and personality disorders (Baer, 2003).

Research demonstrates that mindfulness (through mindfulness-based interventions) changes neural pathways in the brain related to rumination, worry, self-regulation, compassion, attention, emotional reactivity, and affect (Van der Velden et al., 2015). These changes lead to positive outcomes for the mental health disorders listed above.

Additionally, relaxation has been found to be a measurable result of mindfulness practice, which is helpful for stress-related disorders and the physiological responses they initiate (Baer, 2003). However, mindfulness is more than just a relaxation technique. It is considered a form of mental discipline that reduces the reactivity to cognitions. This can lead to relaxation, but the effects extend far beyond basic stress reduction.

For more on the benefits of mindfulness, read our related article that discusses the importance of mindfulness and offers 20 reasons to practice mindfulness.

4 Mindfulness-Based Counseling Techniques

Focus on present momentMindfulness-based techniques are generally administered through the use of mindful meditation focused on the present moment.

Participants are taught to focus on a particular phenomenon (such as the breath), and as thoughts wander, they are asked to bring their awareness back to the present moment.

Breathing exercises

Mindful breathing exercises are particularly powerful because the breath is a consistent part of life (it is always there) and a present moment experience to focus on. The breath also has a direct connection with the sympathetic and parasympathetic nervous systems, which can add additional aspects of relaxation and stress relief (Chiesa & Malinowski, 2011).

To practice mindful breathing, have the client sit in a comfortable position with eyes closed or open and invite them to draw attention to the sensations of the breath. Ask them to be curious, nonjudgmental, and simply notice the qualities of the breath.

Is it shallow or deep, fast or slow?

Where in the body do they notice sensations?

Do they notice the breath in the nose, the back of the throat, the rib cage, or stomach?

As their attention wanders, have them notice it and bring their attention gently back to the breath.

Body scan meditation

A thorough body scan meditation can last anywhere from 30 to 45 minutes. This mindfulness practice focuses attention on the body without judgment (particularly of aches, pains, tightness, or tension) and has the client simply notice with awareness, which helps release stress and tension (Chiesa & Malinowski, 2011).

There are different variations of body scan meditations, but most will have the client lie on their back in a comfortable position with legs spread out and arms at their sides, palms face up (a receiving gesture). The client will notice body parts systematically starting with the toes.

They may be guided to see how they feel, notice the temperature, tension, and to direct the breath to the toes. The scan will move upward, body part by body part on one side (ankle, calf, knee, thigh, etc.) and then move to the alternate side.

Once individual body parts have been scanned, they are united, and the focus shifts to how they all connect. One aim of the body scan is to see the body as a whole, united by the breath flowing in and out (Chiesa & Malinowski, 2011).

Guided imagery

Guided imagery leads individuals through relaxation exercises and explores visual images through various cues. Often it involves a positive image (such as a beautiful place) to help with relaxation. The client may come up with the image, or the clinician may present the concept, but either way, the imagery is controlled by the person experiencing it.

Guided imagery provides a sense of mastery and control and promotes altered states of awareness. It is a method that allows people to communicate with the subconscious mind, distracting from pain, discomfort, and stress (Brown & Ryan, 2003).

Guided imagery encourages the practitioner to use all of their senses and be as imaginative and descriptive as possible. During guided imagery, it is also important to notice thoughts and emotions that arise and effects that might occur to the body.

Mindful eating

Mindful eating is the awareness of the experience of eating and the sensations of smelling, chewing, tasting, and swallowing food. It is the present, moment-by-moment focus of attention on eating without judgment.

Mindful eating can be done with any food but is usually practiced with something simple, like a slice of orange. The client is asked to notice the color, texture, smell, and feel of the orange slice. Then, taking only one bite, they notice the sensations and taste and how this changes as they chew the orange and swallow it. The practice should be done slowly, with intention and deliberation.

Mindful eating can be used to address body image and eating disorders and improve an individual’s relationship with food. Further, it can create a deeper appreciation of meals and the nourishment they provide our body and our lives.

How to Apply Mindfulness in Counseling Sessions

While mindfulness was originally part of a religious or spiritual context, these practices can be easily integrated into secular sessions in nearly any counseling format (Caldwell, 2011).

It is important to understand the rationale behind applying mindfulness to counseling, whether that is for radical acceptance (Dialectical Behavior Therapy or Acceptance and Commitment Therapy), decreasing stress or anxiety, or simply increasing self-awareness.

Psychoeducation

To use mindfulness in counseling practice, clients should first learn about the foundational elements of mindfulness and the tendency of the human mind to focus on the past and future, labeling, making judgments, and having expectations.

Psychoeducation informs participants of research and the effectiveness of mindfulness for healing and specifically aiding in their particular area of distress. This will help them become more receptive and open to learning and applying mindful practices.

Counselors may also provide a basic overview of mindfulness practice and refer clients to additional resources outside of sessions.

Implementation

Once clients understand the fundamental elements and benefits of mindfulness, specific techniques can be implemented. Mindfulness can be implemented both formally and informally.

Counselors may choose to begin sessions with a few minutes of mindful breathing, a body scan, or even some gentle yoga movements. Or counselors may choose a specific intervention, such as Dialectical Behavior Therapy, Acceptance and Commitment Therapy, or Mindfulness-Based Cognitive Therapy, that systematically uses mindfulness along with other therapeutic techniques to elicit healing and help clients reach their goals for therapy.

This valuable article provides more detail in applying mindfulness to counseling and psychotherapy sessions: What Is Mindfulness Therapy and How to Apply It?

4 Best Mindfulness Interventions to Try

Mindfulness-Based Stress ReductionMindfulness-based interventions are designed to relieve symptoms of stress and improve mental health issues, physical pain, and a range of more specific concerns.

These interventions have been extensively researched and have become increasingly popular among mental health professionals.

Mindfulness-based stress reduction (MBSR)

MBSR was designed in the 1980s by Kabat-Zinn and has been subjected to the most empirical testing, with evidence supporting its effectiveness. The 8- to 10-week intervention has been shown to improve psychological function, reduce stress, increase self-compassion, and reduce binge-eating behavior (Kabat-Zinn, 1990).

MBSR uses a combination of mindful meditation, yoga, body awareness, and deep explorations of personal behavior, thinking, feeling, and action.

Mindfulness-Based Cognitive Therapy (MBCT)

MBCT was designed as a psychotherapeutic intervention to prevent relapse in people with major depressive disorder (Brown et al., 2013). The program combines aspects of Cognitive Therapy with MBSR training for groups of up to 12 participants for 8 weekly sessions.

The goal is to develop “metacognitive awareness,” which is a set of negative thoughts and feelings that can be seen as passing events in the mind rather than inherent aspects of the self or reality (Teasdale et al., 2002).

This mindful approach focuses on negative thoughts and feelings rather than the entire range of one’s internal and external experience. By doing this, it has the power to reduce depression without changing the content of beliefs and thought patterns, but instead, it has participants separate themselves from these cognitions.

Dialectical Behavior Therapy (DBT)

DBT was originally created by Marsha Linehan to treat borderline personality disorder but has shown extraordinary efficacy in helping people manage overwhelming emotions (McKay et al., 2019).

DBT teaches four skills: distress tolerance, mindfulness, emotional regulation skills, and interpersonal effectiveness. Research shows that this form of therapy can help strengthen a person’s ability to handle stress without acting destructively or losing control.

Evidence has demonstrated the effectiveness of DBT for treating anxiety, depression, post-traumatic stress disorder, eating disorders, and substance abuse (McKay et al., 2019). The skills of DBT reduce maladaptive behaviors that are generally used as coping mechanisms for extreme emotions.

Acceptance and Commitment Therapy (ACT)

ACT is a mindfulness-based behavioral therapy that uses a mix of paradox, metaphor, experiential exercises, and mindfulness skills. It has been very effective at treating depression, obsessive-compulsive disorder, stress, anxiety, post-traumatic stress disorder, eating disorders, addictions, and schizophrenia (Bach & Hayes, 2002).

In ACT, clients are encouraged to observe themselves and their bodily sensations, thoughts, and emotions as phenomena separate from the person having them. Additionally, clients learn to experience unwanted thoughts and emotions without judging, evaluating, or attempting to change or avoid them.

5 Helpful Exercises, Activities, and Worksheets

Make use of the following activities to guide your clients.

1. Letting Go of Judgment

This guided meditation by Tara Brach teaches individuals to let go of judgment, which is a foundational aspect of mindfulness.

2. Acceptance of Our Circumstance

This worksheet outlines mindful acceptance. It asks clients to identify a distressful situation and walks them through questions that lead to acceptance. By exploring questions and developing self-awareness, mindful acceptance of negative life experiences is possible.

3. Mindfulness for children

These mindfulness ideas for children are great ways to foster the concept in daily life and at a young age. Teaching children self-awareness and how to stay present can help improve their mental and emotional wellbeing.

7 Tips To Help Children Practice Mindfulness Successfully

4. Stabilize Your Body and Mind

This audio recording guides individuals through mindful movements to help work on balance and stabilization. The grounding practice can be a great way to incorporate aspects of mindfulness into daily life.

5. Body Scan Meditation

This body scan meditation guides you through a progressive scan to bring present moment awareness to the physical body. Additionally, you can click on the “quiz” tab to take a quick assessment of your level of mindfulness.

Mindfulness Counseling Training: 3 Options

MBSR TrainingTo take this a step further, why not sign up for training?

We list three great options below.

1. MBSR Training: 8-Week Course in Mindfulness-Based Stress Reduction

This 8-week mindfulness-based stress reduction program was created by Jon Kabat-Zinn at the UMASS center for mindfulness.

The program is appropriate for beginner and advanced meditators as well as teachers, therapists, and coaches who want to incorporate mindfulness into their practices.

2. Advanced Activity-Based Mindfulness for Kids: Teaching Attention, Emotional Balance & Compassion in Schools and Clinics

This activity-based mindfulness program, provided by Pesi.com, was designed specifically for children.

It teaches children life skills such as focusing, quieting, seeing, reframing, caring, and connecting through short activities. This training can be administered in school and community settings.

3. Learn Meditation With Certification to Guide Others

Udemy offers a meditation training course that can be helpful for clinicians who want to implement mindfulness into their sessions. The course provides videos, articles, and 10 guided meditation exercises that can be accessed after completing the course.

For more suggestions, we provide a comprehensive list and description of different mindfulness trainings, courses, and workshops in this article.

PositivePsychology.com’s Mindfulness Resources

Mindfulness X is a wonderful program that includes everything needed for coaches or mental health professionals to create their own mindfulness training, learn how to implement mindfulness into sessions, and create a structured mindfulness program for individuals or groups. It includes an instruction manual, a workbook, exercises, and even marketing materials.

If you’re looking for more science-based ways to help others enjoy the benefits of mindfulness, check out this collection of 17 validated mindfulness tools for practitioners. Use them to help others reduce stress and create positive shifts in their mental, physical, and emotional health.

A Take-Home Message

Mindfulness is the awareness of internal thoughts, feelings, and emotions, as well as the external environment without judgment. Mindfulness has become increasingly popular as a counseling approach to treating a variety of psychological and physical disorders, reducing stress, and increasing joy and happiness (Baer, 2003).

Mindfulness can be incorporated both formally and informally into counseling sessions. The simplicity of mindfulness allows it to be a powerful tool that can be learned and then implemented into daily life.

It is often very difficult to be aware of the present moment, particularly in a fast-paced society and a demanding, stressful world. Through the practice of mindfulness, it becomes easier to experience the moments in life that matter and find a deeper sense of appreciation and connection with ourselves and others.

We hope you enjoyed reading this article. Don’t forget to download our three Mindfulness Exercises for free.

References

  • Bach, P., & Hayes, S. (2002). The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 70, 1129–1139.
  • Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 135–143.
  • Brown, A., Marquis, A., & Guiffrida, D. (2013). Mindfulness-based interventions in counseling. Journal of Counseling & Development, 91, 96-104.
  • Brown, K., & Ryan, R. (2003). The benefits of being present: Mindfulness and its role in psychological well being. Journal of Personality and Social Psychology, 84, 822–848.
  • Caldwell, K. (2011). Mindfulness matters: Practices for counselors and counselor education. Association for Counselor Education and Supervision Conference, 21(14), 95–105.
  • Chiesa, A., & Malinowski, P. (2011). Mindfulness-based approaches: Are they all the same? Journal of Clinical Psychology, 67(4), 404–424.
  • Epstein, R. M. (1999). Mindful practice. Journal of American Medical Association, 282(9), 833–839.
  • Greeson, J. (2009). Mindfulness research update. Complementary Health Practice Review, 14(1), 10–18.
  • Kabat-Zinn, J. (1990). Full catastrophe living: The program of the Stress Reduction Clinic at the University of Massachusetts Medical Center. Dell.
  • McKay, M., Wood, J., & Brantley, J. (2019). The Dialectical Behavior Therapy skills workbook (2nd ed.). New Harbinger.
  • Teasdale, J. D., Moore, R. G., Hayburst, H., Pope, M., Williams, S., & Segal, Z. (2002). Metacognitive awareness and prevention of relapse in depression: Empirical evidence. Journal of Counseling & Clinical Psychology, 70, 275–287.
  • Van der Velden, A. M., Kuyken, W., & Wattar, U. (2015). A systematic review of mechanisms of change in mindfulness-based cognitive therapy in the treatment of recurrent major depressive disorder. Clinical Psychology Review, 37, 26–39.

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