On being a mindful therapist

Have you ever wondered why ACT experts encourage experiential workshops as part of the training regimen? There are a few answers to this question, but a new study out of Germany suggests that mindfulness training can help therapists be generally better at what they do.

Therapy is complex. Consider all the possible sources of information available during any given therapy session that may assist the therapist in their work. During the session, attention may be directed outward to the client’s statements, expressions, and posture or inward to the therapist’s own reactions, analyses, and actions. And all of this, ideally, is done in order to further the work of assisting the client in his or her life. In addition to informational complexity, the way the therapist responds emotionally to the client affects the outcome of therapy. Ludwig Grepmair and colleagues felt that mindfulness training might be helpful for therapists in managing this complexity and their own emotional responding in the room with their clients. In a recently published study, they provided mindfulness training to a group of psychotherapy trainees and compared outcomes on their clients with outcomes on clients receiving therapy from trainees who did not receive mindfulness training. Responses to a variety of symptoms measures showed significantly larger reductions for clients receiving treatment from therapists who had mindfulness training.

Clinical implications

While many of us may engage in a mindfulness practice for personal reasons, this study suggests that doing so may benefit others in our lives as well, namely our clients. Perhaps therapy is more than knowing what interventions to conduct or how to cultivate the therapeutic alliance, but also the capacity and willingness to hold our experience and the experience of our clients lightly in the service of being a more effective instrument for them. Adding a regular mindfulness practice to your routine or utilizing mindfulness and acceptance with your own behavior may add quality to your professional work as well as your life more generally.

Below is a more detailed summary of the study:

Psychotherapy requires careful attention directed at an enormous array of information available during sessions. Mindfulness represents a type of attention that has only recently begun to enter into psychotherapeutic practice, and the effects on such practice remain unexplored.

Psychotherapists in training for depth-psychology-based therapy were divided into two blinded groups, one of which engaged in a daily, one-hour mindfulness session and one that did not. Clients for each group of therapist trainees received inpatient, integrative psychiatric psychotherapy, which included individual sessions and various modes of group therapy. Clients completed the Symptoms Checklist (SCL-R-90) when admitted and when discharged. Clients were blind to the study as well as the Japanese Zen master who led the mindfulness sessions for trainees.

Sixty-three clients receiving treatment from nine therapists engaging in daily mindfulness practice showed significantly better improvement in symptoms compared to sixty-one clients receiving treatment from nine therapists not engaged in mindfulness practice. This trend was demonstrated for the Global Severity Index of the SCL-R-90 as well as the subscales for somatization, insecurity in social contact, obsessiveness, anxiety, anger/hostility, phobic anxiety, and psychoticism, but not for paranoid thinking. Treatment groups appeared comparable in respect to demographics and diagnoses.

Although this study did not contain an alternative treatment condition and therefore did not control for a possible placebo effect, the results provide tentative support for mindfulness as a useful practice in training more effective psychotherapists.

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