The first few minutes in an adolescent counselling room can feel awkward. A young person arriving after school and tutoring still has a busy mind, while the counsellor waits for them to settle into the room. A research team at Heidelberg University focused on precisely this time. Could starting each session with a brief mindfulness exercise make a difference to therapy? The results of a randomised controlled trial were published in a journal last August, and the university announced them in a press release on 16 October.
90 young people aged 11–19 receiving treatment for depression, anxiety or ADHD were split into three groups
The study was carried out at Heidelberg University’s Centre for Psychological Psychotherapy (ZPP). It involved 90 adolescents aged 11–19 receiving outpatient cognitive behavioural therapy for depression, anxiety disorders or ADHD. They were randomly assigned to one of three groups.
At each of 24 therapy sessions, the first group spent the first 5–10 minutes doing mindfulness exercises: breathing exercises, a body scan that shifted their attention across different parts of the body, and walking meditation focused on their steps. The second group did relaxation exercises for the same amount of time, while the third went straight into counselling without a set opening routine. The researchers defined mindfulness as noticing thoughts, feelings and bodily sensations in the present moment, without judging them.
Symptoms improved in all groups; the difference was with the group that did nothing
Symptoms decreased in all three groups as treatment progressed. The group that began sessions with mindfulness saw a greater reduction than the group that started without any opening routine. There was no statistically significant difference compared with the relaxation group. In other words, this study did not find that mindfulness was better than relaxation.
The study’s lead researcher, Professor Johannes Mander, explained that these brief exercises are already used in clinical practice, but their effects in individual counselling had not been clear. The research team also noted in the paper that further studies controlling for other variables are needed.
Young people’s perceptions of their relationship with the counsellor differed
An interesting difference emerged in the therapeutic relationship. The adolescents’ session-by-session ratings of their relationship with the counsellor improved over time in the mindfulness group, but dipped slightly in the group without an opening routine. The relaxation group showed no clear change. Counsellors’ ratings of the relationship improved in all three groups, with no differences between them. This suggests that adults and young people can experience the atmosphere in the same counselling room differently.
Dr Julia Kalmar, who heads the training programme in child and adolescent psychotherapy, said brief mindfulness interventions could easily be incorporated into outpatient psychotherapy and have a positive effect on young people.
Meditation without sitting for long: in Korean classrooms and counselling rooms
One reason this study stands out is the length and format of the meditation. Asking an adolescent to sit still for more than 30 minutes can leave them tired before they have even begun. The exercises used in the study lasted around 5–10 minutes and included movement-based practices such as walking meditation. Because they were added to the beginning of treatment that young people were already receiving, they were also less demanding for those who might struggle to find extra time.
For Korean adolescents spending their days surrounded by information and stimulation, taking a brief moment to catch their breath before counselling or a lesson could be a habit that feels natural to introduce. It is also important to interpret the findings as they are. The lack of a difference between mindfulness and relaxation could be read as meaning there is no single approach that suits every young person. Some may find it comfortable to focus quietly on their breathing; others may prefer to release tension by relaxing their muscles. It is also worth remembering that this study tested an exercise used alongside professional treatment, not as a replacement for it.
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