The first few minutes in a teen counseling room can feel awkward. A young person arriving after school and tutoring sessions may still have a busy mind, while the counselor waits for them to settle in. Researchers at Heidelberg University focused on that moment. Could starting each session with a brief mindfulness exercise change the course of treatment? The results of a randomized controlled trial were published in a journal in August, and the university announced the findings in a press release on October 16.
Ninety 11- to 19-year-olds in treatment for depression, anxiety or ADHD were split into three groups
The study was conducted at Heidelberg University’s Centre for Psychological Psychotherapy (ZPP). It involved 90 young people ages 11 to 19 receiving outpatient cognitive behavioral therapy for depression, anxiety disorders or ADHD. They were randomly assigned to one of three groups.
At the start of each of 24 therapy sessions, the first group did a five- to 10-minute mindfulness exercise. These included breathing exercises, a body scan that shifted attention to different parts of the body, and mindful walking focused on each step. The second group did relaxation exercises for the same amount of time, while the third began counseling without a structured opening activity. The researchers defined mindfulness as noticing thoughts, feelings and bodily sensations in the present moment without judging them.
Symptoms improved in all groups, but the difference was between mindfulness and no structured opening
Symptoms decreased over the course of treatment in all three groups. The group that began sessions with mindfulness saw a greater reduction than the group that started without a structured opening. The difference compared with the relaxation group was not statistically significant. In other words, this study did not find that mindfulness was better than relaxation.
Study lead Prof. Johannes Mander said that brief exercises like these are already used in clinical practice, but their effects in individual therapy had not been clear. The research team also noted in the paper that further studies are needed to control for other variables.
Teens perceived a different relationship with their counselors
An interesting difference emerged in the therapeutic relationship. The teens’ ratings of their relationship with their counselor improved over time in the mindfulness group, while slipping slightly in the group with no structured opening. The relaxation group showed no clear change. Counselors’ ratings of the relationship improved in all three groups, with no differences between them. The findings suggest that adults and young people can experience the atmosphere in the same counseling room differently.
Dr. Julia Kalmar, who heads the child and adolescent psychotherapy training program, said brief mindfulness interventions can be easily incorporated into outpatient psychotherapy and may have a positive effect on young people.
Meditation doesn’t have to mean sitting for a long time—in Korean classrooms and counseling rooms
The study stands out in part because of the length and format of the exercises. Telling teens to sit still for more than 30 minutes can leave them exhausted before they even begin. The exercises in the study lasted about five to 10 minutes and included movement-based options such as mindful walking. Because they were added to the beginning of treatment sessions already underway, they may also be manageable for young people who find it hard to set aside extra time.
For Korean teens who spend their days surrounded by information and stimulation, taking a brief moment to catch their breath before counseling or class could be an approachable habit. It is also important to read the findings as they are: there was no difference between mindfulness and relaxation exercises, suggesting there may not be one approach that works for every young person. Some may find it easier to focus quietly on their breathing; others may prefer to release tension by relaxing their muscles. It is also worth remembering that the exercises in this study were used alongside professional treatment, not as a replacement for it.
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