Should therapist teach Mindfulness?


By David Joel Miller

Should you go to a therapist to learn mindfulness, meditation, yoga or spirituality?

 

Yoga

Yoga
Photo courtesy of Flickr (Sheba_Also)

Some therapists and counselors incorporate the teaching of meditation, mindfulness, spirituality and a whole host of other things into their practice. Clearly, there are times that these techniques can be helpful to clients. It is equally clear to me that you do not need to be a licensed therapist to teach a meditation class.

There are also times when some of these things can be harmful if done incorrectly. Meditation can be very bad for someone with PTSD or complex trauma if every time they try to close their eyes they have a panic attack. Another practice called grounding is recommended for those clients. (That topic needs another post.)

When we start mixing things up, professionals and clients need to be really clear about what is going on. Readers have asked some questions about this and I can see some professionals may be headed for problems.

What if I decide to teach a Wednesday night class in blogging? Can I sign up my therapy clients to come to this? Sure blogging can be a great ways to express yourself and some of my clients might benefit from learning to write, but if I start mixing these two activities up we are headed for trouble.

Could a “Christian Counselor” teach a Bible study? Probably no reason why not. Except if they are doing their Bible study on Wednesday nights and competing with my blogging class this is not very therapeutic for either of us. (I picked Wednesday because I teach at the College on Tuesdays and Thursdays, not because of the traditional Wednesday night prayer meetings that some churches have.)

A counselor can have outside interests. We can and should do other activates. But when the lines between therapy and those other topics get blurry, there are lots of risks to clients. Maybe my Blogging class needs to be taught at the adult education school and the Bible study needs to take place in a church or someone’s home? Then the two roles are kept separate.

By the way, any therapist that tries to bill an insurance company for these other activates under the guise of them being “therapeutic” is probably headed for big trouble.

The role of the counselor or therapists is to help you get over, recover from, or reduce the symptoms of a particular emotional, mental or behavioral problem. This role conflict becomes a problem when a therapist starts signing people up for a yoga class.

Yoga can be helpful for managing certain emotional problems. (My understanding of Yoga is that it is an exercise done slowly and purposefully while managing your breathing.) So yes any exercise may be helpful in treating depression. Working on your breathing can be helpful in reducing symptoms of anxiety and a therapist might spend a few minutes even a session teaching a client how to control their breathing to reduce anxiety. But when the therapist starts signing up clients for a weekly yoga class, they have crossed a line in my book.

Sure any therapist can have another interest. Say the therapist likes to play baseball and they start a Saturday baseball team. Is this therapy and should they be doing this with their therapy clients?

If I was working with a group of severely impaired people, those with no friends and no jobs, a weekly trip to the park to play baseball could be therapeutic. I could teach them how to take turns, follow the rules and how to resolve differences. We could even do some work on social skills, picking a team captain, how to talk with each other and so on.

But if the course of this baseball therapy included people with friends and jobs and we began to talk about baseball skills, bunting and sliding into base, this is no longer a therapy group and we are becoming a baseball team. That is not a function that requires a therapist.

This example I hope is easy to see. There are not many times a sport is likely to be a part of traditional therapy. When therapists start talking about meditation, yoga, mindfulness and a host of spiritual and self-awareness techniques the lines get blurry.

My thinking is that there are times that I may use a particular technique briefly to help a client reduce or manage symptoms but if I stray into teaching them another topic I am no longer in my “scope of practice.”

So if your therapist avoids working on your past traumas or other current issues and wants to spend a lot of time on these other topics that are not specifically designed to reduce or control your mental health symptoms, think this through.

You may need to find another yoga teacher and then restrict your therapist to doing therapy. If they are uncomfortable with that, you need to talk with them about this or eventuality you will need to change providers to get the help you need.

Having a therapist teach a meditation, mindfulness, or yoga class, can be another of those dual relationship issues that we therapists need to be careful about. If a therapist does do those activities there needs to be a clear connection to treating the client’s symptoms.

A therapist can use these techniques to help their client recover but they can’t use their client to support their other interests.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended books.

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5 thoughts on “Should therapist teach Mindfulness?

  1. Thank you. I’ve been extremely sceptical of “mindfulness” ever since I encountered it. You’ve shed some light but I’m still going to need to read a great many more studies before I believe in its efficacy.

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  2. You make some good points here, especially in relating to yoga or spirituality. But, I think mindfulness is inherently related to therapy (from what I’ve read of Daniel Siegel’s stuff on interpersonal neurobiology). I don’t think it is appropriate until way into the therapy process, perhaps when client has worked through trauma and is ready for integration. But there is so much new research showing how relational mindfulness creates new neural pathways – such an exciting new area 🙂

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  3. While I’ve never considered teaching Yoga myself, I’ve considered making it available to my clients. Much like I would have medical or psychiatric personnel provide those services, I would want a trained facilitator managing yoga. I’m fascinated by the work being done at The Trauma Institute in the utilization of Trauma Sensitive Yoga but again, I’ve not considered trying to facilitate it myself. See info here: http://www.traumacenter.org/clients/yoga_svcs.php

    What about breathing exercises? They are closely related to yoga practices but I think we’re probably competent to manage those in a clinical setting? I guess to me it’s a matter of degree and using mindfulness or relaxation techniques in the context of a counseling session seems appropriate as long as it remains a counseling session and doesn’t morph into something else.

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    • Thanks for adding that information. I think we are in agreement here that these things can help clients but that we need to make sure to do the primary function – therapy, not get off track too far in the effort to teach other things.

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