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A brief mindfulness exercise at the beginning of a psychotherapy session can have a positive effect on psychological symptoms in adolescent patients. This is the finding of a study conducted at Heidelberg University’s Centre for Psychological Psychotherapy (ZPP) under the direction of Prof. Dr. Johannes Mander and Dr. Julia Kalmar. Adolescents who completed a mindfulness exercise at the beginning of each session experienced a greater reduction in symptoms than those in the comparison group, who received psychotherapy without a standardized session-introduction. The researchers also found that patients perceived a greater improvement in the therapeutic alliance.
Press Release
Heidelberg, 16 October 2026
Mindfulness Exercises Can Support Psychotherapy for Adolescents
Heidelberg researchers demonstrate positive effects of brief interventions on psychological symptoms and the therapeutic alliance
A brief mindfulness exercise at the beginning of a psychotherapy session can have a positive effect on psychological symptoms in adolescent patients. This is the finding of a study conducted at Heidelberg University’s Centre for Psychological Psychotherapy (ZPP) under the direction of Prof. Dr. Johannes Mander and Dr. Julia Kalmar. Adolescents who completed a mindfulness exercise at the beginning of each session experienced a greater reduction in symptoms than those in the comparison group, who received psychotherapy without a standardized session-introduction. The researchers also found that patients perceived a greater improvement in the therapeutic alliance. However, there was no significant difference between mindfulness and relaxation interventions in terms of symptom reduction.
“Our study shows that innovative approaches such as brief mindfulness interventions can easily be integrated into outpatient psychotherapy and have a positive impact, particularly for the highly vulnerable group of adolescent patients,” emphasizes Dr. Kalmar. The psychologist heads the training program in child and adolescent psychotherapy at the ZPP and conducts research at Heidelberg University’s Institute of Psychology. Mindfulness involves consciously attending to the present moment while trying to observe thoughts, feelings, and bodily sensations without judgment.
The study involved 90 adolescents aged 11 to 19 who were receiving outpatient treatment for depression, anxiety disorders, or ADHD at the ZPP and were randomly assigned to one of three groups. In the mindfulness group, each of the 24 therapy sessions began with a corresponding five- to ten-minute intervention. A second group completed relaxation exercises of the same duration at the beginning of each session, while the third group received no standardized session-introduction. In the field of mindfulness, various types of exercises were used, including breathing exercises, a body scan, and mindful walking.
The researchers assessed the effects of the interventions using a questionnaire completed by the adolescents during and after treatment. The analysis showed that psychological symptoms decreased over the course of therapy in all three groups. However, according to Julia Kalmar, the reduction was greater in the mindfulness group than in the group without a structured session-introduction. By contrast, there was no significant difference between the effects of mindfulness and relaxation interventions. According to the adolescents, the quality of the therapeutic alliance – which plays a crucial role in the course of treatment – also improved over time in the mindfulness group, while it declined slightly in the group without a structured session-introduction. The therapists, however, perceived no differences in the alliance between the groups.
As Prof. Mander explains, the effectiveness of mindfulness exercises has primarily been studied in the context of structured programs, even though individual exercises are also frequently used in therapeutic practice. “Until now, it was unclear what effect these exercises have in this setting. Our study closes this research gap,” emphasizes the researcher, who conducts research in clinical psychology and psychotherapy as an adjunct professor at the Institute of Psychology. The findings were published in the “Journal of Clinical Psychology”.
Dr. Julia Kalmar
Zentrum für Psychologische Psychotherapie
Telefon (06221) 54-7901
julia.kalmar@zpp.uni-heidelberg.de
J. Kalmar, I. Baumann, E. Schleiting, A. Grünert, E. Vonderlin, K. Lindenberg, A.B. Neubauer, T. Heidenreich, J. Mander: The Impact of Mindfulness as a Session-Introduction on Symptoms and Alliance in Individual Cognitive-Behavioral Therapy With Children and Adolescents: A Randomized Controlled Trial. Journal of Clinical Psychology (29. August 2026)
https://doi.org/10.1002/jclp.70216
https://www.zpp.uni-heidelberg.de Zentrum für Psychologische Psychotherapie
https://www.psychologie.uni-heidelberg.de Psychologisches Institut
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Psychology
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