Mindfulness in Group Therapy

Photo Credit: Tim Godehart

Mindfulness in Group Therapy:

Clinical and Ethical Considerations 

 As a Licensed Marriage and Family Therapist Certified in Mindfulness Based Addiction and Trauma Therapy and specializing in Sexual Compulsivity, Pornography Addiction, and Betrayal Trauma, I began introducing mindfulness-based techniques to my therapy clients over a decade ago. 

I wanted to take some time to outline the following in order to support my fellow colleagues who may be interested in learning more about introducing mindfulness in group therapy. 

Throughout the years it has been a joy to witness the individuals I am honored to support experience a reduction in addiction relapse. These clients share that they are able to ride the wave of triggers without relapse and sustain longer periods of sobriety from multiple addictions including sexual compulsivity and out of control pornography use. 

Where recovery was once three steps forward two steps backwards, and a discouraging road of slips and relapses, incorporating specific mindfulness-based tools into my clinical recovery program helped these individuals move forward with long term sobriety so that they could finally create a life and relationships they were proud of. 

Additionally, partners and spouses of addicts share that mindfulness-based therapy has helped them heal their betrayal trauma more deeply. Partners share that specific mindfulness tasks and tools helped them manage, reduce, and understand their safety seeking behaviors such as checking, questioning, ruminating, following, and threatening, which are understandable trauma responses given the level of pain, sometimes leveled over decades, that partners experience.

Incorporating mindfulness work into the treatment plan can help a hurting spouse or partner navigate the intense emotional and physical pain of betrayal as they shift from being stuck for months or even years between the stages of shock, grief, rage and despair. Partners and spouses of addicts share that as they begin to practice mindfulness tools, they find their way back to hope and discover a renewed sense of purpose and joy as they focus on their healing, and reinvest in their own interests, goals and activities. 

Individuals and couples report time and again that learning and incorporating mindfulness exercises into their daily lives has had a noticeable impact on reducing triggers, anxiety, depression, while increasing happiness and connection to self and their loved ones.  

After several years of helping individuals and couples heal what was hurting their hearts and relationships with a mindfulness-based approach, I decided to take the leap in introducing mindfulness work in my addiction recovery therapy groups, as well as my betrayed partners groups. I was curious if the results I’d been seeing in my individual and couples work would be as effective in group therapy. 

My initial concerns centered around supporting the group members compassionately as each person was at different stage in their therapy and trauma healing journey. For example, what if a client in group began to disassociate during a mindfulness exercise? Or what would the impact be on the group if a specific client in group therapy began to experience traumatic recall or have a panic attack in group. These are important clinical assessment questions to consider when moving group therapy clients through mindfulness-based activities or exercises such as breath work, body scans, tapping, or guided imagery for example. 

The first step was to discuss the risks and benefits with each individual in group in order to assess their comfort level. Part of the discussion focused on psychoeducation and what mindfulness is and what it is not (for example, it is not hypnosis). I then prepared a comprehensive handout for the clients in my groups to take home and read. This handout outlined mindfulness research and the benefits of mindfulness.  

Without fail, each client responded with a resounding, “Yes, I’m interested, let’s do this!” And, with that I began incorporating mindfulness-based curriculum to my therapy groups, retreats, workshops and webinars. I continue to do so all of these years later with exciting and gratifying results. 

Mindfulness practices are now a part of every area of my professional life, including: 

• Individual Therapy

• Couples Therapy

• IOP (Intensive Outpatient Therapy)

• Telehealth Therapy

• Walk/Talk Therapy

• Webinars

• Workshops

• Retreats

• Speaking

• Teaching

There is not one area of my professional life, or personal life for that matter, including my business coaching, my CSAT, CPTT, and MBATT Supervision roles, and my teaching and speaking roles where I do not include or teach mindfulness tasks and exercises. An added gift is that mindfulness work has brought such joy, renewed energy, and vibrancy to my private practice and clinical sessions. 

As I bring this blog to a close, it is vital to emphasize that there are a number of important clinical, safety, legal and ethical steps to understand and consider when introducing and practicing mindfulness with clients. Protecting the client as well as operating in the highest standard of care is imperative, especially with clients who have complex trauma or are dealing with severe addictions. 

Complex trauma, as most addiction and trauma therapists know, is at the root of all addiction and intimate partner betrayal. Legal and Ethical considerations are covered step-by-step in the Mindfulness Based Addiction & Trauma Therapist (MBATT) Certification training of which I am honored to be part of as a Senior Faculty Member with The Mindfulness Academy of Addiction and Trauma Training. 

I hope sharing part of my story in bringing mindfulness practices to group therapy has been helpful and inspiring for you. As the field of psychology evolves and moves forward in the years to come, those therapists who understand the importance of a mindfulness-based practice, and who have specific clinical skills will be on the cutting age of clinical work. Clients are seeking out mindfulness trauma educated therapists now more than ever. How exciting for our profession and for our clients!

If you are interested in becoming a Certified MBATT, you can learn more here, and you are welcome to reach out for more information at, mari@thecounselorscoach.com, or info@tmaatt.com. 

In mindfulness,

Mari A. Lee, LMFT, CSAT-S, CPTT-S, MBATT-S

Mari A. Lee, LMFT, CSAT-S, CPTT-S, MBATT-S

About the author: Mari A. Lee is a Licensed Marriage and Family Therapist, the founder of Growth Counseling Services in Glendora, CA. She is a Certified Mindfulness Based Addiction and Trauma Therapist and Supervisor, and a Senior Faculty Member and advisor with the respected Mindfulness Academy for Addiction and Trauma Training. 

She is also a Certified Sex Addiction Therapist and Supervisor, and a Certified Partners Trauma Therapist and Supervisor, as well as a faculty member and ethics board member with the prestigious International Institute of Trauma and Addiction Professionals. 

Additionally, Mari is an EMDR Level II trained therapist, and a Gottman Level II Couples Therapist, and is the author of, “Healing from Betrayal”, “The Creative Clinician”, and the co-author of “Facing Heartbreak”. 

Finally, Mari is a popular national speaker and a respected business coach and founder of “The Counselor’s Coach” where she supports therapist colleagues with business consulting and coaching. You are welcome to contact Mari at mari@thecounselorscoach.com , or you can visit www.TheCounselorsCoach.com to learn more about Mari’s work and support.