Introducing clients to mindfulness

As with any therapeutic tool, the issues of appropriateness and timing are crucial in introducing clients to mindfulness. It is very appropriate to introduce mindfulness to a client who is constantly buffeted by his or her own thoughts. On the other hand a mindfulness exercise may seem inappropriate as an intervention for a client who is trying to decide whether or not to take a promotion.

Similarly, it may or may not be right to introduce a mindfulness practice during the first session. The too early introduction of techniques can leave a client feeling unheard and unless the client feels heard the counselling is unlikely to work.

So you, as a mental health professional, must make a judgment as to whether, when and how to introduce mindfulness.

How to do it? I generally have a sheet on the table with a basic mindfulness exercise (the one at the top of this blog) and information on a couple of other practices. Then I might say something like, "I have an exercise here that many clients find helpful and that I use myself. Maybe you might like to try it out."

Then I briefly explain what mindfulness is and introduce them to the basic exercise. I point out that it can be done in 40 seconds or 40 minutes depending on their preference. I suggest they run through it on getting up in the morning, at odd intervals during the day and when they wake up in bed at night. Sometimes we both do the exercise together.

Here is the introduction on top of the sheet I give clients to take away:

"Mindfulness involves taking your attention away from the past and future and away from your imagination - and instead becoming aware of what is going on right now. You can do this as you go about your daily life. Notice with your senses: what you are seeing and hearing, that you are breathing, standing, walking or sitting or lying down, the feel of the air against your skin as you move along."

"Your mind will keep drifting out of the present so you need to keep bringing it back. It is bringing your mind back to the present that makes up the practice of mindfulness. Never criticise your mind for drifting away: just bring it back kindly and gently."

"Mindfulness has been used for thousands of years in the Buddhist tradition to improve people’s experience of life. It lowers anxiety and stress, provides an antidote to brooding (which can lead to, or maintain, depression). It also helps you to avoid endlessly repeating distressing or unhelpful thoughts, images and mental scenes. Exercises like those below have been used for centuries to help people practice mindfulness as they go about their daily life. The first two need only take a minute or so but will help you if you repeat them a few times a day."

Here are the three exercises as they appear on the sheet:

Awareness

From time to time, notice your breathing.

Notice your posture.

Notice the points of contact between your body and the chair, floor, ground.

Notice your clothes touching your body.

Notice sounds in the room; sounds outside the room; the furthest away sound you can hear.

Every time you drift into thinking, just return to noticing these sensations.

Mindfulness Cues

This involves using habitual behaviours to remind you to practice mindfulness. Choose one or two and then decide that when performing them you will maintain awareness of what you are doing, rather than daydreaming or getting caught up in fears or anxieties: Using the telephone ~ Going up or down stairs or steps ~ Using a computer mouse or keyboard ~ Tidying ~ Washing up ~ Showering.

Awareness of Breathing

As you go through your day, notice your breathing from time to time. All you need to do is notice your breathing: you don’t have to breathe in any special way. Are you breathing with your chest or your tummy (abdominal breathing is usually more relaxing)? As you breathe, can you feel movement in your diaphragm (between your ribs and your abdomen)? Can you feel the air entering and leaving your nostrils?