Center for Mind Body Medicine (CMBM) Small Group Model for Adults

About This Program

Target Population: Adults who have experienced psychological trauma though it can be used with adults suffering from depression, anxiety, stress, or chronic illnesses

Program Overview

The Center for Mind Body Medicine (CMBM) Small Group Model for Adults is an approach designed to heal psychological trauma, relieve stress, reduce symptoms of chronic illness, and increase resilience. Working in small groups of 8–10 people, facilitators teach a variety of self-care techniques drawn from the world’s healing traditions as well as modern medicine to help participants learn to move through emotions and experience their own capacity for self-healing. Trained facilitators guide the experience, helping participants discover their own answers.

Program Goals

The goals of Center for Mind Body Medicine (CMBM) Small Group Model for Adults are:

  • Learn practical mind/body skills to calm the physiological response to stress and achieve emotional and physiological balance.
  • Gain understanding of how stress impacts emotional and physical health.
  • Reduce symptoms of trauma, anxiety, depression and chronic illness.
  • Build personal resilience and self-efficacy for managing future challenges.
  • Identify individual strengths.
  • Learn tools to mobilize imagination in order to develop creative solutions to problems and conditions.
  • Enhance relationships and improve capacity to seek and receive social support.

Logic Model

The program representative did not provide information about a Logic Model for Center for Mind Body Medicine (CMBM) Small Group Model for Adults.

Essential Components

The essential components of Center for Mind Body Medicine (CMBM) Small Group Model for Adults include:

  • Screening: Participants are interviewed by the group facilitator to ensure they are:
    • Interested in learning self-care skills
    • Ready to commit to a group process with sharing
    • Understand there is an expectation for consistent attendance
  • Group Structure and Composition:
    • 8–10 group members meet weekly for 2 hours for 10 weeks
    • One facilitator guides the group process, and participates in sharing and activities along with the participants
    • Group meetings follow the same structure each week:
      • Opening meditation
      • Check-in
      • Didactic content
      • Experiential content
      • Sharing
      • Home practice suggestions
      • Closing meditation
  • Essential Group Didactic Content:
    • Overview of mind/body medicine
    • Biological underpinnings of mind/body medicine
    • Meditation and movement
    • Guided imagery
    • Becoming aware of, expressing, and learning to deal with emotions
    • Basic guidelines for healthy nutrition
    • Spirituality
    • Forgiveness and gratitude
    • Genograms
    • Putting it all together, taking next steps
  • Essential Group Experientials:
    • Drawings
    • Breathing exercises (chaotic breathing, soft belly breathing)
    • Autogenic training and biofeedback
    • Shaking, dancing, and movement
    • Safe space/wise guide imagery
    • Dialogue with a symptom
    • Genograms
    • Mindful eating
    • Forgiveness and gratitude meditations

Program Delivery

Adult Services

Center for Mind Body Medicine (CMBM) Small Group Model for Adults directly provides services to adults (regardless of whether they are parents or caregivers) and addresses the following:

  • Symptoms of posttraumatic or chronic stress; anxiety; depression; hopelessness; isolation and loneliness; sleep disturbance; anger; professional burnout; hypertension; chronic pain; compassion fatigue; addiction, substance abuse; suicidal ideation; hyperactivity; shame and low self-worth; low assertiveness and passivity; symptoms associated with trauma such as reexperiencing/flashbacks, dysregulation, hyperarousal/triggers, avoidance, and numbing; aggression and aggressive behavior, fighting, bullying; high risk and self-harming behaviors; deficits in social skills; lagging or problematic attachment patterns

Recommended Intensity:

One weekly 120-minute session

Recommended Duration:

10 weeks

Delivery Settings

This program is typically conducted in a(n):

  • Community Daily Living Setting
  • Hospital
  • Outpatient Clinic
  • Community-based Agency / Organization / Provider
  • Group or Residential Care
  • Justice Setting (Juvenile Detention, Jail, Prison, Courtroom, etc.)
  • School Setting (Including: Day Care, Day Treatment Programs, etc.)
  • Virtual (Online, Telephone, Video, Zoom, etc.)

Homework

Center for Mind Body Medicine (CMBM) Small Group Model for Adults includes a homework component:

Program participants are encouraged to establish a regular routine of practicing the self-care skills that are taught during the weekly small group meetings.

Languages

Center for Mind Body Medicine (CMBM) Small Group Model for Adults has materials available in languages other than English:

Arabic, Creole, French, Hebrew, Russian, Serbian, Spanish

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

  • 1–2 CMBM-trained Small Group Facilitators
  • Small group meeting room for 10–12 people (or digital meeting platform such as Zoom, if meeting online
  • Crayons or other coloring tools
  • Paper
  • Pens
  • Temperature-sensitive Bio-squares or Thermistors for biofeedback exercise
  • Smartphone or other device for playing music

Manuals and Training

Prerequisite/Minimum Provider Qualifications

There are no educational prerequisites to be trained in the CMBM Small Group Model for Adults. Facilitators should be motivated and able to participate in a self-reflective learning process. Facilitators must be committed to learning the CMBM material presented, practicing the techniques themselves, and bringing what they have learned to others.

Manual Information

There is a manual that describes how to deliver this program.

Program Manual(s)

  • Gordon, J. S., Kimmel, J., & Erb, M. (2020). Bringing mind-body medicine to your community and practice. The Center for Mind-Body Medicine.

Training Information

There is training available for this program.

Training Contact:
Training Type/Location:

Public, regional trainings are held 1–2 times each year. A local, community-wide training can also be arranged for 100+ participants.

Number of days/hours:

There are two parts to training on CMBM’s Small Group for Adults program:

  • 28 hours of experiential and didactic training (Professional Training Program)
  • 28 hours of group facilitation training (Advanced Training Program)

Implementation Information

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Center for Mind Body Medicine (CMBM) Small Group Model for Adults.

Formal Support for Implementation

There is formal support available for implementation of Center for Mind Body Medicine (CMBM) Small Group Model for Adults as listed below:

After completing the Advanced Training Program, facilitators typically receive 16 weeks of ongoing supervision and mentoring through weekly phone or teleconference calls with a CMBM faculty member. This supervision is optional, but strongly encouraged for all newly trained facilitators, and required for those seeking Certification. The supervision process provides coaching and fidelity monitoring and evaluates facilitator effectiveness.

For those interested in a higher level of expertise with the model, there is an option to go through CMBM’s Certification process, which entails additional training and three written papers. The certification provides an extra layer of credibility and experience for facilitators. Once they complete this additional level of training, they are eligible to be listed on the CMBM’s Certified Facilitators directory, which can help connect them with new contract opportunities to do groups and workshops.

Fidelity Measures

There are fidelity measures for Center for Mind Body Medicine (CMBM) Small Group Model for Adults as listed below:

Fidelity measures ensure that the essential components of the model are being incorporated into the group process and gauge the facilitator’s method of leading a group to ensure their approach is consistent with the model’s established method. Direct, in-person supervision and monitoring to ensure fidelity to the model is the central element of the Advanced Training Program.

When trainees facilitate a group during the Advanced Training Program, they receive direct feedback from a CMBM faculty member who is observing and participating in the small group they are leading. The faculty member takes detailed notes on the performance of each trainee, shares the content of the notes with the trainee, and also with other CMBM faculty who may be providing posttraining supervision.

Following this Advanced Training, fidelity is assessed through written, self-reported, process notes that are submitted to the supervisor and discussed during weekly supervision calls (phone or video) with a CMBM faculty member.

Fidelity measures can be obtained by contacting CMBM’s Clinical Director, Amy Shinal at ashinal@cmbm.org.

Fidelity Measure Requirements:

All those who provide groups have been assessed by fidelity measures in the Advanced Training. Further assessment through supervision is optional

Implementation Guides or Manuals

There are no implementation guides or manuals for Center for Mind Body Medicine (CMBM) Small Group Model for Adults.

Implementation Cost

There are no studies of the costs of Center for Mind Body Medicine (CMBM) Small Group Model for Adults.

Research on How to Implement the Program

Research has been conducted on how to implement Center for Mind Body Medicine (CMBM) Small Group Model for Adults as listed below:

Staples, J. K., & Gordon, J. S. (2005). Effectiveness of a mind-body skills training program for healthcare professionals. Alternative Therapies in Health and Medicine, 11(4), 36–43. https://pubmed.ncbi.nlm.nih.gov/16053120/

Relevant Published, Peer-Reviewed Research

Child Welfare Outcome: Child/Family Well-Being

Gordon, J. S., Staples, J. K., He, D. Y., & Atti, J. A. A. (2016). Mind–body skills groups for posttraumatic stress disorder in Palestinian adults in Gaza. Traumatology, 22(3), 155–164. https://doi.org/10.1037/trm0000081

Type of Study: One-group pretest-posttest study
Number of Participants: 92

Population:

  • Age — 18–49 years, (Mean=29.9 years)
  • Race/Ethnicity — Not specified
  • Gender — 58% Females, 42% Males
  • Status — Participants were recruited through the United Nations Relief and Works Agency (UNRWA), and local nongovernment organizations (NGOs) including the Red Crescent, the Gaza Community Mental Health Programme, and Islamic Relief.

Location/Institution: Gaza (Palestine)

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of this study was to examine the Center for Mind Body (CMBM) Small Group Model for Adults effect on symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, and quality of life in adults in Gaza. Measures utilized include the Harvard Trauma Questionnaire (HTQ), the Hopkins Symptom Checklist-25 (HSCL-25), and the World Health Organization Quality of Life Scale – abbreviated version (WHOQOL BREF). Results indicate significant improvements in PTSD, depression, and anxiety symptoms and significant improvements in quality of life (QOL) were observed immediately following participation in the program. At 10-month follow-up, the improvements in the PTSD, depression, anxiety, overall QOL and health scores, and the physical health and social relationship domains of QOL were fully maintained. Improvement was partially maintained for the psychological QOL domain but was not maintained for the environment domain. MBSGs are easily taught to health professionals and can reduce PTSD, depression, and anxiety symptoms, and improve QOL in adults affected by war and political violence. Limitations include small sample size, lack of control group, and missing data at follow-up

Length of postintervention follow-up: 10 months.

Staples, J. K., Gordon, J. S., Hamilton, M., & Uddo, M. (2020). Mind-body skills groups for treatment of war-traumatized veterans: A randomized controlled study. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. https://doi.org/10.1037/tra0000559

Type of Study: Randomized controlled trial
Number of Participants: 108

Population:

  • Age — Mean=55.97 years
  • Race/Ethnicity — Not specified
  • Gender — 96% Male
  • Status — Participants were veterans with posttraumatic stress disorder.

Location/Institution: A specialty clinic in the Veterans Affairs Health Care System

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of this study was to evaluate the effects of a mind-body skills group (MBSG) intervention [now called Center for Mind Body (CMBM) Small Group Model for Adults] on posttraumatic stress disorder (PTSD) symptoms. Participants were randomized to a 10-week Center for Mind-Body Medicine (MBSG) program or standard treatment. Measures utilized include the PTSD Checklist-Military Version (PCL-M), the State-Trait Anger Expression Inventory-2 (STAXI-2), the Pittsburgh Sleep Quality Index (PSQI), the Patient Health Questionnaire-9 (PHQ-9), the State–Trait Anxiety Inventory (STAI), the Post-Traumatic Growth Inventory (PTGI), the Medical Outcomes Study 36-Item Short Form (SF-36v2), and the Inventory of Psychosocial Functioning. Results indicate MBSG participants had significantly greater improvement in the total PTSD score after 10 weeks compared to the standard treatment group. Hyperarousal and avoidance scores significantly improved at 10 weeks and improvements in the hyperarousal symptoms were maintained at 2-month follow-up. MBSG participants also had significant decreases in anger and sleep disturbance. There were no significant differences in the other secondary outcomes. Limitations include subthreshold PTSD was part of the inclusion criteria and 38% had subthreshold PTSD; the lack of a control group which offered similar levels of attention control; the use of the self-report PCL-M is a less accurate measure than a clinician-administered assessment; and length of follow-up.

Length of postintervention follow-up: 2 months.

The following studies were not included in rating Center for Mind Body Medicine (CMBM) Small Group Model for Adults on the Scientific Rating Scale...

Finkelstein, C., Brownstein, A., Scott, C., & Lan, Y. L. (2007). Anxiety and stress reduction in medical education: an intervention. Medical Education, 41(3), 258–264. https://doi.org/10.1111/j.1365-2929.2007.02685.x

The purpose of the study was to assess the effectiveness of Center for Mind Body Medicine (CMBM) Small Group Model for Adults on Year 2 medical students and to assess the sustainability of any noted improvement. Measures utilized include the SCL-90 Anxiety Subscale, the Profile of Mood States (POMS), the 2-Item Depression Index, and the Perceived Stress of Medical School (PSMS). Results indicate that participating students had higher initial anxiety scores than students in the comparison group. Anxiety in the CMBM Small Group Model for Adults declined significantly during the course, with enrolled students becoming indistinguishable from nonenrolled counterparts. These decreased anxiety levels were sustained for 3 months following the conclusion of the course. Limitations include small sample size; lack of randomization; not knowing whether the intervention group’s decreased anxiety levels would be sustainable throughout the rest of medical school and into clinical training; and length of follow-up. Note: This study was not used for rating Center for Mind Body Medicine (CMBM) Small Group Model for Adults in Trauma Treatment (Adult) as the sample did not meet the target definition for the topic area.

MacLaughlin, B. W., Wang, D., Noone, A. M., Liu, N., Harazduk, N., Lumpkin, M., Haramati, A., Saunders, P., Dutton, M., & Amri, H. (2011). Stress biomarkers in medical students participating in a mind body medicine skills program. Evidence-Based Complementary and Alternative Medicine, 2011, Article 950461. https://doi.org/10.1093/ecam/neq039

The purpose of this study was to assess the stress-reducing effects of the Center for Mind Body (CMBM) Small Group Model for Adults by measuring physiological changes in first-year medical students. Saliva samples were collected before (January, time 1 [T1]-pre-intervention) and upon completion of the course (May, time 2 [T2p]-post-intervention), as well as from nonparticipating medical students (May, time 2 [T2c]-control). Results indicate the mean morning salivary cortisol at T2p was 97% of the mean at baseline T1, which was significantly lower than for T2c; DHEA-S showed similar pattern as cortisol where the T2p levels were significantly lower than T2c in both morning and evening collections. Testosterone ratio at T2p was also lower than T2c. On direct comparison, the T2c and T2p means were significantly different for all cortisol, DHEA-S, and testosterone values. CMBM Small Group Model for Adults participants maintained their hormonal balance within the normal range throughout the academic semester while the control group showed significantly increased levels, probably exacerbated by the end of the semester exam stress. Limitations include small sample size; no reliable or valid measures; robustness of the outcomes could have been strengthened by a larger number of subjects in each comparison group and including a balanced number of both genders as well as controlling for possible covariates such as blood pressure, body mass index, insulin and glucose levels; measuring hormone levels in May, in the same control group from baseline, would have provided a stronger study design and allowed for a direct comparison in change of hormone levels between the intervention and control groups; lack of randomization; and lack of follow-up. Note: This study was not used for rating Center for Mind Body Medicine (CMBM) Small Group Model for Adults in Trauma Treatment (Adult) as the sample did not meet the target definition for the topic area. Length of post-intervention follow-up: None.

van Vliet, M., Jong, M., & Jong, M. C. (2017). Long-term benefits by a mind–body medicine skills course on perceived stress and empathy among medical and nursing students. Medical Teacher, 39(7), 710–719. https://doi.org/10.1080/0142159X.2017.1309374

The purpose of this study was to examine the lived experiences with Center for Mind Body (CMBM) Small Group Model for Adults among Dutch medical and Swedish nursing students. Results indicate overall, participation in the MB skills course served as a pathway to inner awareness and supported connecting with others as well as with the surrounding world. Limitations include small sample size; no reliable or valid measures; the sampling procedure might have resulted in inclusion of relatively more study participants with a general positive attitude toward the MB skills course; lack of randomization; and length of follow-up. Note: This study was not used for rating Center for Mind Body Medicine (CMBM) Small Group Model for Adults in Trauma Treatment (Adult) as the sample did not meet the target definition for the topic area.

Additional References

Gordon, J. S. (2014). Mind-body skills groups for medical students: Reducing stress, enhancing commitment, and promoting patient-centered care. BMC Medical Education, 14, Article 198. https://doi.org/10.1186/1472-6920-14-198

Contact Information

Rosemary Lombard, EdM, MBA
Agency/Affiliation: Center for Mind Body Medicine
Website: www.cmbm.org
Email:
Phone: (202) 765-2454

Date Research Evidence Last Reviewed by CEBC: February 2021

Date Program Content Last Reviewed by Program Staff: February 2022

Date Program Originally Loaded onto CEBC: February 2022