State of the Evidence on Training Programs for Self-Management of Emotional Stress

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Limiting the stressors in our lives is not always possible; however, managing HOW we deal with the stress can be within our control. Nearly half of Americans report that their stress levels have increased in the last five years making effective treatments to decrease psychological distress in demand. Even more so, are mind-body programs that provide individuals the opportunity to have greater control over their own health. This focus on the self-management of health is a global phenomenon with increasing usage of complementary and integrative health practices being reported in the United States, United Kingdom, Canada and Europe.


In 2008, 19% of U.S. adults (more than 55 million people) reported using at least one mind-body therapy during the previous 12 months and in 2012, deep-breathing exercises, meditation, yoga, tai chi and qi gong were among the most frequently used techniques. These therapies are based on the biopsychosocial model, a perspective that acknowledges that biological, psychological (e.g., thoughts, emotions, and behaviors), and social factors all play a significant role in human functioning in the context of wellness and illness. It is often used to describe the concept of the “mind–body connection.”


In 2008, 19% of U.S. adults (more than 55 million people) reported using at least one mind-body therapy during the previous 12 months.


A recent Samueli Institute report evaluated the existing body of randomized controlled trials on biopsychosocial training programs for the self-management of emotional stress. The report is especially impactful for researchers, clinicians and policy-makers as they develop new programs and assess the utility of existing ones.


“This evidence helps us to focus on the programs that work, and retire those that don’t,” said Wayne B. Jonas, MD, President and CEO of Samueli Institute. “By allowing the evidence to guide our decisions, we empower patients to gain control over the stress in their lives.”


A full copy of the report including an evidence breakdown, complete methodology and analysis is available for download, but read on for a short summary of some of the findings.


In the pool of well-studied, effective programs were Mindfulness-based Stress Reduction and Cognitive Behavioral Stress Management. Both are well-established programs that require a substantial amount of training before the learned skills can become self-management skills. Multi-modal yoga-based studies were of good quality and found to be effective for stress reduction. There is reasonably sound evidence for program directors to incorporate these practices into their programs.


There were mixed results for relaxation-based techniques, both in terms of research quality and effectiveness. Autogenic Training studies showed moderately good quality, yet mixed effectiveness.


Limited evidence existed for many other programs including Easwaran’s Eight Program of Passage Meditation, dialectical behavioral therapy, FRIENDS program and several others. Researchers should focus on expanding the body of evidence for these programs to determine their efficacy.


The self-care programs described in the report have potential benefits for both clinical and healthy populations experiencing emotional distress. These self-management skills can help to empower individuals, since they can be practiced in virtually any environment, with minimal time required and at low cost.  This may be especially helpful for individuals who are likely to refuse, delay or feel stigmatized by seeking conventional therapies.


Such self-management programs are cost-effective strategies to prevent or manage stressors and because they are multi-modal, they may also offer greater appeal than single-modal programs. There are very few to no adverse effects when these self-management skills are properly learned and practiced.