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Mindfulness is seen as an important agent of change in these approaches because it shifts the individual's perspective in a way that counteracts psychopathological processes.Within these approaches, mindfulness is coupled with cognitive and behavioral principles and techniques to affect change.It is not clear if the brief nature of the intervention or the modality of delivery (telehealth vs. More recently, a randomized controlled pilot study compared Mindfulness Based Stress Reduction (MBSR) plus usual care to usual care alone.Both groups had improved PTSD symptoms at post-treatment, but between-group differences were not observed in intent-to-treat analyses, although the observed within-group effect were larger in the group that received MBSR in addition to usual care.Some studies have found no benefit associated with relaxation as compared to other PTSD treatments (19-21).

Some conventional therapies for PTSD (e.g., cognitive behavioral therapies [CBT]) include elements that are consistent with CAM approaches.Both treatment arms required weekly, structured group interactions and general behavioral activation, which may have partially contributed to the similar levels of clinical change (small to moderate effect sizes) observed in both study arms.Other CAM mind-body practices Research is emerging with preliminary evidence for other CAM mind-body therapies, such as energy therapy for PTSD.As with the trial of mantram repetition described above, the nonspecific treatment effects of MBSR, such as additional clinical contact and group support, were not controlled for in this pilot study, which leaves the possibility that the few differences that were observed could be attributable to these other factors.(17) Relaxation Results are somewhat variable regarding the impact of relaxation on PTSD symptoms.

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