Breathwork in Therapy and Clinical Settings: Who Offers It and Under What Training

Urgent first

A breathwork or breathing-therapy session is not emergency care. In the US, call 911 for a life-threatening situation, and call or text 988 for a mental health crisis. [1] If breathing practice makes you dizzy, faint, panicked or unwell, stop. See warning signs during breathing practice.

One word, several kinds of provider

"Breathwork therapy" and "breathwork therapist" are used for very different things. Some clinicians teach breathing as one part of treatment for a medical or mental health condition. Separately, many people offer breathwork sessions as a wellness practice. This page describes only what the sources we read document. It does not list or recommend anyone.

What research on therapy-style breathwork shows

1. Does breathwork lower stress and anxiety?

   Promising but limited

   A meta-analysis of 12 randomized trials (785 adults) at moderate risk of bias found lower self-reported stress than controls, with similar sizes for anxiety (20 trials) and depression (18). [8] The authors urge caution to avoid a miscalibration between hype and evidence, and one author has trained as a breath teacher. [8]

2. What makes breathing practices work in trials?

   Promising but limited

   A systematic review of 58 trials found effective practices avoided fast-only paces and sessions under 5 minutes, and included human-guided training, multiple sessions and long-term practice. [9]

3. Can an online group breathwork course reduce anxiety?

   Promising but limited; waitlist control cannot separate expectation

   In a waitlist-controlled trial, 107 adults had six weekly 90-minute group sessions of conscious connected breathwork, and anxiety scores fell more than in the waitlist group. [10] The author previously worked as a certified breathwork facilitator. [10]

4. Is yogic breathing useful in psychiatric care?

   Promising but limited

   A meta-analysis of six trials (517 patients) found short-term benefits with a high risk of bias, adverse events were more frequent with fast than slow techniques, and the authors said it should not be used instead of standard therapies. [11]

5. Is clinician-guided respiratory training for panic disorder effective?

   Mixed

   One program with 69 adults reported an 83% intent-to-treat response rate, but it was benchmarked against an earlier trial rather than compared with a control group in the same study. [12] In a randomized trial both raising and lowering carbon dioxide reduced panic, and the authors suggested shared elements such as changed beliefs and attention to slow breathing, not the CO2 change itself. [5]

Conscious connected breathwork is an intensive style, and this page does not describe how to do it. See rebirthing and conscious connected breathing and gentle and intensive breathwork compared.

Questions to ask any provider

NCCIH advises selecting a complementary practitioner with the same care you would use in choosing a conventional medical provider. [6] Reasonable questions: What is your training and licence, and who is the regulator? How do you screen for lung, heart, seizure, pregnancy, psychiatric and trauma history? What happens if I feel unwell, and can I stop at any time? What do you claim to treat? Is touch used, and how is consent handled? See how to choose a breathwork class or facilitator and facilitator red flags.

Trauma and mental health

Some relaxation techniques have been reported to cause or worsen symptoms in people with epilepsy, certain psychiatric conditions or a history of abuse or trauma. [13] See trauma-informed breathwork.