5 grounding techniques you can teach patients in under 2 minutes

Evidence-based grounding techniques you can introduce within standard consultation timeframes.

In primary care, patients frequently present with mental health concerns such as anxiety, panic, stress, or low mood. Yet the time available in a standard consultation is often limited. A standard GP appointment in Australia lasts around 10–15 minutes, with most of this time taken up with history-taking, diagnosis, prescribing, or arranging referrals. This can leave little opportunity to provide patients with practical strategies for managing acute distress.

Grounding techniques offer brief, evidence-based mental health interventions for busy GPs that can be introduced within the consultation itself. They can help individuals to regulate intense emotions, calm the body’s stress response, and feel more present. They can be applied across mild to moderate mental health presentations, role modelled during the consult, and practised independently between consultations.

Outlined below are five evidence-based techniques that can be demonstrated in under two minutes.

1. 5-4-3-2-1 senses

Best for: anxiety, panic, depression

How to introduce it

1. Ask the patient to pause and observe their environment.
2. Guide them through naming:
   1. Five things they can see
   2. Four things they can touch or feel
   3. Three things they can hear
   4. Two things they can smell
   5. One thing they can taste (or imagine tasting)
3. Encourage slow breathing and focus while they follow these steps.

Even guiding a patient through just one or two steps can demonstrate the technique and show how quickly it can settle the nervous system.

Why it works

5-4-3-2-1 senses is a mindfulness technique that draws on the principles of attentional control. When anxiety or the body’s freeze response is experienced, attention becomes narrowed (a hyperfocus on the perceived threat) or disconnected from the present. It’s important to note that, when supporting patients whose mental health challenges stem from trauma, grounding effects have the potential to cause adverse effects if not provided in conjunction with therapy.

The 5-4-3-2-1 senses technique works by systematically engaging the visual, tactile, auditory, olfactory, and gustatory sensory cortices, the brain reallocates resources from the amygdala-driven fear response to the prefrontal cortex, which supports reasoning and grounding. Research demonstrates that this process interrupts rumination cycles and reduces perceived distress.

2. Box breathing (4-4-4-4 breathing)

Best for: stress regulation, hyperarousal, inducing a calm state or sleep

How to introduce it

1. Ask the patient to inhale slowly for four seconds.
2. Hold for four seconds.
3. Exhale for four seconds.
4. Pause again for four seconds.
5. Repeat for 3-4 cycles.

Patients benefit from practicing daily to build familiarity so that it’s easier to remember and use in stressful moments.

Why it works

Slow, deliberate breathing increases vagal tone and activates the parasympathetic nervous system, producing measurable effects such as reductions in heart rate, blood pressure, and cortisol.

Breathing with equal inhale, hold, exhale, and pause also reduces respiratory alkalosis (induced by hyperventilation during panic), helping to stabilise blood gases and prevent further physiological symptoms like tingling or dizziness.

For patients experiencing anxiety or trouble sleeping, this relaxation technique demonstrates how simple breath control can regulate arousal.

3. Physical grounding through movement

Best for: rumination, or cognitive “overload”, chronic pain, and cardiovascular symptoms

How to introduce it

1. Ask the patient to press their feet firmly into the floor.
2. Encourage them to notice the pressure, texture, and support.
3. Suggest small movements such as wiggling their toes, shifting their weight side to side, or clenching and releasing their fists.

This technique can be easily demonstrated in the consultation room and can be completed even in environments with little stimuli. People often appreciate how discrete and portable this technique is.

Why it works

Research into trauma often highlights the importance of sensorimotor integration. Asking a patient to press their feet into the floor or clench their fists activates proprioceptors and mechanoreceptors, re-establishing the sense of being physically present. Again, when supporting a patient experiencing mental health challenges that stem from trauma, grounding techniques have the potential to cause an adverse effect and should only be provided in conjunction with therapy.

This technique also draws on polyvagal theory, which emphasises the role of body-based cues in shifting nervous system states. Small, controlled movements also stimulate the cerebellum, which helps reorient spatial awareness, improving the person’s sense of the “here and now”.

4. Temperature shift

Best for: acute anxiety, panic attacks, emotional regulation

How to introduce it

1. Recommend the patient applies a cool object (e.g. water bottle, glass object, cold pack, or even a packet of frozen vegetables from the freezer) to the skin, or splashes cool water on their face.
2. Encourage them to focus on the sharp change in sensation.

Suggest that they practise this once or twice a day for prevention, not just when overwhelmed. This builds familiarity so that it’s easier to remember and use in stressful moments.

Why it works

This technique leverages the mammalian dive reflex, an automatic physiological response triggered by sudden contact with cold, or sudden facial immersion. The reflex is mediated by the trigeminal nerve and vagal nerve, leading to a slowed heart rate, peripheral vasoconstriction, and reduced oxygen consumption. In practice, this interrupts the cascade of a panic attack (elevated heart rate, hyperventilation) and restores autonomic balance.

Studies in dialectical behaviour therapy show that temperature change strategies significantly reduce acute emotional distress.

5. Affirmation + orientation

Best for: negative self-talk, overwhelm, catastrophising, poor self-esteem

How to introduce it

1. Ask the patient to look around and name one thing they can see in their environment.
2. Guide them to say a short, grounding statement, such as:
   1. I am safe right now.
   2. This feeling will pass.
   3. I can get through this moment.
3. Encourage them to repeat the statement while focusing on their surroundings.

Suggest patients write one or two personalised affirmations on a card or on a note in their phone to carry with them.

Why it works

Negative self-talk and catastrophising activate limbic structures such as the amygdala, which perpetuates anxiety, depression, and stress. Introducing these short cognitive reappraisals engages the dorsolateral prefrontal cortex, which reduces amygdala activity.

Pairing this technique with environmental orientation (i.e. looking around the room and naming what is present) strengthens contextual awareness in the hippocampus. Together, this dual process reduces the emotional intensity of threat-related thoughts while reinforcing a sense of safety and control.

Integrating grounding into short consultations

Grounding techniques are simple, but their effectiveness is underpinned by neurobiological and physiological mechanisms. For busy GPs and health professionals, being able to demonstrate these strategies and explain why they work not only increases patient buy-in, but also reinforces credibility. People often feel reassured when they understand these techniques are grounded in science, and are more than “relaxation tips”.

Grounding techniques should not be considered a replacement for therapy, but they can provide immediate relief, support self-management, and strengthen engagement with longer-term treatment pathways, including psychological therapy, medication, or lifestyle interventions.

We also recommend practising these techniques personally. Not only is it good to thoroughly understand the techniques you’re teaching, it can also increase patient buy-in.

Practical considerations for GPs and health professionals

• Approach implementation with caution if you’re not well-versed in the technique or unsure of its effectiveness, and before using any of the above with a patient, take their history into consideration. For example, patients who have experienced trauma may not respond well to grounding techniques.
• Introduce grounding techniques as a general self-regulation strategy, not solely for people in crisis, to reduce the stigma.
• Demonstrate the techniques briefly – even 30-60 seconds of practising helps people remember.
• If time permits, offer two or three different strategies, so they can choose what works best for them.
• Encourage patients to practice the technique once or twice daily when calm, so it becomes second nature in moments of distress.
• Position grounding techniques as a bridge to further support, e.g. “This can help you right now, and I will also link you with ongoing support through a psychologist/mental health practitioner to help you long-term.”

In summary

In the context of time-limited consultations, introducing a grounding technique requires little effort yet provides patients with an immediate, practical tool. These evidence-based strategies are simple, adaptable across settings, and empower patients to manage their distress between consultations, contributing to improved resilience and engagement with ongoing care.

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For urgent or life-threatening presentations, call 000 immediately.

For more than 30 years, Sonder has been helping South Australians improve their mental health and wellbeing. You can learn more about Sonder’s mental health services at sonder.net.au/mental-health. 

Sonder also provides two walk-in mental health services in northern Adelaide: Northern Adelaide Medicare Mental Health Centre in Elizabeth, and Safe Haven in Salisbury.