Annette Ebbinghaus asks:
Does the SOPHROCARE Trial Really Suggest Sophrology Is Less Effective for Adolescents?
The recently published SOPHROCARE trial offers an important contribution to the evidence base surrounding sophrology and chronic illness. As one of the first randomized controlled trials to explore the impact of a Caycedian sophrology programme in adolescents and young adults with congenital heart disease (CHD), it deserves recognition for advancing research into non-pharmacological approaches to wellbeing.
The study found that an eight-session remote sophrology programme did not significantly improve cardiopulmonary fitness (VO₂max), its primary outcome, in adolescents and young adults with CHD. However, among young adults aged 18–25, meaningful improvements were observed in health-related quality of life, including mental wellbeing and vitality.
The researchers suggested that adolescents may be “less receptive” to sophrology than adults due to developmental differences in emotional maturity, motivation, and self-management.
But is this the only interpretation of the findings?
Perhaps the more important question is not whether sophrology is suited to adolescents, but whether the intervention design was optimally suited to how adolescents learn, engage, and change.
Adolescents Are Not Small Adults – But That Does Not Mean Sophrology Is Unsuitable
The SOPHROCARE authors rightly acknowledge that adolescents are developmentally different from adults. Brain maturation, emotional regulation, identity development, and motivation all evolve significantly during the teenage years.
Yet developmental difference should not automatically be interpreted as developmental limitation. In fact, adolescence may be one of the most important periods for interventions that strengthen emotional regulation, body awareness, resilience, confidence, and stress management.
One of the strengths of sophrology is its adaptability. Techniques can be tailored to an individual’s developmental stage, physical capacity, emotional needs, and cognitive maturity. This flexibility may be especially important during adolescence, when neurological, emotional, and social development is occurring rapidly.
Rather than asking whether adolescents are receptive to sophrology, perhaps the more relevant question becomes:
How can sophrology be most effectively adapted to support adolescents at different developmental stages and health needs?
For some adolescents, this may involve shorter, more dynamic practices. For others, greater emphasis on movement, visualization, emotional regulation, performance confidence, or habit formation may increase engagement.
After more than 15 years of bringing sophrology to adolescents in schools and private practice, my experience has consistently been that adolescents respond remarkably well when sessions align with their developmental needs. Across both group and one-to-one settings, students report improvements in anxiety, sleep, confidence, motivation, stress management, and concentration.
This raises an important consideration: Are we evaluating sophrology itself, or the specific way it was delivered?
What SOPHROCARE Actually Tested
The SOPHROCARE intervention consisted of eight one-hour sophrology sessions delivered remotely, in an individual rather than group format, with five weekly sessions followed by three sessions several weeks later.
The researchers acknowledge that the original programme was intended to be delivered in person and in groups, but pandemic restrictions required a shift to a fully remote and individual format.
This distinction matters.
Remote delivery offers flexibility and accessibility, and many practitioners, myself included, have observed positive outcomes with adolescents online when engagement and practice are well supported. Yet adolescents often thrive through social connection, peer modelling, accountability, and shared experience.
Group sophrology can create normalization: “I am not the only one feeling this way.”
It can also increase motivation and enjoyment, particularly for teenagers managing chronic health conditions who may already feel different from their peers. An important question remains: Would the outcomes have differed if the original group format had been maintained?
It is also worth considering the wider context. If the intervention took place during or shortly after COVID-related school disruption, adolescents may already have been experiencing heightened emotional strain, disrupted routines, reduced peer connection, and screen fatigue. For some young people, another online intervention may have felt psychologically similar to remote schooling, potentially influencing engagement and practice between sessions.
Receptive or Under-Supported?
One of the strongest findings of SOPHROCARE was that acceptability was excellent. Participants completed an average of seven out of eight sessions, with 84% attending more than 87% of sessions. This is notable.
If adolescents were fundamentally unreceptive to sophrology, we might expect lower attendance, higher dropout rates, or poorer engagement. Instead, participants showed up.
This suggests that adolescents were willing to engage with sophrology. The challenge may not have been receptivity, but whether the intervention intensity and format were sufficient to create measurable change.
Another limitation acknowledged by the researchers was the inability to measure adherence to practice between sessions. This may matter more than it first appears. Sophrology strengthens through repetition. Adolescents, in particular, often benefit from structure, encouragement, and accountability to build habits.
In my own work, guided audio practices between sessions, historically through recordings and more recently through a practice App, help reinforce consistency and engagement.
The difference between attending eight sessions and attending eight sessions plus regular supported practice may be substantial.
Did the Study Measure the Outcomes Adolescents Experience Most?
The primary outcome in SOPHROCARE was cardiopulmonary fitness (VO₂max). This is understandable and clinically relevant in congenital heart disease. However, the researchers themselves acknowledge that VO₂max is difficult to improve, even with structured exercise rehabilitation.
This raises an important question: Is improved aerobic fitness the first place we would expect sophrology to create change?
Many sophrologists working with adolescents observe a different pathway. Sophrology may first improve:
- emotional regulation
- sleep quality
- confidence
- motivation
- body awareness
- perceived capability
- willingness to engage in healthy behaviours
These changes may then support increased activity and healthier habits over time.
It is also important to recognize that the role of the sophrologists within the study was to deliver a standardized intervention. Behavioural coaching approaches intended to support habit formation around exercise or confidence building may not have been included within the protocol.
Sophrology may therefore support physical health indirectly through improved emotional regulation, motivation, confidence, and reduced anxiety around exertion.
A More Nuanced Conclusion
The SOPHROCARE trial makes an important contribution to the evidence base for sophrology and highlights the need for continued research.
However, the findings may support a more nuanced interpretation than simply suggesting adolescents are less receptive to sophrology. An alternative interpretation may be:
The remote, low-dose, individually delivered programme may not have been developmentally optimized for adolescents.
Future research could explore:
- group-based or hybrid formats
- more frequent sessions
- app-supported practice
- parental involvement
- longer follow-up periods
- measures of sleep, confidence, emotional regulation, and self-efficacy alongside physical outcomes
Adolescents are not small adults.
But perhaps that means we should not offer them adult-designed interventions and expect identical outcomes. Instead, perhaps the future question is:
How can we adapt sophrology to work best for young people at different stages of development and health?
Annette Ebbinghaus
Founder of beChill® Exams & Life sophrology-based programmes for teens