Grounding Techniques for Anxiety: What the Evidence Supports

Grounding techniques for anxiety are short exercises that pull attention away from anxious thoughts and toward the senses, the body and the immediate surroundings. A 2025 review in Trauma, Violence, & Abuse proposed a working definition: techniques that engage one or more of the five senses to return a person to a state of physiological equilibrium^[1].

The techniques are widely taught but loosely defined. Of the 19 sources the review analyzed, only 4 defined grounding, while 12 mentioned it and 3 described it^[1]. Prevalence figures for anxiety disorders are on the anxiety statistics page; this article covers what grounding is and what the research shows.

Clinicians use grounding mainly in two situations: anxiety or panic that is escalating, and dissociation, when a person feels detached from their body or surroundings^[5][1]. SAMHSA's guide to trauma-informed care describes grounding as a way to help a client stay in the present when they are feeling things related to what happened in the past^[6].

Most grounding exercises fall into three loose groups: sensory exercises that name what can be seen, heard or touched; physical exercises that use movement or touch; and mental exercises that use counting, lists or reassuring self-talk. The groupings are descriptive, not a clinical standard.

The 5-4-3-2-1 technique

The best-known sensory exercise counts down through the senses: five things a person can see, four they can touch, three they can hear, two they can smell and one they can taste^[5]. The University of Rochester Medical Center presents it as an exercise for periods of anxiety or panic that begins with slow, deep breaths^[5].

Techniques used in clinical settings

SAMHSA's Treatment Improvement Protocol on trauma-informed care (TIP 57) lists grounding strategies a clinician can guide a client through^[6]:

• Focusing on the external environment, such as naming all the red objects in the room
• Counting, or listing the day's tasks, to return attention to current reality
• Somatosensory cues such as wiggling the toes or touching a chair
• Self-talk that restates current safety
• An "emotion dial," imagining turning down the volume on a feeling
• Guided imagery of a safe place, and slow breathing with the hands on the abdomen

Dropping anchor

An exercise commonly known as dropping anchor guides attention from sounds, to body sensations, to visual details, with the aim of noticing each without analyzing it^[2]. It is one of the few grounding-style exercises tested in a randomized trial, described below.

Breathing exercises overlap with grounding and have their own trial record, covered in deep breathing for anxiety.

Direct evidence is thin. The 2025 review concluded that grounding techniques have not been subjected to efficacy studies, in part because researchers lack a shared, measurable definition^[1]. Its literature search returned 1,894 results, which narrowed to 19 sources after duplicates were removed and the texts were analyzed^[1].

The closest test of a grounding exercise for anxiety is a 2025 randomized trial published in Depression and Anxiety^[2]. It assigned 1,092 U.S. adults with elevated anxiety to one of 12 app-based exercises or one of two control conditions^[2].

All 12 exercises reduced anxiety more than the controls^[2]. Dropping anchor had an effect size of d = 1.0 against a measurement-only control^[2]. A body scan reached d = 0.9 and diaphragmatic breathing d = 0.6^[2].

The limits matter. Anxiety was measured just before and just after each exercise, so the trial says nothing about how long relief lasts^[2]. Exercises lasted 9.8 minutes on average^[2].

The study was funded by Mind Ease Labs, the company behind the app, and participants were recruited online through a platform that draws on Amazon Mechanical Turk^[2]. The authors also note that the control conditions likely produced lower treatment expectations than the exercises, a limitation that affects every exercise-versus-control comparison^[2].

Structured mindfulness programs, a related but much longer format, have stronger evidence for diagnosed anxiety disorders. In the TAME trial, 276 adults with anxiety disorders were randomized to an 8-week mindfulness-based stress reduction (MBSR) course or the antidepressant escitalopram, and MBSR was noninferior^[9].

Scores on the Clinical Global Impression of Severity scale fell by 1.35 points with MBSR and 1.43 points with escitalopram^[9]. That result applies to an 8-week course, not to a single grounding exercise^[9].

Grounding is taught most often for dissociation. The 2025 review describes grounding techniques as a primary approach clinicians cite for reducing dissociative episodes during treatment sessions^[1].

Two dissociative experiences are the usual targets: depersonalization, feeling as if oneself is not real, and derealization, feeling as if the world is not real^[3]. Roughly 15% to 30% of people with PTSD report these symptoms, according to studies summarized by the VA's National Center for PTSD, which supported adding a dissociative subtype of PTSD to DSM-5^[3]. Data on the standalone condition are on the depersonalization-derealization disorder page.

The VA notes that people with dissociative PTSD may need treatments designed to directly reduce depersonalization and derealization, and that for them exposure treatment can lead to further dissociation^[3].

What trials of grounding-based programs show

The largest trial of a skills program that teaches grounding is Finding Solid Ground. In a 2025 interim report, 291 outpatients with dissociative disorders, dissociative PTSD or complex PTSD were randomized to immediate access to the online program or a 6-month waitlist, while continuing individual therapy^[4]. Its materials included practice activities such as creating and using a list of grounding skills^[4].

After 6 months, the immediate-access group improved more than the waitlist group on emotion regulation (g = 0.71) and PTSD symptoms (g = 0.62)^[4]. Dissociation scores changed over time, but the difference between groups was not significant^[4]. The design cannot isolate whether grounding, or any single component, drove the gains.

Grounding is also one of 25 topics in Seeking Safety, a coping-skills therapy for co-occurring PTSD and substance use disorder; the session is titled "Detaching from Emotional Pain (Grounding)"^[7]. A 2023 meta-analysis of 7 randomized trials found medium effects of the program on substance use at 3 months and on PTSD symptoms at 6 months^[7].

Those results describe the whole therapy, not grounding alone. Other trauma treatments are compared in PTSD treatment options.

No study cited here tests grounding as a stand-alone treatment for an anxiety disorder. Clinical guidance presents it as a skill used within care: SAMHSA's guide frames it as an exercise a clinician leads, with prompts about the day and time, what is on the wall and how the body feels^[6].

Relaxation-based approaches as a group have been compared with cognitive behavioral therapy (CBT). A 2018 review of 16 studies with 856 people with generalized anxiety, social anxiety or panic disorder found that relaxation therapy reduced symptoms of anxiety, depression, phobia and worry^[10].

Another 2018 review, of 50 studies with 2,801 people, found relaxation therapy less effective than CBT for PTSD and obsessive-compulsive disorder and found no difference for generalized anxiety, panic or social anxiety disorder^[10]. Most of those studies carried a high risk of bias^[10].

Trial results for CBT and other psychotherapies are summarized in therapy for anxiety, and drug trial data in anxiety medication.

Relaxation techniques are generally considered safe for healthy people, and most research studies report no negative side effects, according to the National Center for Complementary and Integrative Health^[10].

Occasionally, people report increased anxiety, intrusive thoughts or a fear of losing control^[10]. There are also rare reports of relaxation techniques causing or worsening symptoms in people with epilepsy, certain psychiatric conditions, or a history of abuse or trauma^[10].

That summary covers relaxation techniques broadly; no adverse-event data specific to grounding exercises were found for this article. In the 2025 app trial, the body scan was classed as including exposure to bodily sensations of anxiety and still lowered short-term anxiety^[2].