Mental Health Disorders and Yoga
This study aims to determine if yoga is beneficial as a treatment for individuals with
mental health disorders. This research explores different studies that have been done
involving yoga with anxiety, depression, PTSD and schizophrenia. This study aims to
explore how yoga has benefited individuals with a mental illness and their feelings about
their experience. It also explores how trained psychologists, who are also yoga instructors,
implement yoga within their practice with those suffering from mental health. Within this
research, we will discuss how to become trained as a therapeutic yoga instructor as well
as ethical and multicultural aspects of yoga as an intervention for those who suffer from
a mental health disorder.
Keywords: Anxiety/Depression, Mental Health, PTSD, Schizophrenia, Yoga
Basic overview of current articles
Over the last decade, we have seen research on yoga as an intervention or used
adjunct to psychotherapy for different mental health disorders. In a 2015 study, forensic
inpatients found mindful yoga to increase body awareness and breathing capacity,
alleviate physical tension and mental distress, leading to less anxiety and increased
relaxation (Sistig, Friedman, McKenna, Considine, 2015). In a six-week yoga
intervention with low-income adults with mental illness, there was a decrease in anxiety
and PTSD after the intervention (Brown, Eubanks, Keating, 2017). Jindani and Khalsa
found that individuals with PTSD reported self-observed changes and new awareness
after participating in trauma-sensitive Kundalini yoga (2015).
Research has shown that some of the key elements of a yoga practice are breath,
mindfulness/meditation, relationship with self and connection with the body. This is
found helpful for disorders that include anxiety-based disorders, trauma, eating
disorders, substance abuse and mood disorders (Roth, 2014). Understanding that the
physical body and psychological have responded well through different types of
research gives us insight on how to use yoga with clients.
Overview of the Research
Definition of Mental Health Disorder
According to the American Psychiatric Association DSM-5, a mental disorder is a
syndrome characterized by clinically significant disturbance in an individual's cognition,
emotion regulation, or behavior that reflects dysfunction in the psychological, biological,
or developmental processes underlying mental function (American Psychiatric
Association, 2013). In this review, we will look at mental health disorders such as
anxiety, depression, post-traumatic stress syndrome, and schizophrenia.
Definition of Yoga
Yoga was developed over 5,000 years ago in India to help individuals with their
physical, mental, emotional and spiritual wellbeing (www.yogaalliance.org). Many of us
in the United States have used yoga for its postures in breathing exercises or as part of
a fitness program to achieve physical wellbeing(www.yogaaaliance.org). While this
ancient practice was developed to help the mental and emotional wellbeing of its
participants, research is required to determine the outcome and to what degree.
Importance of research as relevant to counseling
Over the years there have been many theories and techniques used to help treat mental
health disorders. As a counselor, it is important to stay up to date on current research
that educates us on best practices and recent findings to help us give our clients the
best care. Over the years, yoga has been incorporated to help clients with their mental
health. Staying up to date on research allows counselors to see changes in the techniques and
interventions used with clients in a variety of mental health disorders. We learn from
qualitative, quantitative, and mixed-methods research projects. Each type of research
provides us with different insights and serves its unique purpose to counseling.
Research allows us to see the benefits of new and old techniques to help us serve or
clients. Understanding how yoga can help the client, what type of yoga and the length of
the intervention all need to be considered when using this intervention and the research
helps us make those decisions.
Quantitative Evidence for Mental Health Disorders and Yoga
Explanation of Quantitative Research
Dismantling Mindfulness-Based Stress Reduction
A 2017 study, took the Mindfulness-Based Stress Reduction (MBSR) and dismantled
the multicomponent intervention to determine the impact of emotional and physiological
outcomes. There were four groups, no treatment control group, an active placebo control group
consisting of a healthy snack, study breaks, games and access to a therapy dog, yoga
alone and mindfulness training and meditation. College students were used as the
participants and randomly assigned to one of the four groups. Each participant had the
heart rate variability tested for a baseline at rest and at the post-treatment to assess
their ability to manage stress after the four-week interventions, during a challenge
(Hunt, Russel, Dailey, Simon, 2017).
The mindfulness-based stress reduction (MBSR) assessed more than just yoga. It
dismantled the MBSR and tested each component while leaving one group to stay
combined as MBSR. The results showed the combined MBSR and the yoga groups to
have the highest HRV at rest and a decline during the challenge (Hunt, Russel, Dailey,
PTSD and Yoga in Adult Women
Another study focused on PTSD and adult women. After a careful screening to make
sure these women have PTSD, have not participated in a yoga class in six months,
were not substance-dependent in three months, were no suicidal or homicidal, or had
any recent changes to psychiatric medication, they were split randomly for either yoga
or assessment control condition (Mitchell, Dick, Dimartino, Smith, Niles, Koenen &
The pilot study of women with a current of full subthreshold PTSD symptoms showed
decreases in reexperiencing and hyperarousal symptoms after 12 sessions of Kripalu
based yoga intervention. The assessment control group also showed decreases in
reexperiencing and hyperarousal symptoms. More research is needed in this area, but
we do know that the participants responded positively to the intervention. Future
research could include long term effects of yoga, investigating mechanisms by which
yoga may impact mental health symptoms and gender comparisons (Mitchell, Dick,
Dimartino, Smith, Niles, Koenen & Street, 2014).
Maternal Anxiety and Depression
In another quantitative study, data were not normally distributed, so all data were
presented as medians. In a study with pregnant women with high anxiety, there were 2
groups, a yoga group that participated in an eight-week antenatal yoga class and
another group that went on with treatment as usual (TAU). Both groups consisted of
pregnant women who experienced high levels of stress but were low-risk pregnancies
during the second and early part of the third trimester. Each group took the STAI-State
and STAI-Trait, WDEQ and EPDS questionnaires at baseline and the end of the eight-
weeks. Wijma Delivery Expectancy Questionnaire WDEQ is used for pregnancy-specific
anxiety and EPDS is the Edinburgh Postnatal Depression Scale (Newham, Clin, Hurley,
Alpin & Westwood, 2014).
In the study involving anxiety and maternity, the 59 adult women showed that a single
session of yoga reduced both subjective and physiological measures of state anxiety,
determined by the STAI-S and cortisol. This stayed consistent through the final class.
Multiple linear regression analyses identified yoga as a predictive of greater reduction in
WDEQ scores, while TAU increased elevation in EDPS scores. It was concluded that
antenatal yoga is useful in reducing maternity anxiety towards childbirth (Newham, Clin,
Hurley, Alpin & Westwood, 2014).
Explanation of the Statistical Methods used from Research Articles
Quantitative research is useful for examining the relationship between variables (Balkin,
Kliest, 2017). The process includes gathering participants, obtaining measures,
evaluating data, and communicating data. Numeric values are given for the phenomena
as part of quantitative research (Balkin, Kliest, 2017). Each one of the articles discussed
above would be considered quantitative research. Each one had its methods for
analyzing the data.
The primary research approach for the Mindfulness-Based Stress Reduction study was
quantitative measures using heart rate variability. The week before the training each
group was given a baseline assessment that included demographics, the Beck
Depression Inventory, the Positive and Negative Affect Scale, and the state version of
the Spielberger State/Trait Anxiety Inventory. THE HRV was given at resting just before
the challenge and during the cognitive challenge. The use of the questionnaires and the
HRV gives a picture of anxiety and depression mentally as well as the body's heart rate
response (Hunt, Russel, Dailey, Simon, 2017). In a meta-analysis study, yoga asana's
were shown to improve high-frequency heart rate variability, resting heart rate, cortisol
levels, and blood pressure, showing the body changes with the yoga postures (Pascoe,
Thompson, Ski, 2017).
For the PTSD pilot study, descriptive statistics were calculated using PASW statistics
version 18. Growth curve models reflected dynamic change processes and model the
influence of the different time formats for the yoga classes. Using code 1 for yoga and
code 0 for control and observations were nested within the person as the data was
longitudinal. Time sessions for the yoga classes were accounted for by dropping the
"even" assessment points. The measurements used in this study were the trauma life
events at the baseline only and PCL, CES-D and STAI questionnaires were done at
baseline, postintervention, and 1 month follow up assessment (Mitchell, Dick, Dimartino,
Smith, Niles, Koenen & Street, 2014).
The following formula was used, B*(time)/SD raw for the follow-up analysis. B= the
unstandardized coefficient of the regression of slope onto the dummy-coded treatment
group and the time is the mean number of days at baseline and 1 month follow up. SD
raw is the baseline deviation for the total sample. P values <.01 were considered
significant due to the large numbers of statistical comparisons (Mitchell, Dick, Dimartino,
Smith, Niles, Koenen & Street, 2014).
The TAU and yoga groups were compared through linear data using the Mann Whitney
U test. The Chi-square test or Fisher's Exact test was used to analyze categorical data
within both group comparison of baseline and follow-up mood scores for pre and post-
class assessment of STAI-S and salivary cortisol levels using the Wilcoxon signed-rank
test. Linear regression with bootstrapping was used to determine if maternal age,
gestational age at baseline, mood questionnaires at baseline and attendance of TAU in
alternative classes predicted the change in mood outcome. To get clinically meaningful
between-group difference 52 women, 26 in each group would be needed,
this calculation was done using a power calculation (Newham, Clin, Hurley, Alpin & Westwood, 2014).
Explanation of Effectiveness for Yoga and Mental Health
Is it Effective?
These quantitative studies are limited to mostly female participants. Two of the studies
only deal with adult females. More research is needed with a larger sample of men and
women to determine if yoga is beneficial for both men and women with mental health
disorders. We only covered schizophrenia, PTSD and maternal anxiety in these
quantitative studies. Researching other types of mental health disorders would be
While we have discussed yoga being beneficial for those who suffer from a mental
health disorder, is it beneficial for those not diagnosed and just need help regulating
emotions? The mind-body connection is reported during yoga from qualitative studies
(Roth, 2014) and the salivary cortisol tests (Newham, Clin, Hurley, Alpin & Westwood,
2014), as well as the follow up mood scores in the research just described seems to
indicate yoga could help those who are not diagnosed make a better connection with
themselves in order to regulate emotions (Roth, 2014).
Qualitative Research for Mental Health Disorders and Yoga
PTSD and Yoga
In one qualitative study, the objective of this study was to find out how individuals with
posttraumatic stress disorder (PTSD) perceived an eight-week Kundalini program that
was designed to be trauma-sensitive. It took eighty participants who suffered from
PTSD and split them into two groups, one group of forty participated in the eight-week
Kundalini Yoga program and the other forty were waitlisted as a control group. Both
groups demonstrated changes over the eight-weeks, but the yoga group showed a
greater change (Jindani & Khalsa, 2015).
Participants were over the age of eighteen, spoke fluent English, scored below a 57 on
the PCL-17, had a current yoga/meditation practice, not a safety risk and could commit
to not consuming 24 hours before class. There were nine males and thirty-one females
ranging in age eighteen to sixty-three. Trauma included sexual abuse, physical abuse,
emotional abuse, compassion fatigue, and adverse life circumstances (Jindani &
In another qualitative study, we can look at yoga through a psychological lens. Fourteen
dually trained psychologists and registered yoga teachers were interviewed to examine:
1. How do individuals dually trained as psychologists and yoga teachers conceptualize
yoga as a mental health intervention? 2. In what ways do psychologists trained as yoga
teachers integrate their dual training into their current professional psychology practice
(Roth, 2014)? This type of qualitative data can give insight on how to incorporate yoga
with traditional therapy from a professional view.
The data revealed five domains and fifteen categories. The domains were provider
context, conceptualization content, conceptualization process, clinical implications, and
practice integration. This study also revealed 4 explicit yoga components to be essential
for psychological benefit: breath, mindfulness/meditation, relationship with self, and
connection with the body (Roth, 2014).
To understand the connection between the physical and psychological health for pain
and trauma a qualitative research investigation was done using two psychotherapy
groups that incorporated yoga, meditation, and relaxation. Groups were one hour and
held at an urban outpatient mental health clinic. Those who were part of the qualitative
study had been participating in the groups from 1-4 years. The researcher used this
type of research to capture the subjective experience. Understanding their experience
could be helpful to the field of psychology (Kruer-Zerhusen, 2017).
This study found the overarching theme to be "Change of State." The categorical sub-
sets were a community, spirituality, and hope for change. The relationship category was
the second tier with a relationship with others, a relationship with pain, and a
relationship with self. Tier four was intervention modalities pain management skills,
support from group members and leaders, visualization and self-reflection. Tier five is
the outcome, peace, and calm (Kruer-Zerhusen, 2017).
Explanation of the Statistical Methods used from Research Articles
Qualitative research provides a narrative to the research, rather than a numerical value,
like quantitative (Balkin & Kliest, 2017). This type of research relies on interviews,
documents, and observations for the narrative findings. The data is evaluated and
compared to come up with themes after coding certain words/phrases (Balkin & Kliest,
2017). Each of the articles discussed above is considered qualitative research, but each
one had its way to evaluate and compare the data.
Jindani and Khalsa used a series of questions that were asked at the end of the eight-
week program conducted as a phone interview within one week of the completion of the
program. The lead investigator was responsible for data collection and analysis. The
inductive thematic analysis described by Bruan and Clark was used to understand the
participants perceptions. Data was listened to and re-read several times for accuracy. Using
Nvivo10, the interview transcripts were coded using 300 different codes. Of these,
twelve major codes were identified and themes and sub-themes were created.
The three themes were self-observed changes, new awareness, and yoga
programs (Jindani & Khalsa, 2015).
Three researchers and two study auditors used the Consensual Qualitative Research
methodology. After interviews were transcribed, the first step in analyzing the data was
to create a domain list. Assigning raw data to the domains allows for understanding and
describing each individual's experience. Each individual reviewed several case
transcripts to see what topics emerged. Team members met in person and came up
with a list of domains. After all the data was coded into one domain, the team met again
to a consensus about domain content through a review of a consensus-version, which
included domain titles and all of the raw data for each domain (Roth, 2014).
Using a phenomenology approach, the interview questions focused on in-depth
reactions to mind-body interventions for physical and psychological symptom relief.
Interviews were done in person and recorded, with the interviews lasting 45-75 minutes.
All participants reported PTSD and chronical medical symptoms related to their trauma
The recorded interviews were transcribed verbatim and the researcher analyzed the
data to find "meaningful units" and then searched for themes or patterns by linking
these units. Data were organized and codes were used to assess emerging themes.
The demographic information collected at the time of the interview were included in the
data analysis, as well as any additional notes. Data was reviewed for meaning
condensation and meaning categorization. Observational data was used to support
observed themes. Multiple methods were used to triangulate the data by the researcher
Yoga as Perceived by Participants
Positive feedback was received from participants from the studies above. The themes
from the Kruer-Zerhusen, study found that the participants had hope for change after
experiencing psychotherapy and yoga/mindful-based practices (2017). These
participants not only had experienced trauma, along with anxiety/depression that comes
from the trauma but also chronic pain. Participants were able to make a better
connection with their self and connection with their body as well as the pain they
experienced (Kruer-Zerhusen, 2017).
All participants with PTSD found themes of self-observed changes, new awareness and
the yoga program itself (Jindani & Khalsa, 2015). They also revealed a change in the
mind-body relationship, that allowed for personal transformation through the program.
Participants reported no longer feeling consumed by emotions and feelings within the
body. Through the program not only did their mood change, but they felt able to handle
life stressors in a more positive way (Jindani & Khalsa, 2015).
Yoga in Clinical Practice
Psychologists who are dually trained in yoga gave us insight on how to incorporate yoga
within the therapeutic setting. Yoga can be used in individual therapy, group setting or in
workshops. This allows a more holistic approach to therapy by adding in the mind-body
connection. They also reported that the essential components of yoga for psychological
benefit was breath, mindfulness/meditation, relationship with self and connection with
the body. Disorders identified as benefiting from a yoga practice include anxiety-based
disorders, trauma, eating disorders, substance abuse and mood disorders (Roth, 2014).
Evidence-Based Practice of Yoga
Through the research, we have seen that yoga has been studied and valid measures
have been used to determine how yoga can be used to treat mental health. Studies
have shown that yoga has benefits to the psychotherapy practice, along with mindful-
based training that includes yoga components. This can help counselors to determine
how to best serve our clients in a therapeutic setting.
In an action-based research study, Natya yoga that includes music, movement, and
psychotherapy. The stillness of traditional yoga and meditation can cause agitation and
anxiety in some people, so this was designed with movement from Ashtanga yoga. In
the action research methodology where the focus is on linking research with action
toward a goal of making a change. In this study, patients' voices were represented in
the creation, requiring researchers to partner with them. This was done to improve
treatment modality for underserved people with schizophrenia. This study validated that
Natya yoga created an inner meditative calm, free from anxiety and depression
Sitting in stillness could agitate some clients. Knowing that we can help clients create
inner calmness, free from anxiety and depression is helpful through Natya yoga.
Understanding as clinicians there is more than one type of yoga and the physical
postures and breath can help our clients, even ones who need more movement and
Unified Protocol for Transdiagnostic Treatment
The Unified Protocol for Transdiagnostic Treatment for emotional disorders includes
cognitive restructuring, nonjudgmental emotional awareness, and interoceptive and
emotion-focused exposure exercises. This emotion-focused cognitive behavioral
therapy protocol is used to treat all anxiety and unipolar disorders. While this therapy
has been proven to help with emotional disorders, a study was done to see if mantra-
based meditation would offer relief from symptoms associated with the primary
diagnosis. This was a single-subject study, with multiple baseline designs. There were
only six participants in the study. In fourteen weeks of treatment, they received either
UP treatment only, Up and one mantra-based meditation or UP with mantra-based
meditation after three weeks (Roxbury, 2017).
The data was collected through self-reports of emotional wellbeing. This was done at
baselines and pre and post-treatments. The data were analyzed with visual inspection
by examining the change in the slope of self-reported dependent variables from
baseline to intervention phase to the mantra-based meditation phase. The evidence of
this study showed a decrease in symptoms from anxiety and no longer met the criteria
of general anxiety disorder. It also showed an increase in quality of life experiences
This study indicates that meditation, a component of yoga, is helpful for clients suffering
from a general anxiety disorder. While we as counselors can still follow Unified Protocol,
adding in a mantra-based meditation could help our clients not have symptoms sooner,
than more traditional therapy.
Quality of Life and Anxiety
Brown, Eubanks, and Keating used mixed methods convergent parallel design to
explore the effect of yoga on quality of life, trauma, and anxiety on low-income adults
with mental illnesses (2017). Eighteen participants came from a community mental
health agency and participated in a six-week yoga intervention. Quantitative
measurements came from standardized measures of quality of life, Wilcoxon Signed
Ranks Tests at pre and post-intervention. Qualitative measurements were conducted
using focus groups to explore barriers and the effects of participation in a yoga
intervention. Quantitative data from the showed a decrease in anxiety and PTSD
symptoms from the Wilcoxon Signed Ranks Test, but no difference in the quality of life.
Qualitative data corroborate quantitative data, with improved relaxation and better anger
management for those who strongly endorsed the yoga experience (Brown, Eubanks &
Those who are suffering from anxiety and PTSD could benefit from yoga interventions.
The quantitative and qualitative data collected both show the benefits of adding yoga as
an intervention. While it didn't show a difference in the quality of life, the qualitative data
indicated improved relaxation and anger management, which indicates the regulation of
Mindfulness and Yoga
Mindfulness-Based Stress Reduction (MBSR), uses yoga as one of the components of
the evidence-based program. In a meta-analysis, using comprehensive meta-analysis
software version 3, sensitivity analyses were performed using one-study-removed
analyses. Subgroup analysis was conducted for different yoga and control groups,
including MBSR and non-MBSR. Results of 42 studies were included showing
interventions with yoga were associated with reducing cortisol, ambulatory systolic
blood pressure, resting heart rate, frequency heart rate, blood glucose, cholesterol, and
low-density lipoprotein when compared to an active control group. These results show
that yoga poses are associated with improved regulation of the sympathetic nervous
system and the hypothalamic-pituitary-adrenal system (Pascoe, Thompson, Ski, 2017).
This study gives us information on how the body responds to the physical postures of
yoga and breathwork. Understanding how the body responds to stress, through things
such as heart rate, cortisol, and blood pressure, we can see how yoga helps the body's
physical response to stress and anxiety. This type of information can allow us to use
yoga to help the sympathetic nervous system.
In a mixed-methods study with laughing yoga, laughter yoga may be beneficial for those
suffering from depression. The quantitative data came from the depression anxiety
stress scale and the 12-item health survey. This was done at the beginning of the four
weeks, at post-intervention and 3-month follow up. Data also came from the CSQ8,
which is a client satisfaction questionnaire. All participants did an individual qualitative
interview at the 3-month follow up (Bressington, Mui, Yu, Leung, Cheung, Wu, Bollard,
Chien & Kong,2019). Using laughing yoga with clients who have depression symptoms
could be beneficial according to this study.
Qualifications To be considered a therapeutic yoga instructor
To teach yoga, certification is required, but certification is not standardized (Barnett &
Shale, 2012). There are millions of places to take yoga and also become certified in
yoga, however, the yoga certification process leaves a lot of gray areas, which can
make it difficult to determine the quality of the yoga program. There are many ways to
become a registered yoga teacher (RYT), which is the respected title in the yoga
community, that comes from Yoga Alliance. To become an RYT, one must complete a
200-program hour yoga teacher training that has been approved by the Yoga Alliance
community. To qualify to hold a teacher training program, one must submit a curriculum
and have it approved. The school/studio offering the program decides whether or not
the participant passes the yoga program. Once they have completed the program, the
participant applies to become an RYT through yoga alliance (www.yogaalliance.org,
2019). It would be unethical to teach yoga as a therapist if you are not certified in yoga.
This method of certification can make it difficult to determine who is a qualified yoga
instructor that would fit the needs for a therapeutic setting. Looking at the curriculum of
where the individual got their RYT from as well as their knowledge of anatomy, would
be beneficial for therapeutic yoga (www.yogaalliance.org, 2019). It is suggested that the
instructor be hired as an independent contractor and hold liability insurance, as well as
having participants sign waivers to legally protect themselves against lawsuits
State of Current Research
Current research is showing that yoga is beneficial to those suffering from a mental
illness. While it has been stated how to become certified to teach yoga, the type of yoga
and time of intervention have all varied in the research. Through this research, we have
learned studies have lasted from 4 weeks to 12 weeks and have varied in delivery.
Through the research, we can acknowledge that it is important for certain illnesses,
such as PTSD and schizophrenia that we don't worsen the symptoms by asking the
client to sit in stillness or do something that will cause them to have a trigger.
Understanding that we want to do what is best for clients' well-being and never ask
them to stay in poses that make them uncomfortable, while attending to thoughts and
feelings without labeling them as good or bad (Mitchell, Dick, Dimartino, Smith, Niles,
Koenen & Street, 2014).
Legal and Ethical Considerations
The American Counseling Association has protocols set up for research and it must be
followed, but keeping the clients' best interest in mind is the biggest priority. Using
section G of the American Counseling Association lays out what the protocols are for
research (2014). It is important to understand research responsibilities, reporting
accurate data (G.4.a), and the rights of participants (American Counseling Association,
2014). It is important to protect the identity of the participants, G.4.d, as well as protect
them from any type of injury under G. 1.e (ACA, 2014).
Informed consent and explaining that the participant can stop at any point in the
research are important to communicate. The participant needs to know and understand
their rights within the research, according to G.2.a, of the American Counseling
Association (2014). According to G.1. f, the principal researcher is responsible to
maintain ethical practices of the research (ACA, 2014). This includes making sure that
boundaries with participants, G.3.a, and making sure the relationship between the
participants remain professional, G.3.b & c, (ACA, 2014).
Multicultural considerations should always be taken into account. Yoga was intended for
spirituality and some religions forbid yoga (Tel, 2016). As a culturally skilled counselor,
respecting religious and spiritual beliefs is more important than using Anan intervention
(Arredondo, 1996). It would be unethical to force anyone into doing an alternative
therapy that goes against their worldviews. However, some of the underlying principles
of yoga are universal, like physical postures, guided meditation, body awareness, and
breath (Telles, 2016). As counselors, we need to consider the multicultural needs of our
clients and what techniques will be best for them and the American Counseling
Association reminds us of that in the ethic code F.11.c (2014).
Studies have shown a variety of people who suffer from mental health issues such as
anxiety, depression, and PTSD have found yoga to be helpful to their wellbeing (Telles,
2016). While we need to take into consideration personal worldviews and show respect
for the client's goals, we know that some of the research has involved many different
cultures for different mental health concerns. Research is done by Ong, Cashwell, and
Downs showed success with trauma-sensitive yoga among women from different
ethnical backgrounds ranging in age from twenty-six to fifty-two (2019). Further studies
would need to be done to determine what cultures would benefit more from this type of
alternative therapy. Hays found that suggests that adapting meditations as part of
cognitive-behavioral therapy can be helpful to different cultures with the help of the
It is important to understand that there are things not understood about yoga and
psychotherapy. We need to make sure we are doing what is best for the client at all
times while following best practices. Understanding that the time of the intervention, the
delivery of the intervention and the training of those who are delivering the intervention
all play a role in the outcome of the intervention.
The research is showing that the psychological benefits of yoga come from breath,
mindfulness/meditation, relationships with self and connection with the body are the four
explicit benefits of yoga components (Roth, 2014). Understanding this, along with who
can benefit from this type of practice is important. As counselors, we need to make sure
we are not only delivering the yoga in a therapeutic form but delivering it to those who
will benefit from the practice.
Yoga Alliance is a great tool for learning how to become specialty certified in yoga.
While there a many different schools for yoga, just as there are in counseling, you can
request looking at a yoga school curriculum before signing up (www.yogaalliance.org).
We have looked at only some of the types of yoga in this literature review Antenatal,
Kripalu, Kundalini, Hatha, Laughter yoga, Mantra-based mediation and Natya and there
are several more. Using an alignment-based, meditation-based yoga program while
keeping in mind clients' safety is important for intervention to be successful.
Research shows that yoga interventions have been useful for those with several types
of mental health disorders. Disorders identified as benefiting from a yoga practice
include anxiety-based disorders, trauma, eating disorders, substance abuse and mood
disorders (Roth, 2014).
Being dually trained in yoga and psychotherapy would allow more understanding of the
mental health disorder and provide the client with a more experienced treatment plan,
because it would be combined with other psychotherapy techniques that have been
researched and proven successful, like Unified Protocol for Transdiagnostic Treatment
for emotional disorders (Roxbury, 2017).
Holly is a yoga therapist, M.S. clinical counseling candidate, yoga instructor, kids yoga specialist. In 2006, Holly became certified through National Exercise Trainers Association and began teaching yoga. From there, Holly continued to take and explore several types of yoga while also I was also working on her thesis for her Masters Degree in Physical Education Concentration in Pedagogy at this time. It was during her Master’s program when Holly became certified in Yoga Ed, which is for a yoga program for children. So inspired, her thesis for her Master’s Degree was "The Effects of Yoga on Children’s Self-Perceived Stress and Coping Abilities".
After finishing her Master’s, Holly continued to explore yoga and work on her yoga practice and certifications. In 2010, she became certified through Yoga Shelter and in 2011 she became certified through Yoga Medics as a Yoga Therapist, a program that is focuses on spinal care and alignment.
Holly loves teaching yoga to all ages and ability levels. Connect with her at firstname.lastname@example.org.
"American Counseling Association Code of Ethics." ACA(WEBusage), 2019,
Arredondo, P., Toporek, M. S., Brown, S., Jones, J., Locke, D. C., Sanchez, J. and
Stadler, H. (1996) Operationalization of the Multicultural Counseling Competencies.
AMCD: Alexandria, VA
Balkin, Richard S., and David M. Kleist. Counseling Research: a Practitioner-Scholar
Approach. American Counseling Association, 2017.
Barnett, Jeffrey E., and Allison J. Shale. "The Integration of Complementary and
Alternative Medicine (CAM) into the Practice of Psychology: A Vision for the Future."
Spirituality in Clinical Practice, vol. 1, no. S, 2012, pp. 26–39., DOI:10.1037/2326-
Bressington, Daniel, et al. "Feasibility of a Group-Based Laughter Yoga Intervention as
an Adjunctive Treatment for Residual Symptoms of Depression, Anxiety, and Stress in
People with Depression." Journal of Affective Disorders, vol. 248, 2019, pp. 42–51.,
DOI:10.1016/j.jad.2019.01.030. Accessed 27 June 2019.
Brown, Jodi L. Constantine, et al. "Yoga, Quality of Life, Anxiety, and Trauma in Low-
Income Adults with Mental Illness: A Mixed-Methods Study." Social Work in Mental
Health, vol. 15, no. 3, 2016, pp. 308–330., DOI:10.1080/15332985.2016.1220441.
Accessed 28 June 2019.
Desk Reference to the Diagnostic Criteria from DSM-5. American Psychiatric
Hays, Pamela. "An International Perspective on the Adaptation of CBT Across
Cultures." Australian Psychologist, vol. 49, no. 1, 2014, pp. 17–18.,
DOI:10.1111/ap.12027. Accessed 28 June 2019.
Hunt, Melissa, et al. "Mindfulness Training, Yoga, or Both? Dismantling the Active
Components of a Mindfulness-Based Stress Reduction Intervention." Mindfulness, vol.
9, no. 2, 2017, pp. 512–520., DOI:10.1007/s12671-017-0793-z. Accessed 28 June
Jindani, Farah A., and G.f.s. Khalsa. "A Yoga Intervention Program for Patients
Suffering from Symptoms of Posttraumatic Stress Disorder: A Qualitative Descriptive
Study." The Journal of Alternative and Complementary Medicine, vol. 21, no. 7, 2015,
pp. 401–408., DOI:10.1089/acm.2014.0262.
Kinser, Patricia Anne, et al. "Potential Long-Term Effects of a Mind-Body Intervention
for Women With Major Depressive Disorder: Sustained Mental Health Improvements
With a Pilot Yoga Intervention." Archives of Psychiatric Nursing, vol. 28, no. 6, 2014, pp.
377–383., DOI:10.1016/j.apnu.2014.08.014. Accessed 27 June 2019.
Kruer-Zerhusen, Adriane E. "Mind-Body Interventions for Chronic Pain and Trauma: A
Qualitative Research Perspective on Group Psychotherapy Intervention." 2017.
Mitchell, Karen S., et al. "A Pilot Study of a Randomized Controlled Trial of Yoga as an
Intervention for PTSD Symptoms in Women." Journal of Traumatic Stress, vol. 27, no.
2, 2014, pp. 121–128., DOI:10.1002/jts.21903.
Newham, James J., et al. "Effects Of Antenatal Yoga On Maternal Anxiety And
Depression: A Randomized Controlled Trial." Depression and Anxiety, vol. 31, no. 8,
2014, pp. 631–640., DOI:10.1002/da.22268. Accessed 27 June 2019.
Ong, Isabelle, et al. "Trauma-Sensitive Yoga: A Collective Case Study of Women's
Trauma Recovery from Intimate Partner Violence." Counseling Outcome Research and
Evaluation, vol. 10, no. 1, 2019, pp. 19–33., DOI:10.1080/21501378.2018.1521698.
Pascoe, Michaela C., et al. "Yoga, Mindfulness-Based Stress Reduction and Stress-
Related Physiological Measures: A Meta-Analysis." Psychoneuroendocrinology, vol. 86,
2017, pp. 152–168., DOI:10.1016/j.psyneuen.2017.08.008.
Ramaswamy, Aparna. "Natya Yoga Therapy: Using Movement and Music to Create
Meditative Relief in Schizophrenia (Based on Ashta Anga Yoga)." Action Research, vol.
12, no. 3, 2014, pp. 237–253., DOI:10.1177/1476750314534454. Accessed 28 June
Roth, Anne. "Yoga as a Psychological Intervention: Conceptualizations and Practice
Integration of Professional Psychologist-Yoga Teachers." 2014.
Roxbury, Amanda Cooney. "Does Mantra-Based Meditation Training Improve the
Efficacy of the Unified Protocol for Individuals with Generalized Anxiety Disorders?" 16
Serving the Yoga Community. www.yogaalliance.org/. Accessed 24 July 2019.
Sistig, Brigitte, et al. "Mindful Yoga as an Adjunct Treatment for Forensic Inpatients: a
Preliminary Evaluation." The Journal of Forensic Psychiatry & Psychology, vol. 26, no.
6, 2015, pp. 824–846., DOI:10.1080/14789949.2015.1062996. Accessed 28 June 2019.
Telles, Shirley. "Yoga and Mental Health ." Integrative Medicine International, vol. 3,
2016, pp. 119–119., DOI:10.1159/000449195.