Mental Health Disorders and Yoga

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Mental Health Disorders and Yoga

Holly Vogtmann

Malone University

Abstract

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



Introduction

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,

Simon, 2017).



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 &

Street, 2014).



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

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

beneficial.



Regulating Emotions

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 &

Khalsa, 2015).



Psychological Lens

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

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

(Kruer-Zerhusen, 2017).



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

(Kruer-Zerhusen, 2017).



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.



Natya Yoga

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

(Ramaswamy, 2014).



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

less stillness.



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

(Roxbury, 2017).



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 &

Keating, 2017).



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

emotions.



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.



Laughing Yoga

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

(www.yogaallianace.org, 2019).



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

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

client (2014).



Reflection

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.jpg

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 holly@resetbrainandbody.com.





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