Therapeutic Yoga   -

I am posting the proposals submitted to hospitals in the greater Washington area; scroll down to find the ones that interest you:

I.  Proposal for In-Patient Yoga Therapy at GWU Hospital in 2016

II. Proposal for Psychiatric Residents

III. Yoga for Pediatric Patients and their Parents Draft Proposal July 2014



I. Proposal for In-Patient Yoga Therapy at GWU Hospital in 2016
 
Concept  To offer therapeutic yoga to patients in (1) group activities or (2) 1:1 individual sessions at the request of medical program coordinators and directors of services.
 
Content   A gentle yoga and meditation practice that teaches self-care/self-soothing: 
 
·       Centering exercises to create a sense of safety and physical stability
·       Physical movement to build trust, balance and awareness
·       Exercises to improve proprioception and interoception
·       Physical activity that is safe and expansive   
·       Physiological breathing exercises to instill a sense of calmness in the body, 
                  improve vagal tone
·       Psychological languaging to teach self-acceptance and instill a sense of
                  hopefulness
·       Mental concentration to quiet the mind through guided imagery
 
Purpose  
 
(1)  These practices invite patients to embody the benefits of increased physical activity with a focus on balance and stability, in a place of safety and comfort.  Yoga has been proven to help cope with and overcome chronic pain, improve respiration and lower heart rate, improve sleep patterns and maintain a healthy approach toward appetite.  Yoga is a practice dedicated to improving our relationship with our inner self and others in a way that is uplifting and life-affirming.
(2)  Sessions can be attended by staff and healthcare providers for in-service training.  The instructor would model behaviors that can be adapted by medical residents and staff to reinforce a sense of personal safety, encourage personal choices that create comfort, self-control and self-discovery on the yoga mat.
 
Fee     $120 hourly


II. Proposal for GW Psychiatric Resident Training
 
From GW mission statement Overview on Education & Training:“…psychiatric disorders have proven to be brain disorders that are exquisitely sensitive to the emotional and communicational environments in which patients live. The emotional stressors, shifting relationships, and cultural diversity of patients' lives press psychiatrists to become ever more facile in using dialogue and relationships therapeutically…GW psychiatry residents learn clinical approaches that embrace the complexity of patients' lives in their family, community, and cultural contexts. They draw from multiple clinical perspectives and therapeutic traditions to tailor treatments that address creatively each patient's concerns.”

Proposal:
Yoga and meditation are significant therapeutic partners when used in psychiatric settings. Teachings introduce a language for psychiatric practitioners that (1) enhance dialogue,  (2) help build relationships in a creative, comprehensive and compelling manner, (3) and instill a sense of personal worthiness. Simultaneously, the physical practices (1) provide space to observe and experience “safety” within one’s body, (2) acknowledge its strengths, and (3) explore that which is meaningful in one’s life, using the body as metaphor. The implicit benefit is that as patients benefit from yoga and meditation , future therapists will be drawn toward these practices for their own wellbeing as physicians, partners, practitioners and friends.

I.Objectives
·      Acknowledge the significant events that bring people into psychiatric settings
·      Review current research and evidence-based practices using yoga to treat patients to liberate them from stigma, shame and trauma
·      Introduce residents and medical students to the language of yoga, a language of acceptance and non-judging, a language of hope, optimism and self-awareness so that they might use it in psychiatric treatment, and for personal self-care
·      Bring people into healthy association with their bodies, and
·      Teach meditation as self-care, to bring quiet and calmness to their minds
·      Offer the equivalent of a therapeutic yoga teacher training, so that a selection of practices can be easily offered to patients and peers by the end of our sessions together
 
Proposal for GW Psychiatric Resident Training
II. Background
In 2014, a model program was designed for in-patient psychiatric patients at the George Washington University Hospital from August-December 2014. The original purpose was to bring therapeutic yoga and meditation into clinical settings as part of medical student training.

The primary goals were to provide patients with
       (1) on-site services and
       (2) self-care skills they could use during hospital treatment and by themselves 
             when discharged.

Classes would be focused on one’s ability to
       (1) make constructive choices regarding personal comfort and safety
       (2) practice compassion towards one’s self and others
       (3) bring the mindful practice of compassion and loving-kindness into physical and meditative exercises to restore a sense of well-being and worthiness
       (4) develop a relationship with breathing to create a relaxed body and mind.

Patients were offered 22 sessions of community oriented group therapeutics in physical yoga practice, breathing exercises, meditation and guided imagery. A range of 2-8 individuals attended sessions conducted in the Occupational Therapy or Community Room; most remained for the entire 60 minutes.  Attendance varied according to visiting hours, televised sporting events and related episodes in other group processes over the course of the day. Some individuals were accompanied by “sitters” or foreign language interpreters.

Of the 36 responses, there was an extraordinarily positive acceptance of the practices, with nearly 100% agreement that in each session patients were able to experience some sense of comfort, safety, calmness and relaxation. Among the written comments, patients expressed a desire to continue practices when they left the hospital setting, surprise in their ability to deeply relax, appreciation for the experience.

“Where can I find classes like this when I leave?” was a common question at the end of sessions. Written comments:

calming & comforting    3
“I enjoyed this experience”   4     
“brought me inner peace”  1
stress relieving   1                       
“would like to learn more” 1      
acknowledged appreciation for the instructor   11
would love to try more   3        
found this helpful    1                      
experienced physical & mental improvement (balance and sciatica)   2


 Results of In-patient Surveys

Of the 36 respondents, 15 had some experience with yoga before, and 19 people said they had experience with meditation. When asked if there were any comments they would like to share:
 
                 calming & comforting    3       I enjoyed this experience   4     
                 brought me inner peace  1     stress relieving   1                     
                 would like to learn more 1       acknowledged instructor   4
                 would love to try more   3       found this helpful    1            
                  voiced appreciation  7
                  experienced physical & mental improvement (balance and sciatica)   2

Based upon these results, and anecdotal evidence from staff, there is not only a strong desire on the part of the administrators on 6 South to continue programming for the community, but to expand these offerings as in-service training for residents and medical students on rotation.

III. Content of training sessions on yoga therapeutics for psychiatric residents
Group content:  A series of group sessions on yogic practices will be presented in a Master Class format. A therapeutic yoga instructor will:
·       Explain the physiological and physical benefits of yoga
·       Introduce current neuroscience discoveries related to meditation and yoga practice
·       Explore functional anatomy as it relates to chronic pain 
·       Highlight empirical evidence on how yoga improves professional quality of life 
 
The instructor will then guide medical students students, residents and staff through  carefully scripted experiences using heart-centered instruction and metaphor:
 
(1) Centering practice for mind and body, beginning with meditations on the breath, clarifying purpose and theme of the group experience to build a sense of belonging and inclusiveness, reducing anxiety by increasing mindfulness through moment to moment awareness
(2)Seated stretching; transitioning with awareness from seated postures to standing postures, focus on balance (emotional, physical, psychological, spiritual)
(3)Standing balancing practices and stretching; teaching and encouraging relaxation breathing techniques. Focus on maintaining stability, expanding lung capacity and postural awareness.
(4)Reclining or seated deep relaxation; all will be encouraged to stretch out on the floor with their legs supported by a chair (or not). Yoga nidra mindfulness practices for moment-to-moment honoring of thoughts that arise, inviting compassion, loving-kindness and a connection to inner resources, to convey our connection to that which is filled with infinite possibilities.
Individual content:  Each trainee will have an opportunity to have a 1:1 therapeutic yoga session with the instructor that will be tailored to his or her needs; that individual then becomes an “n of 1”.
 
 
IV. Program Direction and Staffing
 
Group facilitation and Training: Linda Lang, Leader
Frequency of group sessions:  1-3 times weekly, or as requested
Duration of group sessions: 45-60 minutes
Individual sessions may be arranged in advance with instructor
Day and Times of Group: at the discretion of psychiatry department and behavioral health administrators and leadership
 
1. Program Direction: The Therapeutic Yoga director is Linda Lang, operating through  her appointment in the Department of Psychiatry and Behavioral Sciences at GWU School of Medicine, and she will be responsible for all program content and staffing.
 
2. All groups will have instruction offered by a professional therapeutic yoga teacher, who will be paid on an hourly basis. Group sessions will be billed at a rate of $175 hourly.
 
V. Concluding Thoughts
 
It is the intention of this training program to:
·       Inspire young professional to teach and recommend yogic practices to their
                  patients and peers
·       To integrate yoga, meditation and mindfulness into the cultural climate of 6
                  South and throughout academic and hospital settings
·       Create safe space for each individual, in an atmosphere of unconditional
                  acceptance
·       Evolve the development of essential skills for physician self-care through yogic
                techniques of movement, breath work and meditation
·       Refine techniques to calm and quiet the mind
·       Find balance when there is instability
·       Feel resiliency where there is vulnerability
·       Reclaim a sense of strength where there is weakness
·       Feel a sense of community and healthy involvement with others
 
This training will promote optimistic experiences in an atmosphere of compassion and loving-kindness, stressing the importance of being present, moment to moment, exactly as we are, without criticism. Perhaps the quintessential purpose of this work, is to return people, each of us, to our homes and communities with an incentive to seek out yoga and meditation to guide our lives forward along a path of hope.

van der Kolk, Bessel, The Body Keeps the Score; Emerson, David, Overcoming Trauma Through Yoga; Richard Miller, The iRest Program for Healing PTSD Lang, Linda; A Pilot Study for Therapeutic Yoga in Psychiatric Settings, 2014 GWU Hospital, 6 South

III. Yoga for Pediatric Patients and their Parents Draft Proposal July 2014
 
Program Title: One Breath at Time: Symptom Reduction and Coping Skills
Audience:Physicians, nurses, mental health professionals
 
Focus: for Pediatric Patients and Their Parents
 
Asthma and Food Allergies Skills, Techniques and Practices: Yoga, meditation, mindfulness practices and creative “partner-oriented play” to inspire healthy bodies, free flowing breath, personal responsibility and optimism
 
Proposed Schedule: Friday afternoons @ Children’s Hospital
 
Option #1 9 Hours in Three Sessions (3 hours daily) $360* per person depending on registration (5 person minimum)
 
Option #2 12 Hours in Four Sessions (3 hours daily) $480* per person (5 person minimum) *Includes: All reading materials and books; hand-outs
 
CME/CNE credits will be requested from GWU-SMHS
 
Participants will develop skills and abilities to:
 
1. Personally develop a yoga practice that allows one to fully experience the physical, physiological and psychological benefits of aligned movement, breath exercises and positive, hopeful thinking
 
2. Demonstrate and teach yoga and meditation to reinforce specific behavioral choices as indicators of resiliency and well-being
 
3. Define and promote healthy relationships between young patients and their medical conditions
 
4. Demonstrate and support healthy communication between patient:doctor; patient:parent; and patient:medical professional
 
5.  Enhance coping skills by demonstrating how to change behaviors from habitual reactions to controlled physiological responses
 
6. Ease transitions from onset of symptoms, to-and-through treatment
 
7. Create an integrative shift from prescribing medications, to reinforcing and teaching healthy behaviors modalities
 
8. Provide instruction and on-going guidance for patient self-care, resiliency and independence, while supporting the emotional growth of parents :)
 
9. Model meaningful life-style choices (yogic life-styles: daily exercise and movement, breathwork, nutrition, relationship development)    
Articles that will be of interest: http://www.ncbi.nlm.nih.gov/pubmed/16919346 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4097899
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