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Posted by RichardB | Filed under Creative Therapy Tools, Handout
Handout: Self-esteem Barometer
13 Wednesday Apr 2022
Tag Archives: handouts
Handout: How I see myself
10 Thursday Feb 2022
Posted in Creative Therapy Tools, Handout
I have spent many years working with groups in a therapeutic setting and the last 17 years have been mostly psycho-educational. The manner that I facilitate groups in this process starts with a lot of direction, as the clients/patients open to sharing so do the boundaries (meaning less direction). Below is an image of a handout I have used.
One day a client mentioned that how others see him is totally different than how he sees himself. So, I added another part (asking folks to write on the back of the page): “how do you think others see you positively/negatively.
At the end of groups, I often ask what was it like doing this activity (useful, annoying, stupid, ect). Folks nearly always reported for this handout that it was useful. The addition of how others see us opened a whole new conversation level about the perceptions of others.
Evidence based Yoga
02 Wednesday Jun 2021
Tags
activities, ADHD, adherents, alignment, analysis, Another, asanas, assessments, asthma, attention, attitude, author, authors, Back, behavior, benefits, Both, bronchodilator, Cardiovascular, cases, Cochrane, composition, concentration, conclusions, consensus, deficit, difference, disease, disorder, disorders, efficacy, energy, Europe, Evidence, Except, factors, handouts, harmony, Hatha, health, improvement, inadequacies, India, Indian, indices, instructor, intervention, interventions, Iyengar, life, lifestyle, literature, measures, medication, medicine, Meditation, metabolic, method, methodology, origins, outcome, output, Overall, pain, Patients, persons, philosophy, postures, pranayama, purposes, questionnaire, Raja, RCTs, relaxation, resistance, response, restriction, results, selection, self, sessions, Spirometry, status, stimulus, subjects, symptoms, syndrome, techniques, therapy, times, tolerance, tradition, treatment, trend, viniyoga, week, weeks
Yoga is a mind and body practice in complementary medicine with origins in ancient Indian philosophy. The various styles of yoga that people use for health purposes typically combine physical postures, breathing techniques, and meditation or relaxation. There are numerous schools of yoga. Hatha yoga, the most commonly practiced in the United States and Europe, emphasizes postures (asanas) and breathing exercises (pranayama).
Since the 1020’s researchers have been studying and publishing articles on the results of a Yoga practice. Listed below are some of the research results of Hatha Yoga and specific medical conditions. :
ADHD Eighteen boys with diagnosed attention-deficit/hyperactivity disorder (ADHD) were randomly assigned to either a yoga treatment or a cooperative activities group. After 20 sessions of yoga, the boys showed improvement on a variety of indices, including oppositional behavior, emotional lability, and restlessness or impulsivity. The subjects exhibited a dose/ response curve, with those subjects who participated in additional home practice showing a greater response. The control group showed superior scores on measures of hyperactivity, anxiety, and shyness, as well as social function measures.7
Anxiety A meta-analysis of the research involving yoga interventions for anxiety and related disorders reviewed eight studies conducted during 2004. Overall, this research reported positive results, especially in cases of obsessive-compulsive disorder. However, the authors were quick to point out a generally poor quality of research techniques, inadequacies in methodology, and difficulty comparing studies.8 A Cochrane review of two RCTs that investigated the effectiveness of meditation and yoga on patients with diagnosed anxiety disorders stated that based on the available research, no distinct conclusions can be drawn on the ability of meditation and yoga to be effective for anxiety disorders.9
Asthma To determine the efficacy of Iyengar yoga practice on symptoms and perceived quality of life of people living with asthma, 62 patients with mild to moderate asthma were randomized and divided into two groups. The treatment group performed Iyengar yoga for 4 weeks, and the control group enrolled in a “stretching” program. Both groups underwent spirometry testing and recorded their bronchodilator use, symptoms, and quality of life assessments. At no point in the study did the yoga intervention group show a measured benefit in clinical indices.10
Another small RCT divided 17 subjects into a yoga treatment and a control group. The yoga group engaged in relaxation pranayama (mindful breathing) techniques, yoga postures, and meditation 3 times per week for 16 weeks. Spirometry testing showed little difference between the two groups; however, the yoga group showed improved exercise tolerance and reported relaxation as well as a more positive attitude as measured by questionnaire. This study also showed a trend toward less use of short-acting bronchodilator medication in the yoga group.11
Back pain A 12-week RCT compared viniyoga practice with conventional therapeutic back exercises or a self-help book for 101 patients with chronic low back pain. The yoga group met with one instructor for a weekly 75-minute viniyoga practice. Patients were also encouraged to practice at home daily and were given handouts and an audio CD guide. This group showed greater improvement in functional status, decreased activity restriction, and increased general health compared to the conventional exercise group or the self-help book group at 12 weeks. At 26 weeks post treatment, the conventional exercise and yoga therapy group did not show a significant difference in outcome, though at all points in time, viniyoga therapy appeared to be more effective than the self- care book. The viniyoga benefit also lasted for months after the intervention.12
Cardiovascular disease A systematic literature review of 70 studies published over the past two decades showed a trend toward beneficial changes in metabolic syndrome risk factors such as insulin resistance, lipid profiles, BP, and anthropomorphic indices. The author noted that by controlling risk factors for metabolic syndrome, a regular yoga practice might possibly reduce the risk of cardiovascular disease (CVD). It is important to note that approximately one-third of the reviewed studies were RCTs and that the majority of the others were uncontrolled or nonrandomized controlled clinical trials.4 A 2002 comprehensive review of the literature on the psychophysiological effects of hatha yoga concluded that regular hatha yoga practice and a “yoga lifestyle” have the potential to benefit CVD risk indices.5
Cardiovascular fitness A 50-minute hatha yoga routine burns 2.2 to 3.6 kcal/min, the equivalent a very slow walk. Except in persons who are very deconditioned, this type of yoga practice alone is unlikely to have a significant training effect on cardiovascular fitness, pulmonary function, body composition, or fat metabolism.13 More vigorous forms of power or vinyasa yoga require a higher energy output, depending on the method of teaching and selection of asanas (postures). One recent study demonstrated a 7% increase in VO2 max after previously sedentary subjects practiced 8 weeks of yoga training.13 However, the general consensus is that yoga does not provide the significant cardiovascular stimulus necessary to enhance cardiovascular function.14
REFERENCES
1. Tindle HA, Davis RB, Phillips RS, Eisenberg DM. Trends in use of complementary and alternative medicine by US adults: 1997-2002. Altern Ther Health Med. 2005;11(1):42-49.
2. Carrico M. Yoga Journal’s Yoga Basics: The Essential Beginner’s Guide to Yoga for a Lifetime of Health and Fitness. New York, NY: Henry Holt and Company; 1997.
3. Nayak NN, Shankar K. Yoga: a therapeutic approach. Phys Med Rehabil Clin N Am. 2004;15(4): 783-798, vi.
4. Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: a systematic review. J Am Board Fam Pract. 2005;18(6):491-519.
5. Raub JA. Psychophysiologic effects of Hatha yoga on musculoskeletal and cardiopulmonary function: a literature review. J Altern Complement Med. 2002;8(6):797-812.
6. Luskin FM, Newell KA, Griffith M, et al. A review of mind-body therapies in the treatment of musculoskeletal disorders with implications for the elderly. Altern Ther Health Med. 2000;6(2): 46-56.
7. Jensen PS, Kenny DT. The effects of yoga on the attention and behavior of boys with attentiondeficit/ hyperactivity disorder (ADHD). J Atten Disord. 2004;7(4):205-216.
8. Kirkwood G, Rampes H, Tuffrey V, et al. Yoga for anxiety: a systematic review of the research evidence. Br J Sports Med. 2005;39(12):884-891.
9. Krisanaprakornkit T, Krisanaprakornkit W, Piyavhatkul N, Laopaiboon M. Meditation therapy for anxiety disorders. Cochrane Database Syst Rev. 2006;(1):CD004998.
10. Sabina AB, Williams AL, Wall HK, et al. Yoga intervention for adults with mild-to-moderate asthma: a pilot study. Ann Allergy Asthma Immunol. 2005;94(5):543-548.
11. Vendanthan PK, Kesavalu LN, Murthy KC, et al. Clinical study of yoga techniques in university students with asthma: a controlled study. Allergy Asthma Proc. 1998;19(1):3-9.
12. Sherman KJ, Cherkin DC, Erro J, et al. Comparing yoga, exercise, and a self-care book for chronic low back pain: a randomized, controlled trial. Ann Intern Med. 2005;143(12):849-856.
13. Tran MD, Holly RG, Lashbrook J, Amsterdam EA. Effects of Hatha yoga practice on the healthrelated aspects of physical fitness. Prev Cardiol. 2001;4(4):165-170.
14. Clay CC, Lloyd LK, Walker JL, et al. The metabolic cost of Hatha yoga. J Strength Cond Res. 2005;19(3):604-610.
Setting boundaries
05 Friday Feb 2021
Posted in boundaries, Handout, Uncategorized
Setting boundaries is an essential skill in life, especially for people in recovery. Addicts often grow up in dysfunctional homes, where boundaries were either too rigid (leading to suppressed emotions or distant relationships) or too enmeshed (depriving them of a sense of personal identity). Later in life, their interpersonal relationships may continue to be defined by old roles and patterns, increasing the risk of depression, anxiety and addictive or compulsive behaviors. 
As part of recovery, addicts learn how to set boundaries and to respect other people’s boundaries in return. In the addiction field, treatment providers often refer to this process as embracing the authentic self. While it may sound like psychobabble, it is really a process of discovering who you want to be, how you want to interact with other people, and taking responsibility for the consequences of your choices.
Why are boundaries important? They keep you safe from being manipulated, abused or taken advantage of, while also protecting other people from harm you may consciously or unconsciously inflict. They prevent both parties in a relationship from blurring the lines between self and others, which can lead to enmeshment and codependency. With healthy boundaries in place, you can begin to tune in to your inner voice and trust your own thoughts and feelings, and then communicate those to other people.
Distinguishing Healthy and Unhealthy Boundaries
Without a healthy role model, it can be difficult to know what healthy boundaries look like. First, let’s cover what healthy boundaries are not. They are not threats or attempts to control or manipulate others into doing what you want. They are not rigid rules or “walls” designed to keep people out or shield you from expressing your emotions.
Healthy boundaries are simply a delineation of what type of treatment is acceptable to you, and what consequences will result from violating a boundary. People with healthy boundaries share their thoughts and feelings, take care of their own needs, and are able to say no when necessary.
By contrast, people with weak boundaries often:
• Sacrifice their personal values, plans or goals to please others
• Allow others to define who they are and make decisions for them
• Expect others to fulfill all their needs
• Feel guilty when they say no
• Hesitate to share their opinions or assert themselves if they are being treated unfairly
• Frequently feel used, threatened, victimized or mistreated by others
• Frequently offer unsolicited advice, or feel pressured to follow someone else’s advice
• Take responsibility for other people’s feelings
• Tell others how to think, feel or act
A Boundary-Setting Roadmap
Every individual is called upon to set their own boundaries. What works for some may seem either too intrusive or too distant to others. When laying out your boundaries, work through the following steps:
Create a Personal Bill of Rights. Before you can start setting boundaries, you have to recognize your right to have your own feelings, values and beliefs and to express to others how you want to be treated. For some, this requires a colossal leap in self-worth.
Identify Your Emotions. Our parents always admonish us to “think before you act.” When you have a strong response, take a time-out to identify the underlying emotion and figure out what you want to convey. Doing so allows you to interact with other people in an honest, direct way rather than blaming or lashing out.
Set Limits. Once you have a few guidelines in place for how you expect to be treated, practice setting limits with people in a clear, direct way. Examples of healthy boundaries are: “I choose to be around sober people” or “I’ll be happy to talk with you when your voice is calm.”
Assert Your Needs. If you feel that your boundaries are being violated, speak up. This doesn’t mean lashing out or blaming others, but rather assertively communicating your needs. Ask for what you want and say no, politely yet firmly, if something isn’t right for you.
Listen to Your Instincts. If a situation feels uncomfortable or inappropriate, chances are a boundary is being pushed. By tuning into your instincts, you’re more likely to respond in ways that are true to your authentic self.
Defend Your Boundaries. Once you set boundaries, expect that they will be tested. Before this happens, set consequences that you are willing and able to enforce (e.g., “If you continue this behavior, I will…”). Know that by setting limits, you may disappoint the other person, especially if they have weak boundaries themselves. While you should always act with dignity and respect, you can’t control other people’s feelings and behaviors.
If someone continually violates your boundaries, you may need to minimize contact with them, or if they are toxic to your recovery, cut ties altogether. By choosing not to let people violate your boundaries, you stop being the victim, stop blaming others and start reclaiming responsibility for your own life.
Respect Other People’s Boundaries. Just as important as honoring your own boundaries is respecting other people’s, even if they are different from yours. If they don’t have defined boundaries, show them the respect you know they deserve anyway.
Thinking influences
17 Thursday Dec 2020
Posted in Anger, Handout, Uncategorized
Thinking influences our feelings through the things that we say to ourselves. Unhelpful thoughts can add fuel to the fire and play a large role in keeping anger going after the event has passed. However, using helpful self-statements (or ‘cooling thoughts’) can be a good way to manage our anger and guide our behavior. 
Examples of these include:
- Chill out
- Calm down
- Breathe away the anger
- Don’t yell
- Don’t give them the satisfaction of seeing you angry
- It’s not worth it
- Give them a chance to have a say
To use this strategy we need to break anger into several stages:
- Getting ready for provocation: when we know we are going to face something that will make us angry.
- During the event: early signs of anger are cues to use coping strategies.
- Coping with stress: early attempts at anger management may not be successful.
- Reflecting on provocation: time to evaluate the effect of the experience on you, continue coping or give self praise.
Preparing for a provoking situations
- This is going to upset me but I know how to deal with it
- What is it that I have to do?
- Stick to the issues and don’t take it personally
- Try not to take this too seriously
- Time for a few deep breaths of relaxation
- Easy does it, remember to keep your sense of humor
During the event
- Stay calm, just continue to relax
- Think of what you want to get out of this
- There is no point in getting mad
- It’s really a shame that she has to act like this
- If I start to get mad I’ll just be banging my head against the wall
- What he says doesn’t matter. I’m on top of this situation and it’s under control
Coping with stress
- My muscles are starting to feel tight, time to relax and slow things down
- It’s just not worth it to get so angry
- Time to take a deep breath
- Try to reason it out. Treat each other with respect
- He’d probably like me to get really angry. Well I’m going to disappoint him Leaving the anger and looking back
- Try to shake it off. Don’t let it interfere with your job
- Remember relaxation, it’s a lot better than anger
- I handled that pretty well. It worked!
- It could have been a lot worse
- My pride can sure get me into trouble, but when I don’t take things too seriously, I’m better off
Evidence based Yoga 2
01 Thursday Oct 2020
Tags
activities, ADHD, adherents, alignment, analysis, Another, asanas, assessments, asthma, attention, attitude, author, authors, Back, behavior, benefits, Both, bronchodilator, Cardiovascular, cases, Cochrane, composition, concentration, conclusions, consensus, deficit, difference, disease, disorder, disorders, efficacy, energy, Europe, Evidence, Except, factors, handouts, harmony, Hatha, health, improvement, inadequacies, India, Indian, indices, instructor, intervention, interventions, Iyengar, life, lifestyle, literature, measures, medication, medicine, meditation, metabolic, method, methodology, origins, outcome, output, Overall, pain, Patients, persons, philosophy, postures, pranayama, purposes, questionnaire, Raja, RCTs, relaxation, resistance, response, restriction, results, selection, self, sessions, Spirometry, status, stimulus, subjects, symptoms, syndrome, techniques, therapy, times, tolerance, tradition, treatment, trend, viniyoga, week, weeks
Yoga is a mind and body practice in complementary medicine with origins in ancient Indian philosophy. Part two of evidence based Yoga:
Carpal tunnel syndrome A randomized, single-blind controlled trial of 42 patients with carpal tunnel syndrome assigned subjects to either a yoga treatment group or a wrist splint group, each 8 weeks in duration. Twice a week, the yoga group practiced postures specifically designed to strengthen and stretch each joint in the upper body. Yoga participants showed improvement in grip strength, pain levels, and Phalen’s sign when compared to the wrist splint group. Nerve conduction studies were not performed.15 A Cochrane review of 21 trials that evaluated the clinical outcome of nonsurgical treatment of carpal tunnel syndrome reported that 8 weeks of yoga practice significantly reduced pain as compared to wrist splinting. The yoga was described as having a “significant short-term benefit,” though the duration of this benefit is unknown.16
Depression A 2004 review of five RCTs that evaluated yoga-based interventions for depression and depressive disorders showed some positive outcomes and no adverse effects on patients’ mild to severe depressive disorders. However, poor study design and incomplete methodologic reporting makes this interpretation preliminary.17 An RCT studying 7 weeks of yoga training in a group of breast cancer survivors showed positive changes in emotional function, depression, and mood disturbance.18 “Yoga and stress management” (in the online version of this article) provides more information on this study and others involving the effects of yoga on stress.
Irritable bowel syndrome In an RCT, treatment with loperamide (Imodium) was compared to treatment with a series of 12 yoga postures practiced twice a day for 2 months in a small sample of patients with clinically diagnosed irritable bowel syndrome. Patients underwent measurement of surface electrogastrography, and trait and state anxiety tests were administered before, during, and up to 2 months after treatment. Both intervention groups demonstrated a decrease in bowel symptoms and state anxiety.19
Menopausal symptoms In a recent pilot study, 14 postmenopausal women reported via interview and questionnaire a decrease in the severity and frequency of hot flushes after 8 weeks of 90-minute “restorative yoga” classes. Although this initial finding sounds encouraging, this trial had no control group or objective parameter measurements.20 An RCT studying postmenopausal sleep quality divided 164 women into groups who participated in either 4 months of low-intensity yoga, a moderate-intensity walking program, or a wait-list control group. This study reported no statistically significant interventional effects of any treatment on total sleep quality or on any individual sleep quality domain.21
Multiple sclerosis An RCT of 57 subjects with clinically defined multiple sclerosis were assigned to weekly Iyengar yoga class plus home practice, a cycling program, or a wait-list control group for 6 months. Results showed that both active interventions produced significant improvement in perceived levels of energy and reduced fatigue; however, the specific effects of the yoga practice were not isolated.22 Osteoarthritis In a pilot study, 11 deconditioned, yoga naive subjects with a clinical diagnosis of knee osteoarthritis showed improvements in pain and knee stiffness after 8 weeks of yoga training. The group performed modified Iyengar yoga sessions once a week.23
Seizure disorders In 2000, a systematic review of the published literature revealed that only one study was able to meet the selection criteria for reliable research design. The reviewers concluded that no available evidence pointed to yoga therapy as an efficacious treatment for epilepsy.24
Strength and flexibility In a recent study on the fitness related effects of hatha yoga, 10 yoga-naïve and previously untrained subjects aged 18 to 27 years participated in 85 minutes of pranayama and hatha yoga practice twice a week for 8 weeks. These subjects showed significant improvement in upper and lower body muscular strength, endurance, and flexibility. No statistically significant change in body composition or pulmonary function was observed.13
In a partial RCT with a longer time frame, 54 subjects aged 20 to 25 years participated in either 5 months of yoga instruction or no activity. After that time period, both groups practiced yoga for an additional 5 months. The group practicing 10 months of yoga showed significant improvements in shoulder, trunk, hip, and neck flexibility, as well as a reported improved performance during submaximal exercise testing.25
A well-executed study compared subjects who underwent 24 hours of hatha yoga classes over 8 weeks with a control group. The yoga training group showed a 13% to 35% improvement in flexibility, balance, and muscular endurance. The authors concluded that hatha yoga practice has significant effects on balance and flexibility.26
REFERENCES
1. Tindle HA, Davis RB, Phillips RS, Eisenberg DM. Trends in use of complementary and alternative medicine by US adults: 1997-2002. Altern Ther Health Med. 2005;11(1):42-49.
2. Carrico M. Yoga Journal’s Yoga Basics: The Essential Beginner’s Guide to Yoga for a Lifetime of Health and Fitness. New York, NY: Henry Holt and Company; 1997.
3. Nayak NN, Shankar K. Yoga: a therapeutic approach. Phys Med Rehabil Clin N Am. 2004;15(4): 783-798, vi.
4. Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: a systematic review. J Am Board Fam Pract. 2005;18(6):491-519.
5. Raub JA. Psychophysiologic effects of Hatha yoga on musculoskeletal and cardiopulmonary function: a literature review. J Altern Complement Med. 2002;8(6):797-812.
6. Luskin FM, Newell KA, Griffith M, et al. A review of mind-body therapies in the treatment of musculoskeletal disorders with implications for the elderly. Altern Ther Health Med. 2000;6(2): 46-56.
7. Jensen PS, Kenny DT. The effects of yoga on the attention and behavior of boys with attentiondeficit/ hyperactivity disorder (ADHD). J Atten Disord. 2004;7(4):205-216.
8. Kirkwood G, Rampes H, Tuffrey V, et al. Yoga for anxiety: a systematic review of the research evidence. Br J Sports Med. 2005;39(12):884-891.
9. Krisanaprakornkit T, Krisanaprakornkit W, Piyavhatkul N, Laopaiboon M. Meditation therapy for anxiety disorders. Cochrane Database Syst Rev. 2006;(1):CD004998.
10. Sabina AB, Williams AL, Wall HK, et al. Yoga intervention for adults with mild-to-moderate asthma: a pilot study. Ann Allergy Asthma Immunol. 2005;94(5):543-548.
11. Vendanthan PK, Kesavalu LN, Murthy KC, et al. Clinical study of yoga techniques in university students with asthma: a controlled study. Allergy Asthma Proc. 1998;19(1):3-9.
12. Sherman KJ, Cherkin DC, Erro J, et al. Comparing yoga, exercise, and a self-care book for chronic low back pain: a randomized, controlled trial. Ann Intern Med. 2005;143(12):849-856.
13. Tran MD, Holly RG, Lashbrook J, Amsterdam EA. Effects of Hatha yoga practice on the healthrelated aspects of physical fitness. Prev Cardiol. 2001;4(4):165-170.
14. Clay CC, Lloyd LK, Walker JL, et al. The metabolic cost of Hatha yoga. J Strength Cond Res. 2005;19(3):604-610.
15. Garfinkel MS, Singhal A, Katz WA, et al. Yoga-based intervention for carpal tunnel syndrome: a randomized trial. JAMA. 1998;280(18):1601-1603.
16. O’Connor D, Marshall S, Massy-Westropp N. Nonsurgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database Syst Rev. 2003(1):CD003219.
17. Pilkington K, Kirkwood G, Rampes H, Richardson J. Yoga for depression: the research evidence. J Affect Disord. 2005;89(1-3):13-24.
18. Culos-Reed SN, Carlson LE, Daroux LM, Hately-Aldous S. A pilot study of yoga for breast cancer survivors: physical and psychological benefits. Psycho Oncol. 2006;15(10):891-897.
19. Taneja I, Deepak KK, Poojary G, et al. Yogic versus conventional treatment in diarrheapredominant irritable bowel syndrome: a randomized control study. Appl Psychophysiol Biofeedback. 2004;29(1):19-33.
20. Cohen BE, Kanaya AM, Macer JL, et al. Feasibility and acceptability of restorative yoga for treatment of hot flushes: a pilot trial. Maturitas. 2007;56(2):198-204.
21. Elavsky S, McAuley E. Lack of perceived sleep improvement after 4-month structured exercise programs. Menopause. 2007;14(3, pt 1):535-540.
22. Oken BS, Kishiyama S, Zajdel D, et al. Randomized controlled trial of yoga and exercise in multiple sclerosis. Neurology. 2004;62(11):2058-2064.
23. Kolasinski SL, Garfinkel M, Tsai AG, et al. Iyengar yoga for treating symptoms of osteoarthritis of the knees: a pilot study. J Altern Complement Med. 2005;11(4):689-693.
24. Ramaratnam S, Sridharan K. Yoga for epilepsy. Cochrane Database Syst Rev. 2000(3):CD001524.
25. Ray US, Mukhopadhyaya S, Purkayastha SS, et al. Effect of yogic exercises on physical and mental health of young fellowship course trainees. Indian J Physiol Pharmacol. 2001;45(1):37-53.
26. Boehde D, Porcari JP, Greany J, et al. The physiological effects of 8 weeks of yoga training. J Cardiopulm Rehabil. 2005;25(5):290.
Evidence based Yoga
24 Thursday Sep 2020
Tags
activities, ADHD, adherents, alignment, analysis, Another, asanas, assessments, asthma, attention, attitude, author, authors, Back, behavior, benefits, Both, bronchodilator, Cardiovascular, cases, Cochrane, composition, concentration, conclusions, consensus, deficit, difference, disease, disorder, disorders, efficacy, energy, Europe, Evidence, Except, factors, handouts, harmony, Hatha, health, improvement, inadequacies, India, Indian, indices, instructor, intervention, interventions, Iyengar, life, lifestyle, literature, measures, medication, medicine, meditation, metabolic, method, methodology, origins, outcome, output, Overall, pain, Patients, persons, philosophy, postures, pranayama, purposes, questionnaire, Raja, RCTs, relaxation, resistance, response, restriction, results, selection, self, sessions, Spirometry, status, stimulus, subjects, symptoms, syndrome, techniques, therapy, times, tolerance, tradition, treatment, trend, viniyoga, week, weeks
Yoga is a mind and body practice in complementary medicine with origins in ancient Indian philosophy. The various styles of yoga that people use for health purposes typically combine physical postures, breathing techniques, and meditation or relaxation. There are numerous schools of yoga. Hatha yoga, the most commonly practiced in the United States and Europe, emphasizes postures (asanas) and breathing exercises (pranayama).
Since the 1020’s researchers have been studying and publishing articles on the results of a Yoga practice. Listed below are some of the research results of Hatha Yoga and specific medical conditions. :
ADHD Eighteen boys with diagnosed attention-deficit/hyperactivity disorder (ADHD) were randomly assigned to either a yoga treatment or a cooperative activities group. After 20 sessions of yoga, the boys showed improvement on a variety of indices, including oppositional behavior, emotional lability, and restlessness or impulsivity. The subjects exhibited a dose/ response curve, with those subjects who participated in additional home practice showing a greater response. The control group showed superior scores on measures of hyperactivity, anxiety, and shyness, as well as social function measures.7
Anxiety A meta-analysis of the research involving yoga interventions for anxiety and related disorders reviewed eight studies conducted during 2004. Overall, this research reported positive results, especially in cases of obsessive-compulsive disorder. However, the authors were quick to point out a generally poor quality of research techniques, inadequacies in methodology, and difficulty comparing studies.8 A Cochrane review of two RCTs that investigated the effectiveness of meditation and yoga on patients with diagnosed anxiety disorders stated that based on the available research, no distinct conclusions can be drawn on the ability of meditation and yoga to be effective for anxiety disorders.9
Asthma To determine the efficacy of Iyengar yoga practice on symptoms and perceived quality of life of people living with asthma, 62 patients with mild to moderate asthma were randomized and divided into two groups. The treatment group performed Iyengar yoga for 4 weeks, and the control group enrolled in a “stretching” program. Both groups underwent spirometry testing and recorded their bronchodilator use, symptoms, and quality of life assessments. At no point in the study did the yoga intervention group show a measured benefit in clinical indices.10
Another small RCT divided 17 subjects into a yoga treatment and a control group. The yoga group engaged in relaxation pranayama (mindful breathing) techniques, yoga postures, and meditation 3 times per week for 16 weeks. Spirometry testing showed little difference between the two groups; however, the yoga group showed improved exercise tolerance and reported relaxation as well as a more positive attitude as measured by questionnaire. This study also showed a trend toward less use of short-acting bronchodilator medication in the yoga group.11
Back pain A 12-week RCT compared viniyoga practice with conventional therapeutic back exercises or a self-help book for 101 patients with chronic low back pain. The yoga group met with one instructor for a weekly 75-minute viniyoga practice. Patients were also encouraged to practice at home daily and were given handouts and an audio CD guide. This group showed greater improvement in functional status, decreased activity restriction, and increased general health compared to the conventional exercise group or the self-help book group at 12 weeks. At 26 weeks post treatment, the conventional exercise and yoga therapy group did not show a significant difference in outcome, though at all points in time, viniyoga therapy appeared to be more effective than the self- care book. The viniyoga benefit also lasted for months after the intervention.12
Cardiovascular disease A systematic literature review of 70 studies published over the past two decades showed a trend toward beneficial changes in metabolic syndrome risk factors such as insulin resistance, lipid profiles, BP, and anthropomorphic indices. The author noted that by controlling risk factors for metabolic syndrome, a regular yoga practice might possibly reduce the risk of cardiovascular disease (CVD). It is important to note that approximately one-third of the reviewed studies were RCTs and that the majority of the others were uncontrolled or nonrandomized controlled clinical trials.4 A 2002 comprehensive review of the literature on the psychophysiological effects of hatha yoga concluded that regular hatha yoga practice and a “yoga lifestyle” have the potential to benefit CVD risk indices.5
Cardiovascular fitness A 50-minute hatha yoga routine burns 2.2 to 3.6 kcal/min, the equivalent a very slow walk. Except in persons who are very deconditioned, this type of yoga practice alone is unlikely to have a significant training effect on cardiovascular fitness, pulmonary function, body composition, or fat metabolism.13 More vigorous forms of power or vinyasa yoga require a higher energy output, depending on the method of teaching and selection of asanas (postures). One recent study demonstrated a 7% increase in VO2 max after previously sedentary subjects practiced 8 weeks of yoga training.13 However, the general consensus is that yoga does not provide the significant cardiovascular stimulus necessary to enhance cardiovascular function.14
REFERENCES
1. Tindle HA, Davis RB, Phillips RS, Eisenberg DM. Trends in use of complementary and alternative medicine by US adults: 1997-2002. Altern Ther Health Med. 2005;11(1):42-49.
2. Carrico M. Yoga Journal’s Yoga Basics: The Essential Beginner’s Guide to Yoga for a Lifetime of Health and Fitness. New York, NY: Henry Holt and Company; 1997.
3. Nayak NN, Shankar K. Yoga: a therapeutic approach. Phys Med Rehabil Clin N Am. 2004;15(4): 783-798, vi.
4. Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: a systematic review. J Am Board Fam Pract. 2005;18(6):491-519.
5. Raub JA. Psychophysiologic effects of Hatha yoga on musculoskeletal and cardiopulmonary function: a literature review. J Altern Complement Med. 2002;8(6):797-812.
6. Luskin FM, Newell KA, Griffith M, et al. A review of mind-body therapies in the treatment of musculoskeletal disorders with implications for the elderly. Altern Ther Health Med. 2000;6(2): 46-56.
7. Jensen PS, Kenny DT. The effects of yoga on the attention and behavior of boys with attentiondeficit/ hyperactivity disorder (ADHD). J Atten Disord. 2004;7(4):205-216.
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Positive Statements about you
11 Friday Sep 2020
Posted in Handout, mental health, Self Esteem
I am a group therapist who generally works with adults. I facilitate groups using creative arts, processing oriented, or psycho-education. Sometimes I actually sort of combine these in to a psycho-educational process oriented creative group. I provide info (psycho-educational, we talk about it from a personal perspective, and than create something out of the discussion.
One thing I have notice over the decades is that when people are stressed or overwhelmed about events in their life they tend towards a negative self perception. Below is a handout that I often use. One way of using this is to start out discussing what is positive self esteem, how you get it, maintain it, and why bother with it. I than pass out the hand out and folks write and than we share it in the group or in groups of 2 or 3 folks.
Positive Statements about you
- I like myself because:
- I’m an expert at:
- I feel good about:
- My friends would tell you I have a great:
- My favorite place is:
- I’m loved by:
- People say I am a good:
- I’ve been told I have:
Grounding
19 Thursday Dec 2019
Posted in grounding, Handout, Health, mental health, Psychoeducation, Therapy
Grounding Techniques are activities you use when you feel overwhelmed by feelings, thoughts, sensations. These techniques help a person move their focus away from what is overwhelming them to something else. That something else is preferable healthy and supportive to their wellbeing. Below is a list that clients and patients have mentioned over the years of things they do that help them ground.
- Get ice or ice water
- Breathe – slow and deep, like blowing up a balloon.
- Take your shoes off and rub your feet on the ground.
- Open your eyes and look around. See yourself in a different place than.
- Move around. Feel your body. Stretch out your arms, hands, fingers.
- Peel an orange or a lemon. Notice the smell. Take a bite. Focus on the taste.
- Pet your cat, dog or rabbit.
- Spray yourself with favorite perfume.
- Eat ice cream! Or any favorite food. Pay attention to the taste.
- Call a friend.
- Take a shower.
- Take a bath.
- Go for a walk. Feel the sunshine (or rain, or snow!)
- Count nice things.
- Dig in the dirt in your garden.
- Turn lights on.
- Play your favorite music.
- Hug a tree!
- Touch things around you.
- Frozen Orange – put your nails into it – the cold and the smell can bring you back
- Pull up the daily newspaper on your browser. Notice the date and read a current article.
- Stomp your feet to remind yourself where you are. Press your feet firmly into the ground.
- Try to notice where you are, your surroundings including people, sounds like the t.v. or radio.
- Concentrate on your breathing. Take a deep cleansing breath from your diaphragm. Count the breaths as you exhale. Make sure you breath slowly so you don’t hyperventilate.
- Cross your legs and arms. Feel the sensations of you controlling your body.
- Call a friend and ask them to talk with you about something you have recently done together.
- Take a warm relaxing bubble bath or a warm shower. Feel the water touching your body.
- Mentally remind yourself that the memory was then, and it is over. Give yourself permission to not think about it right now.
- Realize that no matter how small you feel, you are an adult.
- Go outside and sit against a tree. Feel the bark pressing against your body. Smell the outside aromas like the grass and the leaves. Run your fingers through the grass.
- If you are sitting, stand. If you are standing sit. Pay attention to the movement change. Reminding yourself — you are in control.
- Rub your palms, clap your hands. Listen to the sounds. Feel the sensation.
- Speak out loud. Say your name or significant others name.
- Hold something that you find comforting, for some it may be a stuffed animal or a blanket. Notice how it feels in your hands. Is it hard or soft?
- Eat something. How does it taste, sweet or sour? Is it warm or cold?
- If you have a pet use that moment to touch them. Feel their fur and speak the animals name out loud.
- Visualize a bright red STOP sign to help you stop the flashback and/or memory
- Step outside. If it’s warm, feel the sun shining down on your face. If it’s cold, feel the breeze. How does it make your body feel?
- Take a walk outside and notice your neighborhood. Pay attention to houses and count them.
- Listen to familiar music and sing along to it. Dance to it.
- Write in your journal. Pay attention to yourself holding the pencil. Write about what you are remembering and visualize the memory traveling out of you into the pencil and onto the paper. Tear the paper up or seal it in an envelope. Give it to your therapist for safekeeping.
- Go online and talk with an online friend. Write an email.
- Imagine yourself in a safe place. Feel the safety and know it.
- Watch a favorite t.v. program or video. Play a video game.
- If you have a garden, work in it. Feel your hands running through the dirt.
- Wash dishes or clean your house.
- Meditate if you are comfortable with it.
- Exercise. Ride a bike, stationary or otherwise. Lift weights. Do jumping jacks.
Honesty
30 Wednesday Oct 2019
This is one of the handouts I use with groups when we talk about honesty.
- Figure out why you lie and who you lie to. We’ve all lied at one time or another, to different people, to ourselves, and for different reasons. But coming up with a systematic plan for becoming more honest will be difficult unless you try to define those reasons and those people for yourself.
- Lies to make ourselves look better might include exaggerations, embellishments, and flat-out tall-tales we tell to others, and ourselves, to make ourselves feel better about our inadequacies. When you’re unhappy about something, it’s much easier to fill it in with lies than tell the truth.
- We lie to peers we think are better than us, because we want them to respect us as we respect them. Unfortunately, being dishonest is disrespectful in the long run. Give people more credit for their ability to empathize and understand you on a deeper level.
- Lies that avoid embarrassment might include lies told to cover up bad behaviors, transgressions, or any activity we’re not proud of. If your mom found a pack of cigarettes in your jacket, you might lie and say that they’re your friend’s to avoid punishment.
- We lie to authoritative figures to avoid embarrassment and punishment, including ourselves. When we’ve done something we feel guilty about, lies are told to eliminate the guilt, avoid the punishments, and get back to the objectionable behavior we’re forced to lie about. It’s a vicious cycle.
- Anticipate behaviors that will make you feel guilty. To break the chain of embarrassment and lying, it’s important to learn to anticipate things that you’ll likely feel guilty about in the future, and avoid those behaviors. When you lie, you’re covering up some uncomfortable truth that’s more easily couched in a lie. You can either get comfortable with the truth, or abandon the behavior that makes you embarrassed.
- If you smoke cigarettes, you won’t have to lie if everyone knows it’s true. Own up to it. If a behavior is un-own-upable, it’s probably best to avoid it. It would be humiliating for your wife to find out that you had an inappropriate relationship with a coworker, but you won’t have to lie if you don’t do it.
- Avoid situations in which you’ll have to lie for others. Be wary when someone tells you something in confidence that you know that you should share with someone else (e.g., knowledge of a crime, a lie, or a harmful act against another). Hearing such information puts you in a difficult position, especially when the truth eventually emerges and reveals to the affected person that you knew all along.
- If someone begins a sentence with “Don’t tell so-and-so about this, okay?” be prepared to offer your own disclaimer: “If it’s something that I’d want to know about were I them, then please don’t tell me. I don’t want to be responsible for anyone’s secrets but my own.”
RichardbBrunner 