Kayko and I discussed the best way to enter content via the online system. I suggested that the Action Plan after Intake is an initial plan, and that it will change after each session. For each action that Kayko lists in her plan, she should address whether it was (or wasn't) implemented, whether or not it was successful in helping the client work towards their stated goals, and what the next step would be based on her actual meeting with the client. For example, during initial intake, Kayko listed "Aparigraha/non-attachment - Meditation for observing the mind and separating from emotions to “let go”. However, I did not see any evidence that this action item was discussed or implemented. I suggested that Kayko update her action plan to reflect that "meditation was put on hold to not overload client". I encouraged Kayko to document when she introduces the action item (e.g. Session 1, 2 or 3), assess whether or not the client gained value from the action, and what adjustments or next steps would occur (if any) in the next action plan. In this way, Kayko can better track what yoga therapy tools are working to help her client work towards his goals.

I would not say that Kayko included unnecessary, distracting or superfluous content; it was all meaningful. I simply encouraged her update her Action Plan for each session & then evaluate each session against the updated Action Plan -- adjusting to meet the client's progress or lack of progress.

Kayko's demonstrates a strong understanding of how the Pancha Maya Kosha system, the Ayurvedic Dosha system, the Yoga Sutras, and IYI Branches of Yoga are useful tools for assessing and supporting her client's overall health and well-being. During the intake and subsequent sessions, she selected specific tools (asana poses, breathing practices, Sutra discussion & practice & Yoga paths) to help her client reduce physical pain, reduce stress, and foster a connection to a sense of purpose and meaning in life. Kayko demonstrated good awareness of when her plan needed to be adjusted to meet the needs of her client; for example, removing action items the client was not interested in (such as Karma Yoga) and adding tools (such as Santosha gratitude journal) to help her client progress. One area of minor growth is for Kayko to consider "why" she offers specific tools in the 1-1 sessions or home practice. I encouraged Kayko to remember that she has many tools to choose from as a yoga therapist beyond asana and pranayama, and that each session does not need to address each Kosha layer (or follow the structure of a traditional yoga class). For example, one session may focus on supporting her client's goal of reducing physical pain through asana and pranayama, while another session might introduce Yoga sutras or Yoga paths (ie. Japa yoga) to support her client's desire to reduce stress, depression and consumption of alcohol.

Kayko's analysis of how yogic tools could be used to address her client's goals (reduce pain in legs and feet due to sensory peripheral neuropathy, reduce lower back pain, reduce depression, reduce alcohol consumption) was good. Her action plan included asana and breathing practices to address physical pain, improve balance, and address depression/anxiety. The asana and breathing practices progressed logically through the sessions as the client gained knowledge and skill. When the client experienced a personal set-back related to alcohol consumption, Kayko offered additional yogic tools (e.g. yoga journaling, gratitude) to address emotional, intellectual, and spiritual needs. She also revised sequencing as needed to address potential issues, such as practicing pranayama early in the day before the client's inner voice discouraged him from practicing later in the day. Kayko did a good job helping her client gain awareness of how his actions impact his well-being and discussed strategies on how to develop a regular practice to support him on his journey.

Kayko's intake with the client was very good, enabling her to gain a good sense of her client's physical, energetic, emotional, intellectual, and spiritual needs. Working with her client, they identified 2 primary goals: reducing pain/discomfort in client's legs & feet and reducing alcohol consumption. I spoke with Kayko about scope of practice, and she was aware that the goal of "reducing alcohol consumption" would require support from other practitioners such as her client's doctor, therapist, etc. In her discussions with her client, she was aware that he was receiving help from other practitioners to help him with the 2nd goal. We discussed smaller goals that could support that broader goal, such as "building resilience to stress with yogic tools (e.g. breathing practices, restorative yoga poses)" or "cultivating a sense of meaning with yogic tools (e.g. gratitude journaling) to reduce depression". Kayko did a very good job in addressing the client's physical goals with asana and pranayama practices; and she helped her client progress during the 3 sessions. With regards to the 2nd goal, Kayko did a good job helping her client become more aware of how his actions impacted his health through their discussions at each session. In her care plan, Kayko focused on breathing practices (e.g. Ujjai, Kapalabhti) and restorative yoga poses to help release stress and reduce depression. While these tools are useful, I encouraged Kayko to remember that other yogic tools, such as sadhana chart (tracking), pratipaksha bhavana (cognitive reframing), jnana yoga (self-inquiry), sangha (community), can also be used to affect change. I encouraged her to expand her yogic tool kit to apply skills beyond asana and pranayama in her yoga therapy sessions.

Kayko identified recent and relevant research articles & references that supported her action plan for using asana and pranayama practices to address her clients goals of 1) reducing leg/feet pain due to peripheral neuropathy and 2) reducing the depression/anxiety that contributed to his alcohol use disorder. In the future, I encouraged Kayko to explore research & references that demonstrate the use of other yogic tools (when appropriate) to support her client's desire to balance his overall energy, reduce stress, improve self-awareness & self-regulation, cope with grief and loss, and gain a broader purpose in life. She might also wish to do additional research on the topic of "Yoga and Alcoholism" to consider yogic tools that address the physical, mental & spiritual aspects of the disorder.

Kayko does exhibit critical thinking and an individualized approach to her client. She took time to understand sensory peripheral neuropathy and how it contributed to pain in her client's legs & feet, as well as to imbalance. Kayko created an effective action plan to help him gain greater flexibility, improve balance, reduce pain, and increase energy. With regards to her client's goal to reduce alcohol consumption, Kayko introduced breathing practices and restorative yoga practices to help reduce depression & anxiety. She introduced Yogic teachings (e.g. Yoga Sutras, Golden Present) and practices (e.g. journaling) to encourage self-awareness & self-compassion and to experience moments of joy. Each of Kayko's sessions was focused on helping the client work towards his goals, and she adjusted her plans based on her client's needs.

I would rank this as 3.75 if I could. Kayko's observations and recommendations were solid and well-thought out, and she provided some effective solutions to address the problems / issues faced by her client. For example, she taught her client specific breathing practices to help him regulate his nervous system and provided a breath awareness audio recording as an alternative practice.

Areas of growth: discussing short-term versus long-term goals and time frames. For example, to address her client's goal of reducing alcohol use, Kayko might inform her client that meditation is effective in helping a person change behavior. When practiced over time, it helps people gain greater self-awareness, self-control, compassion & resilience. Within the 3 sessions that was allocated for this case study, there was time to address his physical goals through asana & pranayama, but it would take longer to develop a regular meditation practice -- at least 21 days of daily practice. She might provide alternatives such as (a) continuing to meet with client (b) recommending attending IYI meditation sessions, (c) using a meditation application (such as Insight Timer), (d) tracking the numbers of days he meditates, the length of each day's meditation, and his mood after meditation, etc.

Areas of growth: assessing how to evaluate whether yoga therapy is effective or not. Kayko and I discussed different ways that evaluation can occur. For example, if improving balance is a goal, one could measure whether a client could increase the length of time that he could hold a balance pose (e.g. Tree Pose). Another measurement might be for the client to self-report on how confident he feels with his balance when standing up, walking down stairs, or walking up a hill. For each of her clients / groups, Kayko will want to consider different ways to measure whether the prescription is working or not.

Kayko's writing skills & professional presentation is very good. There were no grammar or spelling errors, and she clearly & concisely documented her client's situation, objectives, assessment and progress. She translated this effectively into the Case Study template. This included a strong intake and initial care plan backed by referenced resources. For each session, she described activities completed, assessed progress, reflected on & evaluated what worked well, provided a home practice, and then evolved the care plan for the next session.

Kayko captured insights during her conversations with her client, assessed what was working (or not), made inferences about underlying issues, and adjusted activities in the session, home practice and plan as needed to the benefit of her client. Her self-reflection / evaluation demonstrates intelligence, self-awareness, and kindness -- qualities of a wonderful yoga therapist.