I am impressed with Kayko's ability to communicate with her client, identify & refine short-time & long term goals, observe what her client says & does and make inferences to develop and adjust the care plan as needed. In addition, Kayko is becoming more competent in recommending / using a broader set of yoga techniques to promote a more holistic approach to recovery & wellness.

Kayko did an excellent job of documenting the client's intake, assessment, goals, care plan & resources. She provided a comprehensive overview and clear plan based on best practices. Kayko did a good job at documenting Session 1, Session 2 & Session 4 (as she is required to submit only 3) for the entire case study. I appreciate that Kayko includes resource links to support her client's home practice (i.e. reading materials, audios, videos, etc.). I also appreciate that Kayko adapted her action plan based on her client's needs. For example, in Session 2, Kayko omitted some planned activities because her client was so exhausted after chemotherapy. Her ability to adapt is very good.

My one suggestion to Kayko is that when summarizing the case study for review, that she ensures there is linkage to ideas (observations/plans) and what was delivered in each session, so that I can provide better guidance to her as a reviewer.

Kayko understands relationships between concepts, and she typically includes references to the reason why she is offering a Yogic tool to her client. For example, Kayko provided a "How Yoga Therapy Can Help the Client" overview, where she highlighted yogic tools that she planned to use to help her client address barriers toward accessing her true Self across the 5 koshas.

However, sometimes Kayko does not always link the "what", "how" and "why" within in her case study documentation. For example, during intake, Kayko notices that her client is struggling with losing her sense of self ("having a perfect body") due to illness and trying to cling to her strong self-image. In Kayko's reflection, she suggests that her client's cause of suffering might be related to the Kleishas, especially "raga" (attachment). [Another kleisha that Kayko might have noted is "asmita" (I-am-ness)]. While I am pleased that Kayko is seeing connections between her client's words and thoughts, I did not see how Kayko delivered this insight to her client (i.e. via discussion, reading assignment, "I-am" practice, etc.) in the case study documentation.

Kayko was thoughtful in her preparation for working with a client receiving chemotherapy for lymphoma. She worked with her client to set realistic goals for yoga therapy (for example, using a wide range of yogic tools to support client during treatment to address physical discomfort, facilitate the recovery process, reduce stress, feel grounded, improve energy, gain awareness of self with compassion, and maintain peace during the cancer journey). Kayko listed references & resources to support her care plan, which addressed all levels in the Pancha Maya Kosha model.

The one area that I discussed with Kayko is to assess what can be accomplished within a limited number of sessions (4) and time (1 hour each). I encouraged Kayko to be prepared, but to realize that she might have to prioritize what she offers based on time. For example, the client indicated that she had sciatica & had seen a PT to help her alleviate that pain. In her care plan, Kayko included postures to address the sciatica (as part of her yogic toolbox).

However, during her sessions with her client, Kayko sometimes ran out of time to cover everything she planned. She incorporated poses to address the sciatica earlier in the session, but then ran out of time to incorporate other planned techniques (breathing, meditation, Yogic philosophy). I recommended that Kayko prioritize what she offers to meet her clients' primary goal of dealing with physical & emotional discomfort during chemotherapy. So rather than devote time to postures that relieve sciatica pain, I recommended prioritizing restorative poses to help her client reduce stress, feel grounded and improve energy (while ensuring that any restorative pose offered did not aggravate the sciatica).

Kayko has a strong understanding of Integral Yoga Therapy teachings, and she was successful in identifying appropriate Yogic tools in her care plan. I appreciated that Kayko developed a broad care plan after the initial intake, and that she adjusted the care plan over time to meet the needs of her client.

Kayko incorporated asana to help her client relieve physical discomfort from the chemotherapy treatment & to reduce stress. She incorporated breathing practices & supported her client in learning how to do them as it was not natural to her client. She offered mudra & chakra meditation to help her client feel grounded, a witnessing practice to help her client build awareness, and restorative poses / deep relaxation to address her client's fatigue. In addition, Kayko's knowledge of Raja Yoga (and yoga sutras) helped her assess her client's nervous energy & negative self-talk.

While Kayko is becoming more & more aware of how subtle practices can support a Yoga therapy session, she may want to continue to refine how she delivers these tools to her clients. For example, Kayko introduced a witnessing practice with the spirit of santosha by encouraging her client to notice when she felt content and at-ease versus tension or discomfort. Her client did not resonate with this practice. I am pleased that Kayko tried something new & encouraged her to continue this exploration. As such, we discussed some alternate ways that Kayko might use to deliver the concept of Santosha (contentment); for example, encouraging her client to write down 3 things per day for which she is grateful.

Kayko did an exceptional job identifying relevant and credible information. She references several research articles on the value of Yoga & meditation for people with cancer & lymphedema who are suffering chemotherapy side-effects. From these articles, she identifies goals that can be achievable through Yoga therapy, such as reduced physical discomfort, reduced stress, reduced fatigue, improved immunity, reduced anxiety / depression, and improved quality of life. Kayko identifies specific asana, pranayama, relaxation techniques, guided imagery, mudra & chakra meditations, Yoga Sutras, and more to help her client reduce suffering and feel a greater sense of peace.

With each use case, Kayko demonstrates a deeper understanding of the difference between yoga therapy and yoga instruction. I am pleased with how Kayko is working with her clients -- listening to their needs, observing and assessing how they move & what they say, assisting them with developing realistic goals, and then using her knowledge to put together thoughtful care plans.

One skill that Kayko is developing is her ability to assess & identify ways to address her client's needs -- even when they are not explicitly talked about in the initial intake. For example, Kayko listens carefully & interprets client comments thoughtfully. When her client says that she tries to 'snap out of' anxiety and 'correct her thoughts', Kayko is able to use her experience to observe underlying issues that may be impacting the client at the mananamaya & vijnanamaya kosha layers. From this interpretation, Kayko identified Yogic tools to help her client become more self-aware and self-compassionate. By the 4th session, her client found herself at greater ease when talking about emotions, such as anxiety, and she is practicing on "letting go". This is beautiful growth for both Kayko & her client.

One issue that Kayko & I discussed was how to deal with feelings that arise when working with a client who is quite ill. Kayko observed that she was shocked by the physical changes her client underwent (loss of hair, shallowness of skin) and Kayko felt sorry for her client. We discussed how a yoga therapist can remain authentic and present while holding space for another person's suffering.

Kayko is becoming more adept demonstrating insightful observations and well-thought out recommendation / solutions to address her client's long term & short term goals. She has a strong understanding of her role as a yoga therapist, offering tools and guidance to help her client be in charge of her own healing. Kayko demonstrated the ability to adapt, adjust and accommodate in several instances: helping her client refine her goals as they progressed in the series, trying different ways to incorporate Yoga philosophy as tools for self-care, removing or adapting asanas that caused her client discomfort; incorporating newer Yogic skills (i.e. Muladhara chakra meditation while chanting seed sound of LAM to encourage grounding), and more.

Kayko and I did discuss the need to assess & revamp care plans at each session to meet the client's needs. For example, when her client was exhausted after a chemotherapy session, Kayko adapted her planned care plan to support her client's need for deeper rest & restoration. I also encouraged Kayko to adapt her planned care plan to prioritize what is most needed by her client on the day that they meet, so that she doesn't run out of time to share key tools by remaining tied to a specific sequence that was pre-planned. Kayko is evolving into a very thoughtful, effective yoga therapist.

Kayko demonstrates professionalism in how she interacts with her clients, writes her documentation, references resources, and summarizes the case study in a clear manner.

Some areas of improvement to consider:
* Clarify the type of cancer in the introduction of intake. You described it as a 3rd occurrence, but it took awhile for me to assess that you were working with a client with lymphoma when you described swelling on the left arm.
* In care plan & activity plan, consider refining the organizational structure such as: (I) Asana (poses), (II) Pranayama (breathing, chakras, chanting), (III) Meditation (e.g. witness practice, meditation on breath/sound/image, loving kindness meditation, Yoga Nidra), (IV) Yoga Philosophy (Ahimsa 2:35, Santosha 2.32, Pratipaksha bhavana 2.33, Kleishas 2.3), (V) Other Yoga Techniques (ie. Bhakti, Jnana, Mudras, Self-reflection/journaling).