• Check in, centering, balanced hatha yoga set considering contraindications, relaxation (with imagery as appropriate),
• Balanced pranayama considering contraindications, meditation/centering.
• Include at least one suggestion from Karma, Bhakti, Raja, or Jnana Yoga tailored for this client.

1. client to do
-dance like a chicken upon wakening from bed (pranayama with some mindful motion),
-asana practice (tadasana, hip circles, bouncy twists, tree pose on each side)
-eat with family a small meal with family
-walk outside for 10-15 mins
-then mom is to put on 432 Hz music and allow the house to be quiet as client puts together her puzzle for as long
as tolerated in silence (meditation practice).

This is a basic template of care plan; it is very much a trial to see what will work and what will not; the idea is that a structure may be helpful for grounding.

This schedule is flexible and may be altered as needs arise; client goes to day program a couple days a week, so may need to alter this when that occurs.

Spoke with parents about client's symptoms. They state she does still have the hallucinations but typically is able to recover after about 5 minutes; decline medication changes. Of note, when client in being spoken about by parents, it seems she sometimes starts to cough.

Danced first today, then did chicken dance, then client decided when it was time to stop. She sat and we discussed her life plans. She really wants to be around her family and likes her day program. Likes to help her mom around the house. Talked about her favorite movies, including Mulan.

Parents predominantly were out of the room; sometimes, though, when client is asked a question, parents interrupt; when this occurs, I redirect and ask the client to answer. This has happened once or twice.

In speaking with client a bit more about what she likes to do, she showed her collection of puzzles. She enjoys putting together puzzles; family of limited financial resources and some of the puzzles are not complete sets. Spoke about use of puzzles as a meditative practice; mother agrees to help client use puzzle making in silence in the AM hours. Mom states she can have her own (separate puzzle) to do in another room so that client stays on track.

Client developing sense of her assertion and creativity in the world and this seems to parallel her recovery.

It has continued to be a learning experience for me, both in learning about the client, and learning about what we can do with her concentration limitations and also my use of Telehealth. There are some clients with mobility limitations that prevent certain practices from being used. The limitations in this case are more mental; the client has an approximate ability to concentrate on a task of about 10mins (though I suspect this time is longer when she does puzzles, looking at the complexity of the puzzles she puts together). I have considering doing a routine that involves the floor, but the camera set up in their home would limit my field of view for floor exercises.

A useful tool is involving her mother, as the mother helps keep her on task; she likes to mirror what others are doing, so having the mom do something alongside her is helpful. The trick is being able to have the mother work in parallel to the client without having her be the center of the client's attention or having the mother correct the client as the client does the practice, as this tendency has been observed. Will continue to work with the parent child dynamic.

I really feel this parent child dynamic work that has been occurring, has been tantamount to saving the client's psychic life. In group based cultures, and especially Chinese culture, the role of the parent in the life of the child is as the role of the Guru in the life of a devotee or the role of a pharaoh in the life of an Egyptian slave of Biblical times. Dedication to family is a fundamental goal of all virtue in Chinese religions and culture. Without a parental seal of appreciation for my work with AN, she herself would never fully engage with me. The trick is to seek the approval of the parents while also encouraging the independence of AN and resisting the inner workings of a culture which uses their children as if they were their own selves..

1. continue to practices asana, pranayama, dance, and other elements.
2. continue to encourage parental contribution while redirecting energies which put AN in a position in which she feels obligated to report her symptoms are better than they really are; difficult to have sessions with AN alone as she does not like being alone. Will continue working toward the goal of greater compassion for client as someone having a disease which severely limits her abilities to perform in a way that is seen in Chinese culture as brining honor to the family unit.