• 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.

Do belly massage, 3 part breathing, alternative nostril breathing before school in the AM and before sleep at night.
Client to make a 'fort' or safe space in the house where he can crawl into safely.
Client also to construct/build a Lego representation of a house where he and his mom are safe and keep it with him.
Client is to keep mother's necklace on him especially when going to school.

Spoke with mom about how client is doing; therapist attended this session and she also gave an update on client. He continues with anxiety and has found the breathing practices helpful. Client states doesn't have as much nausea.

Spoke with therapist about practice of visualizing a safe space that the client builds. She states she will continue to work with client on this practice. Mom states she will encourage client to build a safe space using blocks at home. Also discussed with mom allowing client to build a 'fort' or actual space that he can crawl into. They live in an apartment so a treehouse is not possible, but a separate space the client can crawl into and into which no one is allowed unless he admits them. Mother agrees to do this.

Spoke with client alone. He was very playful and continued to make lego structures as we spoke. He missed one day of school. I offered to show him something and he agreed; he agreed to allow mother and therapist back into room to see the demonstration. Demonstrated the crystal in a bowl with clear water that is then colored with food coloring, eventually becoming muddy. Reached down and pulled out crystal and client clapped.

Explained the connection between the true self/intrinsic peaceful nature/healthy self as being present even when the mind has lots of thoughts. Client was able to talk about what thoughts his mind has, and stated that he gets scared to see his mom go; he is afraid she will not come back.

Advised mother to give client an object of hers; mother has a small pendant necklace and she put it around client's neck and tucked it under his shirt. Client agrees to think of his mom when he sees or feels the necklace.

Reviewed 3 part breathing again. Added in teaching of alternate nostril breathing using index fingers to hold each nostril down. Client was able to do this after some practice.

Mother agrees to use this practice after the belly massage and 3 part breathing at night and in the AM before school.

Some progress is being made with regard to anxiety. Client more easily separated from mother today, when she was asked to leave. I was cautious not to spend too much time with him alone and to bring her back in before we did the demonstration.

Therapist is also of the impression that anxiety is improving. Belly pain has improved. School attendance has improved.

I do really love working with this client; he is full of energy and so sincere in his desire to take care of his mom and his family. I have been working with his thoughts by using concrete structures to represent safe spaces, with the hope that he will be able to keep these spaces in his mind. It may be helpful for him to have a safe space at school as well.

1. plan to teach body scan. Full yoga nidra may be challenging for client to sit still at such a young age.