• 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.

Below are the home practice assignments, the progress will be assessed, and new practice may be added accordingly.

• gentle shoulder rolls and movements
• neck movement practice using visualization
• daily inspirational reading and reflection
• alternate nostril breathing / brahmari breathing
• supine butterfly, supine spinal twist, knee to chest pose, child pose
• median nerve slider, median nerve rocking

9-16
It’s been a month since we met last session as she traveled to see her family. I asked Arnette if there were any physical or mental changes.
She shared that she had a good time visiting his family and friends in NC, she reported the pain on her neck and shoulder has improved.

I began with a few minutes of guided meditation. Then we moved to asana practice started with a gentle shoulder stretch and 4 seated poses, supine butterfly, supported spinal twit, knees to chest, and supported child pose, they were held for 2-3 minutes each.

To end the session, I invited her to 15 minutes of yoga nidra followed by alternate nostril breathing.

10/7

I began today’s session by asking Arnette if there had been any changes since we met two weeks ago. She reported that she was able to manage her pain and continue to pay attention to her posture. Also, she practiced gentle neck/shoulder stretching to release tension and strengthen muscles in the shoulder and back of the neck, and she had some seated posture to improve her digestive system.
I began with a few minutes of guided meditation. Then, we moved to asana practice, which started with a gentle shoulder stretch and four seated poses: supine butterfly, supported spinal twit, knees to chest, and supported child pose. They were held 2-3 minutes each. For her pain caused by a pinched nerve, I demonstrated a median nerve slider and median nerve rocking.

Daily prayer readings and reflective journaling are helping Arnette’s spiritual journey. These practices provide her with clarity, self-awareness, and emotional balance. One of the factors for this progress is adding reflection writing into her daily reading routine.

An interesting comment from Arnette was that she started the exercises her physical therapist (PT) suggested, which she initially reported did not work. She tried several practices, corrected her posture, and stopped reading in bed. I believe those practices, along with our sessions, motivated her to resume her PT’s exercises, which is a good move for her overall well-being going forward.

The plan worked well for Arnette, the key was that she listened to me and practiced regularly to reduce her pain and she was able to manage her symptoms.

2 weeks ago, her husband suffered from a heart attack and I do not know if she can find time to meet soon but I am sure she now knows how to manage
her physical pain, and mental and emotional suffering.

I will follow this care plan and remind her to assess her posture frequently.