Client has pain in her right shoulder and she has limited range of motion. The movements that cause pain are extension of the shoulder, extension and abduction of shoulder, and lateral rotation of the shoulder - she cannot bring the arm behind her (reaching behind) when the arm is flexed, and she has pain when she moves it back like when she has to remove a strap off her shoulder.

Client is seeing a Physical Therapist for her shoulder. He has given her daily exercises which she is doing every other day.

Otherwise, client is able to move normally. Client walks 3.1 miles three times a week with a group of women.

Client says she has borderline chronic obstructive pulmonary disease (COPD) although this has not been diagnosed. Client has smoked cigarettes for years but has not smoked tabaco since March.

Client has always smoked marijuana. And she would like to overcome the addiction to marijuana. She smokes twice a day after work and before bed. It helps her sleep.

Client has some arthritis in the fingers.

Client has high blood pressure and is taking medications for this.

Client does not think she can do poses like downward dog because of her shoulder issue.

Guided client through the "Observe the breath (technique from SMTT manual) pg 122" to assess client for breathing.

Client breaths normally. She does Dirgha Swasan on her own sporadically. Client manages her stress with doing Dirgha Swasan - “It relaxes her body and keeps her from breathing in the chest.”

Client has good energy level. In the mid afternoon she gets a little sleepy.

Client seemed well throughout the session, she smiled a lot and was cheerful.

Client has high stress related to a recent divorce. She is still getting through and over that. She is learning to be on her own after being with someone for 40 years.

Otherwise, her level of stress is moderate.

Client has experienced depression since 1998 and uses prescription drugs and says her depression is stable.

Client goes to church and she feels like she knows why she is alive - “to everything there is a purpose and a reason and a season” - that’s why she knows she is alive - this seems to be enough for her.

She started meditation in a Yoga group in her church six years ago and she did it for balance because she tends to be a lot in her head. Then she started to use the Calm App everyday but now only once every couple of weeks - she has lost interest in it.

She wants to learn to meditate.

Client seems to have a good sense of self. She is happy with her work. She likes the women’s group that she walks with. Generally, she smiled a lot throughout the intake session and was cheerful.

Client likes to read before going to bed and she is in a literary club.

Please quote or extract of the basic content, and say why you’re using. 2000 max characters.

Client will be taught Stress Response education, and how conditioned internal stressors create much of the stress we experience, especially long-term stress. Client will be guided to identify her major inner stress. This will help her understand that stress that is internal is something she is able to have the control over and to change.

She is receiving physical therapy for her shoulder pain. I will give her something that helps her to bring her mind to her shoulder so that she connects with it. The practice is as follows: place opposite hand supporting the elbow of the affected shoulder and lift up to a comfortable position, inhale and pull the shoulder blade back and down to increase the space between shoulder and the ear, then as you exhale gently pull the elbow across the body to get a stretch in the outside and in the back of the shoulder, hold and inhale deeply into the belly and exhaling and inhale deeply again into the belly exhaling out. Therapeutic Yoga to Fix Shoulder Impingement (minute 3:40 – 4:46).

Kinser PA, Elswick RK, Kornstein S. Potential long-term effects of a mind-body intervention for women with major depressive disorder: sustained mental health improvements with a pilot yoga intervention. Arch Psychiatr Nurs. 2014 Dec;28(6):377-83. doi: 10.1016/j.apnu.2014.08.014. Epub 2014 Sep 3. PMID: 25457687; PMCID: PMC4254446.

• 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.