• 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.

The overall care plan did not change, although adjustments of asana, pranayama and meditation were done in some sessions to meet the client’s physical or mental condition. For example, practicing gentler asana when clients came to the class with bruised torso or practicing Metta meditation to support the client whose dog was sick.

Group goals are to Manage pain and increase mobility and flexibility.
Individual client goals:
Client #1. Relieve back pain and tightness at the hip.
Client #2. Manage muscle tightness at the lower back and improve flexibility.
Client #3. Manage pain and aches & maintain blood pressure.
Client #4. Improve mobility and maintain independent.

The group goals have been achieved. For individual goal, client #3 is still dealing with sinus headache, although her pain and muscle tightness (around the neck and shoulder) have decreased.

The physical level improves. The pain has reduced, and mobility, flexibility and balance have improved.

Energy level of all clients, except client #2 improved over time. Client #2 was dealing with her dog’s health and did not sleep very well; therefore, her energy level was low. Nevertheless, she regained her energy (session #6) after her dog was doing better.

All (including client #2) is doing better, i.e., less stressed about their physical pain and limitation after six sessions. While client #4 is still coping with the loss of her daughter, she is not suffering from it.

All clients approach their chronic pain and illness with calmness and advocate for their well-being, as needed. For example, client #2 seek a different physical therapist when she felt that working with the first one was not helpful. Through yogic wisdom, especially klesha, ahimsa and brahmacharya, the clients did not cling to the past and were more mindful of their physical and energy levels.

Client #4 is a Buddhist and has applied Buddhist teaching to her daily life. Other clients are not religious but feel connected to nature.

Gentle movement, breathing and meditation are helpful for pain management. The sessions motivate the clients to find time for practicing yoga as she always feels better after the session. The clients appreciate the discussion about yogic teaching at the beginning of the class; one client said that ‘this is good stuff’.

1. Breath – Three-part breathing daily
2. Meditation – 5min daily _ follow inhalation and exhalation
3. Gentle yoga – 10 min once a week
4. Practice non-attachment – choose something that is not too easy or challenging.

I prepared a PDF document that include series of asana for home practice during the 6 weeks session. I think that it would be beneficial to create a 45 minutes video for clients to continue their practice after finishing the series.

Although this is not a ‘Stress Management’ session, I emphasized how yoga, including asana, pranayama meditation and yogic teaching can help reduce stress which is the root cause of chronic illness. Is this the right approach for a group class like this? I realize that the clients’ goal are related to physical pain and ability. However, I feel that reducing stress will help the clients better manage their pain, while gaining their physical strength and flexibility.

Yes, especially when the clients share their experiences and offer support to each other.