| Entry Type | Assessment |
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| Client/Group | Cas |
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| Entry Category | Case Study |
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| Select your mentor | Brahmi Romero |
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| Intake | |
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| Assessment | |
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| Proposed number of sessions | 5 |
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| Location of sessions | Zoom online |
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| Planned time per session | 90 |
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| Presenting Problem | COPD, High blood pressure, Cholesterol, drinking issues, smoking (not now), Depression, and anxiety |
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| Physical | 61 years old, female client, divorced two years ago
Has two grown-up sons
Diagnosed with COPD a year ago. About to do a biopsy to make sure the second node swelling is not cancerous.
Quit smoking
Had asthma
Had drinking issues - in her defense it is not serious, ugly, violent or abusive in any way
Consuming a glass of wine in the evening
Has depression and anxiety issues
Taking medications for COPD, high blood pressure, cholesterol, depression, drinking issues
Right shoulder tightness and pinching issues due to holding the mouse in a standing desk for a long time.
Works two days a week
Walks three times a week for 3.1 miles
Takes EMDR therapy
Digestion is good
Could include more vegetables and fruits
Overall good health
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| Client/Group goals | To get tools and inspiration for her own practice. |
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| Energetic | Good, consistent energy throughout the day
Has most energy in the morning
Has least energy during the night time
Has good quality sleep but wakes up momentarily, periodically and then goes back to sleep
Breathing was good. No shortness of breath
Noticed shallow breathing when experiencing anxiety or depression. Coped by taking conscious breathing and doing extended exhalation
Does breathing practices daily in the morning - abdominal breathing, Kapalabhati and alternate nostril breathing
No breathing issues
Noticed no visible deep breathing but from what she described, she is not a reverse breather but breath is shallow.
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| Emotional | Ruminated before and coped by being rational about it. “This is your mind, and the mind is processing things. and by not attaching too much with the thought/rumination and let it process. Like watching a movie.” kind of thought.
Has concerns about future and current health situation but feels good about exploring the health condition at an early stage
Worries about living alone after 34 years of happy marriage life
Feels for ex-husband didn’t express any concern about her drinking issues and one-day came and told that he is leaving her and divorcing her
Feels proud about her sons. Expresses that they her pride and joy
Worries about not taking good care of her health long before
Feels butterflies in the stomach and feels the worry in her chest which is not due to the COPD node swelling
Experienced depression from her childhood which was not treated then. Abusive sister, verbally abusive mother, father was away working in the military. Described her childhood as a “complicated childhood”. After marriage felt good and again started experiencing depression after her son’s birth 27 years ago
Goes for EMDR therapy to process and heal her memory
Expresses that she holds her worries in the chest
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| Spiritual orientation and needs | Was very involved with Episcopal church. Both her sons studied there. After divorce drifted away. Not going very often. Not engaged much now. Not finding the comfort she gets like before she got.
Open to try meditation
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| Intellectual / Sense of self | Very intellectual
Reads daily before going to bed. In a book club
Solves zig-zaw puzzles and works on them daily (Up to 1000 pieces.) Feels the experience as meditative
Does needlepoint, plays bridge games, and does collage arts with paper cuttings etc.
Commits herself to walking three times a week with her walking group. Walks for 3.1 miles on Mondays, Wednesdays and Fridays
Wants to learn ways to calm her busy mind
Works as a director of a concern and interacts with people who grand
Has a routine in the morning. Occupies herself with lots of things
Has a routine in the evening as well and winds down in the evening with a glass of wine. She says that she needs to drink a glass of wine.
Social support system is her friends. One good friend from high school, book group friends, walk group friends and her family.Goes to Theater productions. Reads newspaper everyday.
Liberal on most social issues. Supports LGBTQ. On the left of a lot of issues. She is also conservative as she ages. More conservative about world things. What America is becoming
Feels like she didn’t fit in. Feels like an outsider. She was telling about a memory she recalled during her EMDR therapy session. She was holding a man’s hand, maybe her father or another man. He says, i don’t know what we are going to do with her and says that he was talking about her. She always felt like people didn't know what to do with her. And feels like she is not fitting in. To this day, she has moments like that.
Sense of self is very disturbed and couldn’t get in touch with her true Self
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| Yoga philosophy/wisdom research reference(s) | Abhyasa and Vairagya
Kleshas
Ignorance
Viveka
Stress management
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| Scientific research reference(s), why chosen, how you plan to incorporate 1-3 | Study of the effect of yoga training on diffusion capacity in chronic obstructive pulmonary disease patients: A controlled trial(https://pmc.ncbi.nlm.nih.gov/articles/PMC3410191/)
The effects of yoga on dyspnea, sleep and fatigue in chronic respiratory diseases (https://www.sciencedirect.com/science/article/abs/pii/S1744388121000050?via%3Dihub )
Effect of Yoga Breathing (Pranayama) on Exercise Tolerance in Patients with Chronic Obstructive Pulmonary Disease: A Randomized, Controlled Trial (https://pmc.ncbi.nlm.nih.gov/articles/PMC5610410/ )
Cas: Care Plan Design
Centering:
Body awareness
Chanting “om”
Smiling @ palms
Asana: (Chair support)
Setting intention (Sankalpha)
Netra vyayamam
Warmup full body - Joint Activation Practices for All (JAPA)
Back bend - Standing locust pose
Forward bend - Standing forward fold
Inversion - Downward dog using chair
Twist - Seated spinal twist
Relaxation (lying down on the floor)
Basic IY deep relaxation, with all elements
Breath awareness w/ extended exhalation
Energy flowing through the body and awakening each part
Breathing Practices
Deep, 3-part breathing
Kapalabhati
Nadi suddhi
Brahamari
Meditation
Mantra meditation
Chanting “om - ahhh..ooo…mmm..) or Peace begins with me or
Repeating Affirmation “I detach myself from everything that constricts me and fully enjoy my new freedom. I feel safe and secure in the Divine light, which gives me support.”
Closing
Lokah samastha…
Dedicating practice
Smiling at palms
Wisdom teachings:
What is ignorance
What is practice and vairagya
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| Approval Notice | Your care plan should be approved by your mentor, with any amendments they suggested, prior to your remaining Yoga Therapy sessions. |
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| Care Plan | Outline should be a practice adapted to the needs of that client/group, including:
- Check in, centering, balanced hatha yoga set considering contraindications, relaxation (with imagery as appropriate),
- balanced pranayama considering contraindications, meditation/centering.
- Please include at least one suggestion from Karma, Bhakti, Raja, or Jnana Yoga tailored for this client/group.
- Over time, we want to see something from each branch, selected, adapted and re-framed appropriately. Tools from each module should be used (not on each client/group – but overall)
The outline should show the sequence of practices as you plan to offer them.
Your care plan proposal should be approved by the mentor before session 2 if possible, or 3 if approval is delayed by mentor.
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| Session | |
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| Session Instructions (Not Mentoring) | Your session outline should be a practice adapted to the needs of that client, including:
- 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.
Over time, we want to see something from each branch, selected, adapted and re-framed appropriately.
Tools from each module should be used (not on each client – but overall) |
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| Final Client/Group Report | After seeing your client/group (for at least 4 sessions including interactive intake)
Please remember practicum is a learning experience. You’ll learn more from sharing what’s accurate than from what might “look good”. Things you did well, not so well, problems and questions are all valid and useful tools to teach you. We can’t serve you to become the best clinician you can be if you don’t share your challenges and mistakes. Success is anything from which you learn. You can continue to add Session entries after submitting this Final Client/Group Report. |
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| Report briefly on each Kosha below | Progress toward wellness or worsening reported by the client/group or that you observed in the following areas |
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| Additional Information | |
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| Personal reflection from doing client/group. | |
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| Notify Mentor? | Notify Mentor of Updates/Completion
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