• 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.

Om practice
1. Try to find a time and schedule your home practice by first establishing a quiet, comfortable supported position where you feel grounded and safe. Use a body scan to relax;
2. Then, practice pranayama and meditation (she meditates) 2-4x/week for approximately 10 minutes;
3. Consider this goal a starting point, and if you wish, continue to implement the goal by extending the time, frequency and variety of each.

Centering
Grounding and settling in comfortably on the chair
Deep belly breathing, pausing at the top and bottom of the breath
Affirmation
Chanting

Check-in
Client spoke most of the session. She is barely able to get out of the house. She was taken off her medication (chose not to share which one) as it was blurring her vision. She was prescribed an antidepressant for nerve pain. Stated that her mental health was very good. She's been going to the pool once/week for 50 mins. Picks up a friend on the way. She's in her 4th week of PT; and started a system last week of tracking her daily progress. She also reported that her normal pattern is to 'go-strong' for 2.5 months then stop. We talked about her awareness of this behavior. I said, "I hear you’ve noticed this pattern — what ideas do you have about how you might start to change that?” I affirmed the client's awareness and autonomy in an attempt to elicit her own reasons and ideas for change.
PAM said the tracking of her daily progress was one way she hoped to continue with her swimming, and implementing her PT exercises at home most days. She was critical of herself. I praised her for sticking to her health plan goals thus far. I asked, "What has worked for you in the past when you wanted to stop a behavior or start something new?” She said her husband would encourage her but that didn't usually work. After a pause, she said, Let's move on, and we did.

Seated asanas
Head and neck warm-ups; shoulders; gentle C/C.
Supported child's pose using chair, pillow on table top for head

Standing
Tadasana with heels toward the wall and a chair in front of her. Brief Tree with chair.
Discovered that she couldn't stand for very long so we moved back to the couch.

Supine on couch (her choice)
wind relieving one leg at a time; 12 o'clock, 3, 6, 9, pelvis lifts; Windshield wipers, legs with bent knees, feet on couch to point and flex feet. No leg lifts or bridges possible

Restorative
Mt. Brook pose with rolled blanket, pillow, bolster, blanket, and pillow on the belly. She developed a pain in her lower back during this pose. Immediately moved her out of it when she announced this. She said she was, "Very sore today...took yesterday off, maybe I shouldn't have done that."

Focus on replacing negative thoughts with positive ones. Use affirming words, symbols or images about oneself to become the quality you're promoting. Confidence and courage, perhaps.

We moved to a Yoga Nidra to conquer stress and achieve deep relaxation. Pala mudra for calming and trust. I used progressive muscle relaxation with gentle movements then guided the client to focus on breathing. Cool breath in, feel the warmer breath on the exhalation. Prompted to sense the breath in other parts of the body as well. I used a golden light guided imagery then spoke of intuitive awareness. This YN based on Julie Lusk's book w/ scripts. The client fell asleep.

Client was upbeat and happy, talked about her fear of not continuing with her physical practices - swimming, PT, yoga when we weren't meeting. She appeared to be in more pain than in the past. She seemed to prefer to talk, practice a few asanas then move to relaxation.

Her ROM seemed more limited today, and chose to not practice any hip movements on the chair.

I wish she would move to a bigger space when lying down. The couch seems restrictive, and her space isn't quiet. I know I need to let go of this. If she feels good there, then that's where she may need to be.

It seemed very important to her to talk about her physical ailments, and her lack of self confidence and typical behavior re stopping after 2.5months of energetic movement. We spent more time than usual on 'checking-in'. I set aside the original plan, shortening it significantly, placing her physical and mental health first, as a therapist should.

Next session, I'd like to put more time toward centering, asanas, and pranayama, and offer a shorter yoga Nidra. It will of course depend on the client.