• 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.

Adjustments and adaptations to the care plan included integrating a nature-based and mindfulness-oriented spiritual component to align with the client’s interests and enhance engagement, particularly drawing on her love of gardening to encourage reflection on growth, cycles, and inner awareness. Session lengths were extended from the original 30 minutes to 40–60 minutes to allow sufficient time for centering, breathwork, gentle asanas, balance practices, and guided meditation without rushing. Individual movements and postures were carefully modified to accommodate MMP’s limited range of motion, ensuring safety while still providing therapeutic benefit. Props, slower pacing, and additional verbal cues were incorporated to support alignment, stability, and proprioceptive awareness. These adaptations allowed the client to participate fully, experience relaxation and mental calm, and maintain a sense of accomplishment and self-efficacy throughout each session.

The client reported feeling noticeably better and more relaxed after sessions, particularly enjoying the balance-focused asanas. She appreciated that the practice was gentle, manageable, and did not require a large time commitment, which made it easier to integrate into her daily routine when we held sessions. The combination of movement, breath awareness, and mindful attention appeared to support both physical ease and mental calm, contributing to a sense of overall well-being.

During the review of goals, it was suggested that future sessions incorporate more elements of yoga philosophy, including mindful reflection and attention to the mind–body connection. Additionally, integrating spirituality in a way that resonates with the client—such as connecting to nature and observing cycles of growth—to deepen her engagement and support holistic wellness, encouraging sustained practice and inner awareness.

MMP showed small improvements in flexibility, core strength, and endurance, and reported feeling physically lighter and more comfortable during balance and movement exercises. Increased awareness in the areas of movement quality and posture were observed. Transitions were smoother between poses and she reported a slight increase in her ability to maintaining stability.

Breathwork practices, including Dirgha Swasam and Bhramari, were introduced. They appeared to support a greater awareness of energy flow and helped her maintain steadiness during movement. She reported feeling more grounded and less physically tense following sessions.

The client expressed that she may be feeling a bit calmer, noting that mindful engagement with her body and breath contributed to emotional regulation. She reported that she was trying to remember to breathe when feeling angry. Also, she felt some satisfaction from completing practices that seemed achievable and supportive.

MMP stated when asked that yes, the practices made her more self-aware. She also recognized areas of limitation and responded to appropriate modifications. She reflected on her capacity to practice consistently, which reinforced confidence and self-efficacy. She didn't feel that she'd continue when we finished our sessions. Using motivational interviewing, I explored the client’s reluctance to practice and uncovered that she feels she doesn’t take care of herself and doubts her ability to make lasting changes.

By integrating nature-based mindfulness and reflective attention to cycles of growth, she stated that she would attempt to connect to a broader sense of purpose and inner resilience, even without a formal spiritual framework. She reported that these practices enhanced her sense of presence and she'd try to remember them when gardening.

The client shared that she truly enjoyed the sessions and found them meaningful, appreciating the structure, gentle movement, and opportunity to focus on her body and breath. She acknowledged the value of the practice and could see how it supported her physical ease and mental calm. However, she also expressed that, despite recognizing these benefits, she was not personally interested in continuing the sessions on her own. She seemed thoughtful and honest in her reflection, conveying that while the practice was worthwhile, it did not align with her current priorities or interests.

• Sit-to-stand practice (5–8 reps, 1–2 times/day)

• Mental focus training:
o Introduced as attention practice rather than meditation
o Focus on one sensation (feet, breath, posture) for short intervals
Home Practice
• Balance practice at kitchen counter or chair (1–2 minutes/day) – Standing Mountain with chair support, Side-to-side weight transfer, supported leg abduction and extension, Gentle standing back-body strengthening

What I would do differently is devote more time to exploring the last two koshas—the Vijnanamaya (wisdom) and Anandamaya (bliss) layers—by finding ways to introduce them at a level that feels accessible and meaningful to the client. In this case, the client identified as non-spiritual, so using traditional spiritual language might not have resonated. I would focus on translating these subtle aspects into practical, everyday experiences that align with her interests, such as reflection, intuition, mindfulness, and connection to nature. For example, guided reflections on personal growth, noticing patterns of thought and emotion, or observing cycles of life in the garden could serve as approachable ways to engage the wisdom and bliss dimensions. By introducing these layers in relatable, concrete ways, I could deepen the client’s self-awareness, sense of presence, and overall experience of the practice, while maintaining her comfort and autonomy. This approach would allow the full richness of the yoga therapy model to be explored, even with clients who do not identify with spiritual frameworks, fostering holistic growth across all layers of the koshas.

not needed at this time

I genuinely enjoyed providing yoga therapy for this client and found the sessions rewarding. While I wish she would continue practicing, I recognize that this ultimately lies outside of my control. To support her ongoing growth, I plan to send occasional self-study options and resources, with the hope that she may choose to implement them at her own pace.