• 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.

I mentioned the following 3 home practices and sent supported materials.

1. I sent him a sample gratitude journal template and encouraged him to begin his gratitude journal.

2. Japa meditation, I provided him with a positive affirmation as an example and suggested he practice it daily.

3. I gave him step-by-step instructions for mindful walking because he enjoys walking.

I began today’s session by asking Dan how he was feeling and if he had noticed any changes or challenges, both physically and mentally, four days after his dilation procedure last Friday. I then guided him through breath awareness using the script from SMTT. Dan mentioned that he had never paid attention to his breathing before and found this practice so relaxing and very powerful. Following the breath awareness, I led Dan through a body scan, which left him feeling deeply relaxed and more aware of his body. After the body scan, Dan was able to successfully perform most of the JAPA movements while seated on the chair. We continued with a 15-minute session of Yoga Nidra, which further deepened his relaxation. The session concluded with a final breathing practice, leaving Dan feeling calm. Overall, Dan appeared more relaxed and engaged with the practices.
For the wisdom teaching, I explained the importance of shifting his focus from negative thoughts to positive ones whenever he feels something negative. I also suggested starting a gratitude journal to help cultivate a habit of recognizing and appreciating the positive aspects of his life.

Since this was the first session after the in-person intake and assessment, I did not observe any noticeable progress. However, I did sense his willingness and engagement throughout our session.

We originally scheduled our session for last Friday, but Dan forgot his esophageal dilation procedure. He explained how painful the procedure was, mentioned that he started eating normal meals this morning. He seemed more relaxed than in the previous session, likely because he was initially unsure about what to expect from yoga therapy, despite my explanations during intake. Additionally, he physically feels better after the procedure.

I did not have enough time to go through all the items in the care plan, so those will be included in the next session. Overall, I think the session went well. I realized the importance of planning how to allocate time for each condition. While I may not be able to focus on all items in one session, I will prioritize addressing the most severe conditions to reduce his stress.

I plan to follow the care plan in the next session and cover some items I forgot to mention. I will make sure to remind him to lift his legs during Yoga Nidra, which I forgot to mention last time. Also, I will explain the Nadhi Sudhi with affirmation again to make sure he understands both how to and benefits of affirmation. If he feels comfortable, I may add more physical movements, including balancing exercises using a chair to see if he is comfortable standing on one leg.