Breath Assessment and teaching of 3 part breathing

Goal is to assessment client's breathing patterns and teach three part breathing. This will be done in 2, 30min sessions, one in which breath assessment is done and three part breathing is taught. Second session is to follow up with client to see how the intervention worked, any difficulties, and whether they were able to complete the exercise.

67 year old female with history of major depressive disorder and anxiety. Has obesity and diabetes mellitus type II. Client recently lost her grandson, for whom she cared for eighteen years; parents have taken custody. Has had increased feelings of anxiety which affects her ability to focus and sleep.

Plan is to do breath assessment for 10-15mins then to teach three part breathing, during first session. During second session, plan to review patient's experience with the exercise.

The branch being used is hatha yoga. The teaching focuses on pranayama--control of the breathing and thus the life energy. Doing breath assessment and teaching three part breathing is designed to support overall client wellbeing and help reduce feelings of stress. Research has shown that diaphragmatic breathing (which is a part of the three part breath) is effective in reducing stress. Citation: Hopper SI, Murray SL, Ferrara LR, Singleton JK. Effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults: a quantitative systematic review. JBI Database System Rev Implement Rep. 2019 Sep;17(9):1855-1876. doi: 10.11124/JBISRIR-2017-003848. PMID: 31436595.

Client was, during much of the session, quite sad about her situation; posture was stooped while sitting. Breathing was shallow with a predominance of movement in the upper thoracic region. Client was able to put her hands over her chest and abdomen and appreciate the different movements of both areas. Was able to learn three part breathing with some difficulty but was able to do this practice by the end of the session and stated she felt comfortable doing this at home, after first session.

Client was able to do exercise on most days but sometimes forgot. She found it easier to do it at night, since she did not feel well when waking up in the AM.

Client was offered the option to lie down, and put a stuffed animal or other small object on her abdomen, so that she could watch the object on her abdomen move up and down during three part breathing (knees bent). She did this at home and found it helpful.

Yes. I applied the intended plan and goal of teaching three part breathing and doing breath assessment were achieved.

Yes, I had to offer the use of a stuffed animal to help client understand and feel her abdomen move while breathing.

Yes. I would offer the use of a stuffed animal. When having a session online, it is difficult to have a client lie down, however, and still have a good view of the client. So perhaps, making sure their camera is set up for that beforehand, would be helpful.