Increasing vagal tone activates the parasympathetic nervous system and having higher vagal tone means the body can relax faster after stress.

I want to check the ct's resting heart rate and HRV before beginning and again in 2 weeks. The goal is to have the ct try the practices that improve vagal tone every day to reduce resting heart rate and increase/improves HRV. Optional practices include: cold exposure, guided meditation, deep breathing, singing, humming, chanting, gargling, laughing

30ish, female; history of anxiety, ADHD, and not wanting to stick with any practices, even when she likes them at first. I'm hoping to show some evidence that they work, and observe any changes in mindset.

I envisioned explaining that there are practices that can tone the vagus nerve and can bring someone into a calmer state. I would explain (and demo if needed) each option. We would discuss the likelihood of these being carried out. Client would do the practice and note on the chart which practice they chose and how they were feeling.

Hatha yoga includes the breathing practice (extended exhale) and movement/exercise. Client practiced extended exhale and exercise.

Bhakti yoga includes chanting. Client practiced singing, humming/toning.

Cold exposure is another vagus-regulating practice that we learned about in the Psychology module and that is on various lists for vagus-toning activities. Client practiced cold-exposure.

Client was eager to attempt the practices. They asked questions to clarify. After the first meeting to discuss and demonstrate the practices, client practiced on her own. I checked in 2 more times throughout the 2-3 week time period, and she was continuing to do the practices.

I recommend this client continue to practice the activities that resonated most with her.

I did apply the intended plan. The results were not favorable based on the heart rate variability, coherence, and average resting heart rate, probably because of the very short time frame, and possibly because the client could have benefitted from several more meetings to practice.
The goal of introducing the practices and practicing them was met. The goal of improving resilience may or may not have been met. The heart rate variability and resting heart rate did not show improvement on that one day, but the client may continue to benefit from the practices now that they have been introduced.

We should have practiced all of the activities together longer. When we met at the end to reassess, she described feeling lightheaded during the heart rate variability test. She explained that she sometimes feels this way when she attempts the breathing practices, including extended exhale. I asked her to breathe for me to observe. I did this with her sitting and asked her to describe what she felt she was doing in her body when attempting to extend her exhale. She described – and I observed – that she was pushing her abdomen out at the end of the exhale. I had her lie on her back, placed a yoga block on her abdomen and placed my hand on top of the block and asked her to exhale completely, relax and then inhale, and repeat. With this teaching moment, we have begun to correct a habit that was inhibiting her breathing and possibly influencing her dislike for these breathing practices.

The client was not open to all of the practices I suggested. So we discussed them and chose only ones she was likely to do. She chose, extended exhale, exercise, cold exposure, singing and humming/toning.
I would take more time to demonstrate the practices and ask the client to practice more with me to make sure there was nothing I could suggest to make it better for them.
I would do this whole program again, including the chart, but possibly have some meetings along the way or even do this in a group setting weekly for a few weeks with this specific focus on resilience.