TCA StageReport
StudentTanja Kees
Entry ID3970
Date CreatedMay 24, 2021
Date UpdatedJune 3, 2022
AdvisorSarala Evans
Core Module NameFoundations of Integral Yoga Therapy

Plan Information

Selected key teaching (specific core concept):

the brilliant function of pain;
pain alerts us to a potential problem , an imbalance and hoe serious the problem is, is might alert us to ask for help.

Goal for implementation with client (Specific, measurable, attainable, relevant, time-bound relating to the client):

the therapist will meet with the client for 30 minutes, assess the area of pain, the level of pain and severity , the quality of the pain, the duration of the pain. the therapist will ask the client if there is anything that makes the pain better or worse and what the client has done already in order to get help or alleviate the pain.

Relevant Client(s) Details

the client is a 63 yo female with a history of fibromyalgia, depression, and anxiety.She is now complaining of low back pain and pain in her sacroiliac joint on both sides.the pain got worse after she was walking for almost 2 hours in a horse riding ring , next to a horse to help with therapeutic riding lessons.her general health is good, she is of average weight.she is asking the therapist in training for help with her pain. definitions : I will call my self therapist instead of therapist in training for future reference but the client is aware that I am a therapist in training.the client will be called client.

Session Outline
Practice/Activity (5 words or less) Amount of time (in minutes)
brief centering and scanning of the body 2 minutes
warm up 3 minutes
asana 15 minutes
deep relaxation 5 minutes
pranayama 5 minutes

Report Information

How did you envision working with the client(s) to incorporate the selected teaching? (Define the plan)

the therapist has done an assessment of the client and envisions to work with the client on specific asanas to strengthen the clients body core ,lower back ,buttocks, ileopsoas muscle and hamstrings.
the specific asanas would be: start out with rock the baby to open up her hips, then laying on the back in corps pose( savasana) to relax and check in with the body to focus on breathing, followed by pelvic tilt to work on her core, then lying hip opener to further loosen the tightness around her hip, bridge pose (setu bandha sarvangasana ) to strengthen the lower back and spine), knee to chest (apanasana) to relive lower back strain and to massage inner organs, legs lifts to develop strength in the hip flexors, lumbar region and abdomen with this pose we can also incorporate breathing when raising the leg inhale and exhale when lowering the leg. lying down hands big toe pose to stretch the hamstrings , if this is too challenging we can use a strap to stretch the hamstrings or have the hand behind the knee, then again knee to chest pose, to massage the lower back again followed by lying twist to bring blood flow to the spine and to improve mobility.

What branch(es) of IY did you use? How does each support your goal/relate to the key teaching?

I will use the hatha branch of integral yoga with very gentle movements and stretches to increase the clients body awareness, also with focus on the breath and to notice if she is holding her breath, since this can be a sign of holding tension in the body. and to make the client aware if she is holding the breath.This will help the client to learn to notice her body own signals and to make sure that she does not go over her own edge as this would cause pain ,either in the posture or afterwards.
The resources that were used to plan for the class and then to adapt the class were:
1.Integral yoga basic teachers manual Satchidananda Ashram Yogaville Version 2018
2.Yoga anatomy by Leslie Kaminoff and Amy Matthews
3.All I need is this chair yoga by Wilma Carter
4.Easy does it Yoga by Alice Christensen
5.Integral yoga stress management teacher training, adapting yoga to any setting manual Satchidananda Ashram-Yogaville Version 2014

Short notes on time with client:

When I met with the client ,I checked in with her about her pain in her ileosacral joint and she states that her pain had improved and she does not have paint in this area now.She states that she went to. massage therapist and she had shown her a stretch.The client went on to demonstrate the stretch and then she states that she problem is that doing this causes pain and she thinks that she has to work thought the pain.The client was really surprised when the therapist in training told her about concept of the brilliant function of pain and how pain alerts us to a potential problem . How important it to listen to our body and not to take it over the edge, because this would make our pain much worse.The client then proceeds to let the therapist know that she even now has problems to sit in the floor today and sitting in a cross legged position causes her pain.At this point the therapist decided not to implement the treatment plan as spelled out above and decided to switch to a chair. Less chair poses were used ,as well as very slow and deliberate movements with focus on the breath and imagery.

Follow up suggestions for your client (whether with you or on their own):

We talked about how hatha yoga on the mat and being in the moment can improve our body awareness and how we can learn to listen to our body and to avoid pain.In the sort term this will lead to relieve of her current pain in the sacro iliac joint and lower back.
in the longterm this will translate into every area of her daily living and the choices she makes every day.This can be especially helpful to her due to her diagnosis of fibromyalgia .She can learn to better manage this chronic pain syndrome, so she can eventually learn to catch herself before she overexerts her body to the point that she is not able to move the next day.

Reflection
Did you apply your intended plan once you met with the client(s)? Was the goal achieved? Explain.

No I did not apply the intended plan once I meet with the client. The Client had initially told me that she was not in pain today and that sitting on the floor getting up and down was not a problem.Then after she had realized when she was demonstrating the stretch she had learned from her massage therapist ,that she actually is in pain and she started to talk and reflect on it.From there became clear it was not advisable or safe to proceed with the session as planed. The client was able to go and get a chair from the next room and we started the session in the chair.
I do think the goal was achieved in that the client did have an opportunity to learn to listen to her own body and that when she was listening she did feel better.

Did you have to adapt anything in your plan? What lessons did you learn?

yes ,I decided to start the lesson out in the chair since it was painful for the client to sit on the floor in a cross legged poison, she tried to sit on a folded blanked but this also was not comfortable, so she went and got a chair.I decided to limit the postures to a seated cobra pose in the chair to increase her energy and release anxiety, a forward bend by holding the elbows with the opposite hand, and slowly coming forward with a straight back and bringing the elbows to the knees, focusing on the breath and imagining somebody she trusts giving her a back massage . then slowly coming back upland focusing on the breath.This was followed by a supported forward bend with twist ,again very slowly and deliberate, making sure the feet are firmly planted and a block was used so she did not have to come all the way forward and down,with focusing in on the language she is using to talk to herself .Making sure she is using a loving and nurturing language for herself.
I learned that it is very important that even if the client tells me that she is not in pain, she might no be aware and not tell me that she really is in pain ,because she is not aware of it herself because she might not be in tune with her body to notice this for herself. This shows how important it is to watch the persons body language because this can give important clues and feedbacks the therapist can make the client aware and also to prevent injuries during the session.
The client appreciated that she therapist noticed that she actually was in pain, she enjoyed the session the chair.She stated that she is feeling much better after the session and was looking forward to further sessions.She is now realizing how different a yoga therapy session is compared to a regular yoga class.

If you are faced with the same situation again in the future, would you approach it in the same way? Why or why not? What went well? What you might change and why? Summarize.

Yes I would approach it in the same way,I am glad I adapted the session, and was making sure to so slow, deliberate and safe movements with focus on the breath to release tension.When the client told me that she was feeling better and that she session was really helpful to her, I felt that it was right to make the adaptation.She appreciated the teaching and that the therapist was able to adapt the poses.
In the future I will be even more mindful in the case of a client in pain, to plan less poses and to make them even gentler .I make sure I don't push the client to hard as the tendency of the client might be to please the therapist therefore they will not let me know when they are in pain.I learned why it is so important to watch the clients body language so I have the subjective information from the client and objective evidence as well.I learned to slow the pace down, the importance of compassionate language for the client and the therapist.

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