Developing and piloting a trauma-informed yoga intervention for anxiety and depression in consumers with a chronic psychosis or mood-based disorder

Background: There is growing interest in yoga as an adjunct in the treatment of anxiety and depression for people with a chronic psychosis or mood-based diagnosis. Aim: To design and evaluate the acceptability and feasibility of a yoga intervention as an adjunct treatment for consumers with a chronic mental health condition, and self-reported anxiety and/or depression. Methods: A multiphase mixed method research design was utilised over four phases. Findings of Phases 1, 2 and 3 were used to guide the development of Phase 4. Phase 1. Literature review and model development: The literature on potential biological, physiological and psychological mechanisms of change facilitated by yoga for anxiety and depression was reviewed, and a yoga mental health model developed. Phase 2. Yoga practice in the community: A survey of South Australian yoga teachers (n=24) and students (n=181) was undertaken, with questions regarding demographics, yoga practice, mindfulness, self-compassion, depression and anxiety; and implications for designing a yoga intervention for mental health consumers. Phase 3. Stakeholder consultation: Focus groups were held with mental health consumers (n=8) and clinicians (n=13), and interviews with yoga teachers (n=5), from October 2016-April 2017. Participants were asked about the feasibility and appropriateness of a range of yoga practice features to be tested as a yoga intervention for consumers of a mental health service. Phase 4: Develop and pilot a yoga intervention: A mixed method Randomised Control Trial, which involved a 10-week yoga-based intervention (n=10) and a waitlist control group (n=8), was undertaken with consumers of a mental health service, from May-October 2018. Pre- and post-mindfulness and mental health measures were collected, and a focus group was facilitated. There was a high dropout rate from the program (10 of 18). Results: In Phase 1, the yoga mental health model suggested that the influence of yoga on the physiological and psychological systems may lead to a reduction in anxiety and depression. Phase 2 results showed a positive correlation with mindfulness and self-compassion, and negative correlation with depression, anxiety, and stress scores with months of practice. Phase 3 consultation identified the following themes: that mental health understanding and experience of teachers is important; and creating a safe space, environmental design and yoga practice elements. In the Phase 4 pilot randomised controlled trial, there were no differences in outcome measures pre-compared to -post or to three months for the intervention or control group. The focus group identified the following themes: mental health benefits, lifestyle changes, yoga practice recommendations and future directions. Discussion: The development of the yoga mental health model to explain the proposed mental health outcomes of yoga, is a valuable tool for future research and health care services. Survey findings were consistent with other research, showing a positive correlation of yoga experience, practice frequency, and meditation with mindfulness and lower depression and anxiety scores. Consultation results including the importance of yoga teachers’ mental health understanding and experience, and specific yoga practice components and environmental features, are largely consistent with trauma-informed yoga research, and can inform the health care service and future research. The pilot study demonstrated a strong acceptability of yoga-based interventions in this small sample, which is consistent with the growing research evidence. Conclusion: Findings of this research project indicate a high level of acceptability for yoga- based interventions in this small sample of consumers, but future research is needed on its effectiveness.

Author dc:creator

• Snaith, Nicole Anne

Advisors dc:contributor.advisor

• Rasmussen, Philippa
• Schultz, Tim
• Proeve, Michael

• Yoga, mindfulness, mental health nursing, anxiety, depression, pilot study

Language dc:language.iso

en

Handle dc:identifier.uri

https://hdl.handle.net/2440/136977

OAI identifier oai:identifier

oai:digital.library.adelaide.edu.au:2440/136977