CNH14 Deliver Yoga Therapy to clients

Overview

This standard is about delivering yoga therapy to meet an individual’s needs.  Yoga is a living practical philosophy. Those who practice yoga regularly and appropriately gain an awareness of themselves and their relationships with others which enables health and well being to be maintained and improved. Yoga taught to those with impaired health or compromised well being, and to those who are vulnerable is the focus of the National Occupational Standards for Yoga Therapy. The skills and aptitudes required for teaching yoga as a therapy go beyond teaching yoga for fitness or relaxation; although fitness and relaxation are important in a quest for improved health. They also go beyond offering modifications to support individuals in a general yoga class. A Yoga Therapist needs to have the ability to address a client’s specific problems in individual sessions or in small therapy groups. Based on an individual assessment with that client the Yoga Therapist must be able to plan and agree a programme of yoga therapy sessions for that client. Success is also dependant on the willingness of the client to participate in learning and practising. A Yoga Therapist trained in all areas should be able to provide a safe and appropriate practice for anyone from the normally fit and healthy to the terminally ill and dying. Some Yoga Therapists are trained only in specific areas for example aspects of pregnancy, back pain; and these therapists should not work outside their scope of practice. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:

1. the breadth and depth of yoga through key Yoga Texts:
1. Yoga Sutras of Patanjali
2. Hatha Yoga Pradipika
3. Bhagavad Gita
4. Upanishads
2. the Yama and Niyama (lifestyle values) as they apply to assessment and discussion, counselling, reflection
3. the importance of, and need to develop, a sensitive and intuitive approach to clients and their needs
4. the importance of building a relationship of trust and support
5. key models which relate to therapeutic analysis and practice including:
1. panca kosha or panca maya – the holistic model showing 5 dimensions (anna – physical, prana – energetic, mano  - mind, knowledge, vijnana – wisdom, behaviour, ananda  - bliss, emotional)
2. models of energy flow and energy systems – e.g. vayu (prana), nadi, cakra
3. models of mental and emotional behaviour – e.g. klesa – causes of suffering, abhyasa/vairagya  - practice/detachment,  antaraya - obstacles to a clear mind
6. the importance of treating every client as an individual
7. the importance of obtaining permission before touching the client for observation purposes
8. how to analyse an individual using the appropriate yoga models and a case history (which includes medical conditions and other factors conveyed by the client together with the acute/chronic nature of each issue and the client’s priority for improvement)
9. the limits of your competence, training and expertise, and when to refer the client on to other practitioners
10. how to identify priorities for a Yoga Therapy programme covering:
1. preferences and needs of the client
2. current abilities or limitations
3. potential for improvement
4. time constraints for practice
5. choice of 1-1 sessions or small therapy group classes
11. how to select and plan appropriate yoga practices and techniques based on the analysis:
1. in a 1-1 therapy setting: where a tailored initial home practice and further home practices are developed to suit the client’s individual needs
2. in a therapeutic group setting: where group practices are personalised with appropriate modifications and variations for the needs of each client in the group
12. the yoga techniques used in therapeutic practice together with their effects:
1. asana - postures
2. pranayama – breathing techniques
3. dharana/dhyana - concentration/meditation/reflection
4. relaxation
5. bhavana – visualisation
6. mantra – simple sounds and short supportive phrases in Sanskrit or own language
7. mudra – for example hand gestures
8. kriya – for example kapalabhati - cleansing breath
13. how to adapt and modify the techniques for an individual’s specific health needs
14. how to plan a practice using these techniques to begin to meet the needs of the individual
15. how to develop over several sessions the practices and techniques prescribed in ways appropriate to the specific individual
16. contra indications to the use of the above techniques based on the health of that individual
17. the reasons for caution in proposing or excluding yoga practices for clients with major medical conditions or when such conditions are suspected
18. the reasons for some caution in apparently minor complaints (e.g. dizziness; lack of balance) as these can mask an underlying disease
19. the situations when special care with contra indications must be taken, such as:
1. medical emergencies where Yoga Therapy should not be practised and where the client should be immediately referred to a medical practitioner (e.g. heart pain)
2. acute situations where Yoga Therapy should be temporarily stopped e.g. violent sickness/diarrhoea; pain (e.g. migraine)
3. extreme care situations where Yoga Therapy can only be practised in a greatly modified way (e.g. palliative care)
20. the need to explain what is expected from the client in terms of their commitment and the likely number of sessions or classes needed
21. the use of support materials to help the client practice at home – materials could include written instructions, audio recording etc
22. how to encourage and motivate the client to practise regularly; including appropriate aftercare
23. how to evaluate progress and identify whether any adjustments to the programme are required
24. how to recognise when a medical diagnosis is needed to support your assessment of the client’s needs
25. the importance of offering Yoga Therapy only in the way you have been trained and have experience to offer
26. the circumstances in which Yoga Therapy can be given as a first line of action without the need for other interventions e.g. where anxious breathing is retained after minor trauma
27. the circumstances in which Yoga Therapy can be given alongside other treatments e.g. during cancer treatment.
28. the circumstances in which Yoga Therapy cannot be a first line of action e.g. a broken limb which needs to be set
29. the anatomy, physiology and pathology relevant to the medical conditions identified in a client to ensure appropriate Yoga practice is proposed
30. the structure and function of the main systems of the body including: cardiovascular; respiratory; blood, lymph and immune; nervous; endocrine; reproductive; musculoskeletal; digestive; urinary and live; the skin.
31. the pathology of commonly occurring ailments within and between each system including:
1. the factors involved in causing disease
2. methods of diagnosis that are used
3. exacerbating and relieving factors
4. daily variation
5. medical treatments and management

Performance Criteria

You must be able to do the following:

1. consult with the client and plan the yoga therapy in a tailored way to meet the client’s needs
2. check that the environment meets the client’s needs
3. ensure that any equipment and materials are suitable for use
4. prepare your self appropriately to provide yoga therapy
5. implement the yoga therapy safely, correctly and in accordance with professional codes of practice, legal and organisational requirements
6. make appropriate adjustments to the yoga therapy to meet any changing needs
7. deal effectively with the client’s response to the yoga therapy
8. check the client’s well-being throughout and give reassurance where needed
9. provide clear and accurate advice with regard to yoga therapy and any relevant aftercare and self-care
10. evaluate the outcomes and effectiveness of the yoga therapy to inform future plans and actions
11. complete and maintain records in accordance with professional and legal requirements

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB7 Interventions and treatments This standard has replaced CH YT1, CH YT2, CH YT3, CH YT4 and CH YT5. Related Functions Principles of Good Practice CNH1 Explore and establish the client's needs for complementary and natural healthcare CNH2 Develop and agree plans for complementary and natural healthcare with clients