The experience of yoga for persons with complex interpersonal trauma: A phenomenological approach.

BACKGROUND: and Purpose: Complex Interpersonal Trauma is a phenomenon with great impact on the American population. Persons who have survived complex interpersonal traumas can experience symptoms beyond what is captured in the Diagnostic and Statistical Manual's (DSM-5) diagnosis of Post-Traumatic Stress Disorder. Yoga is an ancient practice that has been found to have healing benefit for persons impacted by complex interpersonal trauma. The purpose of this study is to further the body of clinical research in support of yoga as a therapeutic intervention. MATERIALS AND METHODS: This study uses transcendental phenomenology methodology to gain a deeper understanding of the experience of yoga for those who have survived complex interpersonal trauma. Narrative interviews were used to gather data, yielding insight that aligns with current findings in literature supporting yoga as a healing intervention. The sample size for this study was five participants. RESULTS: This study's findings shed light on the benefits of yoga for persons with complex interpersonal trauma. Themes discovered include transformation through yoga, comparing holistic benefits through opposing yoga styles, community and relationships, and trauma healing. CONCLUSION: This study and its findings offer implications for clinical social work practice to incorporate yoga as a therapeutic intervention for trauma.

The Eight Limbs of Yoga can be Maintained in a Veteran Friendly Yoga Program.

BACKGROUND: Posttraumatic stress disorder (PTSD) may occur after a traumatic event and has deleterious effects on individuals, including decreased quality of life and function. Yoga is an intervention that may help with the management of PTSD symptoms, however yoga interventions in research studies frequently only include postures and breathwork, not all eight limbs of yoga. AIMS AND OBJECTIVES: The aims of this qualitative study was to examine whether participants with PTSD in a group yoga program discussed the benefits of yoga in a way that represented the eight limbs of yoga, when answering questions about their experience of the yoga program. METHODS: Qualitative data were collected after participants completed a 16-week yoga intervention. Qualitative data were collected via survey, reviewed, coded, and categorized into themes representing each of the eight limbs of yoga. RESULTS: Overall, 108 people were randomized to the yoga intervention and 67 individuals completed the intervention and follow up questions used in these analyses. The mean age of the 67 participants in this study was 52.4 years (±12.0), the majority were male (70.2%), and most had combat-related trauma (62.7%). All eight limbs of yoga were represented in the data, including each of the five yamas and niyamas, even though the yoga intervention did not explicitly include Sanskrit terms, definitions, or education about yoga philosophy or the eight limbs of yoga. CONCLUSION: Results may indicate that yoga, even when only including postures, breathwork, intentions, and relaxation/meditation, may still address all of the yamas, niyamas, and the other eight limbs of yoga.

Preliminary Report on a Spiritually-Based PTSD Intervention for Military Veterans.

Military veterans can experience spiritual/religious struggles such as weakening of beliefs, loss of meaning, increased guilt, difficulty forgiving, and moral challenges as a result of military trauma. While mainstream treatments (e.g., exposure therapy) have been shown to be effective for many, they often fail to address these issues adequately. This paper describes an 8-session spiritually-based group intervention designed to treat trauma-related spiritual wounds among military veterans. A program evaluation conducted with 24 veterans revealed significant reductions in PTSD symptoms, spiritual injury, and negative religious coping from pretest to posttest. The findings support the need for additional PTSD treatment approaches.

When trauma, spirituality, and mental illness intersect: A qualitative case study.

OBJECTIVE: Studies have identified spirituality to be a helpful resource for dealing with various types of trauma experiences. This coincides with a heightened focus on the role of spirituality within trauma-related theory (e.g., spiritual coping, meaning-making, and posttraumatic growth). Little remains known, however, about the relationship between trauma and spirituality among people with severe psychiatric disorders. Meanwhile, a high percentage of those with psychiatric disabilities are known to have trauma histories, whereas a majority self-identify as spiritual and/or religious. METHOD: Two cases from a hermeneutic phenomenological qualitative study of people with co-occurring psychiatric disabilities and trauma histories are highlighted. Themes related to trauma and spirituality are discussed in-depth. RESULTS: Study participants drew upon a variety of spiritual coping strategies (e.g., prayer, meditation, spiritual readings) to help deal with trauma experiences. Participants additionally experienced spiritual struggles-a detailed account is given of a participant who was able to work through such struggles by shifting to a less self-blaming spiritual worldview (e.g., shifted from believing in a "punishing God" to viewing oneself as part of "oneness with humanity"). The study also examined the meaning-making process and shows how concepts such as global and appraised meaning-making are applicable to people with psychiatric disabilities. Finally, unique challenges related to posttraumatic growth are discussed (e.g., intrusive ruminations and "voices" with spiritual themes). CONCLUSION: This study offers useful examples of how spirituality and trauma can impact one another, and how people with psychiatric disabilities draw upon spirituality to cope as they strive for recovery. (PsycINFO Database Record

Spiritual assessment in mental health recovery.

Mental health recovery-oriented and strengths model proponents recognize spirituality to be a key aspect of the recovery process. In order to incorporate spirituality in practice, practitioners need to know how to conduct spiritual assessment effectively. Although implicit and explicit spiritual assessment approaches have been identified as useful frameworks for conducting spiritual assessment, there is a gap in knowledge about what constitutes effective approaches and questions for addressing spirituality in the lives of people with psychiatric disabilities. To address this gap, focus group interviews were conducted with providers and consumers of mental health services in order to develop practical guidance for spiritual assessment. Focus group participants provided feedback about a list of sample spiritual assessment questions and then suggested principles and questions for practitioners to use. Collective insights from the focus groups formed the basis for recommendations for spiritual assessment.

Spiritual well-being of people with psychiatric disabilities: the role of religious attendance, social network size and sense of control.

The influence of psychiatric symptoms, religious attendance, social network size, and sense of control on spiritual well-being were investigated in a cross-sectional study using the Spirituality Index of Well-being. Forty-seven participants with psychiatric disabilities from six consumer-run organizations participated. A factor analysis result revealed two domains of spiritual well-being for people with psychiatric disabilities: self-perceptions regarding making sense of life (developing life purpose) and self-efficacy in obtaining life goals. Based on our regression analyses, religious attendance, expanding social network size, and having a sense of control over important areas of life may enhance spiritual well-being in spite of severity of psychiatric symptoms. Supporting mental health consumers who hope to be fully integrated into social and spiritual communities is important. Given the increased attention to consumers' internal spiritual experiences in a recovery process, this study adds to knowledge about spirituality in the mental health field.

Effect of Wellness Recovery Action Plan (WRAP) participation on psychiatric symptoms, sense of hope, and recovery.

OBJECTIVE: Self-management of psychiatric illness is a central tenet of consumer-directed mental health treatment. While several manualized self-management programs have been developed in recent years, the most widely disseminated is the Wellness Recovery Action Plan (WRAP). This study examined the effects of WRAP participation on psychiatric symptoms, hope, and recovery outcomes for people with severe and persistent mental illness. METHODS: A quasi-experimental study, with an experimental (n=58) and a comparison (n=56) group was conducted. WRAP sessions (8-12 week) were facilitated by one staff person and one peer worker at five community mental health centers in a Midwestern state. The Modified Colorado Symptom Index, the State Hope Scale, and the Recovery Markers Questionnaire (RMQ) were employed at the first and last WRAP sessions, as well as six months following the intervention. Repeated measures analysis of covariance and planned comparisons before and after the intervention were conducted. RESULTS: Findings revealed statistically significant group intervention effects for symptoms and hope, but not for RMQ. Planned comparisons showed statistically significant improvements for the experimental group in psychiatric symptoms and hope after the intervention, while non-significant changes occurred in the comparison group. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The study results offer promising evidence that WRAP participation has a positive effect on psychiatric symptoms and feelings of hopefulness. If recovery is the guiding vision for mental health system reform, the study results provide evidence that WRAP programming may warrant a place in the current array of services offered through the publicly funded mental health system.

Outcomes of an illness self-management group using wellness recovery action planning.

OBJECTIVE: The aim of this preliminary study was to examine the impact of participation in an illness self-management recovery program (Wellness Recovery Action Planning-WRAP) on the ability of individuals with severe mental illnesses to achieve key recovery related outcomes. METHODS: A total of 30 participants from three mental health centers were followed immediately before and after engaging in a 12-week WRAP program. RESULTS: Three paired sample t-tests were conducted to determine the effectiveness of WRAP on hope, recovery orientation, and level of symptoms. A significant positive time effect was found for hope and recovery orientation. Participants showed improvement in symptoms, but the change was slightly below statistical significance. CONCLUSIONS: These preliminary results offer promising evidence that the use of WRAP has a positive effect on self-reported hope and recovery-related attitudes, thereby providing an effective complement to current mental health treatment.