Benefits of Yoga for Psychosocial Well Being in a US High

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techniques including physical postures and exercises surveys administered pre post indicated that yoga par. that develop strength and flexibility breathing exer ticipants showed statistically significant differences over. cises deep relaxation and meditation mindfulness tech time relative to controls on measures of anger control. niques to train attention Yoga and meditation tech and fatigue inertia There was a pattern of worsening in. niques have been shown to reduce perceived stress and the control group whereas changes in the yoga group. improve mood 6 7 Research documenting the therapeu were either minimal or slightly improved Although. tic benefits of yoga has grown steadily for the past 3 promising for this second pilot study we were inter. decades and now includes controlled clinical trials on ested in focusing on scales developed for normative. psychiatric conditions such as depression and anxiety adolescent populations and basing the intervention on a. breathing disorders such as asthma cardiovascular dis different yoga style Our initial study focused on clini. orders such as hypertension endocrine disorders such cally relevant measures of psychological health using the. as diabetes and a variety of musculoskeletal and neuro Behavior Assessment Scale for Children Second Edition. logical conditions 8 There is also a growing body of BASC 2 Questionnaire whereas this study has focused. research literature documenting the benefits of yoga in more appropriately on psychological constructs relevant. children and adolescents 9 10 For example yoga interven to normative adolescent populations In addition this. tion studies have reported improvements in attention study evaluated a yoga intervention based on Kripalu. deficit hyperactivity disorder in boys in weight loss yoga whereas our previous study evaluated an interven. self esteem and anxiety in mostly Hispanic children and tion based on the Yoga Ed program. adolescents and eating disorders in adolescents 11 13 We predicted that yoga would improve overall well. The multiple techniques of yoga likely work synergis being by both decreasing negative aspects and increas. tically together to yield stress reduction and improved ing positive aspects Although we predicted direct ef. well being There are a few pilot studies that have ex fects of yoga on psychosocial well being we also. amined the psychological effects of yoga in children predicted that yoga may have beneficial effects on the. outside of the school curriculum For example an inner development of self regulatory skills which may in turn. city after school program with a weekly 12 week yoga have indirect effects on psychosocial well being how. protocol showed fewer stress related negative behaviors ever these relationships could not be evaluated given. in comparison with a control group 14 the limited size of the current trial. There are even fewer studies that have evaluated yoga. within the school curriculum A study incorporating METHODS. yoga within the school curriculum evaluated a relaxation Study Participants. program incorporating yoga for fifth grade students in This study took a similar design approach as the. Germany 15 Students experienced significant reductions previous study maintaining the group randomized con. in aggression helplessness in school physical com trolled trial in a physical education PE setting Eligible. plaints and improvements in static balance and stress students for this study were registered for upper division. coping abilities More recently a randomized controlled Grades 11 and 12 PE class at a public high school in. trial of a 12 week in school yoga program in fourth and rural western Massachusetts for the spring 2009 semes. fifth graders reported a positive impact on problematic ter Upper division students were required to take PE for. responses to stress including rumination intrusive at least 1 semester In the 2008 2009 school year this. thoughts and emotional arousal 16 In a single group high school had 625 students in Grades 9 to 12 19 The. pre post design teacher reported improvements in at graduation rate was 81 8 and 16 4 of students were. tention have also been shown for elementary aged chil considered low income students eligible for free reduced. dren practicing yoga who were recently exposed to price lunch or food stamps or receiving Transitional Aid to. war related traumatic stress 17 Families benefits Race and ethnicity composition was. Although yoga and meditation techniques seem ide 92 2 white 3 5 Hispanic 2 1 African American 1 4. ally suited to prevent or alleviate the psychological is multirace and 0 8 Asian Nearly all students spoke English. sues encountered by adolescents in high school we are 0 5 limited English proficiency. unaware of reports of any randomized controlled studies Inclusion criteria were registration for upper division. within the school setting in this population The overall PE and the ability to participate in group yoga classes. purpose of this research program is to evaluate the without the need for excessive individual instruction. psychological benefits of a yoga program conducted The only exclusion criterion was participation in the. within the school curriculum for adolescents This pro yoga study conducted the previous semester which. gram has begun as a series of pilot studies aimed to excluded 4 class periods of students Students were. develop the yoga intervention test feasibility and estab enrolled through a passive consent opt out procedure. lish initial efficacy Our initial pilot study was the first Prior to the study the research protocol was described. group randomized controlled trial of yoga for adolescent verbally to students and a study information sheet was. mental health 18 Upper division students were randomly sent home to parents with the option to opt out Partic. assigned to either regular physical education PE or an ipants in 3 PE class periods were unequally randomized. 11 week Yoga Ed program over 1 semester Self report by class period to the PE as usual group active control. 194 Yoga During High School for Psychosocial Well Being Journal of Developmental Behavioral Pediatrics. 1 class period or the yoga group active treatment 2 ing relaxation Durations of each segment were ex. class periods Group allocation to yoga versus controls tended to varying degrees in the 40 minute sessions. was conducted by blindly and randomly drawing paper typically by including more yoga postures exercises. slips This study protocol was reviewed and approved by Breathing techniques were progressively incorporated. the Institutional Review Board of Brigham and Women s during the initial centering In addition slow abdominal. Hospital breathing was a focus throughout the duration of all. sessions Each session had a theme or talking point that. Yoga Intervention was discussed throughout the session by the instructor. Participants in the class periods assigned to the yoga Themes included a basic yoga approach and methodol. intervention attended 2 to 3 yoga sessions a week alter ogy postures breathing relaxation meditation and. nating weekly due to the school schedule over 10 awareness nonviolence mind body interactions and. weeks 28 yoga sessions total For the sake of clarity a awareness body systems stress management emotional. single yoga instruction period is referred to as a yoga intelligence self talk and critical voice contentment. session whereas class period is used to mean the discipline decision making values and principles com. grouping of students into separate PE classes Individual mitment and acceptance. yoga session attendance was recorded by the teaching. assistants Physical Education Control,The 2 lead yoga instructors who created and imple. Participants in the PE as usual class period met for 30. mented the program were teaching faculty at the Kripalu. to 40 minutes 2 to 3 times a week over the course of the. Center for Yoga and Health They both completed 500. 10 week yoga program The school s goal of the ongoing. hour advanced yoga teacher training programs and the. upper division PE program was to provide an opportu. Yoga Ed training program which provides skills in teach. nity for students to engage in programs that will foster. ing yoga to adolescents in a manner which enhances. lifelong wellness and self responsibility Students were. engagement and compliance while minimizing risk A, graded on participation responsibility and skills and. yoga teaching assistant was present at each yoga session. knowledge development The PE curriculum consisted, 5 assistants in total each of whom had taken a basic. of 2 week units with the first week focused on learning. 200 hour yoga teacher training program from a yoga. the history rules and skills for an activity and the. school and also participated in the Yoga Ed training. second week consisting of a tournament or games Stu. program Their role was to assist students individually. dents unable to participate directly in an activity were. provide gentle adjustments upon permission and keep. assigned to support roles referee setup and coach, notes in the teaching log The school PE instructor was. mentor thereby still participating Units included tradi. usually present as well mainly to support classroom. tional sports such as tennis volleyball hockey football. ultimate frisbee and baseball Nontraditional sports. The yoga intervention developed for this study repre. were also included such as a ropes course backcountry. sents the beginning of the development of a standard. living skills stress management first aid cardiac pulmo. ized Kripalu based program for use in research evalua. nary resuscitation and planned parenthood health and. tion of benefits of yoga within the school setting that. wellness Yoga was not included as a unit or as a com. may ultimately serve for widespread implementation in. ponent of any unit during the semester, schools The yoga program used in this study was com.
The upper division school PE instructor held a bach. pletely secular and included 4 key elements of classical. elor s degree in outdoor education recreation and a Mas. yoga physical exercises and postures breathing exer. sachusetts state certification for Grades 9 to 12 PE He. cises deep relaxation and meditation techniques In. also held activity specific certifications related to many. keeping with principles of Kripalu yoga the overall. of the units in the PE curriculum There were no other. emphasis was on self inquiry and not purely didactic. instructors or assistants during the PE sessions, teaching Furthermore it incorporated a distinct ap. proach to emotion regulation in Kripalu yoga repre. sented in the instruction to breathe relax feel watch Feasibility. and allow Postures were taught as breath coordinated To address how well upper division high school stu. movements and breathing is considered the central tool dents tolerated and accepted the new Kripalu based. for cultivating nonjudgmental compassionate self aware yoga program we administered a Yoga Evaluation Ques. ness The majority of yoga postures were simple and tionnaire YEQ at the end of the study to students in the. adaptable for all physical fitness levels Physically de yoga group The YEQ was an internally created qualita. manding techniques were eventually introduced as op tive survey to assess feasibility of conducting a yoga. tional variations of the standard poses toward the end of program with adolescents The YEQ was an 8 item mea. the program based on students progress sure of the students perception of the benefits utility. The 30 minute yoga sessions were structured to in and value of the yoga program using a 10 cm visual. clude a 5 minute centering a 5 minute warm up 15 analog scale on which students mark their degree of. minutes of yoga postures exercises and a 5 minute clos agreement with statements from not at all to very. Vol 33 No 3 April 2012 2012 Lippincott Williams Wilkins 195. much so In addition there was an open ended entry Perceived stress. for qualitative comments by the participant The 10 item Perceived Stress Scale PSS is the most. widely used psychological instrument for measuring the. Exploratory Outcome Measures degree to which events are appraised as stressful during. the past month Items are rated on a Likert scale from 0. Both the yoga and control group participants com, never to 4 very often with responses summed to give. pleted self report questionnaires 1 week before the start. a total score ranging from 0 to 40 Items were designed. of the yoga program and 1 week following the end of the. to tap how unpredictable uncontrollable and over, yoga program Trained study staff administered the sur. loaded respondents find their lives The scale also in. veys in groups by class period following a script to. cludes a number of direct queries about current levels of. provide overall instructions for completing question experienced stress The PSS has been previously admin. naires honestly and individually and to emphasize read istered to midadolescents eighth and ninth graders 22. ing the instructions as they vary by survey especially in Positive psychology. terms of time frame Participants were given 2 sessions The Inventory of Positive Psychological Attitudes 32R. to complete the questionnaires using pencil and paper IPPA is a 32 item 7 point Likert self report scale with a. They were not aware of group assignment at baseline total score and subscales that measure Self confidence. was conducted by blindly and randomly drawing paper slips This study protocol was reviewed and approved by the Institutional Review Board of Brigham and Women s Hospital Yoga Intervention Participants in the class periods assigned to the yoga intervention attended 2 to 3 yoga sessions a week alter nating weekly due to the school schedule

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