Date Presented 4/8/2016
There is a need for effective, school-based mental health programs. Yoga is widely used and suited to address the needs of anxious children. Occupational therapists use yoga, are mental health experts, and are highly present in schools, making them essential to improving yoga research and school mental health services.
Primary Author and Speaker: Lindy Weaver
PURPOSE: To determine the effects of a school-based yoga program on (1) anxiety and self-regulation and (2) sensory responses and function in daily activities; to determine the social validity of yoga as a school-based mental health intervention for anxious youth; and to explore participants’ perspectives on how yoga affected behavior, self-regulation, adaptive skills, and sensory processing.
RATIONALE: Anxiety is the most common psychiatric issue among youths. Legislation is calling for the expansion of school-based mental health services. School professionals realize that children are most accessible and comfortable in the school setting. Thus, there is a need for increasing the availability of evidence-based interventions. Yoga is widely used and well suited to address the needs of anxious children in a simple and cost-effective manner. Occupational therapists have a key role in school-based mental health service expansion and the application of yoga in schools.
DESIGN: Convergent mixed methods
PARTICIPANTS: Nineteen student–parent dyads; students were sixth through eighth graders (mean age = 12; 7 boys, 12 girls) at a central Ohio school who demonstrated anxiety symptoms on a screening tool. Ten students were randomized to an active control (physical exercise; 8 wk, 45 min/wk) and 9 to the treatment condition (yoga; 8 wk, 45 min/wk). Seven teachers provided pre- and postintervention data.
METHOD: Behavior Assessment System for Children, Second Edition (Anxiety/adaptive skills) and Self-Efficacy for Self-Regulation of School-aged Children/Teacher’s Perception of Student’s Efficacy in Self-Regulation forms (Self-Efficacy); social validity was assessed by postintervention surveys, and participants’ perspectives were assessed via teacher/ student interviews.
ANALYSIS: Repeated-measures multivariate analysis of variance (two-group between subjects) was used to compare pre- and posttest scores. Descriptive statistics were used for postintervention survey results. Interviews and focus group discussions were audio recorded, transcribed, and analyzed by two team members using a case study approach.
RESULTS: Randomized controlled trial indicated that yoga has the potential to produce anxiety reduction and improved adaptive skills, but no statistically significant results were observed; authors attribute this to lack of observed power in the current sample. Results of effectiveness, social validity, and participant perspectives revealed that students/teachers viewed yoga as feasible and valuable. Students/teachers expressed positive changes in student behavior, self-regulation, and anxiety following yoga.
Currently, yoga interventions for anxiety reduction are feasible and well received and may have a positive impact on psychosocial health among children and adolescents.
DISCUSSION: School-based applications of yoga for anxiety should consider (1) the extent to which stakeholders value the intervention and how capable they feel in implementation, (2) ways to increase stakeholder collaboration and involvement, (3) manualized interventions, (4) fidelity measures, and (5) yoga interventions, which are likely most effective when offered at least 2–3 times per wk for >8 wk. Future research should extend this work with a larger sample size, increase frequency, evaluate dose–response relationships, increase parent involvement for greater transferability, and include measures to examine physiological mechanisms of yoga.
IMPACT STATEMENT: Yoga is widely used and purported to improve mental health, and yet there is a need to increase the rigor of yoga intervention research. Occupational therapists (OTs) use yoga, have training in mental/physical health, and are highly present in schools. Thus, OTs are essential to improving yoga research and creating innovative/holistic school mental health programming.
