Getting Started Teaching Yoga in Clinical Practice, Solo episode with Chris McDonald

Feb 11, 2022

Why should you consider using yoga in therapy? Which parts of yoga can benefit and deepen your therapeutic practice? How can yoga empower your clients?

IN THIS PODCAST:

  • Benefits to using yoga in therapy
  • Getting started: take small steps
  • See what your clients already know
  • Keeping yoga trauma-informed

Benefits to using yoga in therapy

Yoga can be used as a bottom-up therapeutic practice for trauma-informed healing.

Clients who struggle with trauma are generally more successful in using bottom-up therapy practices first, such as breathwork, meditation, yoga. They have less success with top-down practice, such as CBT and traditional talk therapy.

[Clients with trauma, anxiety, and depression] have trouble even thinking straight because their [frontal cortex] goes offline if they get too emotional. Bottom-up approaches use more [therapeutic modalities] to get to the deeper parts of the brain so that you can get clients more regulated. (Chris McDonald)

You can use these bottom-up approaches to help the client regulate emotionally and physically before leading into CBT and talk therapy.

– Yoga can be used to achieve emotional regulation because it is present-moment focused.

It helps clients to center themselves on the “now” and be present within themselves and what is happening around them.

– Yoga can be taught as a coping skill. Therapists can teach basic yoga poses or breathing techniques to their clients for them to use at home or whenever they feel unsettled.

It empowers clients to have more control over their regulation and emotions.

Getting started: take small steps

Yoga training is a big commitment of time and money. Help yourself through this accreditation by taking it in small steps.

Consider taking classes in your own time to become more familiar with yoga before getting a certificate.

If you do not want to teach movement, you do not have you. You can start with teaching basic breathwork to your clients.

Remember, it starts with a relationship: build this first. Build a relationship and trust with your clients before diving into doing yoga with them.

I don’t start, depending on the situation, maybe until the third or fourth session if we do any at all, depending on their treatment plan. But for some people who are highly activated, I will sometimes start with breathwork in the second session if we’re not getting anywhere. (Chris McDonald)

Decide what you want to teach. Where is the starting point for you?

The key to teaching this is to know this pose or breathwork inside and out, and for you to feel totally comfortable with it before teaching it to someone else so that you can guide them. Here, repetition is important.

Create a safe and welcoming space. With both telehealth and in-person, make sure whatever is around and behind you is soothing and peaceful.

Welcome them warmly to ease them into this new space and the yoga.

See what your clients already know

Introduce yoga to your clients as an option. It is an invitation, and your clients can decline if it is not for them.

If your client does consent to yoga and wants to incorporate it into their therapy with you, discuss yoga with them to see how familiar they are with it already.

Keeping yoga trauma-informed

– Let your clients know they can stop at any time or to ask a question

– Enquire about potential injuries, surgeries, or limitations your client may have so that you can modify yoga for them

– Tell clients to stop if they feel pain

– Provide clients with a time frame about how long the yoga may take

– Notice where you are seated and where they are seated so that they feel that they have enough space

– Practice alongside your client

– Assign some poses or breathwork sessions as homework for the clients so that they know they can use yoga as a tool to help them regulate

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Resources Mentioned And Useful Links:

Chest Stretch Video

Subtle Yoga for Behavioral Health Professionals

Yoga Skills for Therapists: Effective Skills for Mood Management

Joe Gilbert episode on the Holistic Counseling Podcast

Trauma-Informed Yoga episode with Kristine Weber on the Holistic Counseling Podcast

How to Create Full Bodied Success Mastery with Avital Miller

Practice of the Practice Podcast Network

Transcript

[CHRIS McDONALD:

The Holistic Counseling Podcast is part of the Practice of the Practice network, a network of podcasts seeking to help you market and grow your business and yourself. To hear other podcasts like Behind the Bite, Full of Shift and Impact Driven Leader, go to www.practiceofthepractice.com/network.

Welcome to the Holistic Counseling Podcast, where you discover diverse wellness modalities, advice on growing your integrative practice, and grow confidence in being your unique self. I'm your host, Chris McDonald. I'm so glad you're here for the journey.

Hello, and welcome back to the Holistic Counseling Podcast. I'm your host, Chris McDonald. It's been a long time since I've done a solo episode, and I know it's been long overdue. I do quite enjoy my interviews. So I knew that a solo episode to provide some of the knowledge that I have will be really helpful for you. I've had a lot of people reach out with an interest in teaching yoga and clinical practice, and many are unsure on what steps to take, which led me to this topic today, which is how do you get started teaching yoga and clinical practice? Which of course is one of my favorite topics in the whole world. For those that know me, or if you've been listening to the podcast, I guess you probably know that.

Before we start, I wanted to share some of the are reasons why you should consider using yoga therapy. I know it's not for everybody. I get that. But I think you really should think about what are the benefits and what parts of yoga could benefit my practice because there's so many amazing things in yoga. So many parts to it. Most people think of yoga as just the asanas or the postures, the movement with breath. But again, if you think of the limbs of yoga, there is also breathwork. There's meditation, there's mood dress, so many awesome things you can use.

Let's first start with what are the benefits? You might have heard some of this before, but just as a refresher. Especially working with trauma, because I know I use more trauma informed, which means really trying to modify any triggers for people to really be considerate about any cues that you give when you talk to people about how to do an asana or breathwork and really trying to be mindful of language, body, language, position of yourself, which we'll get more into that later. But first thinking about trauma. It's more of a bottom up approach. I know a lot of you are familiar with that, that already helps clients with trauma instead of a top down.

So thinking of the top down, if you're not sure what I'm talking about, top down is when you're doing regular talk therapy. We're in the frontal cortex of our brain, the front part, the executive function, the thinking, and that's fine. That's great. CBT we do up there, but a lot of times with trauma or I get people who are highly dysregulated with anxiety or depression and they have trouble even thinking straight because our frontal part of our brain goes offline if we're too emotional. So bottom up is using more of things like yoga, breathwork, brain spotting, EMDR, those modalities help to get to the deeper parts of the brain so that you can get that more regulated. With yoga thinking, as the bottom up is they're going to be much calmer after so that you can get to the top down, so we can integrate the whole part of the brain, not just using the top down.

Another benefit, emotional regulation, yes. Yoga can really help with that. I've seen that myself. I have a lot of people that come to me and you've probably seen it in your cases where initially we start out, whether that's on video or in person and they're fidgeting, they just can't get themselves together. They're just tense. I've had, in person, I've seen people sitting on the edge of the seat and they can't even sit back to relax for therapy. I don't jump into talk therapy at that point. From a holistic somatic approach with yoga, I'm going to say, well, let's start with some breathing today, if that's okay with you. And of course we always get consent, if they're all right with that and try to do some breathwork or grounding, something to start the session off so they can be more easeful as we approach some of what's going on with them.

So it's present moment focused, so staying in the present moment, tuning into self, to bodily sensations, which is of course that interceptive awareness. And the yoga I teach is slow, mindful yoga. It focuses a lot of teaching like in asana for an example, but not just going through a fast flow with fit yoga. It's just stopping after you teach in asana or breathwork and just tuning in, how does that feel in your body? What is your attention like now? And just allowing that awareness of what's going on in their body; because a lot of times, especially with trauma, they can often disconnect and aren't aware of what's happening in their bodies.

This is another holistic tool. All these parts of yoga that clients can use at home right on their own for coping. So you can get them started with these coping skills as another way to use them instead of just using top down processing like a thought record for CBT, which are great, this part of holistic, if we incorporate the thoughts as well, but again, this is using the body more. And, of course, it's research-based. So this is evidence-based for all of those that I know really need to make sure they're using those in your therapy, especially if you work for an agency. I know they're very strict on that when I worked for an agency.

And research has showed helps to decrease depression, anxiety, trauma and stress, and so much more. Also helps physically reducing blood pressure. I always tell clients too, if they have a Fitbit or another heart monitor on just to check their heart monitor before we do something and then check it after and to do that at home. Well, to see as well to see what the results are. It can also help within insomnia. So many physical things can be helped. Obviously everything is connected, our mind, body spirit. So we work on one, we'll see the results in the other.

I wanted to share with you, those are just some of the benefits of course, but I just wanted to remind you of what they are. For those that weren't aware that yes, there's so many amazing benefits. I want to talk about my journey with yoga. How did I get here because I've not always done yoga. I'm so different now than when I started out in my counseling career as a school counselor, not in a bad way, but just growth and change. We all change. I first started, I think it was 2015. I started with a meditation group that was Buddhist-related. I was studying a lot of Buddhism at that time and wanted to learn more about mindfulness and I had met my colleague and decided to join his meditation group.

Joe Gilbert, we had an episode on here and I can't think of that number right now, but awesome. It's the inward facing journey. He has an amazing episode on this podcast, if you want to check it out. So I joined his meditation group, which taught me so much and got me started and I really had them as role models about how do you start a meditation practice and what does that look like, common problems with meditation and how to stick with it. That was really the start of my journey.

I also study a lot with online. I took some courses with [inaudible] I always mess his name. He's a Buddhist monk from Vietnam. I think he lives in France now and he has a place called Plum Village, which is an amazing place. You can go for mindfulness retreats. But so much of what he's taught in Buddhism, just so amazing to me and I could connect with, I love the simplicity of it that anybody can learn this; simple but difficult. It's that paradigm. How do we connect with a present moment? Sounds so easy. Well, I'm just going to focus on drinking my tea yet I just have to focus on drinking my tea.

I also moved on to think about, well, how could I use some yoga in clinical practice? How does that work? I wasn't sure. I've always taught some breath work even as a school counselor, but I wanted to do more. So I did take one online course and learned how to teach chair yoga, really basic course, which I love. But again, it was very short. They gave you one yoga flow and I wanted more. So I went to Yogaville. If you haven't been there, I highly recommend. They're starting to open up now as I'm recording this in January, 2022. They're open up for some in-person. I know they were closed with the pandemic, but what a wonderful place. It's an Ashram in Virginia and you can go just for weekend retreats with meditation, mindfulness. They have silent retreats as well as special guest retreats.

I actually went to Amy yoga in, gosh, what year was that? 2017, I think it was. She was at Yogaville. I highly recommend her too. I learned a lot from her and still integrate some of what she taught. She's got a great book out there too about clinical practice of how therapists can integrate yoga into clinical practice. I think that's the name. I could put that in the show notes. That brought me to finally finding subtle yoga. So I was with searching everywhere, because what I wanted when I did my training, I didn't want "traditional yoga" training. Nothing wrong with that if you already have the traditional yoga training and you're a therapist and use it with clients. That's fine.

For me I just wanted something that was focused more on behavioral health. So luckily in my state I found Christine Weber, who was also on this podcast. She taught about trauma informed yoga, one of the most popular episodes, I must say on this podcast, the most downloads. She taught, teaches subtle yoga for behavioral health. So that's a focus, one of her focuses, which was amazing. She offers CEUs, which was also amazing. If you accept NBCC, then you can get credits from her. You can even take one course online. She does a lot online too. So if you ever want to get started, I know it's a great way to do that.

I started taking those. I honestly never thought I would be a certified yoga teacher. That was never ever my goal. I just wanted to learn more strategies, but as I got into it and I remember taking the training and thinking, looking around being like these are my people, I finally found where I belong, because it felt so amazing. This was before the pandemic and just looking around, everybody's doing this yoga together and it's peaceful and comfortable and friendly. I just felt like this is it. This connects deep in my soul. Yes. So that's what got me started. Then I just decided you know what, I'm just going to go for it and got the whole 200 hour training, which if you've never done the 200 hour training of anything, it's intense. It's a lot of hours, a lot of time investment, a lot of money. It's worth it if you're really connected.

If you only want to do it a little bit, I don't recommend it because it does take a lot of time, a lot of commitment. But I do feel yoga is a lifelong process, a lifelong journey for everyone because there's so much, I learned that how we're just tipping the tip of the iceberg, even just with 200 hours because there's just so much information out there and it can get a little overwhelming when you start to study it. But for what we're doing today, what you're learning, don't feel like you have to take it all on today or in the next year. Just take it bit by bit.

I think the best advice to start out is to break it off into bite sized pieces. But before I get to this too, I want you to remember to think about getting more training for yourself to further enhance your skills. Because of course, through a podcast episode where you're not going to be the totally competent yoga provider by any stretch of the imagination, but this is something I'm going to teach you one quick asana today too, that you can teach. It's very simple, very easy. I can put the directions on the show notes too. I think I have the video as well.

So remember that yoga is not just asanas or postures. It's also meditation and breathwork, so just keeping that in mind that if you don't want to teach movement, that's cool. You don't have to. You can always just start with the basic breathwork and that's all right. Key points to getting started, just remembering it starts with a relationship. Build this first, period. So they didn't really talk about this in the training. I've gone to trainings, I should say, but for me this was what I've learned. I don't jump in like, oh, hey, here's our first session. Let's go. Let's start to do some yoga, which I don't think there's anything wrong with that. But for me, I like to build that trust. Especially people are nervous when, or start with you and you're still trying to get yourself comfortable, get them comfortable so that you both feel like you're in a better place.

So I don't always start depending on the situation until maybe third or fourth session, if we do any at all, depending on their treatment plan. But some people, if they're super highly activated, I will sometimes start with breathwork the second session just because we're not getting anywhere as far as movement, if they're so dysregulated. Starting with breathwork is good. As far as asanas movement, I don't do that for a little bit. I try to really get our foundation set for therapy before moving on to that. Makes sense?

Okay. All right. So decide what do you want to teach? Is there a certain yoga posture that you like that you've done a lot or maybe a breathwork you learn somewhere or meditation. Decide where is the starting point for you? But the key to this is you need to know this inside and out and feel good about it in your body. What I learned from the 200 hour I took, I'm not sure about other ones, but it's all about repetition, repetition, repetition. We did, especially the one I'll teach you today is just over and over and over so you're integrated. Because you can tell when somebody teaches you something, if they don't have much experience with it, just comes across.

I don't know if it's the energy or how you comfortable, you feel people can pick up on that. So you want to just feel like it's a part of you that this is something you do every day. What I do now, if I learn a new practice, I'll do it like once a day for like a week, at least before I jump in with a client, so I feel comfortable. If it's someone that's more difficult, then I might try to teach like my husband, my poor husband has learned so much yoga. He does even want to know or someone else, just because if it's more, little bit trickier. But be okay with making mistakes. because I mess up all the time.

Everybody messes up, especially once you get more complex. If like, I teach some yoga with counting with a breath. So like the ratio breath, if you listen to my episode about that like breathing in for a count four, holding for two exhaling for four and then increasing the exhale to five and so on, but using it with movement. So that gets a little trickier and I'm always like, oops, mess that up, move on. Don't beat yourself up. I usually laugh with clients. We do that. They don't care. So just give yourself a break. So practice and that will make it come across better to the clients as well.

Most of you already do this, I'm sure. Creating a safe, welcoming, supportive place, knowing how you decorate your office, even telehealth, because of course behind you is what your clients will see if you have telehealth. So making sure that's warm and comfortable. Don't just do a white wall. I mean, that's fine. I guess if you do projective therapy, I don't know, but I like to have something that's warm, inviting; really take your time to make it look nice so they feel comfortable. Of course with new clients being careful how you greet them and doing the best you can to be warm with them, to help ease them into therapy, and then to yoga, one thing you can do as an idea is to create a ritual when you start your session.

Like I said, with a person that's dysregulated, instead of jumping into top down approaches with top therapy, to jump in with grounding or jump in with each time we meet, I'm going to turn on this electric channel because I know a lot of you can't use fire for real candles. Or asking them what is a way we could start our sessions that would be soothing for you to be like a ritual. Maybe they have an idea or maybe just starting to with closing your eyes and just connecting for a moment, whatever works for you.

Just see what comes, maybe brainstorm what would be some good rituals that we could do. One ritual I do with a lot of my clients is a check-in and it's just a check-in sheet. I made that checks how they're doing mind, body spirit, and I have it laminated so I can just erase it. Then I of course sanitize it for now with the pandemic. That helps me to see where they're at starting out. They know that that's expected. So having some expectations, they know what to expect when they come in to see you, can get things started.

So for you to also learn more about yoga, what are the impacts more than the basics that I shared today, of course, I'm learning more about trauma in the brain, as well as anxiety and depression so that you can teach that to them; and how yoga can calm the nervous system. What does that mean? So they understand using visuals if possible. I think that's always helpful to get buy-in. The yoga I teach is more the slow, gentle, mindful yoga. It's not fitness-based because some people, if you say yoga, they're going to panic, like, oh my God, I got to do headstands, do some really super fast asana. No, not at all.

So I always start with cherry yoga, even though I know how to do matte yoga. I try to start with a minimum first, sometimes just with breathwork first, even before we get to movement, just so they can ease their way into to be like, oh, this isn't so bad. I start with that psychoeducation piece. This yoga is more about calming the nervous system. It's not exercise yoga. It's not meant for you to build your abs or to get fit. It's not quick yoga. It's slowing down, which I'm sure you've seen with your clients as well. So many need to slow down, rushing, rushing through life. I see a lot of type a personalities and overachievers, perfectionists. Oh boy, do they benefit from this?

But let me tell you, it is a challenge for them to be able to move slow. So when you start to introduce that, I know that sometimes, if you haven't done this before, it can feel a little intimidating; how do I even introduce this to a client? Remember it's an invitation, yoga's an invitation. So they can always say no, if they're not into it. You're not somebody that advertise as a holistic provider or you're not really putting that in your website, like me. Some people that come to me know, so it's a little bit easier for me, but for you, if you haven't done it, I got to back the truck up.

Ask something like, "Would you like to try a new approach to ease that anxiety today? Or how would you like to try some breathwork?" I usually start with breathwork and ask them their experiences and ask them to show me how they've used breathwork because some people, if they show me, they'll just show me taking a breath in and out and that's it, which is fine. A lot of people that's all they know. So I try to see what they already know. Some of them already have learned some in practice so I just try to add on to that if there's similar to what I already teach or let them know I can teach them another way if they're open to it, question mark. Or would it be okay if we just started with X, Y, Z.

And always get that informed consent. And oh, by the way, I also put this in my informed consent, written consent about teaching yoga. You don't have to do that if you're just starting, but if you get to that place where you're going to use it more often and definitely get that informed consent. So to keep it trauma informed, tell them they can stop at any time because what you don't want to do is especially people with high anxiety, trauma to feel like, oh my God, I don't like this. This is bringing up something in me. I want to stop. And when's this over, just let them know. It's okay. They can stop at any time or to ask a question if something's unclear.

Also by the way, too, asking too about potential injuries, surgeries, limitations, just to get an idea where they are. If you're just starting out, you probably want have anything that you're going to have to worry about, especially just with breathwork, but just sometimes just knowing can be helpful; because you'll be able to learn how to modify if you do take more training. I also say tell them to stop if you feel pain and that's okay. We can just take pauses whenever we need to. But again, remember this is slow yoga. So we're not going to be doing the fast yoga.

Give a timeframe and say this will take like five minutes so they know what to expect. That's more trauma informed too. So they're taking the uncertainty out of it. And noticing where you're seated and where are they seated to make it trauma informed so they feel safe with that too. So being careful that is this okay, am I far enough away from you or close enough? Because some people may not want to have somebody seated in a certain position near them or whatever it is that might bring up something for them, you want to make them feel safe for the process.

Again, that's what trauma informed is all of about. Again, that's a whole other episode, which Christine Weber talks about that. But there's a lot to that with the keeping trauma informed, which as a therapist, we have the benefits of already creating that safe container. So that's the good news. Practice with them having the, make sure, of course, that you've already practiced. You know what you're doing with this, but practice with them. You're not just going to say, "Hey, put your arm in the air and I'm going to watch." Because that would not be trauma informed.

They might be nervous with that, but you say, I'm going to do this with you. Keep your eyes open though. Don't get too relaxed so that you can focus on them and see their response and notice do they seem like they're getting too triggered? Do we need to stop? You can always ask them that too and just notice any other non-verbals that might indicate that this is not a good pose or breathwork for them and reflecting that to them. And one thing I do as well is assign it as homework because I think that's important too. I let them know that the more they practice, the easier it'll get, the more it's going to build a resiliency to handle stressors when they come. So to reframe it that way too.

It's not another thing to add to your schedule. This is only going to take a minute, like in the morning or tell me what time of day could you practice this, just to get some semi commitment from them. So those are the basic key points I wanted to let you know that I've learned and learned from Christine Weber with subtle yoga. I think that it's a good start. Some of this too is Amy tribe. I've learned from her as well. So think about how you could get started and what you need to learn from here out. But let's start with one asana that might be helpful. That's real easy that anybody can do.

If you are seated in a chair, don't do this if you're driving, but if you're seated at home or if you're lying down, make sure you sit up, feet on the floor, spine straight and put your right hand on your chest, left hand on top. We're going to inhale and put your arms out to the side, your elbows out, elbows bend, arms out to the side, chest forward, shoulders back, and then exhale. Nice and slow mindful movement, back to your chest where we started. I believe I still have the video on this too. It's harder to just do without visual. So if you're not sure what I'm saying I'll see if we have the video we can upload on the show notes too.

Let's try it again. So inhale, arms out to the side, chest forward, shoulders back, exhale, hands back to start. Again, you're doing this with the client. Keep that in mind. Inhale, arms up to the side, exhale. See if you can alternate which hand goes first on your chest and try it a couple more times at your own breathing pace, which might be different than mine. That's just a cue you can use with clients too. So just noticing as you do this movement, how it feels in your body, noticing your chest, noticing your arms, noticing your mood.

When you find your hands back on your chest, just settle there for a moment. Just notice how that feels to be in the moment with your hands on your chest, calming your nervous system, being in the present moment and imagining for a moment, love and kindness coming from your hands to your heart, filling your soul, being present, knowing that being present is a gift you can give yourself. You can put your hands down and tune in. How do you feel after doing that brief asana? Think about that, really tuning in interceptive awareness for you as a therapist. Again, the benefits of teaching yoga, and if you're doing it with them is you get benefit too. So it helps keep you regulated all through the day as well as your client. So it's double benefits, which I love.

I hope you found this episode helpful. It seems like I keep seeing more and more trainings out there about how to teach yoga. So that's a good sign. I think it's becoming more acceptable. I'd love to hear any questions. So again, feel free. You can email me at chris@holisticcounselingpodcast.com. I'd love to hear feedback or questions you have. And just know it's such a wonderful tool to have available. So many clients, even ones I've never experienced yoga and most are like, I never wanted to do this before, but they're open. They try it and they're just glad they did. It's just really a great way for them to reconnect to themselves in integrating body, mind, spirit. I think it's just the epitome of holistic counseling. Can't you tell I love it?

Anyway, if you like this episode, please remember to subscribe on Apple Podcasts. You got to press the plus size, hopefully they I don't change that button, to follow and subscribe, rate and review; of course, wherever you get your podcast. Again, this is Chris McDonald sending each one of you much late in love. Until next time, take care.

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