Running head: YOGA FOR ANXIETY 1 The Effects of Yoga for Youth with Anxiety A Research Paper and Experiential Project Presented to The Faculty of Adler Graduate School ___________________________ In Partial Fulfillment of the Requirements of the Degree of Master of Arts in Adlerian Counseling and Psychotherapy ____________________________ By: Kaye Standke August 2013 YOGA FOR ANXIETY 2 Abstract Youth in the United States have undergone varying degrees of stress, but the stress is becoming a bigger issue, which is demonstrated by the high incidence of anxiety disorders that are found in young people. Anxiety disorders are the most prevalent psychological disorder in the United States. (Albano, et al., 2003). The ways in which to treat anxiety are varied. Yoga, as a mindbody connection practice is proving to have a positive impact on one’s health and well-being. This review will explore the youth in the United States, how anxiety reveals itself within a person, the discussion of what is yoga, and who is participating in yoga, and finally this review will determine whether or not yoga would be a useful tool for youth who struggle with anxiety. YOGA FOR ANXIETY 3 Outline Abstract 2 Outline 3 Introduction 4 Research Question 5 The State of Youth 5 Yoga 7 Youth and Yoga 8 The Incorporation of Yoga for Youth with Anxiety Related Disorders 12 Experiential Project Overview 14 Summary 16 Discussion and Conclusion 16 Future Direction 17 References 18 Appendix A 22 Appendix B 29 YOGA FOR ANXIETY 4 The Effects of Yoga for Youth with Anxiety Currently, anxiety disorders among youth are the most prevalent psychological disorder. (Albano et al., 2003). The increase of youth who have an emotional impairment has risen to between three and five percent of the population in the United States (Robold, 2002). Youth are embodied by stress within their schools, homes, and communities, and this has a dramatic impact on their daily lives. A young person whom has an anxiety disorder are rated by peers as more shy and more withdrawn, than a student who does not have an anxiety disorder (Coplan et al., 2007). The result of anxious youth is that these students have a smaller social network and fewer peer relationships. Strauss, Frame, and Forehand (1987) reported teacher data collection, which revealed students with anxiety exhibit greater psychosocial difficulties and problems with adjustment. These factors play a role in the student’s academic functioning. A study investigating the effects of anxiety in the school domain was conducted by Ialongo, et al., (1994), revealed that children in the top quartertile of anxiety in the fall of first grade were found to be nearly eight times more likely to be in the lowest quartertile of reading achievement and nearly two and a half times more likely to be in the lowest quartertile in math by the spring of their first grade year. Youth who have anxiety demonstrate a dysregulation of emotion, and poor ability to cope with their emotions, which results in poor self-esteem (Suveg et al., 2008). Youth are struggling with how to manage their stress and anxiety. More research has been done on the effects of yoga and other mindfulness techniques for all people, which is demonstrating the positive impact that yoga has on people who practice yoga. As stated by Palgi (2007), the goal of yoga is for youth to learn techniques to self regulate, gain awareness and control over emotional, cognitive, and behavioral processes. Youth are in need of tools to assist in managing their anxiety, so they can YOGA FOR ANXIETY 5 manage their emotions, perform better in school, maintain healthy relationships, and increase overall self esteem. Families and educators are in need of tools to assist youth in managing their anxiety. The nature of the exact cause of anxiety continues to be explored. The amount of research that has been conducted on the impact that yoga has on youth is limited. There has been a significant amount of research conducted on adults with anxiety disorder, which contributes to the findings for the impact of yoga and overall wellness. This study is limited to youth within the United States. There have been various studies conducted in different environments within the United States, which detail the benefits of yoga and mindfulness techniques, but the data is limited to only the participants who have completed the entire study. This paper will limit the findings to students with anxiety and not the whole spectrum of mental health disorders. It is hypothesized that yoga will have a positive effect on all children and youth with anxiety. It would be beneficial for youth who have anxiety to participate in yoga. The initial hypothesis is that a significant number of youth have a form of anxiety, and that they are in need of coping strategies. Research Question As we come to understand the prevalence of anxiety in youth and the effects that it has on their overall being, would Yoga, as a mind-body integrative practice, decrease symptoms of anxiety for this group of people? The State of Youth Youth in the United States experience significant amounts of stress, from a variety of sources including: living in poverty, academic failure, and interpersonal violence (Sibinga et al., 2011). According to Zito (2003), there is a significant increase of youth who are being YOGA FOR ANXIETY 6 prescribed psychotropic drugs. This has resulted in youth being ignorant about alternative ways to handle their emotions, fears, and longings. Some of the symptoms that a person experiences when they have an anxiety disorder include: restlessness, difficulty concentrating, irritability, muscle tension, and sleep disturbance. “Adolescence is a transition period of life, marked by physical, social, as well as psychological changes (Cameron, 2004; Dahl, 2004). With these change naturally occurring, some youth thrive and navigate through the changes successfully, while others struggle and have difficulty managing these changes, this can result in significant amounts of stress and anxiety symptoms. The cost of anxiety care was 42. 3 billion dollars in 1990 and the cost has risen over the past 30 years due to the increased diagnosis of anxiety disorders across the population (Greenberg et al., 1999). When youth have a lack of perceived control they are more likely to have anxiety problems. Youth are also limited in their ability to control and express their emotions. Students across the United States and beyond are experiencing a high amount of stress. As stated previously some of the factors that are causing stress are due to: academic difficulties, large amounts of homework, family trauma, social phobias, separation struggles, and financial hardships. According to research conducted by Mychailyszyn et al., (2010), teachers across the United States have noted that students who do not have an anxiety disorder do much better academically, are significantly happier, and work much harder in school. This information emphasizes that youth who have an anxiety disorder are going to have a more difficult time functioning within the school environment. This information demonstrates that the incidence of anxiety is high and that the interpretation regarding the cause of anxiety is broad in nature. Students need tools and YOGA FOR ANXIETY 7 strategies to manage the anxiety and stress in their lives. This paper is intended to identify if providing yoga to youth will decrease student’s level of anxiety. Yoga The definition of Yoga is to “yoke”, which means to unite or to harness (Galantino et al., 2004). Yoga dates back to 5,000 years ago. Yoga is an ancient discipline, which brings about balance and health to the physical, mental, emotional, and spiritual dimensions of the individual. The intention is to create mind, body, and sprit connection. There are many varieties of yoga practiced in our culture today. The yoga that will be discussed in this paper will incorporate postures, also known as asanas, breathwork, also known as pranyanama, and meditation as defined by finding stillness and quiet within oneself. The number of adults believed to have been practicing yoga on a weekly basis in 2002 was 10.4 million. Studies indicate that number has increased over the course of ten years (Barnes et al., 2004) with an estimation of 15 million people whom practice yoga as of 2011. This trend demonstrates that yoga presents increased health benefits that make people want to practice yoga. The research has proven that yoga has many health benefits for individuals who practice. Yoga and meditation techniques have shown to improve mood, enhance performance on a variety of cognitive, psychomotor, and physical tasks, and increase resiliency to chronic and acute stress (Harinath et. al., 2004; Kirkwood et al., 2005, Malathi et al., 1998; Michalsen et al. 2005, Manjunath & Telles, 2004; Ray et. al., 2001). According to Emerson, Sharma, Chaudry, & Turner’s research conducted in 2003, yoga can reduce autonomic sympathetic activation, muscle tension, and blood pressure, decrease physical symptoms and emotional distress, improve hormonal, and neuroendocrine activity, which equates to improvement in overall quality of life. These authors go on to research that yoga positively affects self-regulation and decreases hyper YOGA FOR ANXIETY 8 arousal. Further research has revealed that yoga improves symptoms of anxiety (Brown & Gerbarg, 2005). In conclusion, yoga when used as a posture, breath control, and meditation practice has significant health and well-being benefits. Benefits include, the reduction of fatigue and boosted ability to handle stress, breath control and management of performance anxiety, increase in selfconfidence, decrease in generalized anxiety, improvement of mood, self-esteem, concentration, strength, flexibility, and motor skills (Harinath et al, 2004). It is clear that the main benefits of yoga are applicable to the further development of this article. As more information has been demonstrated on the disruption that anxiety has on youth in the United States, it deems appropriate to investigate whether or not yoga would be positive mind-body exercise for these individuals. Yoga and Youth As of 2007, yoga has become more commonly used in the schools as a way for students to manage their stress and improve students well being and behavior, (White, 2009). The styles of yoga programs that are being implemented in schools are addressing stress and anxiety by increasing students’ awareness through mind and body techniques. Yoga emphasizes the individuality of each person and stresses the importance of being a non-competitive mind-body exercise. Yoga is appropriate for all children, even those who lack coordination or who have physical limitations because of the various yoga styles that are available. Anecdotal reports reviewed by experts in the youth and yoga field, including Flisek (2001) describe yoga to be calming to children and in reducing obesity, discipline problems, anger and panic attacks, and to improve in academic performance. Yoga for youth puts less emphasis on perfecting any of the physical postures, and instead provides students tools to practice being compassionate and non- YOGA FOR ANXIETY 9 judging towards themselves and others. The breath and body connection allows a young person to become more aware of oneself. Yoga Studies The studies that have been conducted with youth and yoga are limited, but there has been a significant amount of research conducted for adults and the benefits that yoga offers because yoga improves symptoms of anxiety and enhances relaxation (Brown & Gerbarg, (2005); Gupta, Khera, Vempati, Sharma & Bijlani, (2002). A yoga study with youth participants by (Manjunath & Telles, 2001), reported that the ten to thirteen year old girls who practiced 75 minutes of daily yoga, which consisted of breathing, internal cleansing, meditation, devotional songs, and relaxation over the course of one month allowed the girls to decrease the time required to execute a mental test. The study indicated that yoga increased blood flow to the frontal lobe of the brain, which resulted in the rapid realization and correction of errors. Another yoga study took place with students from an alternative high school in New York. Many of these students had issues with mental health. The yoga experience, as it was termed, was a program that provided students with the tools to access their inner resources in order to deal with the disturbances in the outer environment (Bonilla-Bowman, 2010). The classes began with pranayama, or deep yoga breathing; this provided the students the ability to understand that when they breathed slower the blood chemistry changed in their body which assisted in helping them feel more calm. These students typically reacted in a flight or fight response breath. The students then discussed ways in which they could incorporate this breath especially when feeling anxious or challenged. The class would continue with the posture component of the class; the conclusion would be svasana, or the final relaxation of the class. YOGA FOR ANXIETY 10 The result of the yoga experience for this population was students’ responses of feeling more calm from the breathing exercises. They also demonstrated increased confidence from the yoga postures that they excelled at. The most positive and gratifying successes of the yoga experience was the way in which all students relaxed deeply for up to ten minutes during the svasana, or final relaxation of class (Bonilla-Bowman, 2010). After a yoga session, the students would continue with their day in a more peaceful and happy state. In addition, the students were more kind and accepting of one another, and they were more inwardly focused on their own well being. A pilot study in Bronx, New York in March 2006 was conducted amongst fourth and fifth grade students who either participated in a 12 week/ one hour a week yoga program, or for those fourth and fifth grade students who did not practice yoga at all. The 2006 pilot study was conducted to gather information to determine if yoga increased or altered a student’s well being. Both groups of students took a pre-intervention Emotional Well-being Assessment titled Harter’s Self-Perception Profile for Children (SPPC). The yoga class that the yoga participants took part in consisted of the following elements: physical postures, breathing exercises, meditation, and relaxation. The yoga group took a post-intervention survey called Effects of Yoga on Well-being Survey. The results from the pre-intervention and post-intervention assessments are as follows: The yoga group responded that 50%-80% of the participants improved in flexibility, balance, attention, liking oneself, liking the way one’s body feels, behavior in class, strength, ability to calm oneself, and sleep (Berger et al., 2009). A summary of two pilot yoga studies that were conducted in 2010 in Oakland, California with a group of students in a Juvenile Hall indicated that a “yoga based program can produce positive transformation in vulnerable youth,” (Ramadoss & Bose, 2010.) The long-term YOGA FOR ANXIETY 11 beneficial outcomes of such a program if widely implemented could produce greater success for the education of students, public health, economic growth, and community development. The first pilot yoga study was offered at Niroga Institute for incarcerated youth. The youth received daily 60 minute Transformative Life Skills (TLS) consisting of yoga poses, breathing techniques, and meditation, and the program was evaluated on the effectiveness of TLS on the program’s participants perceived stress and self-control. The second pilot study was conducted at El Cerrito High School in a condensed 15-minute TLS protocol offered by Niroga staff. This pilot study evaluated the effects of an 18-week TLS program on perceived stress and self-control, in comparison to a no-intervention control condition. Both studies used data collection from a weekly 4-point questionnaire, which assessed a possible shift in perceived shift. The data collection was challenging due to the participants leaving the facility and at times unwilling to complete the questionnaire. The results indicated that both pilot yoga studies had a significant decrease in the amount of perceived stress the participants reported. There was also a significant increase in the participant’s self-control. The anecdotal results from the Niroga staff reported participants were able to resolve conflict in more adaptive ways, and they improved selfawareness (Ramadoss & Bose, 2010). Both of the studies indicated that a yoga-based program could produce positive transformation in vulnerable youth. A final study was called the Mindfulness-Based Stress Reduction or MBSR. This study was conducted with 33 youth. “The three components of MBSR include: (1) materials related to mindfulness, meditation, yoga, and the mind-body connection, (2) experiential practice of various mindfulness meditations, mindful yoga, and the “body scan” during group meetings and at home, and (3) group discussion focused on the application of mindfulness strategies to problems and situations that the youth encounter,” (Baer, 2003; Kabat-Zinn 1982), (1990). All YOGA FOR ANXIETY 12 33 youth that were the initial subjects participated in at least one session. The data gathered from the MBSR program included all participants that had something positive to say about MBSR and all participants continued to practice some form of MBSR after the program was completed. The majority of the participants indicated that MBSR helped them feel more calm, relaxed, and less stressed; the majority of the participants also indicated that they felt “less down” and “more happy” as a result of the MBSR program. Some additional conclusions were improvements in interpersonal relationships, reductions in general discomfort and hostility, improved healthy eating patterns, increased physical activity, and improved sleep patterns. As demonstrated by the research and the variety of studies that have been conducted in regards to people doing yoga, the results indicate that yoga provides a vast array of health benefits. Yoga has been shown to be effective in relieving symptoms of anxiety (Grossman et al., 2005); & Smith, Hancock, Blake-Mortimer, & Eckert, 2007). As stated by Palgi (2007), who teaches educators how to implement yoga in their classrooms, so they are able to “promote selfawareness and self-control, enhance physical fitness, support academic learning and concentration, and to target at risk behaviors and lifestyles”. These yoga benefits have resulted in a dramatic increase of yoga and mediation programs in schools and communities. These findings, assist in the discussion to bring yoga to youth especially those dealing with anxiety issues. The Incorporation of Yoga for Youth with Anxiety Related Disorders As more information surfaces in regards to youth and the anxiety disorders and the stress that they are dealing with, it appears that is a genuine concern for the youth living in the United States. As educators, families, therapists, and other involved citizens, it seems that these youth need help. YOGA FOR ANXIETY 13 “The association between relaxation and physiological arousal reduction, underpins the rationale for incorporating relaxation as a component in interventions for young persons with emotional and behavioral difficulties,” (Wolpe, 1958). The author continues to state that relaxation is a way to decrease negative emotions and behaviors. The discussion of yoga as a vehicle to reduce anxiety symptoms has been discussed within this literature review. It is also important to note that an additional component of yoga’s teaching addresses the concept of mindfulness. An Adolescent Mindfulness Scale was created in 2011, (Brown, Loverich, West, and Biegel, 2011). Within this scale these four researchers attempted to determine if providing mindfulness practices to two different groups of adolescence would make a positive impact or not. The scale consisted of attending to experiences in the present moment, body scan meditation, sitting meditation, yoga practice, and walking meditation. The study was conducted with two separate populations of high school students. One of the groups of students was a group of neuro- typical students from public high schools across the United States. The second group of students was from a Child and Adolescent Psychiatry Department, who were being treated for a mental health issue. The results (Brown et. al, 2011) indicated that both groups were positively impacted; both groups had an increase in self-esteem, and they both had a decline in perceived stress. The group of students from the Child and Adolescent Psychiatry department also reported decreased symptoms of anxiety, and general psychological symptoms. The study on mindfulness as it was related to mediation, yoga, and bringing awareness to the present moment had a significant impact on typical youth, in addition to the youth who are undergoing mental health treatment. YOGA FOR ANXIETY 14 Physical Benefits It is also important to address the physical benefits that yoga brings to a person who practices it. According to medical professionals, (Streeter et al., 2010), whom conducted a 12week yoga intervention study to determine if yoga had any effects on mood and physical health. The subjects who participated in the yoga study were volunteers between the ages of 18-45, and they did not have a current Axis I diagnosis according to the Diagnostic and Statistical Manual of Mental Health Disorders IV. The results of the study indicated that the yoga -controlled group had improvements in mood and a decrease in anxiety symptoms. There was a positive correlation between acute increases in thalamic amino butyric acid or better know as GABA levels as well as improvements in mood and anxiety from the yoga subjects who completed the study. Gaba is an amino acid, which functions as the most prevalent neurotransmitter in the central nervous system. The 2010 study also determined that the yoga-controlled group’s cortisol levels decreased which lessens stress and anxiety in the body. According to this information, the body’s natural response to yoga is seen to be positive in nature. Experiential Project Overview For the Project portion of the research paper, I had the opportunity to bring Yoga into a metro Charter School as a supplement to a test-taking unit. This experiential project was an extremely gratifying experience because I could incorporate my counseling skills blending yoga and relaxation into student’s school days. This experiential project began with the assistance of a mentor counselor connection with the charter school. The mentor counselor knew my yoga background, and he asked me to join forces to create a comprehensive test-taking unit for the school. My mentor counselor and I met with the Charter School principal to get school background information, and to determine what our goals would be. We then went into a few YOGA FOR ANXIETY 15 classrooms to acquaint ourselves with the students and staff. My mentor teacher and I met to determine our plan for implementing the test taking strategy. There has been research conducted on various ways to prepare students for test taking, and we both determined that the more prepared students are the better the outcome. We then created a YouTube video of me teaching a ten-minute yoga sequence followed by a brief relaxation. This video was made available to the entire Charter School staff to implement in their classrooms. After greater discussion amongst my mentor counselor, the school principal, and myself the days came when we brought our test-taking unit into the classrooms. We visited every class in the school, so that each student had equal access to the information. The day consisted of the following components: introductions, and background information on test taking, a test taking questionnaire and an essay for the students to complete, interactive discussion on the importance of being prepared and finding strategies for test taking, and yoga and relaxation that can be done prior and during test taking. This comprehensive unit allowed for students to feel engaged and connected with us and with their peers. The questionnaires and the essays assisted in determining what students feel more anxious regarding test taking, and these students were identified and the information was shared with their teachers. This identified group of students became a small group, which I met with two additional times to guide them in yoga and relaxation strategies. The yoga portion of the unit was especially fun to be a part of because this was an activity that was very different from a typical school day. The majority of the students remained focused and calm, and they appeared to be enjoying themselves. They reported to their teachers that they enjoyed the yoga. Upon the conclusion of the test- taking unit, we shared a collection of other test preparation strategies with the school principal, so that he could utilize and share YOGA FOR ANXIETY 16 with his teaching staff. The end result was positive in the fact that the Charter School’s MCA math scores increased significantly from last school year. Summary Throughout this literature review there has been a revelation on symptoms that a person with anxiety bears, and there has been benefits presented on what the practice of yoga offers. Some of the significant factors that a person with anxiety deals with include: feeling of sadness and worry, low self-esteem and low self-worth, poor self regulation, limited emotional regulation, decreased academic functioning, inability to concentrate, and feelings of restlessness, and poor sleep patterns. There are direct correlations between a person who practices yoga which has been defined as: breathing exercises, physical postures, meditation, and relaxation, to positive benefits some of which include: improved mood, decreased stress activity, increased concentration and focus, enhanced breath control, improved sleep, improved self control, self efficacy, increased GABA levels, and decreased cortisol levels. After reviewing the numerous yoga intervention studies as they relate to both adults and young people, they demonstrate the impact that yoga has on a person’s overall well being. Discussion and Conclusions This literature review determined that yoga has many health benefits on a physical, emotional, mental, and spiritual level. This review reveals that yoga as it relates to youth is a new and growing field. As more research is being conducted relating these two factors, it would be valuable to share the information with people who would benefit from it such as educators, parents and families with children, therapists, counselors, clergy, sports coaches, and involved community members. Yoga as it relates to youth, specifically the impact that it may or may not YOGA FOR ANXIETY 17 have on those youth with anxiety related disorders, should be a topic that more time, data collection, and research development should be placed. Future Directions Yoga consisting of physical postures, breathing components, and meditation and mindfulness exercises has significant benefits on one’s health and well being. Yoga has proven to decrease anxiety symptoms in adults and youth alike, and it promotes relaxation as it allows the individual to reduce stress. Yoga could be a useful component for educators to use with youth in schools, for medical personnel to use with youth who are ill, and for families who have youth, to incorporate in their homes. Based on studies and findings within this article and continued research, yoga as a noncompetitive practice has proven to increase self-esteem and promote self-awareness, which are integral components in managing anxiety and enhancing mood. A future direction for the use of yoga might involve bringing yoga to multiple environments, and within multiple age groups to gather further data. YOGA FOR ANXIETY 18 References Baer R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology Science Practice, 10, 125-143 Barnes P. M., Powell-Giner E., McFann, K., & Nahin, R. L. (2004). 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H., Owen, L., Rein, T., Karri, S. K., Yakhkind, A., Perlmutter, R., Prescot, A., Renshaw, P. F., Ciraulu, D. A., & Jensen, J. E. (2010). Effects of yoga versus walking on mood, anxiety, and brain GABA levels: A randomized controlled MRS study. The Journal of Alternative and Complementary Medicine, 16(11), 11451152. Sibinga, E. M. S, Kerrigan, D., Stewart, M., Johnson, K., Magyari, T., & Ellen, J. M. (2011). Mindfulness-based stress reduction for urban youth. The Journal of Alternative and Complementary Medicine, 17(3), 213-218. doi: 10.1089/acm.2009.0605. Strauss, C. C., Frame, C. L., & Forehand, R. (1987). Psychosocial impairment associated with anxiety and children. Journal of Clinical Child Psychology, 16, 235-239. Suveg, C., Hoffman, B., Zeman, J. L., Thomassin, K. (2008). Common and specific emotion-related predictors of anxious and depressive symptoms in youth. Child Psychiatry Human Development, 40, 223-239. Wolpe, J. (1958). Psychotherapy by reciprocal inhibition. Stanford, CA: Stanford University Press. Zito, J. M., Safer, D. J., dosReis S., Gardner, J. F., Magder, L., Soeken, K., Boles, M., Lynch, F., & Riddle, M. A. (2003). Psychotropic practice patterns for youth: A 10-year perspective. Archives of Pediatrics & Adolescent Medicine, 157(1), 17-25. YOGA FOR ANXIETY 22 Appendix A Lesson Plan for Test Taking Strategies Background: Identify a school that is looking for ways to increase test scores and decrease test anxiety and related stressors 1. Educators who are leading the test taking strategy unit will meet with the school principal or testing coordinator to receive background information on the school. The team will develop a timeline and a plan for implementation of the test taking strategy unit. 2. The educator and any additional staff will meet to review school background as well as develop a test taking unit specific to the school’s needs. 3. The Educator trained in Yoga will create a short (8-10 minute) video guiding participants through a variety of breathing exercises and yoga poses. The video will conclude with a short relaxation. 4. The educator will visit the school and they will implement the test taking strategy unit to the entire school. Anticipatory set: Counselor or teacher will begin the session with a quick introduction of the lesson and the plan or agenda for the day. The educator(s) can share personal testing stories, which will assist in guiding the topic and overall feel of the day. The testing stories will conclude positively, which will instill a sense of optimism around test taking. 1. Students will take a short questionnaire while the educator reads the questions aloud and assists in pacing the class. The questionnaire will address how students’ feel about testing. The questionnaires would be gathered and the most anxious students would be identified. YOGA FOR ANXIETY 23 2. Students will then be given a short essay question regarding taking tests. The students will be given ample amount of time to write their feelings. The information would be gathered and shared with classroom teachers and school administrator(s). The most anxious students regarding taking tests will be identified. 3. The educator will explain the testing research that has been conducted, which has students’ write about their stressors or worries prior to taking tests. The research states that when a person is able to get the stressors out of their head and onto paper, it can help clear the stressor from the body. 4. Experiential/Hands on Activity: Yoga and Relaxation Students remained seated in their desks, but will be asked to slide their chairs away from their tables and to sit up tall. The yoga-trained educator will guide students through a series of yoga breathing exercises and yoga postures 1. Visualization Think of a time when you felt really successful or that you achieved or accomplished something. Where were you? Was anyone there with you? How do you feel when you think of this time in your life? YOGA FOR ANXIETY 24 2. Breathing exercises Breathing ball: students will use a hoberman sphere which is a ball that opens and closes which provides a visual of the lungs filling up and releasing air from the body. The pace of the inhalations and exhalations will be slow and steady. Volcano breath: The students will begin with their palms touching in front of their heart. If they feel comfortable they can close their eyes and picture something that feels stressful or upsetting to them. The students will then inhale and stretch their arms up overhead. They will then open their arms wide and release them down by sides on there exhale. This will simulate a volcano exploding and the student releasing the stressor or upsetting thought or feeling. Wood chopper breath: This breath will simulate a student chopping wood. The students will stand up. The students will interlace their fingers and they will stretch their arms overhead. The students will then swing their interlaced hands down towards the ground and say, “HUH!” to simulate chopping wood. The students are able to get loud and let out energy and emotion in this breathing exercise. 3. Yoga Poses Mountain Pose: students will start standing, and they will feel how they are strong and tall similar to a mountain. Students can practice shifting their weight from side to side, and they will feel how they are balanced in the center. YOGA FOR ANXIETY 25 Lifting and lowering hands to overhead to get full body stretch. Students will also place their hands on their chair or desk and place and walk their feet away from the desk so their backs can lengthen out and get a stretch. Lunges/Warriors: Students will step one foot back behind them and they will bend into their front legs. Students can stretch arms overhead to activate their legs. Students can then open their bodies up to the side and reach hands to the front and back of the room for the warrior pose. In this posture, students can visualize themselves doing something strong and they will recognize all the things they are good at. Repeat on other side coming back to center in between sides. Tree Pose: students will come back to their mountain pose; they will then begin to focus their eyes on one unmoving object. When students feel ready they will place one foot on top of their standing leg and they will work to maintain balance. This pose instills a sense of focus and determination. Repeat on other side. Eagle Pose: Students will start in mountain pose. They will take their right arm underneath their left arm and cross their hands at their shoulders. If students want to challenge their balance, they will bend both of their knees and they will cross right leg over their left leg and balance on one foot. The right and left hemispheres of the brain are activated in this pose and the student has to remain focused. Students will release out of their Eagle pose, and return back to Mountain Pose. YOGA FOR ANXIETY 26 Students will take three breaths guided by the breathing ball. Final Relaxation at desk: Students will be guided to return to their seats, and quietly begin to relax their bodies. Students can stack their fists on top of one another and then place their forehead on their fists. This assists in calming the mind and body. Students should stay in relaxation pose two to five minutes depending on time. When students are ready to come out of final relaxation, the yoga educator should maintain a quiet voice and keep the tone in the room calm. 4. Visualizations---calm energy in body and mind Students will again thing about a time when you felt successful or that you accomplished something Testing Preparation The Charter School Principal reviewed the questionnaires and essays, and the results were shared with educators who did the testing taking strategy unit. The students who demonstrated the greatest amount of anxiety regarding taking tests were identified. This group of students wrote honest essays regarding their feelings regarding taking tests. The results are unknown whether are not these identified students have anxiety over other issues, but we felt it was important to address this targeted group of students. YOGA FOR ANXIETY 27 The yoga trained educator returned to the Charter Middle School on two separate occasions to work with the small group of targeted students. During her time, she used yoga and relaxation strategies to assist students in gaining awareness of what it feels like in their bodies and minds when they are in a relaxed state. She taught them breathing exercises, and postures they could do at their desks prior to and during a test. The entire student body and staff all viewed a video co-created by the two educators that led participants through a guided breath and yoga flow to incorporate into test preparation. The staff will continue to have access to the video as a resource for further test preparation as well as providing relaxation tools to implement in the classroom on a continual basis. The YouTube video that was created is attached here. http://www.youtube.com/watch?v=98vd9HAKid0 After the school principal reviewed the questionnaires and test essays, he identified a group of ten students whose answers revealed they were very anxious about test taking. The yoga trained educator returned to work with this targeted group of students for two additional sessions. During the time she was there, she led the group in a variety of yoga postures and breathing exercises. The attached YouTube video documents one of the sessions. http://www.youtube.com/watch?v=fD-o31TLKyI YOGA FOR ANXIETY 28 Results The testing results for the Charter School were positive as a result of the test-taking unit. Students overall test scores in the Math MCA Statewide Test went from 63.8% proficiency to 70% proficiency. The school principal was very happy about these results. YOGA FOR ANXIETY 29 Appendix B Action Plan for implementation of yoga and relaxation in schools Yoga Calm is a research-based curriculum that delivers yoga, which is identified as mindfulness practices, physical poses, and nervous-system regulation with social emotional skill development and emotional support and guidance (Gillen, 2011). Yoga Calm is broken into four different levels of teaching, so that school staff can be trained in ways to implement yoga into the school system. There are simple, non-invasive ways to bring a sense of relaxation into the classroom within the design of the room. When students enter into a calm, free from distraction classroom, the students feel welcome and calm. It is important that students feel connected to the classroom or school community, by allowing them to personalize or decorate their space. Every classroom in a school could have a dedicated area in the room where a breathing ball, a chime, a rock, a picture of nature, or a plant reside to create a sense of calm and steadiness. The start of a school day could consist of breathing together and doing some warm up stretches to activate the brain and body. After lunch, the class could be guided in a couple of seated twists and backbends, so they are ready to focus for the remainder of the day. At the conclusion of the day, the class could be guided into a forward fold, or a stretch on their table or desk. A peaceful way to wrap up the school day would be for students to state a positive thing that happened in their day. Students could take turns leading the class with the breathing ball. Each student could rest their head on their desk for the last two minutes of the day to relieve any stress that the student or staff might have developed over the course of the day. YOGA FOR ANXIETY 30 As an assessment tool, teachers and staff could give students stress management surveys to determine if implementing yoga and relaxation strategies in the classroom is benefitting them. School personnel would need to get parent/guardian permission prior to the implementation of yoga and relaxation to the classroom. It would be beneficial to conduct parent surveys as well to determine if students are using the yoga and relaxation strategies they have learned during other times throughout their day. It would be ideal if all staff could attend a four- hour in-service on yoga calm or another type of relaxation curriculum to use in their classroom. At the training the facilitator would give the background and the research behind mind and body connections and the importance of activating the whole body for learning. Staff could break into small groups and determine how they can implement yoga and relaxation into their days without having it feel like it is a burden or an additional item that has to be completed. For the first year of implementation it would be helpful to have every other monthly one -hour workshops for the staff to discuss how it is going, and determine changes that need to be made. It would also be important that staff members are provided opportunities to receive yoga and relaxation from a trained yoga instructor. This could be on a weekly to monthly basis depending on the need and interest of the staff. The overall environment of the school could take on a warm, calm, and accepting place where everyone felt a sense of belonging.