Integrating yoga therapy more fully into health care settings and structures is considered by many to be the path forward for the profession, leading the way to sustainable careers and the mainstreaming of the use of yoga therapy among the population.
It’s been a tough nut to crack. Lack of awareness and understanding of yoga therapy on the part of health-care professionals, structural rigidity within health-care structures and lack of insurance reimbursement for yoga therapy have been major obstacles.
But there is progress to report and more opportunities today than ever before to make inroads, according to several global leaders in the field of yoga therapy.
Here are their takeaways on what is working and how to build on those successes:
Four success stories
Heather Mason, director of the Yoga in Healthcare Alliance in the United Kingdom and the secretariat for the British Parliamentary Group on Yoga in Society, mentioned four programs that are finding success around the world. All of the programs, she said, do a good job of targeting a stated goal of the health-care organization involved, a key to their success.
The Mediyoga program in Sweden developed by Goran Boll (who will present on this topic in the upcoming Global Yoga Therapy Day Conference) is a great example of a yoga therapy program that has flourished because it has shown healthcare policymakers that it meets their benchmarks, Mason said. More than 20 percent of hospitals and clinics in Sweden offer the Mediyoga program, and it is being increasingly copied.
In the U.K., Mason and her partner at the Yoga in Healthcare Alliance, Paul Fox, have developed a yoga therapy program designed for the country’s social prescribing initiative. Under the social prescribing plan, individuals can be referred to community group activities, such as yoga, by a primary health professional. “It’s really quite ingenious,” Mason said. “It’s based on the philosophy that poor health outcomes are associated with isolation, because of poor health behaviors but also cardiological neurological health dysfunction.”
Like the Mediyoga program in Sweden, the yoga therapy program developed by Mason and Fox promotes the program’s usefulness in targeting specific health goals identified by the National Health Service, including improving heart health and reducing stress and anxiety. The program is upscaling in the U.K. and being exported, said Mason, who is also the founder of The Minded Institute, which offers yoga therapy training.
Other yoga-in-health-care success stories include the AYUSH program in India, which brings traditional Indian therapies, including yoga and ayurveda, to underserved rural areas, and the Dean Ornish program for reversing heart disease, which includes yoga therapy. The program, which was promoted as a way to keep health care costs down, an overarching goal of health-care organizations, is now reimbursed by Medicare and several big private insurers.
Covid-19 brings opportunity
Matthew Taylor, a former IAYT board president who has held national yoga therapy leadership roles for more than 20 years, told the forum that the pandemic has both brought great uncertainty as well as great opportunity.
To the question of what insurer reimbursement will look like in the future, Taylor said the state of reimbursement is in flux literally around the world as both state and private insurers grapple with the effects of the pandemic.
But amid the pandemic uncertainty lie a lot of opportunities for yoga therapy, said Taylor, who is currently working with UnitedHealthcare, the world’s largest health insurer, on research and clinical applications.
Big insurers like UnitedHealthcare are not only looking at patient outcomes, but are increasingly looking at employee health, and actively seeking ways to prevent employee burnout.
“When you look at replacing a nurse or doctor, that’s tens of thousands of dollars, if not six figures,” Taylor said. If yoga therapy programs can demonstrate that they enhance quality of life and job satisfaction in a way that retains employees, that’s a pocketful of money saved for them,” he said.
As for addressing the needs of Covid-19 sufferers themselves, there are millions of people who are likely to become long-haulers. That creates a new chronic long-term health condition that will need to be addressed, Taylor said. Yoga therapy has all the tools and is ideally suited to provide such individuals with the holistic tools and sense of safety that are needed for healing.
For a deeper dive into the challenges, and opportunities, of addressing wellness in the Covid era, the Yoga in Healthcare Alliance and Give Back Yoga Foundation are sponsoring a virtual “Wellness After Covid” virtual symposium from May 28-30.
A yoga therapy pilot program for healthcare employee burnout
One organization acting on these opportunities is Yoga for Better Health, which will deliver starting in June a six-week customized therapeutic yoga program to healthcare employees of the VA’s Tennessee Valley Healthcare System.
> Assess the impact a six-week customized therapeutic yoga program has on employee health, resilience, stress and burnout
The purpose of the program will be to
> Measure the demand for delivering real-time therapeutic group yoga online vs. pre-recorded content
> Measure the impact of an employer-mandated yoga program vs. waitlist control
> Better understand employee sentiment, adherence and efficacy of the program
> Assess the health economic impact of the program, with a view to expanding research and rollout of further trials
Individuals or groups that are seeking to offer a yoga therapy pilot program to health care organizations should first make sure they have the time and have secured the resources to host such a program and that the project fits with their own professional strategic objectives. The aims and purpose of pilot programs, such as to measure the efficacy of a protocol or publish research, should be clearly defined and stated.
Johnston agreed with other yoga therapy leaders that the objective of any pilot program should be proposed as a partnership with the healthcare organization to help and meet their objectivesn and gain buy-in.
Building the evidence base for yoga therapy in health care
Marlysa Sullivan, a leading yoga therapy educator and researcher, said it is important to consider how proposed programs can build the case, and the evidence base, for yoga therapy in health care. She said there are many ways a program can add to the body of published research, in the form of theoretical or perspective pieces, case reports, papers that discuss a study protocol, and program evaluations.
Program evaluations, she said, have the particular benefit of reflecting real world conditions and clinical experience vs. what happens in controlled environments such as randomized trials, which often do not reflect what actually happens in clinical settings.
Sullivan said that outcome measurements should be considered carefully when designing yoga therapy programs and research. Outcome measures should demonstrate the uniqueness and importance of yoga therapy and should also reflect what is meaningful for the funders of the study and the society at large.
What the IAYT is doing to help
Getting yoga therapy into health care will require continued career development and marketing support from national and international yoga therapy associations.
Alyssa Wostrel, the executive director of the International Association of Yoga Therapists, said the IAYT was moving ahead with a Yoga Therapy certification exam, which will serve to amplify the visibility and credibility of the profession, as well as to ensure the safety of and standardize the work that yoga therapists do.
In addition, Wostrel said the IAYT was looking to enhance its career development efforts to include outreach efforts to promote yoga therapy to HR managers in hospital systems. She said the association was also looking to collaborate with other organizations, including the Social Workers Association, in an effort to expand career opportunities for the yoga therapist.
Keys to success
For those frustrated by today’s barriers to entry into healthcare settings, Taylor counsels persistence, patience and a dose of humility. “We didn’t even have yoga therapy defined 14 years ago. The fact is that it’s not fully integrated into the health care system where we live is not a surprise.”
The more a yoga therapist speaks the language of the healthcare industry and looks to partner with, and not replace, healthcare professionals, the sooner they will get a seat at the table, the yoga therapy experts agreed.
Taylor counsels against proposing yoga therapy programs that replicate services that other health-care professionals, such as physical therapists or respiratory therapists, are trained to do. The value of yoga therapy, he said, goes beyond individual symptoms and conditions.
“Don’t be the expert in all. Be an expert in some things and refer out” to other professionals for others, said Wendy Landry, a certified yoga therapist and owner of Om Prana Yoga in Parkville, Mo. “There’s a space for all.”
Landry, the community manager for the upcoming Global Yoga Therapy Day (GYTD), also informs of the networking and marketing opportunities available for yoga therapists to connect and share their knowledge through the community sessions of the upcoming GYTD conference. “This is an opportunity for you to get in front of a global audience of healthcare employees and organizations interested in how yoga is therapeutically used to enhance health and well-being; we hope to feature 100+ yoga therapists around the world interested in bringing yoga into health care.”
Above all, the yoga therapy experts agree, when you reach out, propose partnerships that meet the objectives of the health-care institution or system involved. These may include programs that deliver on public health priorities, such as non-pharmacological care on chronic pain, community giveback and outreach and innovative wellness programs for employees and patients.
The fact that yoga therapy is still emerging is actually a plus, Taylor said. “We are small and can move quickly.” “If we can show up in various venues and deliver value, then that is going to bring us to the table much more quickly and effectively.”
Want to learn more? Make sure to join us at the Global Yoga Therapy Day Conference, Aug 13-15. The conference is particularly focused on the integration of yoga into healthcare and features global experts including Sat Bir Khalsa, Alison Whitehead, Saraswathi Vasudevan. To stay up to date with Global Yoga Therapy Day announcements make sure to be on the mailing list!
Article written by Kelly Couturier
Kelly Couturier, MS, C-IAYT, is a yoga therapist at the Addiction Institute of Mount Sinai in New York City. She also teaches yoga and meditation, with both corporate and individual clients.