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Specialized form of yoga expands rollout at Upstate to aid patients

Upstate University Hospital is working on expanding its offerings of Trauma-Adapted Yoga to more patients.

Trauma-Adapted Yoga, also known as Yoga for All, is a form of yoga based on trauma research, evidence-based yoga therapy and body-based methods with gentle exercises for self-management of common symptoms and reactions.  

Currently, it is a regular part of programming for adolescent inpatient psychiatry patients, with hopes to expand to adult psychiatric patients, and outpatient adolescent programs as well as patients in other units who experience chronic pain such as burn unit or oncology patients. Additionally, Nayla Khoury, MD, child and adolescent psychiatrist, who facilitates the program along with Jacquelynn Duquette, NP, and Kathryn Hagen PhD, said plans are to expand offerings to staff to help with stress relief.   

To meet these growing needs, 24 staff members, including attending physicians, residents, nurses, social workers, administrative staff and medical students, are currently being trained by the founders of TAY. 

Khoury describes TAY as a very simplified and gentle form of yoga practice that incorporates some traditional moves but with a different focus of attention. Khoury said that TAY helps individuals reclaim their bodies, improve PTSD symptoms and even behavior.  

“It is certainly not about perfecting any pose,” she said,” but really increasing proprioceptive and interoceptive awareness in the body.” 

Khoury said it avoids complex poses that might leave people feeling vulnerable and that autonomy, choice, agency and safety are front and center.

“We want to promote safety as much as possible,” said Khoury, assistant professor of psychiatry and behavioral sciences. “Some of that is about being attuned to language, being attuned to structure and space in the room, to predictability to scaffolding a class or a practice, to have predictable steps and sequence and giving people choice. Any time we offer a pose or a breathing practice there is always choice.” 

TAY is focused on the nervous system and helping people to regulate or rebalance the nervous system that is either hyper-aroused from trauma or anxiety or hypo-aroused in the case of people who are shut down and depressed, she said. 

On the adolescent psychiatric floor, TAY is offered twice a week in the group therapy rooms and is open to all by invitation, with specific exclusion criteria based on safety concerns.  

“We have said to adolescent patients you are welcome to come and sit on a mat if you are not ready to participate with your body, and some of them say their stress levels go down just by being in that environment,” Khoury said. 

Khoury adds that TAY is also used by individual clinicians as another tool in their toolbox, where they may suggest a breathing exercise or a pose to a patient during care. Patients at Upstate’s Adolescent Intensive Outpatient Programs are being encouraged to try TAY as part of a study led by Hagen, the principal investigator. Eventually, the goal is to expand it to all outpatient programs for youths.  

Staff members are currently being trained on all inpatient psychiatric units to expand the offerings to adults as well. 

Khoury said the rollout is a work in progress but expects the expanded offerings to staff and various patient populations to begin soon. Currently, there are only a handful of staff members fully trained to do the sessions. The goal is to offer weekly sessions to staff. 

“We need a much bigger team to increase the offerings,” Khoury said. “The focus of TAY is to help our staff and clinicians and everyone throughout the hospital to build resilience, to re-regulate and be able to take care of themselves in the stress of everyday work.” 

Caption: Trauma-adapted yoga expert Josefin Wikstrom, left, leads a yoga training class with Nayla Khoury, MD, Upstate child and adolescent psychiatrist.