Yo g a T h e r a p y Today | Winter 2016
By Kristine Kaoverii Weber and Brett Sculthorp
Link to full article:
Excerpts complied by Lauren Spiro
The MGH Benson-Henry Institute recently released a cohort study1 showing that relaxation practices like yoga postures, breathing practices, and meditation can reduce the need for medical care by 43%. A February 2015 report from the Centers for Disease Control and Prevention (CDC)2 cited yoga as one of the most commonly utilized complementary and integrative medicines in America.
While a growing number of researchers and federal agencies like the CDC and the National Institutes of Health (NIH) acknowledge the medical benefits of these practices, the question of how to integrate yoga into the healthcare system remains largely unaddressed by these agencies.
Launched in 2007 by the Institute for Healthcare Improvement (IHI), a nonprofit
focused on testing new models of care, best practices, and effective innovations,
The Triple Aim intends to optimize health system performance by serving three
goals: improving the health of populations, reducing costs, and improving patient
experience of care.
The Triple Aim is now widely looked to as a framework for creating better healthcare,
partly because it was adopted into the Affordable Care Act in 2010.
Yoga is accessible, adaptable, low risk, low cost, and has a broad and growing research base. It has the potential to be integrated into any number of services—for example, a mental health outpatient program at a community mental health center, a weight loss program in a health department, and an employee wellness program at a hospital.
The biopsychosocialspiritual model is considered the gold standard for understanding and treating many diseases.
When human beings are perceived as multilayered and intrinsic to their environments, the viewpoint of the causes of disease begins to shift, as do the approaches to disease treatment and prevention. Health is seen not as a purely biological or personal phenomenon; it is the result of an intricate web of interrelated factors, behaviors, patterns, and interactions. For yoga therapists, it may seem obvious that the benefits of yoga permeate all layers of this model, and research has demonstrated that yoga has numerous structural, physiological, mental health, and social benefits. What may be less obvious to yoga therapists, however, is that these benefits can be scaled to population health through, for example, integrated care strategies that merge mental health and primary care services. If the well-known benefits of yoga—such as improved parasympathetic nervous system function and psychoemotional benefits—are scaled to the community level, we will start to see shifts in population health outcomes. Tremendus potential benefits to society could be realized by approaching yoga therapy through a population health lens.
Health Professional Education
Understanding health through the biopsychosocialspiritual model opens the possi-
bility of a broader agenda for health professional education. How do healthcare professionals need to be educated in order to better understand and address the complex web of health-related factors? How can CIM providers build bridges in thinking and collaboration across what has become a landscape of highly specialized and disciplinary areas of healthcare?
The National Center for Interprofessional Practice and Education has a role in coordinating and documenting new education models, practice competencies, and initiatives across the United States. It has adopted an interdisciplinary mindset and is open to new ideas and new areas of professional engagement. This center and similar organizations can be nodes for CIM integration, where yoga therapy trainers can become a part of implementing whole health pedagogies.
Yoga Therapy Can Reduce Costs
The United States will spend about $10,000 per person on healthcare in 2015 ($3.2 trillion in total), yet our outcomes look more like those of a developing country. Much of the expense can be attributed to (1) high administrative costs (one quarter of all costs); (2) high costs of medications, durable medical equipment, and salaries; and (3) the relatively higher rate of interventions compared to other industrialized countries.
Yoga therapy services, however, can be delivered in ways that are not top heavy in staff or administration, that do not require any expensive equipment, and with minimal interventions that involve props to help with asana practice. When yoga therapy is provided in groups, direct costs (therapist’s fee, equipment, overhead, etc.) are low. From a lifestyle medicine or prevention perspective, these costs become almost negligible. Yoga-based lifestyle change can reverse heart disease and positively impact other chronic illnesses. Many of these illnesses (as well as chronic pain and addiction challenges) respond well to lifestyle therapy, which is starting to be considered best practice in some areas of medicine.
Yoga is unique in providing interventions across the four domains of public
health—treatment, recovery, prevention, and health promotion. The time for yoga
to become a part of the healthcare system is here. The yoga therapy community
should partner with healthcare leaders to initiate both top-down policy-level advoca-
cy and initiatives and bottom-up local-level integrative models. Yoga professionals
can facilitate this shift by becoming more engaged in a broader range of health
and research institutions and by conducting their own small-scale research, as
well as by training the healthcare work-force in the value of including yoga therapy in an integrated healthcare system.