1 2473 179 YOGA AS ADJUNCTIVE THERAPY IN THE TREATMENT OF PEOPLE WITH ANOREXIA NERVOSA: A DELPHI STUDY. BACKGROUND: THERE IS PRELIMINARY EVIDENCE TO SUGGEST THAT YOGA CAN BE BENEFICIAL IN REDUCING ANXIETY, DEPRESSION AND GENERAL EATING DISORDER SYMPTOMS IN PEOPLE WITH ANOREXIA NERVOSA (AN). IT IS UNCLEAR WHETHER THE THERAPEUTIC BENEFITS OF YOGA ARE SUPPORTED OR UTILISED IN THE TREATMENT OF AN AMONGST CLINICAL EXPERTS. THE PRESENT STUDY AIMED TO EXPLORE AND SYNTHESISE EXPERT OPINION ON THE USE OF YOGA AS AN ADJUNCTIVE THERAPY IN THE MANAGEMENT OF ANXIETY, DEPRESSION AND OVER-EXERCISE IN INDIVIDUALS WITH AN. METHODS: A DELPHI METHODOLOGY WAS EMPLOYED, WITH CLINICIANS CONSIDERED EXPERTS IN THE TREATMENT OF AN RECRUITED INTERNATIONALLY TO FORM THE PANEL (N = 18). THE FIRST ITERATION OF QUESTIONNAIRES COMPRISED OF FOUR OPEN-ENDED QUESTIONS CONCERNING THE EXPERTS' UNDERSTANDING OF THE TERM YOGA AND OPINIONS ON ITS' USE IN THERAPY GENERALLY AND MORE SPECIFICALLY IN THE TREATMENT OF AN. USING CONTENT ANALYSIS, STATEMENTS WERE DERIVED FROM THIS DATA AND INCLUDED AS LIKERT-BASED ITEMS IN TWO SUBSEQUENT ROUNDS WHERE PANELLISTS RATED THEIR LEVEL OF AGREEMENT ON EACH ITEM. SEVENTEEN OUT OF 18 RESPONDENTS COMPLETED ALL THREE ITERATIONS. RESULTS: CONSENSUS (LEVEL OF AGREEMENT DEFINED AT >/= 85%) WAS ACHIEVED FOR 36.47% OF THE ITEMS INCLUDED IN THE SECOND AND THIRD ROUNDS. THE PANEL REACHED CONSENSUS ON ITEMS DEFINING YOGA AND PERTAINING TO ITS' GENERAL BENEFITS. THE PANEL AGREED THAT YOGA IS A ADJUNCT THERAPY FOR VARIOUS PROBLEMS, CONSENSUS WAS NOT ACHIEVED ON THE SPECIFIC USE OF YOGA AS AN ADJUNCT THERAPY IN THE TREATMENT OF COMORBID ANXIETY, DEPRESSION OR TRAUMA IN PATIENTS WITH AN. ALTHOUGH THE EXPERT PANEL ACKNOWLEDGED A NUMBER OF BENEFITS FOR USE OF YOGA IN AN, THEY STRONGLY ENDORSED THAT FUTURE RESEARCH SHOULD EVALUATE THE POTENTIAL RISKS OF USING YOGA AS AN EMBODIED PRACTICE. CONCLUSIONS: IT IS POSSIBLE THAT YOGA COULD BE CONSIDERED FOR INCLUSION IN FUTURE GUIDELINES IF SUPPORTED BY EMPIRICAL RESEARCH. WE CONCLUDE THAT THERE SEEMS TO BE ENOUGH CONSENSUS THAT SUCH FURTHER SCIENTIFIC INVESTIGATION IS WARRANTED. THIS STUDY AIMED TO EXPLORE EXPERT OPINION ON THE USE OF YOGA AS AN ADJUNCTIVE THERAPY IN THE MANAGEMENT OF ANXIETY, DEPRESSION AND OVER-EXERCISE IN INDIVIDUALS WITH ANOREXIA NERVOSA (AN). CLINICIANS CONSIDERED EXPERTS IN THE TREATMENT OF AN RECRUITED INTERNATIONALLY TO FORM THE PANEL (N = 18). EXPERTS WERE ASKED ABOUT THEIR UNDERSTANDING OF THE TERM YOGA AND THEIR OPINIONS ON ITS' USE IN THERAPY. THE PANEL REACHED CONSENSUS ON ITEMS DEFINING YOGA AND PERTAINING TO ITS' GENERAL BENEFITS. ALTHOUGH THE PANEL AGREED THAT YOGA IS A NICE ADDITIONAL THERAPY FOR VARIOUS PROBLEMS, CONSENSUS WAS NOT ACHIEVED ON THE USE OF YOGA AS AN ADDITIONAL THERAPY IN THE TREATMENT OF SPECIFIC PROBLEMS LIKE ANXIETY, DEPRESSION OR TRAUMA IN PEOPLE WITH AN. THE EXPERT PANEL ACKNOWLEDGED A NUMBER OF BENEFITS FOR USE OF YOGA IN AN. HOWEVER THE PANEL STRONGLY CONSIDERED THAT FUTURE RESEARCH SHOULD EVALUATE THE POTENTIAL RISKS OF USING YOGA AS AN EMBODIED PRACTICE. THE AREAS OF COLLECTIVE AGREEMENT GAINED IN THE STUDY CAN SERVE AS PRELIMINARY GUIDELINES FOR THE USE OF YOGA IN AN WHILST GUIDING FUTURE RESEARCH DIRECTIONS. 2021 2 1159 58 ESTABLISHING KEY COMPONENTS OF YOGA INTERVENTIONS FOR REDUCING DEPRESSION AND ANXIETY, AND IMPROVING WELL-BEING: A DELPHI METHOD STUDY. BACKGROUND: PREVIOUS RESEARCH SUGGESTS BENEFITS OF YOGA IN REDUCING DEPRESSION AND ANXIETY. HOWEVER, COMMON CONCERNS IN REVIEWS OF THE RESEARCH INCLUDE LACK OF DETAIL, RATIONALE AND CONSISTENCY OF APPROACH OF INTERVENTIONS USED. ISSUES RELATED TO HETEROGENEITY INCLUDE AMOUNT, TYPES AND DELIVERY OF YOGA INTERVENTIONS. THIS STUDY AIMS TO DOCUMENT CONSENSUS-BASED RECOMMENDATIONS FOR CONSISTENCY OF YOGA INTERVENTIONS FOR REDUCING DEPRESSION AND ANXIETY. METHODS: THE DELPHI METHOD WAS USED TO ESTABLISH CONSENSUS FROM EXPERIENCED YOGA TEACHERS. THIRTY-THREE ELIGIBLE TEACHERS WERE INVITED TO PARTICIPATE, FROM FOUR DIFFERENT COUNTRIES. TWO ROUNDS OF AN ONLINE SURVEY WERE SENT TO PARTICIPANTS. THE FIRST ROUND SOUGHT INITIAL VIEWS. THE SECOND ROUND SOUGHT CONSENSUS ON A SUMMARY OF THOSE VIEWS. SURVEY QUESTIONS RELATED TO FREQUENCY AND DURATION (DOSAGE) OF THE YOGA, APPROACHES AND TECHNIQUES TO BE INCLUDED OR AVOIDED, AND TRAINING AND EXPERIENCE FOR YOGA TEACHERS. RESULTS: TWENTY-FOUR TEACHERS AGREED TO PARTICIPATE. EIGHTEEN COMPLETED THE SECOND ROUND (N = 18). GENERAL CONSENSUS (>75% OF PARTICIPANTS IN AGREEMENT) WAS ACHIEVED ON PARAMETERS OF PRACTICE (DOSAGE): AN AVERAGE OF 30 TO 40 MINUTES, TO BE DONE 5 TIMES PER WEEK, OVER A PERIOD OF 6 WEEKS. NUMEROUS RECOMMENDATIONS FOR YOGA TECHNIQUES TO INCLUDE OR AVOID WERE COLLECTED IN THE FIRST ROUND. THE SECOND ROUND PRODUCED A CONSENSUS STATEMENT ON THOSE RECOMMENDATIONS. BREATH REGULATION AND POSTURES WERE CONSIDERED VERY IMPORTANT OR ESSENTIAL FOR PEOPLE WITH DEPRESSION; AND RELAXATION, BREATH REGULATION AND MEDITATION BEING VERY IMPORTANT OR ESSENTIAL FOR PEOPLE WITH ANXIETY. OTHER RECOMMENDED COMPONENTS ALSO ACHIEVED CONSENSUS. THERE WAS ALSO GENERAL CONSENSUS THAT IT IS VERY IMPORTANT OR ESSENTIAL FOR TEACHERS TO HAVE A MINIMUM OF 500 TRAINING HOURS OVER 2 YEARS, AT LEAST 2 YEARS TEACHING EXPERIENCE, TRAINING IN DEVELOPING PERSONALISED YOGA PRACTICES, TRAINING IN YOGA FOR MENTAL HEALTH, AND PROFESSIONAL SUPERVISION OR MENTORING. CONCLUSIONS: THE DELPHI PROCESS HAS ACHIEVED A CONSENSUS STATEMENT ON THE APPLICATION OF YOGA FOR REDUCING ANXIETY AND DEPRESSION. THIS CONSENSUS PROVIDES A CHECKLIST FOR IDENTIFICATION OF COMMONALITIES AND EVALUATION OF PAST RESEARCH. FUTURE RESEARCH CAN PROCEED TO DEVELOP AND EVALUATE CONSENSUS-BASED YOGA INTERVENTION PROTOCOLS FOR THE REDUCTION OF ANXIETY AND DEPRESSION, AND IMPROVEMENTS IN WELL-BEING. 2015 3 2903 48 [HOW SHOULD YOGA IN ANOREXIA NERVOSA TREATMENT BE APPLIED? A QUALITATIVE PILOT STUDY ON YOGA STRATEGIES PERCEIVED TO BE BENEFICIAL FROM PATIENTS' PERSPECTIVE]. AN ALTERED INTEROCEPTION IS A CENTRAL CORRELATE OF ANOREXIA NERVOSA (AN) AND ADDRESSING THIS ISSUE OFFERS A PROMISING APPROACH IN THE TREATMENT OF AN. FIRST RESULTS HAVE SHOWN THE EFFECTIVENESS OF YOGA AS A BODY-FOCUSED INTERVENTION IN THE TREATMENT OF AN. HOWEVER, TO DATE THERE IS A LACK OF EMPIRICAL EVIDENCE REGARDING THE QUESTION HOW YOGA STRATEGIES AND YOGA ELEMENTS (POSTURES, RELAXATION, BREATH, MEDITATION) SHOULD BE APPLIED. AGAINST THIS BACKGROUND, WE CONDUCTED A QUALITATIVE PILOT STUDY WITH N=6 FEMALE PATIENTS WITH AN UNDERGOING TREATMENT IN A SPECIALIST UNIT SUPPORTING RE-INSERTION SUBSEQUENT TO A PRECEDING INPATIENT AN TREATMENT. STUDY PARTICIPANTS RECEIVED A WEEKLY ONE-HOUR HATHA-YOGA INTERVENTION OVER AT LEAST 12 WEEKS. AFTER THE YOGA INTERVENTION, SEMI-STRUCTURED INTERVIEWS (1/2 TO 1 HOUR) WERE CONDUCTED TO ASSESS THE EXPERIENCES OF THE STUDY PARTICIPANTS DURING THE YOGA INTERVENTION. THE DATA WERE ANALYZED USING GROUNDED THEORY. AT THE UPPER LEVEL OF ANALYSIS, FOUR CATEGORIES WERE DIFFERENTIATED: INFORMATION REGARDING 1) STUDY PARTICIPANTS' SYMPTOMS, 2) ASPECTS OF THE SETTING EXPERIENCED TO BE BENEFICIAL, 3) YOGA STRATEGIES PERCEIVED TO BE BENEFICIAL AND 4) PERCEIVED CONSEQUENCES OF YOGA STRATEGIES. WITH REGARD TO THE YOGA STRATEGIES PERCEIVED TO BE BENEFICIAL, ANALYSES REVEALED 4 SUBCATEGORIES: FEATURES OF 1) POSTURES AND MOVEMENTS, 2) BREATH AND MEDITATION EXERCISES, 3) RELAXATION EXERCISES AND 4) GENERAL INFORMATION ABOUT THE SETTING. THE RESULTS GIVE FIRST INDICATIONS REGARDING THE CONCEPTUALIZATION OF YOGA IN THE TREATMENT OF AN AND POTENTIAL MECHANISMS. FURTHER QUALITATIVE AND QUANTITATIVE STUDIES ARE NEEDED, E.G., WITH REGARD TO EFFECTIVENESS, CONTRAINDICATIONS, MEDIATORS OR MODERATORS TO BETTER EVALUATE THE POTENTIAL OF YOGA IN THE TREATMENT OF AN. 2021 4 2453 41 YOGA AS A COMPLEMENTARY THERAPY FOR CHILDREN AND ADOLESCENTS: A GUIDE FOR CLINICIANS. YOGA IS BEING USED BY A GROWING NUMBER OF YOUTH AND ADULTS AS A MEANS OF IMPROVING OVERALL HEALTH AND FITNESS. THERE IS ALSO A PROGRESSIVE TREND TOWARD USE OF YOGA AS A MIND-BODY COMPLEMENTARY AND ALTERNATIVE MEDICINE INTERVENTION TO IMPROVE SPECIFIC PHYSICAL AND MENTAL HEALTH CONDITIONS. TO PROVIDE CLINICIANS WITH THERAPEUTICALLY USEFUL INFORMATION ABOUT YOGA, THE EVIDENCE EVALUATING YOGA AS AN EFFECTIVE INTERVENTION FOR CHILDREN AND ADOLESCENTS WITH HEALTH PROBLEMS IS REVIEWED AND SUMMARIZED. A BRIEF OVERVIEW OF YOGA AND YOGA THERAPY IS PRESENTED ALONG WITH YOGA RESOURCES AND PRACTICAL STRATEGIES FOR CLINICAL PRACTITIONERS TO USE WITH THEIR PATIENTS. THE MAJORITY OF AVAILABLE STUDIES WITH CHILDREN AND ADOLESCENTS SUGGEST BENEFITS TO USING YOGA AS A THERAPEUTIC INTERVENTION AND SHOW VERY FEW ADVERSE EFFECTS. THESE RESULTS MUST BE INTERPRETED AS PRELIMINARY FINDINGS BECAUSE MANY OF THE STUDIES HAVE METHODOLOGICAL LIMITATIONS THAT PREVENT STRONG CONCLUSIONS FROM BEING DRAWN. YOGA APPEARS PROMISING AS A COMPLEMENTARY THERAPY FOR CHILDREN AND ADOLESCENTS. FURTHER INFORMATION ABOUT HOW TO APPLY IT MOST EFFECTIVELY AND MORE COORDINATED RESEARCH EFFORTS ARE NEEDED. 2010 5 2247 38 THE INTEGRATION OF YOGA IN PHYSICAL THERAPY CLINICAL PRACTICE. HEALTH PROFESSIONALS ARE BEGINNING TO USE YOGA AS A TREATMENT MODALITY. HOWEVER, EVIDENCE EXPLAINING PHYSICAL THERAPISTS' INTEGRATION OF YOGA IN CLINICAL PRACTICE IS LACKING. OBJECTIVE: THE PURPOSE OF THIS STUDY WAS TO EXPLORE HOW, WHY, AND WITH WHOM PHYSICAL THERAPISTS INTEGRATE YOGA INTO CLINICAL PRACTICE. DESIGN: THIS STUDY IS A SECONDARY ANALYSIS OF QUALITATIVE DATA COLLECTED DURING A LARGER MULTI-METHODS STUDY. THEMATIC ANALYSIS OF 13 INTERVIEWS WAS CONDUCTED. RESULTS: ANALYSIS INDICATED FOUR THEMES, AND SIX SUBTHEMES. FACILITATING YOGA IN CLINICAL PRACTICE AND YOGA TRAINING THEMES; INCLUDING EVALUATION OF OUTCOMES, BILLING, TERMINOLOGY, AND SAFETY SUBTHEMES DESCRIBE HOW PHYSICAL THERAPISTS ARE USING YOGA IN CLINICAL PRACTICE. THE PERCEIVED CLIENT OUTCOMES THEME, INCLUDING PHYSICAL AND PSYCHOSOCIAL OUTCOMES EXPLAIN WHY PHYSICAL THERAPISTS USE YOGA IN PRACTICE. THE YOGA WITH CLINICAL POPULATIONS THEME ADDRESSES WITH WHOM PHYSICAL THERAPISTS ARE USING YOGA. CONCLUSION: PHYSICAL THERAPISTS ARE USING YOGA WITH INDIVIDUALS WITH VARIOUS HEALTH CONDITIONS TO IMPROVE THEIR PHYSICAL AND MENTAL HEALTH. FINDINGS SUPPORT THE NEED FOR PHYSICAL THERAPISTS TO INCREASE THEIR ASSESSMENT AND DOCUMENTATION OF FUNCTIONAL OUTCOMES ASSOCIATED WITH CLIENT'S YOGA PARTICIPATION. DOCUMENTATION COULD CONTRIBUTE TO EVIDENCE-BASED LITERATURE RELATED TO HOW, WHY, AND WITH WHOM PHYSICAL THERAPISTS ARE USING YOGA. DOCUMENTED OUTCOMES COULD ALSO PROVIDE RATIONALE FOR YOGA TO RECEIVE CLASSIFICATION AS A REIMBURSABLE COMPLEMENTARY AND INTEGRATIVE HEALTH APPROACH. FUTURE RESEARCH INVOLVING A LARGER, DIVERSE SAMPLE (E.G., PHYSICAL THERAPISTS WITH VARYING LEVELS OF EDUCATION AND YOGA TRAINING) FOCUSED ON HOW, WHY, AND WITH WHOM PHYSICAL THERAPISTS INTEGRATE YOGA INTO CLINICAL PRACTICE IS RECOMMENDED. 2021 6 1218 31 EXPLORING THE THERAPEUTIC EFFECTS OF YOGA AND ITS ABILITY TO INCREASE QUALITY OF LIFE. THE OBJECTIVE OF THIS STUDY IS TO ASSESS THE FINDINGS OF SELECTED ARTICLES REGARDING THE THERAPEUTIC EFFECTS OF YOGA AND TO PROVIDE A COMPREHENSIVE REVIEW OF THE BENEFITS OF REGULAR YOGA PRACTICE. AS PARTICIPATION RATES IN MIND-BODY FITNESS PROGRAMS SUCH AS YOGA CONTINUE TO INCREASE, IT IS IMPORTANT FOR HEALTH CARE PROFESSIONALS TO BE INFORMED ABOUT THE NATURE OF YOGA AND THE EVIDENCE OF ITS MANY THERAPEUTIC EFFECTS. THUS, THIS MANUSCRIPT PROVIDES INFORMATION REGARDING THE THERAPEUTIC EFFECTS OF YOGA AS IT HAS BEEN STUDIED IN VARIOUS POPULATIONS CONCERNING A MULTITUDE OF DIFFERENT AILMENTS AND CONDITIONS. THERAPEUTIC YOGA IS DEFINED AS THE APPLICATION OF YOGA POSTURES AND PRACTICE TO THE TREATMENT OF HEALTH CONDITIONS AND INVOLVES INSTRUCTION IN YOGIC PRACTICES AND TEACHINGS TO PREVENT REDUCE OR ALLEVIATE STRUCTURAL, PHYSIOLOGICAL, EMOTIONAL AND SPIRITUAL PAIN, SUFFERING OR LIMITATIONS. RESULTS FROM THIS STUDY SHOW THAT YOGIC PRACTICES ENHANCE MUSCULAR STRENGTH AND BODY FLEXIBILITY, PROMOTE AND IMPROVE RESPIRATORY AND CARDIOVASCULAR FUNCTION, PROMOTE RECOVERY FROM AND TREATMENT OF ADDICTION, REDUCE STRESS, ANXIETY, DEPRESSION, AND CHRONIC PAIN, IMPROVE SLEEP PATTERNS, AND ENHANCE OVERALL WELL-BEING AND QUALITY OF LIFE. 2011 7 1715 40 PERCEIVED MECHANISMS OF CHANGE IN THERAPEUTIC YOGA TARGETING PSYCHOLOGICAL DISTRESS. INTRODUCTION: THIS STUDY WAS DESIGNED TO INVESTIGATE YOGA TEACHERS' AND YOGA THERAPISTS' PERCEPTIONS OF THE WAYS YOGA IS APPLIED TO TREAT SYMPTOMS OF PSYCHOLOGICAL DISTRESS, AND IDENTIFY THE DEFINING FEATURES, MAIN COMPONENTS, AND MECHANISMS OF CHANGE IN THERAPEUTIC PRACTICE. METHODS: A QUALITATIVE DESIGN WAS EMPLOYED. SIX YOGA TEACHERS WHO HAD SPECIFIC TRAINING AND EXPERIENCE IN TEACHING THERAPEUTIC YOGA OR PRACTICING 'YOGA THERAPY' TOOK PART IN ONE-TO-ONE INTERVIEWS DURING WHICH THEY GAVE ACCOUNTS OF THEIR EXPERIENCES OF HELPING PEOPLE COPE WITH PSYCHOLOGICAL DISTRESS THROUGH YOGA. PARTICIPANTS' INTERVIEWS WERE TRANSCRIBED VERBATIM AND WERE ANALYSED USING AN INTEGRATIVE INDUCTIVE-DEDUCTIVE THEMATIC ANALYSIS. RESULTS: FOUR KEY THEMES WERE IDENTIFIED IN RELATION TO THE BENEFITS OF THERAPEUTIC YOGA: AWARENESS, CHOICE, RELATIONSHIPS, AND TAILORING. CONCLUSIONS: THE FINDINGS SUPPORT PREVIOUS RESEARCH WHICH SUGGESTS THAT INDIVIDUALISED YOGA THERAPY IS A PROMISING INTERVENTION, AND MAY HELP TO FORM A THEORETICAL RATIONALE FOR THE FUTURE TREATMENT OF PSYCHOLOGICAL DISTRESS WITH YOGA. 2020 8 259 34 ACCEPTABILITY AND FEASIBILITY OF THE ONLINE DELIVERY OF HATHA YOGA: A SYSTEMATIC REVIEW OF THE LITERATURE. OBJECTIVES: HATHA YOGA HAS DRAMATICALLY INCREASED IN POPULARITY IN THE UNITED STATES AND A GROWING BODY OF EVIDENCE POINTS TO YOGA'S ABILITY TO SUCCESSFULLY MANAGE BOTH PHYSICAL AND MENTAL HEALTH CONDITIONS. CONCURRENTLY, THE DELIVERY OF TELEHEALTH INTERVENTIONS ALSO CONTINUES TO RISE. THE ONLINE-DELIVERY OF YOGA LIES AT THIS INTERSECTION, AND TO DATE, NO STUDY HAS SYSTEMATICALLY REVIEWED THE EXISTING LITERATURE OF EMPIRICAL STUDIES INVOLVING THE ONLINE DELIVERY OF YOGA. DESIGN: THIS STUDY SYSTEMATICALLY REVIEWS THE LITERATURE FOR EVIDENCE ON THE FEASIBILITY AND ACCEPTABILITY OF ONLINE YOGA INTERVENTIONS AND PROVIDES A QUALITATIVE SYNTHESIS. A TOTAL OF 10 ARTICLES WHICH REPRESENT EIGHT UNIQUE EMPIRICAL STUDIES WERE INCLUDED IN THE FINAL REVIEW. RESULTS: ACROSS THE EIGHT STUDIES, PARTICIPANTS EXPRESSED OVERALL SATISFACTION WITH AN ONLINE YOGA INTERVENTION. ONLINE YOGA WAS FOUND TO BE FEASIBLE, BASED ON ATTENDANCE AND PRACTICE RATES, AND ACCEPTABLE. ALTHOUGH GROUPS VARY IN DEGREE OF INITIAL ENGAGEMENT. RESULTS ALSO FOUND PRELIMINARY EVIDENCE THAT ONLINE YOGA CAN HELP MANAGE SYMPTOMS ASSOCIATED WITH A RANGE OF DISORDERS. CONCLUSIONS: UNDERSTANDING THIS INNOVATIVE APPROACH TO DELIVERING YOGA INTERVENTIONS WILL ALLOW FUTURE RESEARCH TO INCLUDE ONLINE YOGA AS A LOWER-COST, NON-INVASIVE INTERVENTION FOR A WIDE VARIETY OF PHYSICAL AND MENTAL HEALTH DISORDERS, AS WELL AS PROVIDE PRELIMINARY EVIDENCE TO SUPPORT THE INTEGRATION OF ONLINE YOGA INTERVENTIONS INTO ROUTINE CLINICAL CARE. 2021 9 2402 38 YOGA AND EATING DISORDERS: IS THERE A PLACE FOR YOGA IN THE PREVENTION AND TREATMENT OF EATING DISORDERS AND DISORDERED EATING BEHAVIOURS? THIS PAPER ADDRESSES THE QUESTION: WHAT CAN THE PRACTICE OF YOGA OFFER THE FIELD OF EATING DISORDERS IN TERMS OF PREVENTION AND TREATMENT? REGARDING PREVENTION, PRELIMINARY RESEARCH SUGGESTS THAT YOGA MAY BE EFFECTIVE IN DECREASING RISK FACTORS, AND INCREASING PROTECTIVE FACTORS, FOR EATING DISORDERS. YOGA WAS ALSO FOUND TO BE HELPFUL IN A SMALL NUMBER OF TREATMENT STUDIES. HOWEVER, FINDINGS ARE NOT CONSISTENT ACROSS STUDIES, WHICH ARE LIMITED IN NUMBER, AND DUE TO THE PRELIMINARY NATURE OF THIS BODY OF RESEARCH, MOST STUDIES HAVE WEAKNESSES IN THEIR DESIGNS (E.G. OBSERVATIONAL DESIGN, NO CONTROL GROUPS, OR SMALL SAMPLE SIZES). THE BASIC TENETS OF YOGA, ANECDOTAL REPORTS OF ITS EFFECTIVENESS, ITS HIGH ACCESSIBILITY AND LOW COST, AND INITIAL RESEARCH FINDINGS SUGGEST THAT YOGA MAY OFFER PROMISE FOR THE FIELD OF EATING DISORDERS. TWO OPTIONS ARE SUGGESTED FOR PREVENTION: (1) EATING DISORDER PREVENTION CAN BE INTEGRATED INTO ONGOING YOGA CLASSES AND (2) YOGA CAN BE INTEGRATED INTO EATING DISORDER PREVENTION PROGRAMMES. REGARDING TREATMENT, IT IS IMPORTANT TO EXAMINE THE EFFECTIVENESS OF DIFFERENT TEACHING STYLES AND PRACTICES FOR DIFFERENT EATING DISORDERS. POTENTIAL HARMS OF YOGA SHOULD ALSO BE EXPLORED. FURTHER RESEARCH, USING STRONGER STUDY DESIGNS, SUCH AS RANDOMISED, CONTROLLED TRIALS, IS NEEDED. 2014 10 1300 51 HATHA YOGA FOR DEPRESSION: CRITICAL REVIEW OF THE EVIDENCE FOR EFFICACY, PLAUSIBLE MECHANISMS OF ACTION, AND DIRECTIONS FOR FUTURE RESEARCH. BACKGROUND: THE PURPOSE OF THIS ARTICLE IS TO REVIEW THE EVIDENCE FOR THE EFFICACY OF HATHA YOGA FOR DEPRESSION AND POSSIBLE MECHANISMS BY WHICH YOGA MAY HAVE AN IMPACT ON DEPRESSION, AND TO OUTLINE DIRECTIONS FOR FUTURE RESEARCH. METHODS: LITERATURE REVIEW AND SYNTHESIS. RESULTS AND CONCLUSIONS: A LITERATURE SEARCH FOR CLINICAL TRIALS EXAMINING YOGA FOR DEPRESSION UNCOVERED EIGHT TRIALS: 5 INCLUDING INDIVIDUALS WITH CLINICAL DEPRESSION, AND 3 FOR INDIVIDUALS WITH ELEVATED DEPRESSION SYMPTOMS. ALTHOUGH RESULTS FROM THESE TRIALS ARE ENCOURAGING, THEY SHOULD BE VIEWED AS VERY PRELIMINARY BECAUSE THE TRIALS, AS A GROUP, SUFFERED FROM SUBSTANTIAL METHODOLOGICAL LIMITATIONS. WE WOULD ARGUE, HOWEVER, THAT THERE ARE SEVERAL REASONS TO CONSIDER CONSTRUCTING CAREFUL RESEARCH ON YOGA FOR DEPRESSION. FIRST, CURRENT STRATEGIES FOR TREATING DEPRESSION ARE NOT SUFFICIENT FOR MANY INDIVIDUALS, AND PATIENTS HAVE SEVERAL CONCERNS ABOUT EXISTING TREATMENTS. YOGA MAY BE AN ATTRACTIVE ALTERNATIVE TO OR A GOOD WAY TO AUGMENT CURRENT DEPRESSION TREATMENT STRATEGIES. SECOND, ASPECTS OF YOGA-INCLUDING MINDFULNESS PROMOTION AND EXERCISE-ARE THOUGHT TO BE "ACTIVE INGREDIENTS" OF OTHER SUCCESSFUL TREATMENTS FOR DEPRESSION. THIRD, THERE ARE PLAUSIBLE BIOLOGICAL, PSYCHOLOGICAL, AND BEHAVIORAL MECHANISMS BY WHICH YOGA MAY HAVE AN IMPACT ON DEPRESSION. WE PROVIDE SUGGESTIONS FOR THE NEXT STEPS IN THE STUDY OF YOGA AS A TREATMENT FOR DEPRESSION. 2010 11 2422 40 YOGA AND MINDFULNESS AS THERAPEUTIC INTERVENTIONS FOR STROKE REHABILITATION: A SYSTEMATIC REVIEW. AIM. THIS PAPER REPORTS A SYSTEMATIC REVIEW AND CRITICAL APPRAISAL OF THE EVIDENCE ON THE EFFECTIVENESS OF BEHAVIORAL THERAPIES SUCH AS YOGA AND MINDFULNESS PRACTICES FOR STROKE REHABILITATION. BACKGROUND. THE EXPERIENCE OF STROKE CAN HAVE A NEGATIVE IMPACT ON BOTH PSYCHOLOGICAL AND PHYSICAL HEALTH AND ON QUALITY OF LIFE. YOGA AND RELEVANT PRACTICES ARE PROMISING THERAPIES THAT HAVE BEEN USED WITH PATIENTS WITH A VARIETY OF CONDITIONS. IN ORDER TO DRAW CONCLUSIONS ON EFFECTIVENESS FOR STROKE PATIENTS, THE EVIDENCE REQUIRES SYSTEMATIC ASSESSMENT. METHODS. A COMPREHENSIVE SEARCH OF MAJOR BIOMEDICAL AND COMPLEMENTARY MEDICINE DATABASES WAS CONDUCTED. RELEVANT RESEARCH WAS CATEGORIZED BY STUDY TYPE AND APPRAISED ACCORDING TO STUDY DESIGN. RESULTS. FIVE RANDOMIZED CONTROLLED CLINICAL TRIALS AND FOUR SINGLE CASE STUDIES WERE FOUND. ADDITIONALLY, ONE QUALITATIVE RESEARCH STUDY WAS IDENTIFIED. STUDIES REPORTED POSITIVE RESULTS, INCLUDING IMPROVEMENTS IN COGNITION, MOOD, AND BALANCE AND REDUCTIONS IN STRESS. MODIFICATIONS TO DIFFERENT YOGA PRACTICES MAKE COMPARISON BETWEEN STUDIES DIFFICULT, AND A LACK OF CONTROLLED STUDIES PRECLUDES ANY FIRM CONCLUSIONS ON EFFICACY. CONCLUSION. YOGA AND MINDFULNESS COULD BE CLINICALLY VALUABLE SELF-ADMINISTERED INTERVENTION OPTIONS FOR STROKE REHABILITATION. FURTHER RESEARCH IS NEEDED TO EVALUATE THESE SPECIFIC PRACTICES AND THEIR SUITABILITY IN STROKE REHABILITATION. 2013 12 549 20 CONTEXTUALIZING THE EFFECTS OF YOGA THERAPY ON DIABETES MANAGEMENT: A REVIEW OF THE SOCIAL DETERMINANTS OF PHYSICAL ACTIVITY. THIS ARTICLE PROVIDES A REVIEW OF LITERATURE BOTH TO IDENTIFY THE EFFECTS OF YOGA-BASED THERAPY ON THE MANAGEMENT OF TYPE 2 DIABETES MELLITUS AND TO EXAMINE THE SOCIAL CONTEXT OF PHYSICAL ACTIVITY. FINDINGS FROM THE REVIEW INDICATE THAT YOGA HAS A POSITIVE SHORT-TERM EFFECT ON MULTIPLE DIABETES-RELATED OUTCOMES; HOWEVER, LONG-TERM EFFECTS OF YOGA THERAPY ON DIABETES MANAGEMENT REMAIN UNCLEAR. THE CONTEXT OF THE SOCIAL ENVIRONMENT, INCLUDING INTERPERSONAL RELATIONSHIPS, COMMUNITY CHARACTERISTICS, AND DISCRIMINATION, INFLUENCES THE ADOPTION AND MAINTENANCE OF HEALTH BEHAVIORS SUCH AS PHYSICAL ACTIVITY, INCLUDING YOGA PRACTICE. FURTHER RESEARCH IS NECESSARY TO DETERMINE THE EXTENT OF THIS INFLUENCE. 2008 13 2451 42 YOGA AS A COMPLEMENTARY APPROACH TO HEALING FOR ADULT VICTIMS AND SURVIVORS OF INTERPERSONAL VIOLENCE. PURPOSE: YOGA IS INCREASINGLY ACCEPTED TO IMPROVE OVERALL HEALTH AND WELLNESS AND IS CONSIDERED A MEANINGFUL ADJUNCT TREATMENT FOR MENTAL AND PHYSICAL HEALTH AILMENTS ASSOCIATED WITH INTERPERSONAL VIOLENCE (IV). THIS REVIEW PROVIDES BACKGROUND INFORMATION ABOUT THE USE OF YOGA AMONG INDIVIDUALS WITH IV HISTORIES AND AIMS TO INFORM RESEARCHERS AND PRACTITIONERS ABOUT THE AVAILABLE EVIDENCE ON YOGA'S APPLICATION AND EFFECTIVENESS. METHODS: USING SIX DATABASES, WE SYSTEMATICALLY REVIEWED EMPIRICAL LITERATURE EXAMINING YOGA AMONG IV SURVIVORS. CRITERIA FOR STUDY INCLUSION: YOGA INCLUDED A PHYSICAL COMPONENT AND WAS THE PRIMARY INTERVENTION; PARTICIPANTS HAD AN IV HISTORY; PEER-REVIEWED; AND PARTICIPANTS WERE 17 YEARS AND OLDER. AFTER REVIEW, 10 ARTICLES REPORTING FINDINGS FROM SEVEN INDEPENDENT SAMPLES WERE INCLUDED. FINDINGS: YOGA DEMONSTRATED PRELIMINARY, POSITIVE IMPLICATIONS AS A COMPLEMENTARY TREATMENT FOR INDIVIDUALS WITH AN IV HISTORY. SYNTHESIZING ACROSS ARTICLES FOUR THEMES EMERGED: (1) ACCEPTABILITY AND FEASIBILITY, (2) ENHANCEMENT OF MENTAL AND PHYSICAL HEALTH, (3) PROMOTION OF PERSONAL GROWTH, AND (4) FACILITATORS AND BARRIERS TO PRACTICE. CONCLUSIONS: THE NASCENT LITERATURE INDICATES POTENTIAL BENEFITS OF INTEGRATING YOGA INTO INTERVENTIONS FOR IV SURVIVORS TO ENHANCE PHYSICAL AND PSYCHOLOGICAL FUNCTIONING. THE PRIMARY BARRIERS TO INTERVENTION WERE RESOURCES (E.G., ACCESS) AND INCOMPATIBILITY WITH SPIRITUAL BELIEFS FOR SELECT CLIENTS. DESPITE CONSISTENT BARRIERS, PRELIMINARY FINDINGS INDICATE YOGA HAS MANY POSITIVE IMPLICATIONS FOR INDIVIDUALS WITH AN IV HISTORY. GIVEN THE SMALL EVIDENCE BASE AND INSUFFICIENT METHODOLOGY, ADDITIONAL EMPIRICAL RESEARCH WITH DIVERSE SAMPLES AND SITES, AND ROBUST DESIGNS, COULD IMPROVE THE STATE OF KNOWLEDGE AND STRENGTHEN THE EFFICACY OF THIS PROMISING PRACTICE. 2021 14 2923 27 [WHERE AND HOW DOES YOGA WORK? - A SCIENTIFIC OVERVIEW]. AS A TRADITIONAL HEALTH CARE SYSTEM, YOGA COMBINES PHYSICAL ACTIVITY, BREATHING TECHNIQUES AND MEDITATION. IT IS INCREASINGLY USED AS A PREVENTIVE OR THERAPEUTIC MEANS. YOGA HAS BEEN RESEARCHED IN HUNDREDS OF RANDOMIZED CONTROLLED TRIALS. POSITIVE EFFECTS ARE ESPECIALLY FOUND FOR CHRONIC PAIN CONDITIONS, HYPERTENSION, DEPRESSION AND IN SUPPORTIVE CANCER CARE. WHILE THERE ARE CASE REPORTS OF SERIOUS ADVERSE EVENTS ASSOCIATED WITH YOGA, THE RISK SEEMS TO BE EXTREMELY LOW AND COMPARABLE TO OTHER FORMS OF PHYSICAL ACTIVITY. YOGA CAN THUS BE CONSIDERED AS A SAFE AND EFFECTIVE ADJUNCT THERAPY FOR A NUMBER OF CONDITIONS. 2017 15 1484 39 INTEGRATION OF HATHA YOGA AND EVIDENCE-BASED PSYCHOLOGICAL TREATMENTS FOR COMMON MENTAL DISORDERS: AN EVIDENCE MAP. BACKGROUND: INTEREST IN THE USE OF YOGA TO ENHANCE ENGAGEMENT WITH AND AUGMENT THE BENEFITS OF PSYCHOLOGICAL TREATMENT HAS GROWN. HOWEVER, A SYSTEMATIC APPROACH TO REVIEWING EXISTING RESEARCH EXAMINING THE USE OF YOGA WITH PSYCHOLOGICAL TREATMENT IS LACKING. MATERIALS AND METHODS: THIS MAPPING REVIEW IDENTIFIED AND SYNTHESISED RESEARCH TRIALLING YOGA AS AN INTEGRATED OR ADJUNCT THERAPY WITH EVIDENCE-BASED PSYCHOLOGICAL INTERVENTIONS FOR THE TREATMENT OF ANXIETY, DEPRESSION, PTSD, AND EATING DISORDERS. RESULTS: OVERALL, THE REVIEW IDENTIFIED TEN PUBLISHED AND THREE UNPUBLISHED STUDIES, REPRESENTING EITHER SINGLE GROUP OR SMALL QUASI-EXPERIMENTAL RESEARCH DESIGNS. DISCUSSION: LIMITED BUT PROMISING FINDINGS WERE SHOWN FOR YOGA WITH CBT FOR ANXIETY AND DEPRESSION, AND THE INTEGRATION OF YOGA WITHIN INTENSIVE TREATMENT MODELS FOR PTSD. CONCLUSIONS: FUTURE RESEARCH IS ENCOURAGED TO FOCUS ON CONTROLLED TRIALS THAT ENABLE EXAMINATION OF THE COMPONENT EFFECT OF YOGA WHEN APPLIED WITH EVIDENCE-BASED PSYCHOLOGICAL TREATMENT AND ACCEPTABILITY AND FEASIBILITY DATA TO FURTHER KNOWLEDGE REGARDING A ROLE FOR YOGA IN CLINICAL PRACTICE. 2022 16 1 38 "A FEELING OF CONNECTEDNESS": PERSPECTIVES ON A GENTLE YOGA INTERVENTION FOR WOMEN WITH MAJOR DEPRESSION. MAJOR DEPRESSIVE DISORDER (MDD) IS ONE OF THE MOST COMMON AND DEBILITATING HEALTH CONDITIONS IN WOMEN IN THE UNITED STATES AND WORLDWIDE. MANY WOMEN WITH MDD SEEK OUT COMPLEMENTARY THERAPIES FOR THEIR DEPRESSIVE SYMPTOMS, EITHER AS AN ADJUNCT OR ALTERNATIVE TO THE USUAL CARE. THE PURPOSE OF THIS STUDY IS TO UNDERSTAND THE EXPERIENCES OF WOMEN WHO PARTICIPATED IN A YOGA INTERVENTION FOR THEIR DEPRESSION. THE FINDINGS FROM THIS INTERPRETIVE PHENOMENOLOGICAL STUDY ARE DERIVED FROM INTERVIEWS WITH AND DAILY LOGS BY 12 WOMEN WITH MDD WHO TOOK PART IN AN 8-WEEK GENTLE YOGA INTERVENTION AS PART OF A LARGER PARENT RANDOMIZED, CONTROLLED TRIAL. RESULTS SHOW THAT THE WOMEN'S EXPERIENCE OF DEPRESSION INVOLVED STRESS, RUMINATIONS, AND ISOLATION. IN ADDITION, THEIR EXPERIENCES OF YOGA WERE THAT IT SERVED AS A SELF-CARE TECHNIQUE FOR THE STRESS AND RUMINATIVE ASPECTS OF DEPRESSION AND THAT IT SERVED AS A RELATIONAL TECHNIQUE, FACILITATING CONNECTEDNESS AND SHARED EXPERIENCES IN A SAFE ENVIRONMENT. FUTURE LONG-TERM RESEARCH IS WARRANTED TO EVALUATE THESE CONCEPTS AS POTENTIAL MECHANISMS FOR THE EFFECTS OF YOGA FOR DEPRESSION. 2013 17 2292 32 THERAPEUTIC EFFECTS OF YOGA FOR CHILDREN: A SYSTEMATIC REVIEW OF THE LITERATURE. PURPOSE: WE COMPLETED A SYSTEMATIC REVIEW OF THE LITERATURE ON THE EFFECT OF YOGA ON QUALITY OF LIFE AND PHYSICAL OUTCOME MEASURES IN THE PEDIATRIC POPULATION. WE EXPLORED VARIOUS DATABASES AND INCLUDED CASE-CONTROL AND PILOT STUDIES, COHORT AND RANDOMIZED CONTROLLED TRIALS THAT EXAMINED YOGA AS AN EXERCISE INTERVENTION FOR CHILDREN. SUMMARY OF KEY POINTS: USING THE SACKETT LEVELS OF EVIDENCE, THIS ARTICLE REVIEWS THE LITERATURE ON YOGA AS A COMPLEMENTARY MIND-BODY MOVEMENT THERAPY. WE ADDRESS THE RESEARCH THROUGH THREE PRACTICE PATTERNS ACCORDING TO THE GUIDE TO PHYSICAL THERAPIST PRACTICE AND PROVIDE CONSIDERATIONS FOR THE INCLUSION OF YOGA INTO CLINICAL PRACTICE. STATEMENT OF CONCLUSIONS AND RECOMMENDATIONS FOR CLINICAL PRACTICE: THE EVIDENCE SHOWS PHYSIOLOGICAL BENEFITS OF YOGA FOR THE PEDIATRIC POPULATION THAT MAY BENEFIT CHILDREN THROUGH THE REHABILITATION PROCESS, BUT LARGER CLINICAL TRIALS, INCLUDING SPECIFIC MEASURES OF QUALITY OF LIFE ARE NECESSARY TO PROVIDE DEFINITIVE EVIDENCE. 2008 18 2927 45 [YOGA FOR MENTAL DISORDERS]. BACKGROUND: THE DEMAND FOR COMPLEMENTARY CLINICALLY EFFICACIOUS, SAFE, PATIENT ACCEPTABLE, AND COST-EFFECTIVE FORMS OF TREATMENT FOR MENTAL ILLNESS IS GROWING. YOGA HAS BENEFICIAL EFFECTS ON SOMATIC AND MENTAL HEALTH FACTORS; THEREFORE, YOGA HAS PREVENTIVE AND THERAPEUTIC CAPABILITIES TO IMPROVE MENTAL DYSFUNCTION. OBJECTIVE: IN THIS OVERVIEW OF THE CURRENT LITERATURE, THE EVIDENCE OF THE EFFECTS OF YOGA ON SELECTED MAJOR PSYCHIATRIC DISORDERS IS SUMMARIZED. RESULTS: THE STRONGEST EVIDENCE BASE FOR YOGA EXISTS IN REDUCING DEPRESSIVE SYMPTOMS BUT ITS USE IN MAJOR DEPRESSIVE DISORDERS IS LESS CLEAR. THE EVIDENCE FOR THE EFFICACY OF YOGA FOR ANXIETY DISORDERS, AND POSTTRAUMATIC STRESS DISORDER (PTSD) IS ENCOURAGING, BUT NOT DEFINITIVE DUE TO ONLY A FEW RANDOMIZED CONTROLLED TRIALS AND METHODOLOGICAL PROBLEMS. CONCLUSION: THERE IS PRELIMINARY EVIDENCE THAT MEDITATION-BASED YOGA INTERVENTIONS MAY BE HELPFUL FOR DEPRESSION, ANXIETY AND PTSD; HOWEVER, THERE MAY ALSO BE THE RISK OF ENGAGING IN EXTREME YOGA PRACTICES. THE VALUE OF INTEGRATING YOGA INTO A TREATMENT PLAN FOR PATIENTS WITH PSYCHIATRIC DISORDERS NEEDS TO BE EVALUATED ON AN INDIVIDUAL BASIS. HEALTHCARE PROVIDERS CAN MOTIVATE AND HELP PATIENTS EVALUATE WHETHER A GIVEN YOGA CLASS IS HELPFUL AND SAFE FOR THEM. METHODOLOGICAL PROBLEMS AND THE UNCLEAR RISK-BENEFIT RATIO PRECLUDE DEFINITIVE RECOMMENDATIONS FOR YOGA AS AN ADJUNCT TREATMENT. 2018 19 1725 37 PERCEPTIONS OF YOGA THERAPY EMBEDDED IN TWO INPATIENT REHABILITATION HOSPITALS: AGENCY PERSPECTIVES. INPATIENT MEDICAL REHABILITATION HAS MAINTAINED A TYPICAL MEDICAL-MODEL FOCUS AND STRUCTURE FOR MANY YEARS. HOWEVER, AS INTEGRATIVE THERAPIES, SUCH AS YOGA THERAPY, EMERGE AS TREATMENTS WHICH CAN ENHANCE THE PHYSICAL AND MENTAL HEALTH OF ITS PARTICIPANTS, IT IS IMPORTANT TO DETERMINE IF THEY CAN BE EASILY IMPLEMENTED INTO THE TRADITIONAL REHABILITATION STRUCTURE AND MILIEU. THEREFORE, THE PURPOSE OF THIS STUDY WAS TO EXAMINE THE PERCEPTIONS OF KEY AGENCY PERSONNEL ON THE FEASIBILITY AND UTILITY OF YOGA THERAPY IMPLEMENTED IN INPATIENT REHABILITATION. THIS STUDY REPORTS THE RESULTS OF FOCUS GROUPS AND AN INDIVIDUAL INTERVIEW WITH KEY STAKEHOLDERS (ADMINISTRATORS AND REHABILITATION THERAPISTS) FROM TWO REHABILITATION HOSPITALS FOLLOWING THE IMPLEMENTATION OF YOGA THERAPY. RESULTS FOCUSED ON SEVERAL KEY THEMES: FEASIBILITY FROM THE THERAPIST AND ADMINISTRATOR PERSPECTIVES, CHALLENGES TO IMPLEMENTATION, AND UTILITY AND BENEFIT. OVERALL, THE IMPLEMENTATION AND INTEGRATION OF YOGA THERAPY WERE POSITIVE; HOWEVER, SOME PROGRAMMATIC AND POLICY AND ORGANIZATIONAL CONSIDERATIONS REMAIN. IMPLICATIONS FOR PRACTICE AND FUTURE RESEARCH ARE PROVIDED. 2015 20 1294 28 GUIDELINES FOR DEVELOPING YOGA INTERVENTIONS FOR RANDOMIZED TRIALS. LITTLE GUIDANCE IS AVAILABLE TO ASSIST RESEARCHERS IN DEVELOPING TREATMENT PROTOCOLS FOR RESEARCH ON YOGA FOR HEALTH CONCERNS. BECAUSE YOGA IS A COMPLEX MULTIFACTORIAL MIND-BODY DISCIPLINE HISTORICALLY DEVELOPED FOR NONMEDICAL PURPOSES, NUMEROUS DECISIONS MUST BE MADE IN ORDER TO THOUGHTFULLY DEVELOP SUCH PROTOCOLS. IN THIS PAPER, A SYSTEMATIC APPROACH IS PROPOSED TO ASSIST RESEARCHERS IN SELECTING AN INTERVENTION THAT IS APPROPRIATE FOR THE CONDITION UNDER CONSIDERATION AND EXPLICITLY DEVELOPED. RESEARCHERS NEED TO CONSIDER THE TYPE OR "STYLE" OF YOGA, THE COMPONENTS TO INCLUDE (E.G., BREATHING EXERCISES, POSTURES) AS WELL AS THE SPECIFIC PROTOCOL FOR EACH COMPONENT, THE DOSE TO BE DELIVERED (FREQUENCY, DURATION OF PRACTICE, AND THE TOTAL DURATION OF PRACTICE), AND ISSUES RELATED TO SELECTION OF INSTRUCTORS AND MONITORING THE FIDELITY TO THE INTERVENTION. EACH OF THESE DOMAINS AND THE KEY ISSUES FOR THE DEVELOPMENT OF PROTOCOLS IS DISCUSSED. FINALLY, SOME AREAS FOR FURTHER RESEARCH RELATED TO PROTOCOL DEVELOPMENT ARE RECOMMENDED. 2012