Atlas›Domain X · Body, movement, breath & physical›Guide 135
Guide X-135

Yoga therapy (IAYT standards)

2012
A 24 · L 56 · M 2025 interventions in the Trinity explorer
Client cardCompare
[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: International Association of Yoga Therapists (IAYT), Scope of Practice for Yoga Therapy (12 April 2016, revised 1 September 2020); IAYT Educational Standards and Competencies Profile (published 1 July 2012, as described by Blashki 2013); session structure as published by an IAYT-accredited programme (Kripalu School of Integrative Yoga Therapy, 800-hour programme). IAYT has since announced a further revision of its professional documents (Scope, Code of Ethics, Touch in Yoga Therapy and an expanded definition); the wording of that revision is [uncertain].

What it is. Yoga therapy, as IAYT defines it, is the professional application of yoga principles and practices to promote health and well-being, inside a therapeutic relationship that includes personalised assessment, goal setting, lifestyle management and yoga practices for individuals or small groups [source: IAYT Scope of Practice 2020]. It is not a single technique but a professional framework: IAYT sets educational standards, accredits training programmes, certifies individuals (C-IAYT) and publishes a scope of practice and code of ethics [source: IAYT Scope of Practice 2020]. Each accredited school teaches its own lineage-based method within that framework; this guide gives the IAYT-level process and, where a concrete session format is needed, the one Kripalu publishes.

How change is thought to happen. IAYT views the person as a multidimensional system of body, breath and mind (intellect and emotions). Practices are chosen to reduce or manage symptoms that cause suffering, improve function, help prevent onset or recurrence of underlying causes of illness, and support well-being. Plans are meant to be self-empowering: the client learns practices they continue on their own [source: IAYT Scope of Practice 2020]. Many schools map the person onto the pancha maya kosha model (five sheaths) from the yoga tradition; IAYT's early illustrative standards approximate the koshas in contemporary terms as anatomical, physiological, emotional, intellectual and spiritual dimensions [source: IAYT Current Illustrative Standards]. The koshas, prana and related energy concepts are teachings of the yoga tradition, not established physiology, and should be presented to clients that way.

Who may deliver it and how it is regulated. IAYT states that it is not a licensing body, that its Scope is not legally binding, and that yoga therapy is not a licensed healthcare profession in most jurisdictions; yoga therapists are not physicians and do not diagnose or treat from a medical or other licensed perspective [source: IAYT Scope of Practice 2020]. C-IAYT is a professional credential, not a licence. A licensed professional (for example a psychotherapist) who is also C-IAYT may use practices beyond the yoga therapy Scope within their own licence, and the Scope does not restrict them [source: IAYT Scope of Practice 2020]; the reverse also holds: the yoga therapy Scope places individual or group psychological counselling outside scope unless the practitioner is appropriately qualified. Yoga teacher registration (for example a 500-hour teacher level as Yoga Alliance standards describe it) is treated by IAYT as an entry point to yoga therapist training, not as a therapy credential [source: IAYT Current Illustrative Standards]. In Australia, yoga was among 16 natural therapies removed from private health insurance benefits in 2019; after the Natural Therapies Review led by the Chief Medical Officer, with NHMRC support, the government accepted that yoga (with Pilates, tai chi, shiatsu, naturopathy, Western herbal medicine and Alexander Technique) should be re-included, with coverage and provider credentialing left to insurers [source: Butler media release]. The commencement date is [uncertain].

Evidence status (brief). The US National Center for Complementary and Integrative Health (NCCIH) summarises yoga (not yoga therapy specifically) as follows: a slight benefit for low back pain (Cochrane review, Wieland et al. 2022, found yoga slightly better than no exercise, possibly not meaningful to patients); a substantial effect on anxiety symptoms in a 2019 review but limited, inconclusive evidence for diagnosed anxiety disorders, and in a 2021 NCCIH-supported trial Kundalini yoga helped generalised anxiety disorder less than CBT; symptom reduction for depression in many studies and small added benefit alongside other treatment for major depression; only low-quality evidence for PTSD; possible help with sleep and with symptoms and quality of life in people with cancer [source: NCCIH]. Yoga is not a treatment for cancer or any physical disease; IAYT itself requires practitioners to avoid false or inaccurate claims about yoga's healing capacity [source: IAYT Scope of Practice 2020].

2. Framework

Training and credential.

  • Standards: IAYT published its Educational Standards for the Training of Yoga Therapists on 1 July 2012, with an accreditation route for training programmes; the Competencies Profile is the core [source: Blashki 2013].
  • Competency areas: (1) yoga philosophy, the mind, and understanding of health and disease; (2) biomedical and psychological knowledge (anatomy, physiology, mental health, pathology, the healthcare environment, body–mind connection); (3) therapeutic skills (individual and group client education, the therapeutic relationship and duty of care); (4) yoga therapy practice (breadth of practices; intake and assessment, design and instruction of practices, ongoing support); (5) professional practice (regulation, peer relationships, ethics, personal development) [source: Blashki 2013].
  • Hours: IAYT-accredited programmes must be at least 800 hours, not counting prerequisites, taught over at least two years (24 months); they include at least 150 hours of practicum in which the student works as the lead yoga therapist, with at least 30 hours of mentorship that must meet IAYT's residential-hours definition. Entry prerequisites are a 200-hour yoga teacher training, one year of teaching experience and one year of personal practice, none of which count towards the 800 hours [source: IAYT Accreditation Pre-Application Readiness Assessment, September 2019]. Kripalu's 800-hour programme is one example, with prerequisites such as foundation courses and anatomy [source: Kripalu 800-hour programme page; Kripalu one-on-one article]. Check the current accreditation standards with IAYT, as they are revised.
  • C-IAYT routes: graduation from an IAYT-accredited programme (apply within one year of completion, or the exam is required from January 2025) or Portfolio Review and Evaluation for experienced practitioners; current IAYT membership; agreement to the Code of Ethics, Grounds for Disciplinary Action and Use of the C-IAYT Credential; review of the Scope. The certification exam is required for those who enrolled in an accredited programme on or after 1 July 2023 and for all portfolio applicants [source: IAYT Certification Eligibility].
  • Recertification: every 3 years, active membership, at least 24 hours of continuing education, plus the current online Code of Ethics training and Scope of Practice training, each with a quiz [source: IAYT Recertification FAQs].

The yoga therapy process (IAYT Scope, Section 1). Four stages, cycling rather than strictly linear:

  1. Assessment. Qualitative and/or quantitative yoga therapy assessment; identify risk factors and contraindications; keep records as the law requires. This is not a medical assessment, though it may draw on a referring clinician's report [source: IAYT Scope of Practice 2020].
  2. Planning. A plan built on the client's needs, goals, learning style, life circumstances and access to time and equipment; clear goals for each session [source: IAYT Scope of Practice 2020].
  3. Implementation. Teaching an integrated set of practices, modified by verbal instruction and/or consented touch within competence; clear home-practice instructions with a way to give feedback; support for independent practice and self-responsibility [source: IAYT Scope of Practice 2020].
  4. Evaluation and follow-up. Review at regular intervals, clear routes for client feedback, adjustment of practices [source: IAYT Scope of Practice 2020].

Format. One-to-one sessions, or small-group yoga therapy. What makes a group yoga therapy rather than a class is an individual intake and assessment for each member, a personalised practice, and reassessment at intervals across the series; for minors, local child-safety law applies [source: IAYT Scope of Practice 2020]. A one-to-one session in the Kripalu format runs: intake form (first visit), check-in, body-awareness scan, breath awareness and gentle movement, joint-freeing warm-up, chosen postures, closing movement and guided relaxation or visualisation, integration and sharing, home practice [source: Kripalu one-on-one article].

Session count and criteria for moving on. Neither IAYT nor the Kripalu article sets a number of sessions [uncertain]. Practical criteria [synthesis]: move from assessment to a written plan once safety screening is complete and at least one client-owned goal is named; move from guided sessions towards spaced follow-up when the client does the home practice independently and reports it accurately; end or refer when goals are met, when the client's needs fall outside scope or competence, or when progress stalls after a plan revision.

Position of the psychotherapist who is also C-IAYT [synthesis, built on the Scope and the therapy codes in Sources]. Two workable arrangements: (a) yoga therapy integrated into psychotherapy, under the psychotherapy licence, contract and notes, using yoga-derived practices as one set of methods; or (b) two separate services (psychotherapy and yoga therapy) with separate contracts, fees and records. The first is usually cleaner. Running both for the same client without saying which hat you wear creates a dual-role problem; see Section 3 and Section 5.

3. Guiding principles

  • Work within scope and competence. Yoga therapists do not diagnose, prescribe or stop medication, prescribe herbs or supplements, interpret raw test results or advise on another clinician's treatment unless licensed [source: IAYT Scope of Practice 2020]. In practice: your psychotherapy licence governs any diagnosis or psychological treatment; your yoga therapy training governs the practices; neither covers medical advice.
  • Not licensed, say so. IAYT advises a client information document stating services, qualifications and that yoga therapy is not a licensed healthcare profession in most jurisdictions [source: IAYT Scope of Practice 2020]. In practice: give it at intake, alongside your psychotherapy contract.
  • Safety first: screen for risk and contraindications. Part of assessment, not an add-on [source: IAYT Scope of Practice 2020; NCCIH]. In practice: no movement work before the health screen is done and any needed clearance is in hand.
  • Person, not condition. The plan fits needs, goals, learning style, circumstances and resources [source: IAYT Scope of Practice 2020]. In practice: the same diagnosis can get very different practices.
  • Self-empowerment and self-responsibility. The aim is the client's own sustainable practice and support network [source: IAYT Scope of Practice 2020]. In practice: teach fewer practices well; plan for the client not needing you.
  • Health promotion, not cure. Yoga therapy "focuses on well-being and health promotion" and is "not about curing disease" [source: Kripalu one-on-one article]. In practice: frame goals as function, symptom management and well-being.
  • Non-harming (ahimsa). Named as an ethical principle guiding sessions [source: Kripalu one-on-one article]. In practice: choose the gentlest practice that serves the goal; stop at signs of strain.
  • Client leads; plan stays revisable. The therapist lets the client lead from what arises and revises the plan when it no longer fits [source: Kripalu one-on-one article]. In practice: a prepared plan is a draft until the check-in.
  • Touch only with consent, documented, within competence. Touch may support awareness and alignment; it needs clear consent, is recorded in the notes, and adjustments, manipulation or massage are outside scope without specific qualification [source: IAYT Scope of Practice 2020]. Kripalu uses touch "only with permission" to direct awareness, not to move the body [source: Kripalu one-on-one article]. In practice: verbal cueing is the default.
  • Collaborate and refer. Send and receive referrals, join multidisciplinary teams, communicate with other clinicians using good referral and feedback practice [source: IAYT Scope of Practice 2020]. In practice: with consent, tell the client's physician what you are doing.
  • Accurate claims. Avoid false or inaccurate claims about yoga's healing capacity [source: IAYT Scope of Practice 2020]. In practice: describe evidence as modest and condition-specific.
  • Respect the tradition. Energy and spiritual concepts (prana, koshas, chakras, mudra as energetic seal, bandha as energy lock) belong to yoga's Hindu, Jain, Buddhist and wider Indian traditions [synthesis]. In practice: attribute them ("in yoga philosophy…"), offer plain-language versions, never require belief, and do not teach sacred or initiatory practices outside their tradition.
  • Plain language. The Kripalu author avoids Sanskrit in favour of words the client understands [source: Kripalu one-on-one article]. In practice: name postures in English first.
  • Keep roles clear (psychotherapist + yoga therapist). Codes require avoiding multiple relationships that impair judgement or risk harm, working within competence, and managing boundaries [source: APA Ethics Code; UKCP Code; BACP Ethical Framework]. In practice: one contract that names both components, or two clearly separated services.

4. Intervention inventory

The inventory follows the IAYT process (assessment, planning, implementation, evaluation) and the list of practices the IAYT Scope names: asana, pranayama, relaxation, meditation, mudra, bandha, mantra, mindfulness, bhavana (imagery), sankalpa (intention or affirmation), yogic lifestyle guidance and dietary advice within the yoga therapy framework [source: IAYT Scope of Practice 2020]. Session-level steps follow the Kripalu one-to-one format [source: Kripalu one-on-one article]. All example wording is illustrative. No hold times, repetitions, durations or breath timings are given: these are set by the trained practitioner for the individual client.

A. Setting up

4.1 Client information document and combined contract

  • Purpose / when: Before the first session. IAYT advises a document describing services, qualifications and that yoga therapy is not a licensed healthcare profession in most jurisdictions [source: IAYT Scope of Practice 2020]. For a psychotherapist, it also has to say how yoga therapy relates to the psychotherapy [synthesis].
  • Steps: (1) State your qualifications separately: psychotherapy licence or registration, and C-IAYT (a professional credential, not a licence). (2) Say which arrangement you offer: yoga-based practices within psychotherapy, or a separate yoga therapy service. (3) Describe what a session involves (talking, movement, breath, relaxation, possible optional touch). (4) State the right to decline any practice or touch, at any time. (5) Explain records, confidentiality, and that you may ask permission to contact their physician. (6) Explain that yoga therapy does not replace medical care. (7) Get signed consent; revisit it when the plan changes [synthesis].
  • Example language (illustrative): "In our work I may sometimes suggest movement or breathing practices from yoga therapy. They are always optional. I'm not a doctor, and yoga therapy isn't a medical treatment, so please keep seeing your GP for anything physical."
  • Watch for: clients who feel they must say yes to please you; confusion about what they are paying for; clients seeking yoga therapy to avoid medical care (NCCIH advises not using yoga to delay seeing a provider [source: NCCIH]). Working: the client can say in their own words what each part of the service is.

4.2 Intake form and history

  • Purpose / when: Before or at the first session, to gather history across the dimensions of the person and identify risks [source: IAYT Scope of Practice 2020; Kripalu one-on-one article].
  • Steps: (1) Send a personal-history form before session one. Kripalu organises it around the koshas: physical, energetic, emotional, the "wisdom body" and the "bliss body" (kosha terms from the yoga tradition) [source: Kripalu one-on-one article]. (2) Cover sleep, mood, thought patterns, sources of joy, family status, lifestyle, occupation, diet and how often they exercise [source: Kripalu one-on-one article]. (3) Add a health section: diagnoses, medications, surgeries, injuries, pregnancy, balance, blood pressure, eye conditions, and any clinician's restrictions (see 4.3) [synthesis based on NCCIH cautions]. (4) Ask what the client hopes to achieve; if unsure, goals usually emerge by the end of session one [source: Kripalu one-on-one article]. (5) As a psychotherapist, add or cross-reference your usual mental-health assessment, including trauma history, dissociation, eating-disorder and body-image concerns, self-harm and suicide risk [synthesis].
  • Example language (illustrative): "This form asks about your body, energy, feelings, thinking and what brings you joy. Some of it uses yoga's own way of describing a person; answer only what feels relevant."
  • Watch for: gaps between the form and what the client says in person; minimised symptoms; body-image distress triggered by questions about weight or exercise. Working: the history is enough to judge safety and to name a first goal.

4.3 Physical-safety screening, contraindications and medical clearance

  • Purpose / when: Before any movement or breath practice, and again whenever health status changes. Identifying risk factors and contraindications is part of the IAYT assessment; yoga therapists need a basic understanding of common diseases, medication effects and contraindications, and integrate diagnoses made by other professionals [source: IAYT Scope of Practice 2020].
  • What sources say about risk: sprains and strains are the most common yoga injuries, most often of the knee or lower leg; emergency department visits for yoga-related injury are higher in people aged 65 and over; serious injury is rare and risk is lower than in higher-impact activities [source: NCCIH]. People who may need modified practice include pregnant women, older adults and people with health conditions, including pre-existing knee or hip injury, lumbar spine disease, severe high blood pressure, balance problems and glaucoma [source: NCCIH]. In pregnancy: avoid hot yoga and poses involving long periods of stillness or lying on the back. Hot yoga carries a risk of overheating and dehydration. Beginners should avoid headstands, shoulder stands, lotus position and forceful breathing. Learning without supervision has been associated with higher risk [source: NCCIH]. Osteoporosis and spinal flexion: medical reports link some yoga positions with vertebral compression fractures [uncertain]. Breath-practice cautions for epilepsy, psychosis, panic disorder and cardiovascular disease are widely taught in yoga therapy training [uncertain]; treat forceful or rapid breathing and breath-holding as unsuitable for these clients unless their physician and a trained practitioner agree [synthesis].
  • Steps: (1) Review the health section of the intake. (2) Ask about recent surgery, pain on movement, dizziness, falls, eye pressure, pregnancy, blood-pressure control and current medications (as information, not advice). (3) Where a condition is listed above or you are unsure, ask the client's permission to contact their physician and request written clearance or restrictions. (4) Record contraindications in the plan and exclude those practices (for example inversions with glaucoma, supine positions later in pregnancy, forceful breathing for beginners). (5) Rescreen at each check-in [synthesis built on IAYT Scope and NCCIH].
  • Example language (illustrative): "Before we try any movement, I'd like to check a few health things, and with your permission speak to your doctor about what's safe for your back."
  • Watch for: pain (sharp, joint, radiating), dizziness, breathlessness, chest symptoms, visual change, numbness; stop and refer for medical review. Working: a written list of practices to avoid sits in the plan, and the client knows it.

4.4 Initial assessment through observation

  • Purpose / when: First session and at reviews. IAYT allows qualitative and/or quantitative yoga therapy assessment tools; this is not medical assessment [source: IAYT Scope of Practice 2020].
  • Steps (Kripalu format): (1) Check in on how the client feels today and what has changed since the form. (2) Guide a body-awareness scan seated or lying, according to ability, then ask what they noticed: Kripalu treats this as assessment for both client and therapist. (3) Teach breath awareness and watch the breath. (4) Introduce gentle breath-linked movement (Kripalu names Sun Breaths) and observe arm movement and range of motion [source: Kripalu one-on-one article]. (5) Note posture, ease of transitions, balance, breath pattern, emotional tone and attention [synthesis]. (6) Map findings onto the dimensions you use (body, breath, mind; or the koshas, attributed to the tradition) [source: IAYT Scope of Practice 2020; Kripalu 800-hour programme page].
  • Example language (illustrative): "Just notice your body from your feet up to your head. There's nothing to fix. Afterwards I'll ask what you noticed, and anything is fine, including 'not much'."
  • Watch for: dissociation (glazed look, delayed responses, numbness), shame about the body, hypervigilance with eyes closed; offer eyes open and a seated option [synthesis]. Quantitative measures, if used, should be named validated instruments within your psychotherapy competence [synthesis]. Working: the client can describe some sensation and you have a picture of capacity and limits.

4.5 Goal setting and the therapeutic plan

  • Purpose / when: End of the first session, revised at reviews. The plan is based on needs, goals, learning style, life circumstances and access to time and equipment, with clear goals for each session; "therapeutic plan" here means a yoga therapy plan, not medical treatment [source: IAYT Scope of Practice 2020]. Kripalu trains practitioners to build plans from intake and assessment through the five koshas [source: Kripalu 800-hour programme page].
  • Steps: (1) Agree one to three client-owned goals in function or well-being terms (sleep, steadiness when anxious, moving with less fear). (2) Select practices for each goal, excluding contraindicated ones. (3) Note learning style (visual, verbal, kinaesthetic) and real-world time available. (4) Define what the client will notice if it helps. (5) For a psychotherapy client, link each goal to the psychotherapy formulation and write it in the treatment plan [synthesis]. (6) Set a review point [source: IAYT Scope of Practice 2020].
  • Example language (illustrative): "If this worked, what would be different in a normal week? … So: falling asleep more easily, and feeling less shaky before meetings. Let's build a short practice around those two."
  • Watch for: goals that are about weight or appearance in clients with eating-disorder risk (reframe toward function and wellbeing); cure goals for physical disease (reframe to symptom management alongside medical care). Working: goals are specific, owned and reviewable.

4.6 Session check-in

  • Purpose / when: Opening of every session [source: Kripalu one-on-one article].
  • Steps: (1) Ask how the client is now and what has changed since last time. (2) Ask about home practice: what they did, what they noticed, what got in the way. (3) Rescreen for new injuries, symptoms or medication changes. (4) Adjust the prepared plan; Kripalu may send returning clients a plan in advance and revises it as needed [source: Kripalu one-on-one article]. (5) Use the check-in to explain how yoga may help with today's concern [source: Kripalu one-on-one article].
  • Example language (illustrative): "Before we start: how's your body today, and how did the practice go this week, including the days you didn't do it?"
  • Watch for: distress that needs a talking session rather than a practice; new medical symptoms. Working: the session is shaped by what the client brings today.

4.7 Consented touch (optional)

  • Purpose / when: Only where it clearly helps awareness and only with explicit consent. IAYT: modifications may be made through consented touch within trained competence; touch can help develop proprioceptive and interoceptive awareness and support alignment; it requires clear consent and must be documented; physical adjustments, manipulation or massage are outside scope without specific qualification [source: IAYT Scope of Practice 2020]. Kripalu uses touch only with permission, to direct awareness, not to move the body [source: Kripalu one-on-one article].
  • Professional codes: mainstream psychotherapy codes contain no explicit touch provision but all prohibit sexual contact; APA 10.05 prohibits sexual intimacies with current clients; UKCP prohibits sexual contact with clients; BACP prohibits behaving sexually towards clients [source: APA Ethics Code; UKCP Code; BACP Ethical Framework]. The USABP code requires assessing whether touch is appropriate for each client, informed consent before touch (written consent highly recommended), periodic re-checking of consent, the client's right to refuse or end touch at any time, touch only for the client's benefit, and states that genital or other sexual touch is always inappropriate [source: USABP Code of Ethics]. EABP requires that clients be informed beforehand that physical techniques may be used [source: EABP Ethics Guidelines].
  • Steps: (1) Decide whether touch is needed at all; verbal cueing or the client's own hand is usually enough [synthesis]. (2) Do not use touch with clients where it is likely to be confusing or re-traumatising (recent trauma, strong transference, dissociation on contact) [synthesis]. (3) Ask before each instance, naming where and why. (4) Touch only non-intimate areas (for example shoulder blade, back of the hand), lightly, without moving the body. (5) Invite the client to say stop at any time; check during. (6) Record consent and the touch in the notes [source: IAYT Scope of Practice 2020; USABP Code]. (7) Some yoga schools use consent cards or tokens for group classes [uncertain]; a simple yes/no card works in one-to-one work too [synthesis]. Never sexual or genital touch, under any circumstances.
  • Example language (illustrative): "Would it help if I put two fingers on your shoulder blade so you can feel where to breathe? It's completely fine to say no, and you can tell me to stop at any point."
  • Watch for: hesitations, freezing, a too-quick yes, breath-holding at contact; any of these means no touch. Working: the client's own awareness improves and they can later find the place without touch.

B. Practices within a session

4.8 Body-awareness scan

  • Purpose / when: Opening practice of each session and a shared assessment tool [source: Kripalu one-on-one article]; builds interoceptive awareness, which IAYT links to yoga therapy aims [source: IAYT Scope of Practice 2020].
  • Steps: (1) Offer seated or lying, according to ability [source: Kripalu one-on-one article]. (2) Offer eyes open or closed. (3) Guide attention through the body region by region, inviting noticing without changing anything. (4) Afterwards, ask what the client noticed and listen without interpreting at first [source: Kripalu one-on-one article]. (5) In a psychotherapy frame, note what was easy or hard to feel and link it gently to the formulation later [synthesis].
  • Example language (illustrative): "Let your attention rest on your feet… whatever is there, warmth, pressure, nothing at all… now the lower legs. If any area feels uncomfortable to attend to, skip it and move on."
  • Watch for: numbness or absence (possible dissociation), rising panic, intrusive memories; shorten, open the eyes, orient to the room, move to an external focus [synthesis]. Working: the client reports more detailed sensation over time and can choose where to put attention.

4.9 Breath awareness and gentle breath practices (pranayama)

  • Purpose / when: Early in sessions, especially for new clients, breath awareness comes first [source: Kripalu one-on-one article]. Pranayama is among the practices IAYT lists [source: IAYT Scope of Practice 2020]. In yoga philosophy pranayama works with prana, a life-force concept of the tradition; present it to clients as a tradition's teaching, and in plain terms as attention to breathing.
  • Steps: (1) Start with observing the natural breath without changing it. (2) Invite noticing where movement is felt (belly, ribs, chest). (3) Where the plan calls for it, introduce a gentle, comfortable change such as an easy, slightly fuller exhale, always at the client's own pace [synthesis]. (4) Avoid forceful breathing with beginners [source: NCCIH] and avoid breath-holding, rapid breathing and retention practices with clients who have panic disorder, epilepsy, psychosis, cardiovascular disease or pregnancy unless a physician and a trained practitioner agree [synthesis; cautions uncertain]. (5) Return to natural breathing to finish.
  • Example language (illustrative): "Just watch your breath come and go, the way you might watch waves. You don't need to change it. If watching the breath makes you uneasy, rest your attention on your hands instead."
  • Watch for: dizziness, tingling, air hunger, chest tightness, panic (breath focus can trigger it in anxious clients); return to normal breathing and an external focus. Working: the breath settles of its own accord and the client can use breath noticing outside sessions.

4.10 Gentle breath-linked movement

  • Purpose / when: After breath awareness, to warm up and to observe movement. Kripalu names Sun Breaths (arms rising and lowering with the breath) [source: Kripalu one-on-one article].
  • Steps: (1) Demonstrate. (2) Invite the client to move the arms up and down in time with their own breath, seated or standing. (3) Observe range of motion, shoulder ease and breath coordination [source: Kripalu one-on-one article]. (4) Adapt range to comfort.
  • Example language (illustrative): "As you breathe in, let the arms float up only as far as is comfortable; as you breathe out, let them come down. Your breath sets the pace, not me."
  • Watch for: shoulder pain, breath-holding during movement, dizziness when arms are raised. Working: smooth coordination and reported ease.

4.11 Joint-freeing warm-up

  • Purpose / when: Before postures [source: Kripalu one-on-one article].
  • Steps: (1) Gentle, small movements of the main joints (for example wrists, shoulders, neck within comfort, hips, ankles), seated if balance is limited. (2) Keep range small for anyone with joint injury, hypermobility or recent surgery [synthesis]. (3) Ask for feedback after each area.
  • Example language (illustrative): "Small circles at the wrists, whichever direction feels good. Keep everything well inside what's easy."
  • Watch for: joint pain, clicking with pain, hypermobile clients pushing to end range. Working: the client feels looser and more present.

4.12 Postures (asana) chosen for the client

  • Purpose / when: Core of the practice phase. Postures are chosen for the client's history and needs, for example poses that build awareness of muscles supporting a joint, and can also be chosen to cultivate qualities such as confidence or safety [source: Kripalu one-on-one article]. IAYT lists asana first among practices [source: IAYT Scope of Practice 2020].
  • Steps: (1) Pick a small number of postures linked to each plan goal, excluding contraindicated ones (for example no inversions with glaucoma, and NCCIH advises beginners to avoid headstand, shoulder stand and lotus [source: NCCIH]). (2) Demonstrate and describe by name and purpose, in plain English first (for example Mountain pose for steadiness and grounding; a supported Child's pose for a sense of rest; Warrior-type standing poses for strength and confidence; supported chair versions for limited balance) [synthesis]. (3) Offer choices and props (chair, wall, blocks). (4) Cue sensation and comfort rather than shape. (5) Let the client decide when to come out. (6) Ask what they noticed, physically and emotionally. Hold times and repetitions are set individually by the trained practitioner and are not given here.
  • Example language (illustrative): "This is a standing pose many people use to feel steady. Find your own version: feet wherever is stable, a hand on the chair if you like. Notice what 'steady' feels like in your legs. Come out whenever you choose."
  • Watch for: pain, strain, breath-holding, shaking from effort, emotional surges (grief, fear) in particular postures, competitiveness or shame; ease off, change posture, or pause to talk. Working: the client can find the quality named (steady, safe, confident) and recall it later.

4.13 Relaxation and guided visualisation (bhavana)

  • Purpose / when: Closing phase, after gentle breath-linked movement [source: Kripalu one-on-one article]. Relaxation and bhavana (imagery) are in the IAYT list [source: IAYT Scope of Practice 2020]. The therapist may draw on the client's sources of joy for the imagery [source: Kripalu one-on-one article].
  • Steps: (1) Offer a comfortable position (supported lying, or seated; not flat on the back in later pregnancy [source: NCCIH]). (2) Offer eyes open or closed. (3) Guide physical settling, then imagery built from what the client said brings them joy or safety. (4) Keep a voice presence so the client is not alone with their mind. (5) Bring them back gradually: movement in fingers and toes, opening eyes, orienting to the room [synthesis].
  • Example language (illustrative): "You mentioned your garden. If you like, picture yourself there… the light, the smells… If another image comes, that's fine too. In a moment we'll come back to the room together."
  • Watch for: falling asleep (fine occasionally), dissociation, intrusive imagery, panic with stillness, which can be common in trauma survivors [synthesis]; switch to eyes-open, seated, or a movement-based ending. Working: visible settling and a report of rest.

4.14 Meditation and mindfulness

  • Purpose / when: Both are in the IAYT list of practices [source: IAYT Scope of Practice 2020]. Kripalu notes home meditation need not be seated and awareness can be carried into daily life [source: Kripalu one-on-one article].
  • Steps: (1) Choose a simple anchor (breath, sound, a word, walking). (2) Explain that wandering attention is normal and returning is the practice. (3) Keep it short at first and lengthen only if the client wants. (4) Offer moving options. (5) Debrief.
  • Example language (illustrative): "Pick something to rest your attention on, the sound of the clock or your feet on the floor. When your mind wanders, which it will, just come back. That coming back is the practice."
  • Watch for: rumination or self-criticism increasing, re-experiencing, derealisation; shift to eyes-open, movement or external anchors and talk it through. Working: easier return of attention and less reactivity to thoughts.

4.15 Integration, sharing and intention (sankalpa); hand gesture (mudra)

  • Purpose / when: End of session. The client returns to sitting and may share their experience; the therapist may offer an affirmation, intention or hand gesture to seal the practice [source: Kripalu one-on-one article]. IAYT lists sankalpa (affirmation or intention) and mudra, which it calls energetic gestures and seals [source: IAYT Scope of Practice 2020]; the energetic meaning belongs to the yoga tradition.
  • Steps: (1) Invite sharing without pressure. (2) Reflect what you heard. (3) Co-create a short, positive, present-tense intention in the client's words. (4) If using a hand gesture, present it as a reminder cue the client can use anywhere, and if you mention its traditional meaning, attribute it [synthesis]. (5) Link the session to the client's goals and, in psychotherapy, to the work you are doing [synthesis].
  • Example language (illustrative): "What stood out for you today? … Would you like a short phrase to take with you, in your own words? Something like 'I can be steady'?"
  • Watch for: intentions phrased as demands or self-criticism; religious discomfort with Sanskrit terms or gestures (offer secular alternatives). Working: the client leaves with a clear, owned takeaway.

4.16 Mantra and sound

  • Purpose / when: IAYT lists mantra (sacred sounds) [source: IAYT Scope of Practice 2020]; Kripalu gives the example of using a word as a mantra in home practice [source: Kripalu one-on-one article].
  • Steps: (1) Ask whether the client has a religious or spiritual background that makes a traditional mantra welcome or unwelcome. (2) Offer a neutral word or sound chosen by the client as the default. (3) Traditional Sanskrit mantras are sacred within Hindu, Buddhist and Jain traditions; teach them only if you have been taught by a recognised teacher of that lineage and the client wants them; do not alter or commercialise them [synthesis].
  • Example language (illustrative): "Some people find it calming to repeat a word silently, like 'calm' or 'here'. In the yoga tradition this is a mantra. Would you like to pick a word?"
  • Watch for: perceived religious pressure; obsessional clients turning repetition into a compulsion. Working: the word becomes a portable cue.

4.17 Bandha (attributed concept; not proceduralised here)

  • Purpose / when: IAYT lists bandha, which it describes as energy locks [source: IAYT Scope of Practice 2020]. In classical practice bandhas are combined with breath control including breath retention [synthesis]. They are taught within lineages by qualified teachers. Given breath-retention cautions, this guide does not give instructions [synthesis]. A psychotherapist should use bandha only if trained to do so in an accredited programme, never with retention for clients with panic, epilepsy, psychosis, cardiovascular disease or pregnancy [synthesis; cautions uncertain]. Steps: none are given in this guide; refer interest in bandha to a qualified practitioner and screen against the breath-practice contraindications above [synthesis].
  • Example language (illustrative): "That's a more advanced yogic practice that I'd keep for later, if at all; what we're doing now gives you most of the benefit safely."
  • Watch for: clients learning advanced practices from video without supervision; NCCIH notes higher risk with self-teaching [source: NCCIH].

4.18 Yogic lifestyle and dietary guidance (within framework)

  • Purpose / when: IAYT includes yogic lifestyle guidance and dietary advice within the yoga therapy framework, but dietary advice does not include prescribing herbs or supplements and does not make the practitioner a nutritionist or Ayurvedic practitioner unless they hold those qualifications [source: IAYT Scope of Practice 2020].
  • Steps: (1) Stay with general, habit-level guidance tied to goals (sleep routine, regular practice, mindful pauses, mindful eating). (2) Refer to a dietitian, physician or eating-disorder service for nutritional or weight questions [synthesis]. (3) Never give weight-loss targets or restrictive diets; screen for eating-disorder risk first [synthesis].
  • Example language (illustrative): "Would it help to tie your practice to something you already do, like after brushing your teeth at night?"
  • Watch for: disordered eating framed as 'yogic purity'; supplement questions (refer). Working: small sustainable routine changes.

C. Between sessions and over the course

4.19 Home practice

  • Purpose / when: End of each session. IAYT requires clear home-practice instructions with feedback mechanisms and support for independent practice [source: IAYT Scope of Practice 2020]. Kripalu gives a small homework task, if the client is willing, that builds on the session, for example balance awareness during daily activities or using a word as a mantra [source: Kripalu one-on-one article].
  • Steps: (1) Ask whether the client wants home practice at all. (2) Choose one or two practices already done safely in session. (3) Describe each qualitatively: what to do, what to notice, how to know it is enough ("stop while it still feels easy"), and what to avoid. Do not set hold times, counts or breath timings in writing for the client to push towards [synthesis]. (4) Embed it in daily life where possible: awareness in ordinary movement, meditation that need not be seated [source: Kripalu one-on-one article]. (5) Give a simple written or recorded reminder in your own words. (6) Agree how they will report back (a note, a word in the next check-in) [source: IAYT Scope of Practice 2020].
  • Example language (illustrative): "This week, when you're waiting for the kettle, try standing the way we practised and notice your feet. That's it. Next time tell me what you noticed, or what got in the way."
  • Watch for: pain or symptoms during home practice (stop and report); perfectionism or guilt about missed practice; clients adding advanced practices from videos. Working: the practice happens most days without strain and the client starts adapting it sensibly.

4.20 Review and reassessment

  • Purpose / when: At regular intervals [source: IAYT Scope of Practice 2020]; in group yoga therapy, reassessment at intervals across the series is part of what makes it therapy [source: IAYT Scope of Practice 2020].
  • Steps: (1) Repeat the parts of the initial assessment that matter for the goals (the client's own ratings, observation of the key movements, breath, sleep, mood). (2) If you use standard measures, use the psychotherapy measures you already use [synthesis]. (3) Ask for feedback on the work and on you [source: IAYT Scope of Practice 2020]. (4) Rescreen safety. (5) Keep, change or drop each practice; revise goals. (6) Record the review.
  • Example language (illustrative): "We've had a few sessions. Let's look back at the goals: what has changed, what hasn't, and what would you like to do differently?"
  • Watch for: politeness masking no change; new medical issues; growing dependence on sessions rather than self-practice. Working: progress toward named goals, more client ownership.

4.21 Small-group yoga therapy

  • Purpose / when: Groups with similar or varied conditions. IAYT distinguishes group yoga therapy from a yoga class by an individual intake and assessment for each member, a personalised practice and reassessment at intervals [source: IAYT Scope of Practice 2020].
  • Steps: (1) Individual intake and screening for each member (4.2–4.3). (2) Agree a group contract including confidentiality, choice and the right to decline any practice. (3) Plan a common sequence with named individual variations. (4) Use choice-based, invitational cueing. (5) Do not use touch in groups unless each person has opted in privately [synthesis]. (6) Reassess individually at intervals. (7) For a psychotherapy group, be clear whether it is a therapy group with yoga-based practices or a yoga therapy group [synthesis].
  • Example language (illustrative): "Everyone has their own version today. If you're on the chair, stay on the chair; if a pose doesn't suit you, rest in any position and rejoin when you like."
  • Watch for: comparison and competition, members hiding pain, disclosures that need individual follow-up. Working: individuals report progress on their own goals, not just enjoyment of the group.

4.22 Integrating body experience into psychotherapy (for the dual-trained therapist)

  • Purpose / when: When yoga-based practices are part of psychotherapy. Not described by IAYT or Kripalu as such; [synthesis] throughout, within the Scope's statement that licensed practitioners may practise within their own licence [source: IAYT Scope of Practice 2020].
  • Steps: (1) Agree the purpose of each practice in psychotherapy terms (for example building tolerance of bodily sensation, a regulation skill, a felt sense of steadiness). (2) After the practice, invite description first, then meaning. (3) Link what was noticed to patterns explored in therapy. (4) Note emotional material that arises and decide with the client whether to explore it now or contain it. (5) Record the practice and response in clinical notes.
  • Example language (illustrative): "You said your chest tightened when we stood tall. Is that familiar from anywhere else in your life? We can explore it, or simply note it for now."
  • Watch for: practices being used to avoid painful material; trauma memories emerging in particular postures; clients complying physically while disconnected. Working: insights and skills transfer between the mat and daily life.

4.23 Referral and collaboration

  • Purpose / when: Whenever needs fall outside scope or competence. IAYT: practitioners are responsible for client safety and must refer when needs exceed the Scope; they may send and receive referrals, join multidisciplinary teams and communicate with clinicians, but may not advise on other modalities except by referral unless qualified [source: IAYT Scope of Practice 2020]. Psychotherapy codes likewise require referral when appropriate [source: UKCP Code; BACP Ethical Framework].
  • Steps: (1) Keep a network of healthcare peers [source: IAYT Scope of Practice 2020]. (2) With written consent, send a brief letter to the physician describing the yoga therapy plan and asking about restrictions. (3) Refer for medical review for new or worsening physical symptoms; to a physiotherapist for injury rehabilitation; to a dietitian for nutrition; to psychiatry or crisis services for risk. (4) Ask for feedback and update the plan.
  • Example language (illustrative): "That pain in your hip is something I'd like a doctor or physio to look at before we go further with standing work. Shall I write a note you can take?"
  • Watch for: delay in referral because sessions seem to be helping; giving opinions on another clinician's treatment (outside scope). Working: other clinicians know and support the plan.

4.24 Suggesting or referring to an external yoga therapist or yoga class

  • Purpose / when: When you are not trained to deliver yoga therapy, or keeping the roles separate is better [synthesis].
  • Steps: (1) Check the practitioner's credential: C-IAYT shows completion of IAYT-accredited training or portfolio review plus agreement to IAYT's ethics [source: IAYT Certification Eligibility]; a teacher registration alone indicates teacher-level training, not yoga therapy [source: IAYT Current Illustrative Standards]. (2) Ask about their experience with trauma, anxiety or the client's condition and their approach to touch and consent. (3) Prepare the client: what to expect, their right to decline poses or touch, how to stop. For clients with trauma, dissociation, eating disorders or body-image concerns, agree a plan for what to do if distress arises and invite them to bring experiences back to therapy. (4) With consent, coordinate with the yoga therapist and agree who does what (EABP asks therapists to consider and discuss with clients the implications of parallel services [source: EABP Ethics Guidelines]).
  • Example language (illustrative): "If you'd like to try yoga therapy, look for someone certified as C-IAYT. You're always allowed to say no to a pose or to being touched, and we can talk here about anything that comes up."
  • Watch for: clients pressured into touch or intense practices; harms reported after classes (record, support, and help the client complain to IAYT or the relevant body if the practitioner is C-IAYT). Abuse within some yoga communities has been reported [uncertain]; take any disclosure seriously and follow your safeguarding duties. Working: the client feels safe with the practitioner and the two strands of work support each other.

4.25 Ending

  • Purpose / when: When goals are reached, the client can practise independently, or the work is not helping. Not set out in detail by IAYT; follows from its aims of independent practice and self-responsibility [source: IAYT Scope of Practice 2020] [synthesis for steps].
  • Steps: (1) Signal the ending in advance. (2) Review goals and changes. (3) Consolidate a short written home practice in the client's words, with what to avoid and when to seek help. (4) Name supports: classes, groups, peers, physician. (5) Offer follow-up review if useful. (6) If psychotherapy continues, mark clearly that the yoga therapy component has ended.
  • Example language (illustrative): "You've built a practice that's yours now. Let's write down what you want to keep, what to watch for, and where you could go if you'd like company in practising."
  • Watch for: loss or abandonment feelings, especially where yoga sessions carried an attachment function; relapse plans. Working: the client continues practising after ending and knows when to return.

5. Handling problems

Sources give little problem-handling guidance beyond scope, referral, consent and plan revision; most responses below are [synthesis] unless a source is tagged.

Dual-role ethics (psychotherapist who is also C-IAYT).

  • The issue: IAYT's Code of Ethics and Professional Responsibilities (board-approved February 2016, effective 12 April 2016, applying to all C-IAYTs, with applicants affirming they will abide by it; since revised) [source: IAYT Code of Ethics page; IAYT Updated Professional Documents] sits alongside your psychotherapy code. C-IAYTs must complete IAYT's Code of Ethics and Scope of Practice training videos, each with a quiz, for recertification [source: IAYT Ethics and Scope of Practice Trainings]. Its provisions on dual relationships and touch are not summarised here [uncertain]; obtain the current Code from IAYT and read it alongside your own code. Psychotherapy codes require avoiding multiple relationships that impair judgement or risk harm (APA 3.05; UKCP item 8; BACP para 33), practising only forms of therapy you are trained in (UKCP item 23; APA 2.01), and ban sexual contact with clients [source: APA Ethics Code; UKCP Code; BACP Ethical Framework]. The yoga therapy Scope puts psychological counselling outside scope unless appropriately qualified, and does not restrict licensed practitioners within their licence [source: IAYT Scope of Practice 2020].
  • Response: choose one frame per client. Either yoga-based practices within psychotherapy (one contract, one record, governed by your psychotherapy licence and code, with the yoga therapy Scope as a floor for the movement work), or separate services with separate contracts and fees, and a clear statement of which code governs which. Do not sell yoga classes or retreats to current psychotherapy clients; do not see clients socially at your yoga studio; avoid turning a psychotherapy client into a yoga student in your public classes. Take dual-role decisions to supervision and record them. Where a client is also seeing another yoga teacher or therapist, discuss the implications with them [source: EABP Ethics Guidelines] [synthesis for the rest].

Touch-related problems.

  • Client consents and then freezes or dissociates: stop touch immediately, return to verbal cueing, ground and orient, explore later only if the client wishes; record it; do not reintroduce touch without a fresh conversation. USABP notes initial consent may not reveal problems the client is not yet aware of, so consent is monitored over time [source: USABP Code of Ethics].
  • Client requests touch as comfort or contact: explore what it means in the therapy; yoga therapy touch is for awareness, not comfort, and adjustments or massage are outside scope without qualification [source: IAYT Scope of Practice 2020]. Never sexual or genital touch; any erotic transference is handled in talk therapy and supervision, never acted on [source: USABP Code of Ethics; APA Ethics Code].

Overwhelm, panic or trauma responses during practice. Stop the practice; eyes open, feet on floor, orient to the room, name the present; shift attention outward (sounds, objects); offer a sip of water; do not continue breath-focused work that session. Later, review what triggered it (posture, stillness, eyes closed, a particular breath instruction, a cue word) and remove or adapt it. For clients with panic disorder, avoid breath-focused practices that produce air hunger or dizziness [synthesis; breath cautions uncertain].

Physical symptoms or injury. Stop for sharp or joint pain, dizziness, chest symptoms, visual changes, numbness or breathlessness; arrange medical review; document; rescreen before resuming. Older adults (more emergency visits after age 65), people with knee, hip or lumbar problems, severe high blood pressure, balance problems, glaucoma, and pregnancy need modified practice [source: NCCIH]. Do not use hot or heated rooms in therapy sessions; NCCIH notes overheating and dehydration risks [source: NCCIH].

Stuck: no change after a fair trial. Review the plan against goals, learning style and real-life time [source: IAYT Scope of Practice 2020]; simplify; check whether the practice is being done; check whether goals are the client's or yours; consider whether a different modality, medical review or another practitioner would serve better, and refer.

Non-adherence to home practice. Shrink the practice until it is easy; attach it to an existing routine; drop practices the client dislikes; explore meanings of 'homework' (school, perfectionism, shame); ask about barriers without judgement. Remember IAYT asks for home practice with feedback mechanisms, not compliance [source: IAYT Scope of Practice 2020].

Resistance, scepticism or discomfort with the tradition. Some clients object to Sanskrit, chanting or gestures on religious grounds; others want 'just exercise'. Offer plain-English, secular versions; attribute concepts such as prana, koshas and chakras to the yoga tradition rather than asserting them; never require belief. Conversely, clients from Hindu, Jain, Buddhist or wider Indian backgrounds may feel the tradition is being stripped or misrepresented; discussions of cultural appropriation and decolonising yoga exist in the yoga community [uncertain]; acknowledge the roots, use names accurately, and do not proceduralise sacred practices.

Rupture. A practice can feel like a demand, a touch like an intrusion, or a correction like criticism. Name it, take responsibility for your part, invite the client's view, and adjust; in combined work, ruptures from the movement work are material for the psychotherapy.

Body image, eating disorders and exercise compulsion. Avoid weight, shape or calorie language; avoid mirrors; watch for over-exercising, restricting or 'purity' framing of yogic diet; coordinate with the eating-disorder team; reduce or pause physical practice if medically advised.

Dissociation and severe mental illness. Prefer eyes-open, upright, short and externally anchored practices; avoid long stillness or intense breathwork; for psychosis, mania or high suicide risk, prioritise psychiatric care and safety planning per standard practice, and use only simple grounding movement if at all.

Client wants yoga therapy to treat a physical disease (for example cancer). State clearly that yoga is not a treatment for cancer or other disease; it may help some symptoms and quality of life alongside medical care [source: NCCIH; IAYT Scope of Practice 2020]; encourage continuing medical treatment and do not advise on medication [source: IAYT Scope of Practice 2020].

Complaints and harms by another practitioner. Support the client, document, and follow safeguarding and mandatory reporting duties [synthesis]. IAYT takes ethics complaints only against a named individual holding the C-IAYT credential: the complainant reads the Grounds for Disciplinary Action, completes IAYT's Notice of Complaint form, and the complaint goes to the Ethics and Disciplinary Review Panel; anonymous complaints are not accepted and review often takes several months. Complaints about an IAYT-accredited programme go first through the school's own grievance policy, then to IAYT's Accreditation Department [source: IAYT Complaint FAQs]. For a practitioner without C-IAYT, use the relevant association's route. Remember that yoga therapy is generally unlicensed, so state regulatory routes may not exist [source: IAYT Scope of Practice 2020].

Sources

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