Background: The Trauma Center at Justice Resource Institute has adapted a form of Hatha yoga into a trauma-sensitive adjunctive component of intervention for use with complexly traumatized individuals exhibiting chronic affective and somatic dysregulation and associated behavioral, functioning, and health complaints. Objectives: This article explores the use of yoga with traumatized youth (aged 12-21 years) in residential treatment. Design: A review of the literature on the somatic impact of trauma exposure provides a rationale for the use of yoga with this population and highlights an emerging evidence base in support of this practice. Case vignettes illustrate the integration of structured, gentle yoga practices into residential programming for youth with severe emotional and behavioral problems. Results: Anecdotal data and clinical observation underscore the promise of yoga as a viable approach to build self-regulatory capacity of traumatized youth. Conclusions: Future directions in the development and evaluation of trauma-informed yoga practices for youth are discussed.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (text revision). Washington, DC: Author.
2.
AndaR. F.BrownD. W.FelittiV. J.BremmerJ. D.DubeS. R.GilesW. H. (2007). Adverse childhood experiences and prescribed psychotropic medication in adults. American Journal of Preventive Medicine, 32, 389-394.
3.
ArchJ. J.CraskeM. G. (2006). Mechanisms of mindfulness: Emotion regulation following a focused breathing induction. Behaviour Research and Therapy, 44, 1849-1858.
4.
BarronJ.CurtisM. A.GraingerR. D. (1998). Eye movement desensitization and reprocessing. Journal of the American Psychiatric Nurses Association, 4(5), 140-144.
5.
BatemanA.FonagyP. (2004). Mentalization based treatment of borderline personality disorder. Journal of Personality Disorders, 18, 36-51.
6.
BerrolC. F. (1992). The neurophysiologic basis of the mind-body connection in dance/movement therapy. American Journal of Dance Therapy, 14(2), 19-29.
7.
BlausteinM. E.KinniburghK. M. (2010). Treating traumatic stress in children and adolescents: How to foster resilience through attachment, self-regulation, and competency. New York, NY: Guilford Press.
BortzJ. J.SummersJ. D.PipeT. B. (2007). Mindfulness meditation: Evidence of decreased rumination as a mechanism of symptom reduction. Journal of Neuropsychiatry and Clinical Neurosciences, 19, 217-218.
10.
BowenS.WitkiewitzK.DillworthT. M.MarlattG. A. (2007). The role of thought suppression in the relationship between mindfulness meditation and alcohol use. Addictive Behaviors, 32, 2324-2328.
11.
BradleyR.GreeneJ.RussE.DutraL.WestenD. (2005). A multidimensional meta-analysis of psychotherapy for PTSD. American Journal of Psychiatry, 162, 214-227.
12.
BradyK. T.SinhaR. (2005). Co-occurring mental and substance use disorders: The neurobiological effects of chronic stress. American Journal of Psychiatry, 162, 1483-1493.
13.
BremnerJ. D. (2002). Does stress damage the brain? Understanding trauma-related disorders from a neurological perspective. New York, NY: W. W. Norton.
14.
BriereJ.ScottC. (2006). Biology and psychopharmacology of trauma. In BriereJ.ScottC. (Eds.), Principles of trauma therapy: A guide to symptoms, evaluation, and treatment (pp. 185-229). Thousand Oaks, CA: Sage.
15.
BrownR. P.GerbargP. L. (2009). Yoga breathing, meditation, and longevity. Annals of the New York Academy of Sciences, 1172, 54-62.
16.
BurgessA. W.HartmanC. R.ClementsP. T.Jr. (1995). Biology of memory and childhood trauma. Journal of Psychosocial Nursing and Mental Health Services, 33(3), 16-26.
17.
CarriónV.HaasB.GarrettA.SongS.ReissA. (2009). Reduced hippocampal activity in youth with posttraumatic stress symptoms: An FMRI Study. Journal of Pediatric Psychology, 35, 559-569.
18.
CohenL.WarnekeC.FouladiR. T.RodriguezM. A.Chaoul-ReichA. (2004). Psychological adjustment and sleep quality in a randomized trial of the effects of a Tibetan yoga intervention in patients with lymphoma. Cancer, 100, 2253-2260.
19.
CookA.SpinazzolaJ.FordJ.LanktreeC.BlausteinM.CloitreM. . . van der KolkB. (2005). Complex trauma in children and adolescents. Psychiatric Annals, 35, 390-398.
20.
CorsoP. S.EdwardsV. J.FangX.MercyJ. A. (2008). Health-related quality of life among adults who experienced maltreatment during childhood. American Journal of Public Health, 98, 1094-1100.
21.
DaleN.BakerA.AnastasioE.PurcellJ. (2007). Characteristics of children in residential treatment in New York State. Child Welfare, 86, 5-27.
22.
DavidoffF.BataldenP.StevensD.OgrincG.MooneyS. (2008). Publication guidelines for quality improvement in health care: Evolution of the SQUIRE project. Quality & Safety in Health Care, 17(Suppl. 1), i3-i9.
23.
De BellisM. D. (2001). Developmental traumatology: The psychobiological development of maltreated children and its implications for research, treatment, and policy. Development and Psychopathology, 13, 539-564.
24.
De BellisM. D. (2002). Developmental traumatology: A contributory mechanism for alcohol and substance use disorders. Psychoneuroendocrinology, 27, 155-170.
25.
DeCarloA.HockmanE. (2003). Rap therapy: A group work intervention method for urban adolescents. Social Work With Groups, 26, 45-59.
26.
DeirdreH. (2006). Art as therapy: An effective way of promoting positive mental health?Disability & Society, 21, 179-191.
27.
DelgadoL. C.GuerraP.PerakakisP.VeraM. N.del PasoG. R.VilaJ. (2010). Treating chronic worry: Psychological and physiological effects of a training programme based on mindfulness. Behavior Research and Therapy, 48, 873-882.
28.
DesciloT.VedamurtacharA.GerbargP. L.NagarajaD.GangadharB. N.DamodaranB.. . . BrownR. P. (2010). Effects of a yoga breath intervention alone and in combination with an exposure therapy for PTSD and depression in survivors of the 2004 South-East Asia tsunami. Acta Psychiatrica Scandinavica, 121, 289-300.
29.
DubeS. R.FairweatherD.PearsonW. S.FelittiV. J.AndaR. F.CroftJ. B. (2009). Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic Medicine, 71, 243-250.
30.
EmersonD.SharmaR.ChaudhryS.TurnerJ. (2009). Trauma-sensitive yoga: Principles, practice, and research. International Journal of Yoga Therapy, 19, 123-128.
31.
FarrM. (1997). The role of dance/movement therapy in treating at-risk African-American adolescents. The Arts in Psychotherapy, 24, 183-191.
32.
FelittiV. J.AndaR. F.NordenbergD.WilliamsonD. F.SpitzA. M.EdwardsV.. . . MarksJ. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) study. American Journal of Preventive Medicine, 14, 245-258.
33.
FoaE.KeaneT. M.FriedmanM. J. (Eds.). (2000). Effective treatments for PTSD: Practice guidelines from the international society of traumatic stress studies. New York, NY: Guilford Press.
34.
GallopR. (2002). Failure of the capacity for self-soothing in women who have a history of abuse and self-harm. Journal of the American Psychiatric Nurses Association, 8(1), 20-26.
35.
GlodC. A.McEnanyG. (1995). The neurobiology of posttraumatic stress disorder. Journal of American Psychiatric Nurses Association, 1(5), 164-199.
36.
GordonJ. S.StaplesJ. K.BlytaA.BytyqiM.WilsonA. T. (2008). Treatment of posttraumatic stress disorder in post-war Kosovar adolescents using mind-body skills groups: a randomized controlled trial. Journal of Clinical Psychiatry, 69(9), 1383-92.
37.
GranathJ.IngvarssonS.von ThieleU.LundbergU. (2006). Stress management: A randomized study of cognitive behavioural therapy and yoga. Cognitive Behaviour Therapy, 35, 3-10.
38.
GriffinG.MartinovichZ.GawronT.LyonsJ. S. (2009). Strengths moderate the impact of trauma on risk behaviors in child welfare. Residential Treatment for Children & Youth, 26, 105-118.
39.
HarrisD. A. (2007). Dance/movement therapy approaches fostering resilience recovery among African adolescent torture survivors. Torture, 17, 135-155.
40.
HartmanC. R.BurgessA. W. (1993). Information processing of trauma. Child Abuse and Neglect, 17, 47-58.
41.
HendonC.BohonL. M. (2007). Hospitalized children’s mood differences during play and music therapy. Child: Care, Health, and Development, 34, 141-144.
42.
HermanJ. L. (1992). Trauma and recovery. New York, NY: Basic Books.
43.
HillaryB. E.SchareM. L. (1993). Sexually and physically abused adolescents: An empirical search for PTSD. Journal of Clinical Psychology, 49, 161-165.
44.
HolzelB. K.CarmodyJ.VangelM.CongletonC.YerramsettiS. M.GardT.LazarS. W. (2011). Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Research: Neuroimaging, 191, 36-43.
45.
HolzerS. R.UppalaS.WonderlichS. A.CrosbyR. D.SimonichH. (2008). Mediational significance of PTSD in the relationship of sexual abuse and eating disorders. Child Abuse & Neglect, 32, 561-566.
46.
HughesD. (2006). Building the bonds of attachment: Awakening love in deeply troubled children (2nd ed.). Northvale, NJ: Jason Aronson.
47.
HusseyD. L.GuoS. (2002). Profile characteristics and behavioral change trajectories of young residential children. Journal of Child and Family Studies, 11, 401-441.
48.
IrishL.KobayashiI.DelahantyD. L. (2010). Long-term physical health consequences of childhood sexual abuse: A meta-analytic review. Journal of Pediatric Psychology, 35, 450-461.
49.
JaycoxL. H.EbenerP.DamesekL.BeckerK. (2004). Trauma exposure and retention in adolescent substance abuse treatment. Journal of Traumatic Stress, 17, 113-121.
50.
JensenP. S.KennyD. T. (2004). The effects of yoga on the attention and behavior of boys with attention-deficit/ hyperactivity disorder (ADHD). Journal of Attention Disorders, 7, 205-216.
51.
KannappanR.LakshmiB. R. (2008). Efficacy of yoga: Cognitive and human relationship training for correcting maladjustment behaviour in deviant school boys. Journal of the Indian Academy of Applied Psychology, 34, 60-65.
52.
KendallP.BeidasR. (2007). Smoothing the trail for dissemination of evidence-based practices for youth: Flexibility within fidelity. Professional Psychology: Research and Practice, 38, 13-20.
53.
KerrT.StoltzJ.MarshallB. D. L.LaiC.StrathdeeS. A.WoodE. (2009). Childhood trauma and injection drug use among high-risk youth. Journal of Adolescent Health, 45, 300-302.
54.
KhalsaS. B. (2004). Treatment of chronic insomnia with yoga: A preliminary study with sleep-wake diaries. Applied Psychophysiology & Biofeedback, 29, 269-278.
55.
KhalsaS. B.ShorterS. M.CopeS.WyshakG.SklarE. (2009). Yoga ameliorates performance anxiety and mood disturbance in young professional musicians. Applied Psychophysiology & Biofeedback, 34, 279-289.
56.
KilpatrickD. G.RuggieroK. J.AciernoR.SaundersB. E.ResnickH. S.BestC. L. (2003). Violence and risk of PTSD, major depression, substance abuse/dependence and comorbidity: Results from the national survey of adolescents. Journal of Consulting and Clinical Psychology, 71, 692-700.
57.
KinniburghK. J.BlausteinM.SpinazzolaJ.van der KolkB. A. (2005). Attachment, self-regulation, and competency. Psychiatric Annals, 35, 424-430.
58.
KornD. L. (2009). EMDR and the treatment of complex PTSD: A review. Journal of EMDR Practice and Research, 3, 264-278.
59.
KreidlerM.KurzawaC. (2009). Trauma spectrum disorders: Clinical imperatives. Journal of Psychosocial Nursing and Mental Health Services, 47(11), 26-33.
60.
KuttnerL.ChambersC. T.HardialJ.IsraelD. M.JacobsonK.EvansK. (2006). A randomized trial of yoga for adolescents with irritable bowel syndrome. Pain Research & Management, 11, 217-223.
61.
LevinE. C. (2009). The challenges of treating developmental trauma disorder in a residential agency for youth. Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, 37, 519-538.
62.
LoboY.WinslerA. (2006). The effects of a creative dance and movement program on the social competence of head start preschoolers. Social Development, 15, 501-519.
63.
Lyons-RuthK.DutraL.SchuderM. R.BianchiI. (2006). From infant attachment disorganization to adult dissociation: Relational adaptations or traumatic experiences?Psychiatric Clinics of North America, 29, 63-86.
64.
MacyR. D.MacyD. J.GrossS. I.BrightonP. (2003). Healing in familiar settings: Support for children and youth in the classroom and community. In MacyR. D.BarryS.NoamG. G. (Eds.), Youth facing threat and terror. New Directions for Youth Development (Vol. 98, pp. 51-79). Hoboken, NJ: Jossey-Bass.
65.
MoadelA. B.ShahC.Wylie-RosettJ.HarrisM. S.PatelS. R.HallC. B.SparanoJ. A. (2007). Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: effects on quality of life. Journal of Clinical Oncology, 25, 4387-4395.
66.
NemeroffC. B. (2004). Neurobiological consequences of childhood trauma. Journal of Clinical Psychiatry, 65, 18-28.
67.
OgdenP.MintonK.PainC. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. New York, NY: W. W. Norton.
68.
PearlmanL. A.CourtoisC. A. (2005). Clinical applications of the attachment framework: Relational treatment of complex trauma. Journal of Traumatic Stress, 18, 449-459.
69.
PilkingtonK.KirkwoodG.RampesH.RichardsonJ. (2005). Yoga for depression: The research evidence. Journal of Affective Disorders, 89, 13-24.
70.
RainC.Fyfe-JohnsonA. L.BreunerC. C.BrownM. A. (2010). Randomized controlled clinical of yoga in the treatment of eating disorders. Journal of Adolescent Health, 46, 346-351.
71.
SalmonP.LushE.JablonskiM.SephtonS. E. (2009). Yoga and mindfulness: Clinical aspects of an ancient mind/body practice. Cognitive and Behavioral Practice, 16, 59-72.
72.
SalmonP.SephtonS.WeissbeckerI.HooverK.UlmerC.StudtsJ. L. (2004). Mindfulness meditation in clinical practice. Cognitive and Behavioral Practice, 11, 434-446.
73.
ScaerR. (2001). The body bears the burden: Trauma, dissociation, and disease. Binghamton, NY: Haworth Medical Press.
74.
SchreinerI.MalcolmJ. P. (2008). The benefits of mindfulness meditation: Changes in emotional states of depression, anxiety, and stress. Behaviour Change, 25, 156-168.
75.
SingerM. I. (2007). Assessment of violence exposure among residential children and adolescents. Residential Treatment for Children & Youth, 24, 159-174.
76.
SpinazzolaJ.FordJ. D.ZuckerM.van der KolkB. A.SilvaS.SmithS. F.BlausteinM. (2005). Survey evaluates complex trauma exposure, outcome, and intervention among children and adolescents. Psychiatric Annals, 35, 433-439.
77.
StreeterC. C.JensenJ. E.PerlmutterR. M.CabralH. J.TianH.TerhuneD.B.. . . RenshawP. F. (2007). Yoga asana sessions increase brain GABA levels: A pilot study. Journal of Alternative & Complementary Medicine, 13(4), 419-426.
78.
TolW. A.KomproeI. H.SusantyD.JordansM. D.MacyR. D.JongJ. T. V. M. (2008). School-based mental health intervention for children affected by political violence in Indonesia: A cluster randomized trial. Journal of Adolescent Mental Health, 300, 655-662.
79.
van der KolkB. A. (1994). The body keeps the score: Memory and the emerging psychobiology of post traumatic stress. Harvard Review of Psychiatry, 1, 253-265.
80.
van der KolkB. A. (2003). Neurobiology of childhood trauma and abuse. Child and Adolescent Psychiatric Clinics, 12, 293-317.
81.
van der KolkB. A. (2005). Developmental trauma disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35, 401-408.
82.
van der KolkB. A. (2006). Clinical implications of neuroscience research in PTSD. Annals of the New York Academy of Sciences, 1071, 277-293.
83.
van der KolkB.McFarlaneA. C.WeisaethL. (1996). (Eds.). Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York, NY: Guilford Press.
84.
van der KolkB. A.SpinazzolaJ.BlausteinM. E.HopperJ. W.HopperE. K.KornD. L.SimpsonW. B. (2007). A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: Treatment effects and long-term maintenanceJournal of Clinical Psychiatry, 68, 37-46.
85.
WarnerL. A.PottickK. J. (2003). Nearly 66,000 youth live in U.S. mental health programs. Latest findings in children’s mental health (Policy Report submitted to the Annie E. Casey Foundation). New Brunswick, NJ: Institute for Health, Health Care Policy, and Aging Research, Rutgers University.
86.
WegmanH. L.StetlerC. (2009). A meta-analytic review of the effects of childhood abuse on medical outcomes in adulthood. Psychosomatic Medicine, 71, 805-812.
87.
WeierichM. R.NockM. K. (2008). Posttraumatic stress symptoms mediate the relation between childhood sexual abuse and non-suicidal self-injury. Journal of Consulting and Clinical Psychology, 76, 39-44.
88.
WilsonJ. P.KeaneT. M. (Eds.). (2004). Assessing psychological trauma and PTSD (2nd ed.). New York, NY: Guilford Press.
89.
YatesT. M.CarlsonE. A.EgelandB. (2008). A prospective study of child maltreatment and self-injurious behavior in a community sample. Development and Psychopathology, 20, 651-671.
90.
ZelechoskiA. D.SharmaR.BaserraK.MiguelJ.DeMarcoM. (in press). Traumatized youth in residential treatment settings: Prevalence, treatment and policy implications. Journal of Child & Adolescent Trauma.
