Across the country, health and human service providers have shown a growing interest in using yoga as an option for treating people who experience mental health problems, such as depression, anxiety and post traumatic stress disorder (PTSD), due to various forms of trauma. But a recent study from the UNC School of Social Work found that while there are some promising benefits to using yoga, including to enhance other treatments, there isn’t yet enough evidence to support the practice as a standalone solution for improving mental health and well-being.
Distinguished Professor Rebecca Macy, who headed up the study, said she began to think more seriously about the coping effects of yoga a few years ago while taking yoga classes. Like many enthusiasts of the practice, including social workers, Macy said she found the meditative features of yoga helpful with managing stress. But would clients struggling with mental health issues or the effects of trauma also experience similar benefits?
“As a researcher who works with violence and trauma survivors, I was just very intrigued by the idea of yoga as an intervention,” said Macy, who recently co-authored an article on the topic for the journal, Trauma, Violence & Abuse. “So much of what I was seeing and hearing about were people showing up at domestic violence shelters, mental health centers, substance abuse treatment centers, veterans’ programs, and rape crisis centers, and many were receiving recommendations to take yoga. In some of these places, social workers are offering yoga themselves. But I really wanted to know if yoga is something we should be suggesting to people who have post-traumatic stress disorder, or depression, or anxiety or various traumas. What does the evidence really say?”
For their study, Macy and her colleagues (Elizabeth Jones, MSW ‘14, with Durham’s Center for Child and Family Health; Laurie Graham, a Ph.D. student at the School; and Leslie Roach, a certified yoga instructor and massage therapist with UNC Health Care at Meadowmont Wellness Center) analyzed 13 literature reviews to conduct a meta-review of 185 articles published between 2000 and 2013. Overall, the researchers found that “yoga holds potential promise for helping improve anxiety, depression, PTSD, and/or the psychological consequences of trauma at least in the short term.”
The study also suggested that clinicians and service providers consider recommending yoga as an intervention in addition to other “evidence-based and well-established treatments,” including psychotherapy and medication.
However, because most of the current studies analyzed lacked appropriate documentation on the types of yoga used, how the practices were delivered, as well as inconsistent evaluation and insufficient follow-up with individual participants, the co-authors agreed that more rigorous research is needed to build up the evidence base for yoga as a primary treatment model.
“Even though I do think yoga is, in general, incredibly beneficial, I also think there needs to be a whole lot more education about how to use yoga specifically to treat survivors of trauma in order to be the most effective and helpful,” Roach said. “So as a standalone treatment right now, it’s just not viable. However, I think with more education, more research, and more experienced instructors, it will be. The body holds a wealth of information and once we learn to work with it in conjunction with our breath, a lot of healing can take place.”
Macy and Roach are considering several possible future studies, including one that would examine the use of yoga within a rape crisis center or domestic violence shelter. However, because yoga is a holistic practice, researchers must be careful not to “undermine yoga’s approach,” Macy added.
“One of our recommendations was that researchers and yoga instructors partner together so that we use holistic methods in future research,” Macy said. “We need to ask ourselves if we’re taking these Western research methods and trying too hard to fit a round peg in a square hole. As a researcher, I don’t want to undo the potential benefits of yoga by making the practice unnecessarily standard and systematic.”
Although their study did not produce solid proof about the benefits of yoga for treating the effects of trauma, Macy also cautioned against abandoning a practice that many individuals may still find helpful.
“Obviously, talk to your doctor and make sure you’re not doing something you shouldn’t, but if yoga feels good, especially for someone who is a survivor of trauma, they should do it,” she said. “Ultimately, we want this study’s findings to inform future research of yoga for trauma so that we can help the field move forward.”
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