CHAPTER 13: SCHool-BASEd YogA PRogRAMS • 317- Childress and Harper (2015) implore that school-based yoga teachers stay up to date on
the research so that they are aware of any risks that are identified for particular stages of
development for children and youth. - School-based yoga teachers should only instruct poses they feel very confident teaching
(Childress & Harper, 2015). - School-based yoga teachers should get additional training to work with students with dis-
abilities (Childress & Harper, 2015). Further, partner with school-based professionals such
as the physical therapist, occupational therapist, and school mental health professionals
in order to deliver a safe yoga program. - Provide students with alternatives and modifications for poses. Always offer choices.
ConCluSionS And fuTuRE diRECTionS
Overall, the current state of research in area of yoga in schools is in its early stages. Much
more research is needed and continued funding and initiatives from the National Center for
Complementary and Alternative Medicine (NCCAM; nccam.nih.gov) are necessary for the
field to continue to move forward. Overall, yoga in schools can be informed, and is supported
by, the current body of research. As the rate of publications in this area is rapidly increasing,
school personnel are encouraged to stay informed. As a field we remain committed to more
rigorous research (i.e., randomized controlled trials; Forfylow, 2011; Khalsa & Butzer, 2016;
Serwacki & Cook-Cottone, 2012). We acknowledge that other standard quality-of-research
issues are not yet addressed including: follow-up assessments; over-reliance on use of self-
report measures, with less frequent use of performance measures; a need to expand across
ethnicity, age, sex, levels of experience, and ranges of disorder-specific issues in order to
provide a sufficient body of evidence that can be generalized to particular groups of indi-
viduals; as well as a need for studies with larger sample sizes (Forfylow, 2011; Hallgren
et al., 2014; Khalsa & Butzer, 2016; McIver et al., 2009; Serwacki & Cook-Cottone, 2012).
Dosage is a key variable that has not been effectively addressed in mindfulness or yoga
research (e.g., Cook-Cottone, 2013, 2015). Strongly considered in other fields (e.g., pharma-
cology), standardized dosages are essentially missing from mindfulness and yogic research.
Specifically, frequency, duration, session length, and content of sessions should be detailed
and accounted for (Cook-Cottone, 2013; Cook-Cottone, 2015). Relatedly, few studies measure
whether or not the treatment or control group members practice meditation, yoga, or breath
work at home or outside of the scope of the study intervention (Cook-Cottone, 2013; Cook-
Cottone, 2015). Few studies report a content-specific treatment integrity percentage (e.g., were
all the breath-work activities completed during the session? Were all of the prescribed yoga-
postures implemented; Cook-Cottone, 2013; Cook-Cottone, 2015). Further, few studies assess
engagement in other confounding physical activities as an important potentially confounding
variable (Cook-Cottone, 2013; Cook-Cottone, 2015). For example, did the treatment or control
participants engage in mindful walking or attend a Tai Kwon Do class? Finally, content of
interventions must be better detailed. This is especially salient within the context of yoga inter-
ventions. Specifically, the type of yoga, aspect of yoga, and amount of each type and aspect of
yoga should be detailed and evaluated for efficacy (Cook-Cottone, 2013; Cook-Cottone, 2015;
Forfylow, 2011). There is some evidence that the type of yoga utilized may matter (Delaney &
Anthis, 2010). Outside of standardized protocols and manualized methods, how are mindful
and yogic approaches being integrated?