Yoga Nidra Self Assessment Scale developed by Dr Hanna Chusid Ed.D

FIRST NAME & LAST INITIAL ______Date ______Days Sober ______

A. BEGINNING OF SESSION Rate how you feel for each scale from 1-10, with 1 being the BEST and 10 being the WORST

CRAVINGS

NO CRAVINGS HIGHEST CRAVINGS

ANXIETY

VERY PEACEFUL HIGHEST ANXIETY

DEPRESSION

VERY HAPPY HIGHEST DEPRESSION

HOPE

SUICIDAL VERY HOPEFUL

Anything else you want to share from the BEGINNING:

B. END OF SESSION CRAVINGS

NO CRAVINGS HIGHEST CRAVINGS

ANXIETY

VERY PEACEFUL HIGHEST ANXIETY

DEPRESSION

VERY HAPPY HIGHEST DEPRESSION

HOPE

SUICIDAL VERY HOPEFUL

IN THIS SESSION What was the most useful, helpful, or encouraging thing you

Learned:

Practiced:

Heard:

Shared/Expressed:

Yoga Nidra for Addiction : Discussion of YNSAS Preliminary Research Tool by Hanna Chusid,Ed.D

Development of Research Tool The Yoga Nidra Self Assessment Scale (YNSAS) was developed by Dr. Hanna Chusid ,Ed.D in October 2017, while working with clients in a rehab treatment program for substance addiction and underlying trauma. YNSAS is a Likert -like scale of measures that includes the “loudest”, most recognizable symptoms of addiction: 1.Cravings 2.Anxiety 3.Depression. In addition, clients were asked to score their feelings of hope, as a measure of resilience . The clients were asked to complete this YNSAS all four measures pre and post experience of yoga nidra. The purpose of the self-evaluation tool was initially to provide the Yoga Therapist with client feedback to use in clinical documentation. Other benefits were discovered in the process as described below. Pros 1.Various layouts of YNSAS were tried before settling on one page, two-sided sheet of paper. It is easy to administer and cost effective to duplicate. 2. There is no significant investment required from the Yoga Therapist or the organization. 3. YNSAS can be easily replicated in various settings due to its concise and clear instructions 4. YNSAS can be readily adapted to other client populations and foci of concern 5. YNSAS provides immediate feedback to the client, the practitioner,the treatment team and insurance providers 6.The concrete feedback provided facilitates Yoga Therapist/team identification of instability/red flag concerns , supporting triage and immediate intervention after yoga nidra, as needed. 7. A self-assessment format invites self-reflection and empowerment of the client. 8. Clients addressing addiction /trauma often present with difficulty in recognizing and regulating their emotions. This tool is an intervention in itself, as it invites clients to observe, notice and assess incremental sensate /emotional change. The tool provides gentle structure for entrainment of self observation. 9. The tool provides documentation required by organizations for billing and insurance claims. Yoga nidra is commonly provided in a group setting,with insufficient time for depth verbal sharing/feedback from all participants. This tool aids Yoga Therapist ‘s client notes . 10. For this study the tool was HIPPA compliant since someone other than the data collector /an assistant codified the results ,leaving off names

Cons 1. In developing the YNSAS , the practitioner understood the importance of including the strengths-based perspective. However, including a measure of hope posed a challenge. Since this was viewed as the only positive attribute (as compared to symptoms of anxiety, cravings, and depression), clients had difficulty using the same rating scale. Lower ratings of symptoms were intuitively viewed as “good,” while higher rates were viewed as “bad.” Some clients felt the measure of hope should be rated inversely, with higher rates as “good.” Clients were confused by this measure and often unintentionally reported low rates of hope. The tool was reformatted various times in an attempt to highlight this difference. In addition, the practitioner highlighted this matter verbally in each session. The collected data on “hope” was so corrupted by this confusion that it was not included or tabulated in final analysis. 2. Another source of confusion was the rating scale itself. The rating scale was listed from 1-10, with 1 being the lowest amount and 10 being the highest amount. Some clients hand wrote in a 0, to reflect no amount of symptoms. In the future, the tool may be revised to allow for a 0 rating, as a current rating of 0 contaminates the data. 3. Self-assessments are inherently flawed due to their subjectivity and lack of experimental reliability or validity. Therefore, YNSAS is recommended for all the Pros listed above but is not sound enough to help understand the long-term effect/impact.

Yoga Nidra for Addiction : Discussion of YNSAS Preliminary Research Tool by Hanna Chusid,Ed.D

YNSAS Preliminary Study Data Analysis / May 28,2018

By Katie Abelson MSW, ASW supervised by Dr. Hanna Chusid, Ed.D

Repeated Measures T-Test

The Yoga Nidra Self Assessment Scale (YNSAS) uses self-evaluation before and after the yoga nidra intervention. The four measures include cravings, anxiety, depression, and hope.

During the study, the measure of hope appeared to confuse participants. All self-ratings for hope were discarded from the study. Incomplete evaluations were also discarded, resulting in a total sample size of n=64. While analyzing the data, 15 outliers were noted. These outliers consisted of participants who rated themselves with higher cravings, anxiety, or depression after the intervention. Although one would expect the data to be contaminated by these outliers, the statistical analysis proved that the results were the same with outliers included or excluded.

To measure the effects of yoga nidra, the researcher used a repeated measures t-test. This statistical calculation compares the same sample before and after the intervention. Using a p- level of 0.05 means that there is 95% confidence that the sample mean reflects the population mean. Upon testing each measure (cravings, anxiety, depression), the level of significance, or p- value was p < .00001. This means that the confidence level is greater than 99.9% and the sample is reflective of the total population. Differences in self-assessment before and after the intervention are statistically significant.

Graph

The Repeated Measures T-Test measures the whole sample (n=64) before and after yoga nidra. Self-report of cravings, anxiety, and depression were all significantly lower after the intervention. When calculating for before and after cravings, the value of t is -5.101410. The value of p is < 0.00001. The result is significant at p ≤ 0.05. While examining changes in anxiety, the value of t is -9.862010. The value of p is < 0.00001. The result is significant at p ≤ 0.05. Finally, calculations for differences in depression resulted in a value of t at -6.864510. The value of p is <

0.00001. The result is significant at p ≤ 0.05.

T-Test for Two Independent Means

The YNSAS was administered at an intensive outpatient program for addiction treatment. The clients stay in treatment for varying amounts of time and participate in a variety of therapeutic modalities. While some clients experience yoga nidra multiple times, some clients experience it only once. While n=22 participants received the intervention once, n=42 participants received the intervention multiple times. The study did not explore differences in amount of sessions within the multiple sample group. To measure differences between the two sample groups, the study utilized a t-test for two independent means. This statistical analysis is used to compare two independent groups, the one- time versus multiple times yoga nidra participants. Using a p-value of 0.05, the differences in cravings, anxiety, and depression were not statistically significant between groups. The positive short-term effects of yoga nidra can be seen after the first session; however, the YNSAS does not measure long-term effects of continued yoga nidra practice.

Graph

The T-Test for Two Independent Means was used to compare two samples: participants who received yoga nidra once and participants who received yoga nidra multiple times. The one-time intervention group had a sample size of n=22, while the sample that received yoga nidra multiple-times was n=42. When comparing the mean self-assessment for each measure after the intervention, there was no statistically-significant difference between the groups. Although there are many known benefits of long-term yoga nidra practice, this study does not measure the effects over time.

When comparing ending cravings, the t-value is 0.11013. The p-value is .912431. The result is not significant at p < .05. Calculating between group differences in anxiety resulted in a t-value of 1.1923. The p-value is .23475. The result is not significant at p < .05. Comparing difference in depression ratings found a t-value of -1.33702. The p-value is .182941. The result is not significant at p < .05.

Future Research

Yoga nidra practice has proven beneficial to participants in addiction recovery. The preliminary study results are significant enough to warrant further research with a randomized, controlled group study to further explore the efficacy of yoga nidra practice. However, this research does not delve into the differences within the sample. Future research may differentiate between length of sobriety and type of addicting substance. In addition, a measure of pain can be easily added to the YNSAS. Yoga nidra appears to be an effective remedy for pain, which many clients experience during detox and the period after. The self-assessment measures can be modified based on the population being served.

The YNSAS is an effective tool to measure participants’ self-perception about their internal changes after each practice/experience. Although this study was done with clients in addiction recovery, the scale can be adapted for use in many settings.

YOGA NIDRA Efficacy; a preliminary study Resources collated by Dr .Hanna Chusid Ed.D

WHAT IS YOGA NIDRA? Yoga nidra is a potent ,specific guided meditation entraining aware relaxation at each level of the systematically and utilizing the natural stages of sleep to engage the participant's natural capacity for self healing , rebalancing brain chemistry, improving sleep , mood regulation and more. While there is a recent body of research applying yoga nidra to PTSD for use in VA hospitals, the practice has untapped potential to be relevant in the Tx of addiction.

LINEAGES To my knowledge, as of just a couple years ago there were only four distinct but overlapping approaches to yoga nidra that are rooted in identifiable lineages. Who brought these teachings forward in the USA beginning in the 1960s:. (Hanna has training in all 4 and significant training in 1 and 2):

1. Amrit IAM Yoga Nidra ; Gurudev Shri Amritji ( Amrit Desai) 2. Himalayan Institute : /Swami Tunaigait , Rod Stryker 3. Behar School of Yoga Nidra ;Swami 4. iRest (Integrity Restoration),combines yoga nidra with MBSR; Dr Richard Miller PhD

ANCIENT SOURCE TEXTS One of the earlist source texts that mentions Yoga Nidra as Mystic Slumber is the Brahma Samhita . There are myriad iterations of the Story wherein The Creator Vishnu/Narayan /Bhagwan takes shelter of Yoga Nidra. , mystic slumber, and where he then dreams the material worlds into being.

Stages of sleep are described in the ancient Mandukya Upanishads.

There are specific descriptions in ancient texts of two of the fundamental yoga nidra companents:61 points and 45 breaths practices.

RESEARCH / BOOKS All the extensive research on meditation and guided meditation over the recent past 30+ years appears to be relevant to yoga nidra since this is a meditation practice. As a starting point, there is a 22 page Bibliography, mostly of research studies in the back of the book Yoga Nidra by Kamini Desai PhD. This is Hanna’s top book recommendation for a clear overview. Dr Richard Miller PhD also provides resources at : www.irest.us/research.

RECORDINGS For Yoga Nidra recordings my top sources include CD :”Relax Into Greatness” by Rod Stryker, avail on Amazon (Himalayan lineage) and mp3s through www.johnvosler.com (AMRIT lineage). Recordings will also be available on my website soon (see below)

CONTACT: www.drhannachusid.com or www.mindful-selfcare.com disclaimer: Hanna receives no financial or other benefit from the CDs , books or recordings noted