I was chatting with a fellow yoga therapist (we were both trainees at the time) about the challenges we were facing as inexperienced therapists working with yoga therapy clients. He was telling me about a new client who’d completed the Intake Questionnaire we used. On the questionnaire was an outline of a person and the request to circle any part or parts on the image where there was a concern. His new client had simply circled the whole body.
I laughed and sympathised at the same time at the daunting nature of this client’s disclosure, for any therapist and more so for a new therapist. And it highlights the importance of collecting that vital information on the Intake Questionnaire.
A good Intake Questionnaire teases out information on the health concerns, sets the stage for the yoga therapy process, finds out about important related areas, such as sleep and energy levels, and provides insight as to the client’s expectations and goals.
A symptom scale in a questionnaire (or a separate symptom scale) can be used to measure the client or care-seekers own self-assessment towards the end of the course of care. In my experience this helps to clearly indicate changes – it’s difficult, if not impossible, to remember how exactly one’s health is over time and reviewing change and seeing progress is a real encouragement.
Brevity in a questionnaire is important as no-one want to feel like they are sitting an exam! The basic information with contact details, occupation and how they found you, medical and surgical history, a checklist of health conditions and well-being factors (e.g. sleep/digestion) are all valuable and any on-going current treatment. There should be at least one question on the care-seekers expectations about the yoga therapy course of care to understand what they want and as a helpful way to set a goal.
The care-seekers information, preferably in their own words, is the initial part of any yoga therapy process. This provides the subjective information: everything that is about the client or care-seekers condition.
In many healthcare settings, the SOAP framework of information is used, both initially and in subsequent sessions and it provides an excellent model for yoga therapists too.
Subjective – Objective – Assessment – Planning
Subjective – all the information provided by the care-seeker.
Objective – the information that the therapist observes in the therapy session. There will be observations of simple postures highlighting restrictions or movement patterns and observations of breathing. It covers how the care-seeker appears, behaves and describes their story. Using the lens of yoga, the therapist links their observations to any relevant models such as the panchamaya model or Ayurvedic assessment.
Assessment – an overview of the main concerns from a yogic perspective. How will yoga therapy help? What will be the focus? This is written as though presenting the case to a fellow yoga therapist.
Planning – what is the plan of therapeutic work including short-term and long-term goals. A plan for the current session and the next step on. Whatever practice is prepared for the care-seeker to use away from the session, is recorded in this section for future reference.
If this seems complex and time-consuming, which it is, the benefits far outweigh the time involved. It clarifies and can simplify the intervention strategy or strategies that are used and leads to more effective outcomes. With good intake information, care seekers know that their yoga therapy treatment is coherent and professional. For the therapist, returning to clear and informative notes makes future session easier and allows information on progression to be easily discussed with the care-seeker over the course of the sessions.
And for my colleague with the daunting initial intake questionnaire with the whole body being of concern? It told him, perhaps in a way more than words can, that this care-seeker was looking for a whole person approach and that they were feeling overwhelmed by poor health, which was valuable information for him to understand.
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