If my hunch is correct, the field of yoga therapy is due for a big growth spurt. The increasing popularity of yoga, the mounting scientific evidence for the therapeutic benefits of yoga practice, the aging of the baby boomers into the decades in which chronic diseases become common, and the public's continuing desire to find safe and effective adjuncts and alternatives to conventional medical care all bode well for the growth of yoga as medicine. I worry, however, that the yoga world may not be prepared for the demand. In the years to come, there may be many more people seeking yoga therapy than there are qualified teachers to provide it.
Part of the problem is that the field of yoga therapy is new. So far, there are no agreed-on definitions of what yoga therapy is, who is qualified to do it, or how much and what kind of training is necessary. Since neither the federal nor state governments currently regulate yoga therapy, there is no licensure or accreditation of practitioners. This may change in the years to come, but in the meantime, yoga teachers hoping to expand their teaching to include therapeutic work can begin to get the necessary training and experience.
In general, the amount of training you'll need depends of what type of therapy you'll be doing, the type of students you're likely to work with, and the nature of the problems for which they consult you. It also depends on your prior training and experience. If you've worked for a decade as a nurse or have been to physical therapy school, you've got a leg up.
There are seven basic areas of knowledge, skills, and experience that good yoga therapists depend upon:
1. Yoga philosophy, techniques, and teaching skills.
2. Yoga therapy. How to apply yoga to people with different health conditions, both physical and emotional. This includes an understanding of contraindications and modifications of yoga practices to suit individuals.
3. Anatomy. A thorough knowledge of functional anatomy is particularly important for such problems as back pain, arthritis, and carpal tunnel syndrome, in which anatomical alignment of the bones and soft tissue has a major impact on symptoms.
4. Physiology in both health and various disease states. How the body works and what goes wrong. You should be able to spot the warning signs that the student has a serious problem that requires medical attention. Knowledge of physiology can also help you explain to doctors and other medical personnel some of the likely mechanisms of yoga's therapeutic effectiveness.
5. Understanding of medical care for various problems. Unless you have additional training, you will not, as a yoga therapist, be called on to diagnose conditions or offer medical advice. However, you do need an overview of the treatments your students may be dealing with and how you may need to adapt yogic practices accordingly. This overview should include possible side effects of medications and other therapies.
6. Understanding of Ayurveda and other alternative healing systems. Ayurveda, with the philosophical foundation it shares with yoga and its insights into diet and constitution, can be particularly useful in yoga therapy. Other modalities, such as various schools of bodywork and Western psychology, can also be valuable complements to yogic work and are worth at least some study.
7. Business/ethics. The nuts and bolts of how to run a yoga therapy practice (or any business).
Sources of Knowledge
There are many ways to gain knowledge in the areas listed above. Most yoga therapists draw from these seven major ways of acquiring expertise:
1. Yoga teacher training (YTT). Ideally, all yoga therapists should go through YTT and other trainings with a minimum of 500 hours of instruction. In reality, mastery of yoga therapy requires many times this number of hours, so your best bet is to set yourself on a path of lifelong learning. To use the full gamut of yogic tools therapeutically, you'll need training not just in asana but in the yamas and niyamas, Pranayama, guided relaxation, and meditation. If the YTT program you've completed doesn't cover everything you'd like to include in your practice, look for additional workshops in these areas.
2. Yoga therapy training. Some schools offer training in therapy for teachers who have already completed YTT. Prominent teachers offer workshops and trainings in a variety of areas, such as Yoga for Depression and Yoga for People with HIV/AIDS. You can also find training in specific modalities with therapeutic utility, such as in Iyengar-based restoratives, mindfulness-based stress reduction, or the guided meditation of Yoga Nidra.
3. College and professional training courses. Some people study small-business ownership, anatomy or physiology through local community colleges. Professional training aimed at nurses, massage therapists, or other health care professionals is also widely available.
4. Book study. For those who have the discipline to teach themselves, excellent books on anatomy and physiology are in libraries and bookstores, as are general health guides that cover the treatment and diagnosis of common diseases. You may find it useful to form study groups with colleagues.
5. Apprenticeships. Yoga and yoga therapy are best learned from seasoned teachers who you can observe and interact with. If they can watch you work with students and critique your work, so much the better. Apprenticeships can be formal or informal, and some training programs offer them as part of their program.
6. On-the-job training. No matter how well prepared you are, a substantial part of learning to practice yoga therapy comes from doing it—from plain old trial and error—and from closely scrutinizing your students' responses to your interventions. Try to learn from every student. When you're seeing someone who has, say, asthma, if you spend a few minutes reading about the condition and its treatment, you're more likely to understand the physical and emotional signals your student is sending out in class.
7. Your own yoga practice. This may seem obvious, but your ongoing sadhana should be a major source of your understanding of yoga and what you bring to each yoga therapy session. Teaching is not enough: People who attempt this art without a firm grounding in their own regular yoga practice are unlikely to do it well.
Dr. Timothy McCall is a board-certified internist, Yoga Journal's medical editor, and the author of the forthcoming book Yoga as Medicine (Bantam Dell). He can be found on the Web at www.DrMcCall.com.