Yoga for Stress Management Program as

a Complementary Alternative Counseling

Resource in a University Counseling Center
Colleen K. Milligan

AYoga for Stress Management Program (YSMP) that served as a complementary alternative therapy resource
was successfully implemented at a midsize, predominantly undergraduate university. It v/as offered in addition to traditional treatments for student mental health. Counselors, Residence Life staff, and faculty found
that the program v/as useful for their students/clients, who reported many benefits from participation.
Participants in thisYSMP included students and faculty/staff. Logistics of setting up aYSMP are outlined.

he innovative practice program of focus is a Yoga for Stress Management Program (YSMP), first implemented in the fall of 2001. The
program has been used since then as a complementary alternative
therapy designed to help students cope with stress (Long, Huntley & Ernst,
2001; Rubin & Feeney, 1986). This program was developed and has been
used with the intention of providing preventive, psychotherapeutic, and
developmental assistance to students (Keeling, 2005). In this article, I introduce the concept of a YSMP, consider therapeutic uses of yoga, and
describe the basic logistics of creating and implementing such a program.

Overview and Rationale for the YSMP

University counseling centers are serving a more psychologically diverse student population who present with more severe issues than
ever before. Furthermore, students are less likely to persist academically in the face of distraction and difficulty, and most of those who
leave college report difficulty with chronic health problems, sleep,
anxiety, and depression. Often, counseling center financial, physical,
and personnel resources do not increase in proportion to increased
student needs for services (Kitzrow, 2003; Levine & Cureton, 1998a,
1998b; Sharkin, 1997, 2004; Wilson, Mason, & Ewing,1997). The
use of primary prevention and health promotion groups can be an efficient, creative, and diversity-enhancing way of meeting students' stressmanagement needs. These groups can help students become more aware
of their own mental and physical health and provide many teachable
moments, thereby improving their capacity to self-assess and manage
their health (Keeling, 2005).
Colleen K. Milligan, Central Michigan University Counseling Center. Correspondence concerning this article should be
addressed to Colleen K. Miiiigan Central Michigan University Counseling Center, 102 Foust Hail, Mt Pleasant, Ml 488S9
(e-mail: miili1ck@cmich.edu).

2006 by the American Counseling Association. All rights reserved.

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The YSMP is designed as a skill-based group therapy technique. It is designed

to help promote normal developmental growth potential by increasing selfawareness and self-acceptance and by teaching stress-management skills. These
yoga-based skills can help to prevent student stress from leading to developmental delays or declining mental and physical symptoms. For centuries. East
Indian cultures have incorporated yoga into their psychological mind-body
therapies and often use yoga with the assumption that it is helpful to those with
mental, emotional, and physical problems (Ram, 2005; Sinha, 1984). The
many physical and mental benefits of general yoga practice in helping clients
have been reported anecdotally and are empirically supported (Jensen & Kenny,
2004; Malathi, Damodaran, Shah, Patil, & Maratha, 2000; Mishra & Sinha,
2001; Naveen, Nagrathna, Nagendra, & Telles, 1997; Nespor, 1993; West,
Otte, Geher, Johnson, & Mohr, 2004). The National Institute of Mental
Health (NIMH) has suggested that mild exercise or yoga may have a positive
effect on various aspects of mental and physical health (NIMH, 2005).
In my YSMP counseling center group, I integrated physical yoga exercises
(asana) and breath work (pranayama) with Eastern psychology, mindfulness,
meditation, and traditional stress-management principles. The mission of the
program is to provide stress-management and relaxation skills, which assist
participants in improving their ability to relax at will, to focus their attention, to reduce anxiety and depressive symptoms, and to enhance their
overall wellness. Because stress can be crippling to natural abilities, students
in the YSMP are encouraged to realize that stress is the body's natural
internal communication, which cannot and should not be disregarded or
eliminated entirely. Rather, stress must be worked with effectively in order
to increase self-awareness. The YSMP provides information about how the
body and mind interact and increases understanding of how to care for the
body and mind using techniques taught in group meetings.

Logistics
Publicizing the YSMP
The most effective methods for publicizing the program for students were
referral by counselors and Residence Life staff, invitation by fiiends, and the
use offiyers.Using an electronic mailing list was the best method of advertising
the program among faculty and staff, who were periodically e-mailed announcements about the YSMP during the semester. Students were given flyers to
share with fiiends who might also find the program useful. Many faculty members who received the announcement via an electronic mailing list were willing
to announce the YSMP in classes. Flyers were provided to all instructors of First
Year Experiencefi-eshmanorientation courses, increasing awareness of not only
the YSMP but also the university counseling center's resources in general. As
the facilitating therapist, I made many campus presentations to counseling center personnel, to faculty/staff groups, and to registered student organiza-

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tions. Student Health Services was given flyers and posted them each semester.
Residence Life staff were given flyers each semester.
Participants
Both students and faculty/staff were included as program participants. This
was done in the hope of increasing interest in the program and increasing the
number of participants. In addition, it was hoped that faculty/staff might act as
mentors and role models for students by using the YSMP to manage their own
stress. Although faculty and staff do not receive counseling services at the
university counseling center, the administration determined that there was no
conflict of interest in allowing interested faculty/staff to attend the group because individuals were not expected to disclose personal information during
YSMP sessions. An unexpected multigenerational effect was noted. Students
found it encouraging to see faculty of various ages achieve, or struggle to
achieve, the yoga postures, much hke the students themselves. They also enjoyed getting to know the faculty and staff as "real people."
Participants indicated a variety of motivations for attending the YSMP, including relief from stress associated with being a student, a desire to learn and
experience a new exercise, invitation by friends (social or recreational motivation), referral by counselors and other campus professionals, or trying to overcome the negative impact of stress (academic or social struggles) on one's
college career. Goals that participants stated they hoped to achieve by attending the YSMP included relaxation, stress relief, desired increase in energy,
improvedflexibility,mental focus, health and fitness, greater body awareness,
gaining peace and patience, having fun, and attempting to establish a routine.
Location and Scheduling
A local campus ministry had an especially pleasant open space for gatherings
and was asked for a loan of the room to the counseling center for the group
meetings. The campus ministry did not choose to charge for the room
because the YSMP was a service offered to students free of charge. Other
campus rooms have been used at times but were not available on a regular
basis. When trying to fmd a place to hold group meetings, both on-campus
and off-campus locations (within walking distance) can be considered.
A number of scheduling options were attempted at the beginning of the program. The Thursday morning (8 a.m.), once-a-week program showed the best
attendance compared with a twice-weekly program. Many participants said they
preferred a late-in-the-week schedule because it helped them decompress stress
accumulated earlier in the week, and many wanted to de-stress before the weekend. A schedule of two sessions per week was also tried with one session at 8
a.m. on Mondays and one session at noon on Thursdays. This program became
spottily attended on both days. Attendance at the noon session dropped because
people felt more rushed than they did in the Monday morning session and be-

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cause more noon classes are now being offered by the university. Students,
faculty, and staff have frequently requested a night program.
Finding the YSMP Facilitator
Some university counseling centers may not have a staff member who is
trained in yoga or interested in facilitating a YSMP. One way of procuring
a qualified person to facilitate such a program is by co-opting a yoga-trained
member of the university health or athletic facility who may already lead a
yoga class. Counselors could then collaborate with the athletic/physical
education professional, sharing stress-management concepts and developing affirmations (or using existing affirmation materials) appropriate for
promoting mindfulness and relaxation. Affirmations would be used during
asana practice and breath/mindfulness portions of the sessions. Attendance
at yoga seminars by yoga-interested faculty or extending invitations for
professional development to yoga experts to make presentations at the
university may be ways of finding a YSMP facilitator and ultimately encouraging buy-in from the counseling staff once they may have experienced
some yoga and learned something about it. Community yoga centers and
health clubs may also be considered as resources for finding individuals
specifically trained in teaching yoga with whom counseling staff can consult
or collaborate in developing a YSMP.
Program Considerations
The YSMP is not entirely different from general yoga classes that are held
at fitness facilities or yoga centers. One does not necessarily have to have a
problem with stress to attend because yoga has a preventive as well as a
reparative focus. The YSMP differs from general yoga because the affirmations
used during asana, guided meditation, and relaxation are infused with typical examples of age- and stage-appropriate case considerations. The YSMP
capitalizes on openness, relaxation, and teachable moments created by the
yoga practice. Some examples of issues that can be infused into yoga
affirmations are body/self acceptance issues, feeling overwhelmed, social
judging and being judged by others, finding balance between activity and
stillness, overcoming feelings of anxiety or depression, instilling hope, motivation, increasing one's ability to focus the mind, and beliefs about confidence or empowerment over a situation in one's life. Other more specific
stress-management principles include awareness of physiological changes when
anxious, breathing or muscle tension awareness, consciously letting go of
control, becoming aware of beliefs and releasing unwanted thoughts, instilling the belief that thoughts control emotions, and increasing awareness of
supportive or unsupportive self-talk. Metaphors are frequently used by yoga
teachers during guided meditation exercises to help provide a framework for
understanding the self For example, a yoga teacher may teach students to

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view uncontrolled emotions as wild horses pulling in various directions,

which they can learn to tame. In this way, students develop the belief that
they control their mind and are not controlled by it and that situations have
solutions that may be hidden deep inside the individual and that can be
accessed through stillness. Breath and meditations may also be depicted as
a silken thread, a string, and finally a rope, which can then be used to escape
the tower of doubt, fear, and anxiety that has entrapped the individual. In
sum, each instructor must use his or her own personal/clinical experience
and imagination to develop affirmations or metaphors. There are various
texts that instructors can consult, and variations of affirmations and metaphors can be created depending on the group being facilitated (see Yee &
Zolotow, 2002, for examples).
For the purposes of the YSMP, the yoga teaching level should remain at a
gentle beginning level of physical challenge and should be made accessible to
all students, regardless of ability. It is important to emphasize that individuals
need to be aware of their limitations when attempting to perform yoga postures and breath work and must listen to their bodies, remembering not to
compete or compare themselves with others in the group. This tenet should
be strongly promoted in YSMP programming. The YSMP must not be a
forum for competition or comparison. Individuals of any physical ability can
perform many of the relaxation techniques, breath practices, and asana postures. However, individuals should consult their physician with concerns prior
to participation. Persons with physical disabilities can perform the procedures
from a seated posture (on the floor or in a wheelchair) and can use the mind
to envision the completion of the posture to afford the energetic and stressmanagement benefits of yoga.

Conclusion
The YSMP can be considered as an innovative approach for addressing student stress problems and increasing the diversity of services offered by university counseling centers. A student who is reluctant to seek traditional
counseling may see this type of therapy as an acceptable alternative. Barriers
(e.g., shame for seeking help) and stereotypes held by some students about
seeking mental health services can be overcome by offering such an alternative type of therapy service. Yoga tends to be viewed as an enjoyable way to
cope with stress.
This counseling center program has become a favorite among students and
faculty who wish to manage stress in a natural and alternative fashion. However, at least three considerations need to be made prior to beginning such a
program. First, buy-in from counseling staff is crucial for a program to be
successful. Also, because this type of program may be considered a departure
from traditional counseling center services, informing the campus community
of the potential benefits of such a program and garnering interest and support

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are an initial challenge. Presentations must be developed discussing the

history, applications, and usefulness of yoga and its potential applications to
managing stress. Contacts with interested parties are made in this manner.
A second challenge in setting up a YSMP is locating available staff who have
an interest in yoga and who have developed expertise in stress management or in the relationship of exercise to mental health. The YSMP can
function as a natural extension to traditional stress-management programs.
A third challenge is assessing and gaining administrative support and examining policy and liability issues related to this type of programming. In
my experience, the most essential components are a willing and interested
counseling center staff and the support of the administration. Discussing
specific programming ideas with colleagues may increase the likelihood of
referrals and also reduce misunderstanding about the purposes, risks, or
benefits of such a program. Each counseling center is unique in its mission
and core values in providing services to its campus community. Interested
counseling centers must determine whether or not a YSMP will work in
their setting. In some cases, the feasibility of a YSMP may not seem promising based on an analysis of setting, personnel, budgetary resources,
administrative support, and flexibility of programs. In cases where a fullfledged program is deemed unlikely to succeed, some simple yoga techniques may be easily learned and implemented by counselors as an adjunct
to their usual individual sessions. Use of simple yoga techniques in sessions for relaxation and calming may be appropriate for clients who have
difficulty using traditional mental health strategies for managing stress.
Simple yoga techniques may allow clients to calm themselves and ultimately function more effectively, both in and outside of sessions. In conclusion, the use of a YSMP as a complementary alternative counseling
resource in university counseling center settings is a promising innovative
practice. It is hoped that practitioners will explore the potential benefits of
this program on their own college and university campuses.

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