The Effectiveness of Yoga for Reducing Negative Stress Behaviors in Children

Breanna Dickson, OTS & Kristen Kincaid, OTS

School of Occupational Therapy, Touro University Nevada, Henderson, NV, 89074
Critically Appraised Topic

Clinical Scenario

Methods
Client Population
Intervention

Children; Students;
Adolescents; Youth
Yoga

Outcomes

Stress; Behavior

Inclusion Criteria

Prolonged or excessive psychosocial

stress in children and adolescents has
been shown to be associated with
pathology. Current literature suggest that
yoga can reduce stress and stress-related
dysfunction in adults but few studies have
examined the effect of yoga on stress in
children (Hagins, Haden, & Daly, 2013).
Occupational therapists regularly address
stress management techniques as a way
to protect their clients emotional
resilience and develop the coping
strategies needed for day to day life.
With additional training, occupational
therapists can incorporate yoga into
therapy. According to Fedosh (2014) the
use of yoga as an intervention is gaining
popularity in the occupational therapy
community. Many parents have expressed
interested in exploring alternatives to
medication to help their children and may
seek CAM therapies to complement
traditional care.

Level I-III articles

Written in English
Full-length publications in peer-reviewed journals
Published in the last 10 years
Child and adolescent populations only
Exclusion Criteria

Non English
Level IV-V, dissertations, or books
Published prior to 2004

Results
White (2012) found no significant difference
between the yoga intervention group and the wait
list control group for perceived stress, coping
frequency, self-esteem, or self-regulation.
Khalsa, Hickey-Schultz, Cohen, Steiner & Cope
(2012) found that the PE control group had a
significant decrease in resilience, anger control,
and fatigue. Therefore yoga may be more effective
at maintenance in these areas compared to PE.
Frank, Bose & Schrobenhauser (2014) conducted a
nonranomized before & after study and found
there was a significant reduction of problematic
involuntary stress responses in students.
Hagins, Haden, & Daly (2013) found no statistically
significant differences between the yoga and PE
control group for measures of stress reactivity.

Summary of Study Designs

Level of
Evidence
I
II
III
IV
V
Other

Study Design/Methodology of Selected Articles

Randomized control trials, Meta-analysis, Systematic
review
Two groups, non-randomized studies (cohort, casecontrol)
One group, non-randomized studies (before and after,
pretest and posttest)
Descriptive studies that include analysis of outcomes
(single subject design, case series)
Case reports and expert opinion, which include
narrative literature reviews and consensus statements
Qualitative Studies
TOTAL:

Number of Articles
Selected
6
0
3
0
0
0
9

Implications for Practice

The clinical & community-based practice of OT: There were mixed results and no negative
outcomes reported, therefore; the use of yoga to reduce stress in children should be
determined on a case-by-case basis.
Program development: The studies that had a higher frequency and duration tended to show
greater improvement in stress reduction.
Societal needs: Yoga is a low-cost and relatively risk-free alternative or complement to
medication for the management of stress in children.
Healthcare delivery & policy: Further large-scale studies are needed to determine the benefits
of yoga in comparison to general physical activity before bringing this intervention option to
policy makers attention.
Education & training of OT students: Further education on specific yoga techniques and
methods, which would be beyond entry-level OT education, is needed.
Refinement, revision, and advancement of factual knowledge or theory: Future research
should be done to compare the effectiveness of yoga with general physical activity for
reducing negative stress behaviors.

Selective References
Frank, J. L., Bose, B., & Schrobenhauser-Clonan, A. (2014). Effectiveness of a school-based yoga
program on adolescent
mental health, stress coping strategies, and attitudes toward violence:
findings from a high-risk sample. Journal of
Applied School Psychology, 30(1), 29-49. doi:10.1080/15377903.2013.863259
White, L. S. (2012). Reducing stress in school-age girls through mindful yoga. Journal of Pediatric
Health Care, 26(1), 45-56.
doi: 10.1016/j.pedhc.2011.01.002