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Otterbein University

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Doctor of Nursing Practice Scholarly Projects Student Research & Creative Work


Poster: Toward Expert Consensus on Guidelines

for the Use of Yoga in the Treatment of Anxiety in
Children and Adolescents
Laura J. Abels
Otterbein University,

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Recommended Citation
Abels, Laura J., "Poster: Toward Expert Consensus on Guidelines for the Use of Yoga in the Treatment of Anxiety in Children and
Adolescents" (2019). Doctor of Nursing Practice Scholarly Projects. 41.

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Toward Expert Consensus on Guidelines for the Use of Yoga in the
Treatment of Anxiety for Children and Adolescents
Laura J. Abels, BA, MSN, PMHCNS-BC, APHN-BC; John Chovan, PhD, DNP, APRN-CNP, PMHNP-BC; Annette Sues-Mitzel, DNP, APRN-CNS, HTCP
Otterbein University, Westerville, Ohio
Abstract Introduction Project Description & Design Outcomes Conclusion
Round One Questionnaire
Problem Statement: Despite Pediatric psychiatric mental health is a high Modified Delphi method Expert n Asked: Is there consensus among experts on the Psychiatric and
clinical evidence to support priority topic. using a series of three need for evidence-based clinical practice guidelines? psychological mental health
the use of yoga as a treatment questionnaires to survey • Consensus was found among identified experts in care providers would benefit
Psychiatrist 17
option for children and Anxiety disorders are the most commonly identified experts in child psychiatry and psychology (80%) on the need for from the development of
adolescents with anxiety, identified psychiatric disorder in children, and the & adolescent psychiatry, evidence based clinical practice guidelines evidence-based clinical
Psychiatric APRN 22
clinical practice guidelines do earliest mental health concern to present, with a psychology, and yoga (N = • Consensus was not found among identified yoga practice guidelines.
not exist. median age of 6 years at initial diagnosis. 111). experts (29%) on the need for evidence based
clinical practice guidelines Guidelines should:
Purpose: This project used Psychiatric RN 19
However, 80% of children with anxiety do not Quantitative data were • Be operationalized
the modified Delphi technique receive treatment for this mental health condition. used to: Round Two Questionnaire • Be disseminated
to determine if consensus • Describe the sample Psychologist 14 Asked: What are the most important items to include • Incorporate feedback
exists on the need for clinical • Determine consensus in clinical practice guidelines, and who should
practice guidelines among Current research highlights a need for pediatric Clinical 13 develop the guidelines?
experts in the fields of child mental health interventions which are effective, Qualitative data were used Counselor • Subjects ranked benefits, risks, and the items which
and adolescent psychiatry, have low perceived stigma, are easily accessible, to: they felt should be included in clinical practice Limitations
psychology, and yoga. span multiple languages and cultures, and are of • Identify themes Social Worker 5 guidelines.
Additionally, this project low risk to the child. Yoga interventions have the Benefits • Inconsistent response to
aimed to determine if potential to meet this need. A score of 80% or higher Yoga Instructor 17 • Emotional regulation and/or self-regulation Round Two Questionnaire
consensus exists on what was interpreted as • Focus on the here and now • No yoga professionals
should be included in clinical consensus • Mindfulness or calming the mind responded to the Round
Yoga Therapist 4
practice guidelines for the use Background • Physical exercise or stretching Three Questionnaire
of yoga as a therapeutic Institutional Review Board • Body awareness • Questionnaires were not
intervention for anxiety in (IRB) approval received • Breathing standardized
children and adolescents. Physiological benefits in adults: through Otterbein Risks • PMH-APRNs represent a
GABA University (HS # 18/19- • Emotional triggers (negative memories, emotional disproportionately large
Methods: Three rounds of Serotonin 02) discomfort, and trauma) response rate to all three
questionnaires were used to Dopamine • Physical injury (muscle strains and sprains) questionnaires
survey identified experts in Alpha and theta EEG waves Items • Low Response Rate:
psychiatry, psychology, and Parasympathetic response • Indications  Round One 15%
yoga. Quantitative data were • Contraindications  Round Two 8%
collected to describe the Norepinephrine • Safety measures  Round Three 6%
sample and to determine Systolic & diastolic blood pressure • Professional boundaries
consensus using frequencies Resting heart rate • Risks
and percentages as measure Sympathetic response • Type of assessment to perform References
of central tendency, and • What age children and adolescents can practice yoga
ranges as measures of Psychological benefits in adults: without a parent
dispersion. Qualitative data Identification of subconscious problems • What age children and adolescents can start
were gathered, and a textual Living in the present practicing yoga
content analysis was Acceptance as a precursor of change • What type of yoga to use
performed. Desensitization
Habit reversal Round Three Questionnaire
Significance: Establishing Coping with negative emotions through Asked: Is there consensus on the risks, benefits, and
expert consensus on the need Relaxation items which should be included, and who should
for clinical practice guidelines write the guidelines?
for the use of yoga as Overall anxiety and depression symptoms • Consensus was established on risks (86%)
treatment intervention for Figure 1: Bali Kids Guide. (2018). Boat Pose.
• Consensus was established on the benefits (100%)
children and adolescents with Retrieved from • Consensus was established on items that should be
anxiety has the potential to Benefits in children: included in evidence-based clinical practice
improve access to safe and Coping skills guidelines (100%)
effective mental health care Confidence • Consensus was also found (100%) among subjects
for children and adolescents Self –awareness that if the American Academy of Child and
who might otherwise go Relaxation Questions? Adolescent Psychiatry (AACAP) developed guidelines
untreated. Contact Laura Abels at using the risks, benefits, and items outlined in the
Stress questionnaire, these guidelines would be beneficial
Anxiety to their practice