Appendix A
Comprehensive Yoga Therapy Assessments
Please use these assessments with clients as a means of understanding them deeply. These assessments were designed to expose individual differences and assist you in formulating an individualized, comprehensive lifestyle program for each client.
Most assessments follow the same format. For example, in the Gunas Assessment, the third answer is always representing a sattvic practice or personality, or in the Five Paths Assessment, “Habitually” indicates a strong aptitude for that path.
Some assessments, however, have mixed results. For example, in the Chakras Assessment, “Habitually” will sometimes expose healthy energy flow and other times the same answer with indicate an area of concern.
With each client, read the Assessments thoroughly and consider the “whole person” as you contemplate the results and best course of action. Remember, Assessments are tools to help hone your dialogue with clients and the directions of your sessions, they are not the ultimate in understanding clients or in designing the program that is best. Rather, Assessments open the door for sincere questions and enquiry into each client’s healing path.
Restraining Behaviors (Yamas) / Habitually / Often / Occasionally / RarelyNon-harming
I act out my anger physically
I say mean or hurtful things
I think about hurting others
I worry I'm not good enough
I push myself beyond what is healthy
Truthfulness / I make up things that didn't happen
I tell white lies
I won’t tell someone something that might get me in trouble
I can’t speak easily about painful or uncomfortable things
I fantasize about things that haven't happened yet
I exaggerate
Non-stealing / I take things that aren't mine
I am unsure how to give myself and others space to be as they are
I don’t think much about the far-reaching implications of my choices (political, environmental, etc.)
I forget what I am grateful for
I complain
Continence / I go to extremes
I spread myself too thin
I sleep with people outside of committed relationships
I overeat
I lay around a lot
I over exercise
Non-coveting / I long for things I don't have
I wish things were different
I'm jealous of others' success or possessions
I look forward to my life being different/better
Positive Habits (Niyamas) / Often / Sometimes / Rarely
Purity / I practice good personal hygiene
My home is clean
My workspace is neat and organized
I choose virtuous thoughts
I eat whole foods
Contentment / I'm happy with the way my life is
It's okay if things don't work out
I don’t want things I don't yet have
I believe that all is well in my life
Discipline/Austerity / I maintain a daily routine
I perform tasks even when I don't want to
I incorporate spiritual thought into daily acts
I do my best
Self-Study / I read uplifting, personal growth, or spiritual works
I learn about myself in various situations
I seek to see myself clearly
I endeavor towards improving myself
Surrender / There are lessons in all circumstances
Iam okay not knowing the ultimate reason(s) things happen
I have strong faith
I trust a higher power/intelligence
I let go of the end results of my efforts
Psychospiritual Body (Chakras) / Habitually / Often / Sometimes / Rarely
Energy Anatomy / I sense energy moving within me
I notice the “feel” of a location
I am aware of others' energy
I notice areas in my body that are more energetically sensitive than others
I have reoccurring aches, pains, or organ/gland troubles
I often feel low, lethargic, or “blocked”
Root / I feel connected to the earth
I feel safe and grounded
There are few serious issues with my family of origin
My finances are sound
My digestion is sluggish or too quick
I have problems with leg muscles or lower joints
Sacral / I am in touch with physical sensations
My reproductive organs are healthy
I am creative
My urinary organs are healthy
I am aware of my true emotional feelings
I enjoy sex
I have trouble with my reproductive functions
I have issues with my low back or sacrum
Solar Plexus / I have a sense of purpose
I am confident
My stomach is healthy
I have low self-esteem
I experience stomachaches
I have acid reflux
I have problems with my middle back
I slouch
Heart / I experience joy in life
I freely give
I easily receive love
My heart and circulation are healthy
I have moved through my grief
I have upper back issues
I have chest pains
I have rounded shoulders
Throat / I speak the truth
I express myself kindly
I am able to listen, even when I don't like what I'm hearing
My neck and shoulders are relaxed
I voice my feelings when appropriate
I talk too much
I often get sore throats
I have neck and shoulder tension/pain
Third Eye / I see situations clearly
I follow my intuition
My mind is clear and calm
I have strong visual senses
I get headaches
I am prone to migraines
Crown / I spend time in spiritual company
My bones are strong
My skin is clear and healthy
I am a spiritual person
I have rigid beliefs
Self-Report / Areas I most notice tension/blockages are:
I believe my main chakra/energetic issues are:
Life Force Winds (Prana Vayus) / Habitually / Often / Occasionally / Rarely
Prana - Heart to Throat: Respiration
My body feels light and able
I feel filled with energy
My heart feels physically/emotionally stable
My lungs feel strong
I have a strong inhalation
I can inhale for a long time
My senses are clear
Apana - Navel to Soles: Elimination
My body elimination is strong and regular
I feel fluid sexual energy, physically and mentally
I have a strong exhalation
I can exhale for a long time
I easily let things go
I feel grounded
I am confused
Other people affect my thoughts, feelings, and decisions
I am lazy
Samana - Navel to Heart: Discrimination/ Assimilation
My digestion is balanced and strong (it is easy to eat a variety of foods; I don’t experience upset stomach)
I seek out what is good for me in life
I feel fire and power in the body
My emotions sit in the stomach
My digestion is hot and acidic
My digestion is weak and cool/gassy
I experience greed, anger, and/or lust
Udana - Throat to Head: Uplifting
I have clear speech
I express words as well as thoughts
I have a joyful perception of life
I easily communicate what I’m thinking
I feel energy in my head when meditating/breathing
I have respiratory issues
I experience chronic sore throat
Vyana – Pervasive: Circulation
I am physically strong
I experience a solid mind-body connection via the nervous system
I feel united with my authentic self
I experience a sense of “flow” in life
I am balanced, physically and mentally
I quickly adapt to changes in environment
I have healthy interpersonal boundaries
Therapist Observation
The strength of inhale:
The strength of exhale:
Client’s energy level:
Ask where energy (fire) is spent:
Note client’s ability to translate meaning through words:
Other:
Facets of Reality - GUNAS
Reflecting on your behavior over the last 4 months,please choose which of the following three statements is most accurate for you:
O I don’t go to bed on time and my sleep is disrupted periodically through the night
O Sleep is great and it's a challenge to get up sometimes
O Sleep is a regular part of my routine
O I recharge by resting, reading, watching TV
O I recharge by exercising, socializing, cleaning
O I recharge through meditation, prayer, and spiritual practice
O When stressed, I generally crave chocolate, candy, and chips
O When stressed, I generally crave caffeine, meat, or spicy foods
O When stressed, I generally crave vegetables, grains, and nuts
O My thoughts are slow and my mind tends to feel cloudy
O My thoughts tend to race and my mind often feels full
O My thoughts are changing and my mind watches this
O I have few relationships and am often lonely
O My relationships are full and active
OI have a few, close relationships
O Other people do a better job than I do
O I work hard to make sure things are the way they should be
O I do my best so it doesn't bother me if things don't work out
O When faced with an addictive substance, I avoid it completely so it won't get a hold on me
O When faced with an addictive substance, I consume it and enjoy the effect it has on me
O When faced with an addictive substance, I evaluate whether or not it is the best choice to consume it
O I worry I’m not good enough
O I work hard to prove myself
O I feel worthy
O It’s hard to get going
O I am ambitious
O I work at a measured pace
O I’m lazy
O I’m high energy
O I’m active and restful
Five Paths of Spiritual PracticePath / Habitually / Often / Occasionally / Rarely
Love / I am a people person
(Bhakti) / I feel spiritually connected when loving and giving
I feel spiritually inspired in relationships
I am a religious person
I am devoted to a Higher Power or spirituality
I follow my heart not my head
Knowledge / I seek to understand spirituality
(Jnana) / I study spiritual works
I study myself
I learn about myself in relation to spiritual texts
I am introspective
I seek the larger picture
I surrender my entire ego and act as pure Spirit
Psychology / I meditate
(Raja) / I seek inner balance
I learn about the workings of my ego
I am interested in the workings of the mind
I see spirituality in psychology
I follow the eight-fold path of the Yoga Sutras
Work / My efforts serve others and the community at large
(Karma) / I perform to the best of my abilities in all situations
I see my work as a spiritual opportunity, no matter the job/task
I am living a purposeful life (I have a personal purpose to my actions)
I let go of the end results, before, during, and after my work on the task
Physical / I learn about and spend time improving my health
(Tantra) / I practice Hatha Yoga (poses, breathing, mind)
I study the chakras/bioenergy systems of the body
I enjoy nutritious food and exercise
Sex is sacred or a form of meditation/spiritual practice
I balance the energies of the body, nature, and medicine
When performing a daily task, such as cooking, I think of [choose one]:
- Cooking as a practice of love and devotion towards those who will be fed
- Cooking as a duty; there no attachment to how it turns out or is enjoyed, as long as I did my best
- The chance to practice body awareness, proper posture and movement, and deep breathing
- Finding a meditative zone while cooking
- Seeing the larger picture and organizing an effortless meal
Bhakti Yoga - Path of Love and Devotion / Habitually / Often / Occasionally / Rarely
I love spiritual practice/God
I derive spiritual gratification from my relationships
I ask for feedback in relationships
I reach out to others
My mind is still when I am with others
I accept myself as I am
I accept others as they are
I am open about who I am and rarely “put on a face”
I understand the roots of my emotional needs
I am able to receive what I need emotionally
I seek counseling for my emotional issues
I am not defensive when others ask me to change a behavior
I compromise easily
I consider others’ ideas and listen to their concerns
I listen to others and try to understand where they are coming from
I learn as much as I can about those I love
When I have an aversion to a task or new idea, I consider the reason of its greater good
I look for the soul or authentic self in everyone
I follow through on what I say I will do for others
I am bright and enthusiastic at work
I am loving and devoted towards those I care about
I help people who are helping others
I support those who are sad or ill
I let go of unsupportive friendships
I don’t pay attention to negative or harming people
I try to make others happy
My romantic partnership is stressful (if applicable)
I think of my own needs in relationships before others’
I feel inadequate in relationships
I am afraid of abandonment or people being mad at me
I have unresolved issues with my family of origin
I want things from those around me
I focus on what others should change
I feel frustrated when loved ones don’t agree with me
When others speak, I think of what I’m going to say next, or how to respond
I offer advice
I have a lot to say
I complain to others
Karma Yoga - Path of Work and Action / Habitually / Often / Occasionally / Rarely
I enjoy my job
My mind is calm at work
I am bright and enthusiastic at work
I am willing to take risks at work
I am willing to perform all of my work tasks
I focus on the task at hand
I focus on solutions
I focus on obstacles and challenges
I break tasks down into smaller, more manageable tasks
I set clear and measurable daily and weekly goals
I do my best in all areas of work
I meet my deadlines
Excellence is important to me, no matter how small the job
I do not worry about the results of my hard work
I am not defensive when receiving constructive feedback
I ask for feedback about my performance
Others would say I have an excellent attitude about work
I compromise with my coworkers
I consider others’ ideas and listen to coworkers’ concerns
I learn as much as I can about the company I work for, including others’ roles in the whole
I care about the company I work for
I feel my pay is on par with the work I perform
My job gives me a sense of purpose
When I have an aversion to a task or new idea, I consider the reason of its greater good
I inspire coworkers
I support others’ work
I am generous with my time, skills, and possessions
I am punctual
I rarely call in sick
My workspace is clean and organized
I help customers, clients, and coworkers to the best of my abilities when they are rude or aggressive
I am inspired by life
I prioritize my personal/spiritual growth above all else
I put family or work above my personal growth needs
I work more than 40 hours per week
I bring work home with me, either physically or mentally
My job is stressful
I feel inadequate at work
I am afraid of failure
When others have less work to do, I expect them to help me with my work
I have troubled relationships with coworkers or supervisors
Layers of Human Existence - Koshas / Habitually / Often / Occasionally / Rarely
Body
I exercise regularly
I follow a healthy nutritional plan
I get 6-9 hours of sleep per night
I connect to the purpose of eating
I eat when I’m hungry
My doctor supports and advocates for holistic wellness
I frequently contract colds or feel under the weather
Breath/ Energy
I regularly practice slowing and deepening my breath
I am aware of the subtleties of my experiences
I am aware of the energy in food
My daily routine supports stress-free living
My energy levels are steady and regular
I hold or shorten my breath without noticing
Mind / I am kind to myself
I spend time in nature
I am strongly affected by sensory stimuli
I live in a busy area
I am driven by my emotions
I experience eyestrain, ringing in ears, or other sensory afflictions
I have to see it to believe it
I keep music or the television on most of the time
I am easily distracted
My emotions guide my choices
Past experiences effect my current emotions
Intellect
I read spiritual resources
I witness my feelings and experiences
I observe my inner environment impassively
I am logical
I am aware of the effect of nutrition, exercise, breathing, spirituality, and creativity on my well-being
I use thoughts to calm my emotions
I am often accused of “not getting it”
Past experiences effect my thoughts and perceptions
Spirit
I make time for spiritual reflection
I am aware of spiritual context or beauty in everyday situations
I am comforted by a connection to "something more"
My daily actions lead to spiritual fulfillment
I meditate or have spiritual practice at the same time each day
I feel fulfilled
I am a member of a spiritual or artistic community
I have spiritual mentors and teachers
I have had “peak experiences” or moments of profound personal meaning in life
My community supports holistic living
I have strong, unwavering beliefs
Koshas Self-Assessment Diary: Nutrition for the Whole Person
Instructions: Throughout the day, (every time you change activities; every hour; at significant times) log what you are “feeding” yourself on each level of being. Follow this format/make copies and stick to the process for at least one week.
Time / Activity / Body / Breath / Mind / Intellect / Spirit8am / Prepare for work / Omelet, juice, tea / Rapid, shallow / Fearful, stressed Surrounded by noise (TV, radio) / Making lists, planning day / Largely ignored; noticed birds in tree
10am / Morning Break / Did yoga poses / Deep during poses / Found quiet place
Relaxation happened / Slowed down / Grateful for time for myself and effects of poses
Koshas Inspiration Chart
Instructions: Now that you have completed the Self-Assessment Diary for a consistent period of time, you are more aware of your habits and “nutrition” for all levels of your being. For the next week (at least) follow the same format, this time adding suggestions about how you may offer your entire self a more nourishing life.
Time / Activity / Body / Breath / Mind / Intellect / Spirit8am / Prepare for work / Omelet, juice, tea / Rapid, shallow / Fearful, stressed Surrounded by noise (TV, radio) / Making lists, planning day / Largely ignored; noticed birds in tree
Modify / Be mindful / Say grace; taste food / Deepen breath / Enjoy music from one source, or silence / Mindfulness
Be present rather than project future / Appreciate and be grateful for morning experiences
10am / Morning Break / Did yoga poses / Deep during poses / Found quiet place
Relaxation happened / Slowed down / Grateful for time for myself and effects of poses
Modify / Allow effects of practice to remain through other activities
Food Nutrition / Habitually / Often / Occasionally / Rarely
I eat whole foods
I eat 4 servings of vegetables per day
I eat 2 servings of whole fruit per day
My heart palpitates if meals are missed or delayed
Most of my protein comes from plant sources
I eat 2 to 3 servings (the size of my fist) of protein per day
I drink at least 1 liter of water per day
I move my bowels at least once per day
I limit prescription medications
I limit recreational drugs
I limit alcohol
I do not eat dessert
I limit even hidden sugars in foods
I drink coffee
I drink 2 glasses of fruit juice per day
I limit convenience foods
I limit white flour and refined foods
I limit caffeine
I limit fast foods
I don’t use artificial sweeteners
I drink one or more soft drinks per day
I have an excessive appetite
I have a low appetite
I eat when I’m nervous
I get lightheaded if meals are delayed
If I am feeling fatigued, eating relieves it
List any drug, supplement or food allergies: ______