Strength and Awareness in Action

Since October of 2001, approximately over 2 million troops have been deployed in the Global
War on Terror. Many service members are returning with both physical injuries and mental
health conditions. High rates of both post traumatic stress disorder (PTSD) and/or mild
traumatic brain injury (mTBI) and associated symptoms have been noted. It has been estimated
that approximately 18-20% of returning service members meet criteria for PTSD and that 11-23%
of veterans have a history of mTBI. It has been well established in the research literature
that these two conditions frequently co-occur. While there is a dearth of evidence-based
treatment for co-occurring PTSD and mTBI, it has been suggested that best practices entail
treating presenting symptoms (hyperarousal, hypo-arousal, emotional reactivity, irritability,
depression, anxiety, concentration problems) regardless of etiology. Yoga may be particularly
well-suited to treating returning servicemen as data suggests that core symptoms that develop
with a history of trauma exposure (e.g: hyperarousal; hypoarousal; emotional reactivity;
anxiety, irritability), are physiologically based, somatically experienced and often not
amenable to change through talking alone. In addition, yoga may assist with dysregulation
often associated with mental health and physical conditions, and facilitate the development
of mindfulness skills. Research suggests that that moment-to-moment awareness of present
experience may decrease emotional reactivity and anxiety, and increase the capacity for
self-regulation. Mindfulness skills have also been associated with: building resilience in
the midst of stress; allowing one to better cope with physical discomfort; decreasing anxiety
and depression; decreasing reactivity. All of these areas are relevant to improving the
health and well-being of Veterans.

Inclusion Criteria:

- Veterans receiving care by a primary care provider at DVAMC

- Between the ages of 18 and 50

- Able to provide informed consent

- Able to adequately answer comprehension questions

- Documented VA primary care provider medical clearance to participate in the study as
noted on the medical clearance form

Exclusion Criteria:

- Veterans younger than 18, or older than 50 years of age

- Inability to provide informed consent

- Inability to answer comprehension questions

- Meet criteria for active substance dependence, excluding Cannabis dependence as
determined by clinical interview

- Identification of active psychosis as determined by clinical interview

- Documentation on the medical clearance form by VA primary care provider which suggests
barriers to Veteran participation

- Veterans whom have sustained an amputation and/or whom have limited physical mobility
as documented by the VA primary care provider

- Veterans already participating in an ongoing yoga practice of up to two times weekly