Could trauma-informed yoga benefit drug treatment for youth?
Yoga Outreach has been providing trauma-informed yoga classes to justice-involved and at-risk youth for 18 years.
Based on the empirical studies that have established trauma-informed yoga as an evidence-based treatment intervention, and the observations of Yoga Outreach teachers, Yoga Outreach submitted a proposal to the Department of Justice to examine the efficacy of trauma-based yoga, and similar mindfulness-based stress reduction programs, as a promising adjunctive treatment intervention for justice involved youth receiving treatment for substance use disorders.
This study examines published studies and “grey literature” on both the standard substance use treatment models as well as a small, but growing body of empirical studies investigating the efficacy of trauma-based complementary programs. The literature review also considers the need for gender-responsive and culturally-responsive treatment models that more specifically address the unique needs of female young offenders and Aboriginal young offenders.
In conjunction with the literature review, Yoga Outreach also completed an environmental scan of existing drug treatment options for youth in BC. Of the 50 programs identified, 38 requested to be listed as potential program partners for a pilot project to design, implement, and test the success of incorporating trauma-informed yoga into drug treatment programs for their clients. The feedback from these organizations was, overall very positive with many respondents commenting that they believed that bringing trauma informed yoga into treatment was indeed a missing piece in their programming. They expressed the importance of body-based therapies and the lack of funding to bring this kind of programming in.
The environmental scan did not identify many aspects of cultural relevancy that may need to be adjusted in order to make trauma-informed yoga programming accessible to youth in conflict with the law. Although most treatment programs listed issues including poverty, neglect, abuse, homelessness and marginalization as key challenges facing youth struggling with addiction. Of particular interest was the accessibility, and spiritually neutral nature of trauma-informed yoga, which many felt would make it accessible to a broad range of youth including those serving aboriginal populations.
The Research: Does trauma-informed yoga enhance health outcomes in drug treatment for justice-involved youth?
Data from national and provincial surveys relating to adolescent health and substance use patterns indicate that substance use is prevalent among Canadian youth. While experimenting with substances such as alcohol and marijuana is often considered part of adolescent risk taking, early onset of substance use (e.g., younger than 12 years of age) and frequent use of substances (including substances such as cocaine, methamphetamines, or heroin) put youth at a greater risk of developing early onset substance use disorders and/or mental health disorders, becoming street-involved or homeless, and engaging in high-risk health and/or anti-social behaviours that increase the likelihood of such youth becoming justice involved.
While many youth do not report experiencing negative consequences as a result of their substance use, vulnerable and at-risk youth (e.g., street-involved or homeless youth who may be struggling with mental health challenges) are more likely to come into conflict with the law, and are more likely to experience negative consequences such as being injured, doing things they do not remember, overdosing or needing to seek help for their substance use. Unlike their mainstream peers, at-risk youth have typically faced multiple adverse childhood events and trauma exposures.
Adverse events include experiencing physical or sexual abuse, living in families where one or both parents struggle(d) with substance abuse and/or mental health difficulties; being placed in government care on several occasions; and living in precarious housing or on the street. Research suggests that at-risk youth frequently circulate between the streets, foster or group homes and the youth justice system where they might receive treatment for their substance use—only to relapse when they are released from custody back into the same stressful social conditions.
Justice-involved and at-risk youth also report struggling with concurrent substance use and mental health challenges, including traumatic stress responses, PTSD, and diagnoses that typically exist concurrently with PTSD. However, traumatized youth in custodial and residential treatment facilities are not always screened for trauma or correctly diagnosed when they are assessed. This can have significant implications both for developing appropriate treatment plans and for traumatized youths’ ability to successfully complete treatment programs, given the extent of dysregulation they have experienced as a result of their trauma histories. Numerous trauma researchers advocate for adopting a trauma-informed organizational culture and treatment philosophies/practices that emphasize building strengths and resilience while also working to develop and master self-regulation skills.
Trauma also has a somatic component and research has shown that trauma-informed complementary treatment approaches such as trauma-informed yoga or variations on Mindfulness-based stress reduction practices are effective in reducing traumatic stress symptoms and increasing wellness in adults. Less research has been done to empirically establish the efficacy of trauma-informed yoga for helping at-risk youth, and specifically in contributing to successful outcomes for youth undergoing substance use treatment.