Phase-Based Yoga Therapy: A Roadmap to Recovery

Phase-based yoga therapy helps both client and therapist chart a course for safe, effective treatment.

NOTE: What follows is a fictional case study that represents experiences commonly shared by survivors of trauma. Any likeness to an actual person or situation is accidental.

Jordan stiffened, as if frozen in place. She'd just walked into the yoga studio for her yoga therapy intake session, and saw two yoga mats next to each other in the middle of the space.

After initial introductions, Jordan braved, "I ... I have a problem being in the middle of the room. I prefer to have my back against a wall."

Yoga therapist Avery smiled warmly at her. "Yes, absolutely. I totally understand. A lot of people don't like the middle of the room," she reassured Jordan. "I had a client right before you and forgot to roll up the yoga mats. We'll be over here."

Avery waved her hand to a corner of the room with two stuffed chairs draped with blankets and pillows, a coffee table, and fluffy rug. The chairs were right angles to each other, and both were against a wall. At the sight of that cozy spot, Jordan's shoulders relaxed, the color came back into face and she let out a sigh of relief. "Thank you so much! I can't tell you how much that means to me."

She invited Jordan to choose whichever chair and arrangement of pillows and blankets she liked, and get comfortable. She offered her some water, pulled a privacy screen around them, and reassured Jordan that no one would enter this space while they met for her yoga therapy intake session. Jordan shared what brought her to yoga therapy: She had low back pain that she thought she'd resolved. But now it was back, and her doctor couldn't find any structural cause.

With another big sigh, Jordan shared that the only big change her life was starting therapy recently to address some early childhood trauma. Her trauma therapist suggested she look into yoga therapy as part of a holistic approach to her overall care and healing. Jordan said she wasn't sure how her back issues could possibly be related.

"Yeah, I totally get that, " Avery said. "Is it possible that dredging up these painful past experiences causes you to hold tension in your body--in your back--that you're not consciously aware of?"

Jordan paused. "I'm not sure. I never thought about that."

"Why would you?" the therapist asked. "There may or may not be a relationship between the trauma you're talking about with your therapist, and the back pain. Either way, we'll do a full assessment and work together to figure out what's going on to get you some relief."

To determine where to start with Jordan, Avery's intake assessment included obtaining written consent from Jordan to speak with the therapist who'd referred her--her primary trauma therapist. This allowed the two to confer about her case, and is how Avery learned that Jordan was in the first phase of trauma treatment. Phase-based treatment is considered best practice when working with trauma at any level (Courtois and Ford, 2015).

Using such an approach helps the YP and client collaborate on and calibrate treatment. It also allows the YP to coordinate care with other members of a client's trauma team, if they have one. By zeroing in on the appropriate phase, YP and client can create an effective treatment plan of yoga tools that is tailored to the client's unique needs. Read about phase-based treatment in detail in our upcoming book Yoga Therapy for Complex Trauma: Working with Child, Adolescent and Adult Clients (to be released Fall 2025).

In the meantime, here's an introduction to the phases of treatment, and tips on how to integrate them into yoga therapy.

Phase-Based Treatment

• Phase 1: Safety and Stability

• Phase 2: Trauma Processing

• Phase 3: Integration

Phase 1: Safety and Stability

Safety and stability are the bedrock of Phase 1 trauma treatment. This starts with being trained in trauma-informed care. Trauma-informed care ensures that you acknowledge the impact of trauma on a client and take steps to avoid re-traumatizating them (MindRemapping Academy, 2023). For instance, Jordan preferred to have her back to a wall in new settings, which is true of many clients who have experienced trauma. Adding a question to your intake form about room logistics helps you prepare your clinical space with your new client's needs and preferences in mind. This increases their trust in you, and yoga therapy. And building trust is a key ingredient to establishing safe, caring rapport with clients.

Another important aspect of creating safety is empowering clients in their own treatment. As part of trauma-informed care, the Window of Tolerance helps clients manage their emotions by identifying body sensations associated with their stress and triggers (National Institute for the Clinical Application of Behavioral Medicine, 2025). In the graphic of this concept, an open window represents the client's "window of tolerance." When a client is within their own personal window, they feel calm, well-regulated, and alert, the color in their face is even, their body posture is relaxed, and they easefully relate with you. If eye contact is part of the social norm in their culture, they engage in regular eye contact.

Above and below the window represents states in which the client is triggered or stressed. Above the window is hypervigilance (acutely anxious states) where a client appears agitated, lacks focus, and isn't as engaged with you (including lack of eye contact). Below the window is hypovigilance, where a client appears disengaged, shows slower reaction times (such as when answering questions) and may report feeling numb and/or empty. Their body posture appears limp and collapsed, and they stop relating with you. It's important to note that people can feel both hyper-and hypovigilance at the same time. This is a more extreme state of stress to protect against and avoid, and why determining a client's unique window is so important early on in treatment.

Clients (and you) use the window of tolerance to notice when a particular yoga tool pushes them outside their zone of comfort. For instance, Jordan shared in her intake that she'd never liked savasana much. "I make myself do it, because I love all other parts of yoga--the movement, the breathing, the focus--but I feel so antsy rather than relaxed in relaxation pose." It is not uncommon for clients to have a similar aversion to savasana. When this is the case, help the client find other yoga tools that achieve a restful, relaxed state such as a breathing technique or possibly Sa Ta Na Ma mantra. Creating safety and stability in Phase 1 means clients learn yoga tools and trauma-informed techniques that help them feel calm and well-regulated. In other words, the client and you avoid yoga tools and topics that trigger stress or traumatic reactions.

Phase 2: Processing Trauma

In Phase 2 of yoga therapy for trauma treatment, clients go from avoiding the triggers to facing them with the support of their trauma team. Clients start to process the trauma through psychotherapy, and yoga therapy can be an incredible complement. In Jordan's case, after a few months of yoga therapy, she felt ready to do some of the yoga tools that had felt uncomfortable. Together with Avery her yoga therapist, she listed off the yoga tools or situations that had felt uncomfortable: sitting with her back exposed, savasana. Avery invited her to start slowly and with one particular yoga tool.

Jordan said she really wanted to "make friends" with savasana, since it's such a regular part of public, group yoga classes. Again, Avery suggested she start slow. Using her window of tolerance, Jordan and Avery created a graduated series of "steps" to savasana. They created four versions of relaxation that helped Jordan gently push the boundaries of her window of tolerance. By starting from a seated position with her eyes open, Jordan noticed she could use deep breathing with an emphasis on the exhale to calm her heart rate and breathing, and decrease her anxious thoughts. Sitting against a wall not only lowered her anxiety, but helped her back feel supported and relaxed. Every two weeks they increased the "intensity" of the version. For example, in Version 2 Jordan continued her relaxation pose sitting up, but experimented with closing her eyes. The table below shows how Jordan allowed herself to gradually experience some of the uncomfortable feelings she associated with relaxation in a gentle and manageable way over the course of 10 weeks.

Example Yoga Therapy Practice: Graduated "Exposures" in Phase 2

Yoga Tool Version	Initial Symptoms after Exposure	Yoga Tool Remedy	Frequency/Effect
Version 1: "Sitting" savasana at the wall for 2 minutes (eyes open)	faster heart rate & breathing, some anxious thoughts	Deep breathing—focus on exhale	3xweek for 2 weeks/ Normal, even breathing; fewer anxious thoughts
Version 2: "Sitting" savasana at the wall for 2 minutes (eyes closed)	Same as Version 1	Same as above; Jordan reported opening eyes a few times to verify safety	3xweek for 2 weeks/ Mostly even breathing with slight moments of panic, was able to use breathing to calm
Version 3: Legs up the wall in a corner (eyes open)	Faster heart rate, but for shorter time than exposure 1	Deep breathing; hands on belly	4xweek for 2 weeks
Version 4: Legs up the wall in a corner (eyes open)	Faster heart rate, hard at first to slow breathing	Deep breathing; hands on belly; repeat personal affirmation	Only in yoga therapy sessions with Avery for 2 weeks
Version 5: Legs up the wall in a corner (eyes open)	Better able to slow down breathing, feeling more relaxed	Deep breathing; hands on belly; repeat personal affirmation	Continue in-session practice with Avery, and on own 1-2xweek

Phase 3: Integration

After 10 weeks, Jordan shared that she really liked doing legs up the wall and felt like it was her own personal version of savasana. She said she not only felt more peaceful in legs up the wall (versus savasana) but that the positioning of her spine in relation to the floor seemed to relieve some of her back pain. With the encouragement of both her trauma therapist and Avery, she decided whenever possible this is the version she'd do when she went to public yoga classes. She showed excitement about advocating for herself in the group setting, where she'd sometimes felt different and left out when savasana hadn't been relaxing for her like it seemed to be for the other students. This is an example of what happens in phase 3 of trauma treatment. Clients begin to integrate tools they've learned in therapy--whether it's trauma therapy, yoga therapy for trauma or both--into the rest of their life.

It's important to remember that Jordan's is a fictionalized case, and therefore doesn't reflect the complexity of working with actual clients. For instance, most clients move back and forth among the phases rather than moving through them chronologically as this case example showed. Doing so in this case makes it easier to see how the phases work together.

If this was helpful, check out our Youtube channel for how-to videos and practices that are tailor made for any level of trauma, and are kid-friendly: https://www.youtube.com/@rhythmyogatherapy

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