Kayla Waaraniemi

Northland Community and Technical College

Occupational Therapy Assistant Program
Critically Appraised Topics Assignment

Focused Question: What is the research to support mind-body connection interventions to

increase occupational therapy outcomes?

Clinical Scenario: According to Mathew (2008), a healthy mind supports a healthy body and
vice versa. Thoughts, feelings, and behaviors affect our physical health, and physical health plays
a big role in how we think, feel, and behave. Mathew (2008) suggests that the mind and body
work in collaboration to present with its peak functional ability and optimal health. Mind-body
strategies have not always been the optimal plan for all health care professionals. However, to
fully rehabilitate and have the stamina to fulfill the requirements for rehabilitation and/or
development, physical and emotional energy are major components. Mathew (2008) further
states that the mind and body interactions enable individuals to fully engage in the holistic
interventions that occupational therapy is defined of.

Mind-Body interventions are techniques that are intended to strengthen the impact and
connection of your mind on your body and of your body on your mind. Mind-body practice uses
techniques that address the physical, behavioral, psychological, social, spiritual, and expressive
body. Meditation or prayer are often combined with a physical exercise, such as yoga, and a
focus on ones breathing to improve the links between the body and mind to improve mental and
physical health. (Center of Spirituality and Healing, 2016)

As stated in Highlights from the 2016 Yoga in America Study (2016) the top five reasons
that people start practicing yoga is for flexibility (61%), stress relief (56%), general fitness
(49%), improve overall health (49%) and for physical fitness (44%). There are 36.7 million yoga
practitioners in the United States; that is up 20.4 million from in 2012. Sykes Wylie (2015) stated
that in 2007, 20 million adults were seeking meditation for health purposes; these figures are the
most recent ones available, however, they do not seem to correctly report the torrential numbers
of people practicing meditation. Statistical data on this topic is limited, but anecdotal data is
available. One such example is from Matthew Sanford (as cited in Mathew, 2008). Sanford is
yoga instructor and founder of the Mind-Body Solutions center. Sanford experienced the mind-
body philosophy first hand. At the age of 13, Sanford was involved in an accident that left him a
paraplegic and his father and sister dead. It was then a process of emotional and physical
rehabilitation that took a good amount of time and energy on Sanfords part. Sanford points out
that he was encouraged to understand that what was damaged on his body was damaged. The
compensation mindset. Sanford set out to find ways to reconnect his mind with his lower
extremities. He explains how he was emotionally tired of his new life; he missed his whole body
working together. Sanford tried body work, acupressure, as well as other interventions but found
that yoga was the intervention that provided him with the therapy he needed. Through yoga, he
found the mind-body connection that was necessary for his healing process and overcame the
compensation mentality. Sanford went on to describe how he has discovered that parts of his
physical body are injured, but his mind-body relationship is not. This realization allowed Sanford
to feel emotionally whole. In addition, this connection has helped him execute transfers more
gracefully, he can lift his tailbone, and he engages his whole body when otherwise he could not.
Finding a connection within the mind and body does not guarantee a full recovery, but it
enhances a holistic view of oneself and as Sanford said a connection to the disconnected parts
of oneself (as cited in Mathew, 2008, pg. 1).

Occupational Therapy encourages holistic therapy approaches to reach the goals and best
outcomes of clients, yet mindfulness may be an underused practice (Elliot, n.d.). The purpose of
this research is to determine if mind-body intervention or mindfulness-based interventions have
effects on occupational therapy outcomes. Statistical analysis will be done to determine
differences in meaningful outcomes between groups who participate in mind-body intervention
or mindfulness-based interventions and those receiving standard therapy interventions.

Summary of Key Findings:

Level I:

The Effects of Two Novel Gratitude and Mindfulness Interventions on Well-Being; Oleary
& Dockray (2015)

This study examined the effectiveness of mindfulness interventions and gratitude

interventions in reducing stress and depression and increasing happiness. The study included a
gratitude group with 29 women, a Mindfulness group with 22 women, and 10 women were
assigned to a wait-list control. Both groups completed interventions online 4 times per week for
3 consecutive weeks. The gratitude intervention consisted of a diary where each time they listed
5 things they were grateful for and then completed gratitude reflections focused on 1 thing they
felt grateful for. The mindfulness intervention group kept a mindfulness diary where they listed
their thoughts, feelings, and emotions in the current moment. They also participated in
mindfulness meditation, the Body Scan, guiding attention to the breath and body. Results show
participants in both gratitude and mindfulness interventions had reduced stress and depression
and increased happiness. The study suggests that incorporating mindfulness or gratitude
interventions into an individuals daily life is beneficial because the wait-list participants did not
see changes in the areas of stress, depression, and happiness. Mindfulness interventions were
found more effective in reducing depression and increasing happiness, however, gratitude
interventions were more effective for reducing stress. The study concludes that both
interventions, independently used, show improvements in well-being, but combining the two
interventions could catalyze improvements in well-being. These results indicate that further
research on such interventions is justified.

The Efficacy of Mindfulness-Based Interventions in Primary Care: A Meta-Analytic

Review; Demarzo, Montero-Marin, Cuijpers, Zabaleta-del-Olmo, Mahtani, Vellinga,
Vicens, Lopez-del-Hoyo, & Garcia-Campayo (2015)

This study systematically reviewed the emerging role of Mindfulness-Based interventions

(MBIs) used as base treatment methods in 6 randomized control trials (RCTs) consisting of 553
primary care patients. The authors purpose was to determine if MBIs were beneficial in relation
to outcomes of general health, quality of life, and mental health in primary care patients. The
results of this study indicate that overall MBIs were moderately effective in regards to improving
general health, although there was little diversity of patients. Another important finding, with a
diverse population, MBIs were effective when used for treatment with mental health disorders as
well as improving quality of life in all participants. The authors state that the limited number of
trials using MBIs in primary care, compared to secondary and tertiary, suggests that further
research is necessary, but mindfulness-based interventions implemented into treatment of
primary care patients show signs of success regarding quality of life and mental health.

Promoting resilience among maltreated youth using meditation, yoga, tai chi and qigong: A
scoping review of the literature; Waechter & Wekerle (2015)

This article examined 8 studies on Eastern Art based interventions such as yoga;
compassionate, mindful, or transcendental meditation; tai chi; and qigong. The studies included
were all original research studies involving maltreated youth and Eastern Art based interventions.
The goal of this research was to determine what evidence exists on Eastern Arts and its effects on
resilience in maltreated youth and what the quality of the programs and their implementations
are. The study concluded that literature on this subject is insufficient, however, 7 out of the 8
studies reviewed showed improvement in the Eastern Arts intervention group compared to the
control group; some improvements were more significant than others. The article suggests that
Eastern Arts have shown positive effects on areas such as emotional and physical well-being;
psychological distress and Post Traumatic Stress Disorder (PTSD) symptoms among high school
students; stress and confidence during stress with high school students; anxiety and depression
among children in the foster care system; depression, hopelessness, and PTSD symptoms in
children and adolescents presenting with PTSD; and self-esteem, psychological distress, and
well-being among 7th grade students. A mindfulness-based program used for the reduction of
sexual assault rates involving female college students did not show a positive effect. The study
suggests that the results of the sexual assault rates study could be skewed by there only being
two 2-hour mindfulness sessions spaced a week apart and the pre-post measurements taken in a
matter of two months. This indicates that there may not have been enough time between
measurements to get accurate results as well as the programs lack of intensity. In conclusion, the
article states that because of the positive outcomes and minimal side effects of Eastern Arts on
resilience of maltreated youth, further research is justified and necessary.

Mindfulness Intervention in Physical Rehabilitation: A Scoping Review; Hardison & Roll

(2016)

Mindfulness Interventions in Physical Rehabilitation reviewed 16 articles on the use of

mindfulness interventions in conjunction with or following physical rehabilitation. The main
purpose of this study was to describe how mindfulness is being used in physical rehabilitation, to
identify potential applications of mindfulness intervention within occupational therapy, and
identify areas to be examined in future research. The study found that mindfulness interventions
have shown improvements in urinary incontinence, chronic pain, and vestibular functioning. The
study also shows improved outcomes for cognitive and behavioral goals in patients with
traumatic brain injuries. The best outcomes were shown in improvements in adaptation to
illnesses or disabilities related to self-efficacy for management of a disease, improved quality of
life, and a finding of acceptance to pain symptoms. Mindfulness interventions not only proved
immediately effective in these areas but also showed a maintained effectiveness at follow-ups.
Mindfulness interventions were positively appraised by patients and none of the studies
examined showed negative or adverse effects. In the cases of mindfulness interventions provided
primarily by Occupational Therapists, the results were promising however limited by a small
sample size and minimal control conditions. Because results show positive effects and there
being a limited number of studies and literature, further research on this topic is warranted.

Level II:

The Effects of Yoga on Inner-City Childrens Well-Being: A Pilot Study; Berger, Silver, &
Stein (2009)

This pilot study analyzed two groups of 4th and 5th grade children that presented with
significant stressors in their life that affected their well-being. The study assessed emotional and
physical affects. The study included 39 students in a yoga group and 32 students in a non-yoga
group. The yoga-group participated in an after-school program that implemented a structured
yoga class as intervention. The yoga group attended the class one hour a week for 12 weeks. The
non-yoga group attended an after-school program that used basic physical activities. The non-
yoga students were allowed to choose their own activities to participate in. At the end of 12
weeks, the yoga group presented with fewer negative behaviors, significantly better balance
skills, and improved well-being when compared to the non-yoga group. The yoga group also
reported improved strength, flexibility, balance, self-perception of well-being, and self-regulation
(i.e. improved attention span, ability to calm oneself, improved behavior in class, and better
sleep). This study suggests that participation in yoga may benefit a childs emotional and
physical well-being and may be an applicable practice for children faced with significant
stressors affecting their well-being. It further suggests that yoga may serve as a preventative tool
in a community setting.

Level III:

Changes in spirituality partly explain health-related quality of life outcomes after

mindfulness-based stress reduction; Greeson, Webber, Smoski, Brantley, Ekblad, Suarez, &
Wolever (2011)

This study used a diverse sample of individuals to determine whether spirituality in

relation to mindfulness-based stress reduction programs may affect health-related quality of life.
The study sample included 279 people that participated in an 8-week standard Mindfulness-
Based Stress Reduction program taught by an experienced instructor. This course included
training on mindfulness meditation, awareness of breathing, awareness of emotions, yoga,
mindful eating, mindful listening, group discussion, and lovingkindness- among other things.
Participants attended a 2.5-hour class each week as well as 20-45 minutes of meditation outside
of class 6 days a week. This course also included one day of 7 hours of meditation that took
place the Saturday of the 6th week of class. The study concluded that participants had significant
increases in mindfulness in regards to thoughts and feelings, daily experiences, and mental health
but physical health did not change significantly. The study showed direct relation from increased
daily spiritual experiences to increased mindfulness. Following Mindfulness-Based Stress
Reduction, the participants showed increase in mental health related quality of life as well. The
results of this study suggest that mindfulness meditation training can improve spirituality, and
mindfulness and mental health improvements are key outcomes of Mindfulness-Based Stress
Reduction. Additional studies are necessary to replicate results.

Level IV:

National Survey of Yoga Practitioners: Mental and Physical Health Benefits; Ross,
Friedmann, Bevan, & Thomas (2013)

This study used an online survey to examine self-reported benefits or barriers of yoga and
how it has impacted participants health. Participants included 1045 randomly selected
individuals at least 18 years of age who practiced yoga. All of the participants had practiced yoga
at least one time per week for at least two of the past six months. Participants included both
female and male as well as several different races and all marital statuses, except divorced.
Results of this survey indicate positive results from yoga practice in areas of sleep, energy level,
general health, diet, attain and maintain healthier weight, relationships, and happiness. All races
and genders of yoga practitioners agreed that yoga improved their health. The amount and time
of yoga practice by participants did heighten the odds of believing yoga affected their health. The
study concludes that yoga practice may be beneficial for many individuals including elderly,
those with chronic health conditions, and especially in individuals with depression. Further
research is necessary, especially using a large scale, long-term study to fully examine yogas
benefits for health.

Qualitative:

Mind-Body Medicine and the Art of Self-Care: Teaching Mindfulness to Counseling

Students Through Yoga, Meditation, and Qigong; Schure, Christopher, & Christopher
(2008)

This was a qualitative study done on teaching mindfulness to students. Masters students
in counseling programs attended a 15-week course on mind/body medicine and self-care. The
course included yoga, meditation, qigong, journaling, and reading. The students answered 4
questions at the end of the course to determine the results of the study. The class was 2 times a
week in class, and included 75 minutes of mindfulness practice accompanied by hatha yoga,
sitting meditation, qigong, and conscious relaxation techniques. Outside of class work included
45 minutes of practice four times per week. Students kept a journal on reports and reflection of
readings, practice, and personal experiences related to the course. Results indicated five positive
themes from the student responses and the effects of what they learned and practiced during the
course. Themes included positive physical changes; positive emotional, attitudinal or mental
changes; spiritual awareness, and interpersonal changes. Participants felt positive outcomes from
the mind/body and self-care course and stated that they plan to continue practicing and
integrating concepts into their professional lives. The article states that students also felt
increased trust in themselves and increased self-confidence. Most students also stated that their
professional lives would find benefits from personal mind/body practice. This article suggests
that mind-body medicine is beneficial to an individuals well-being but further research and
quantitative studies are recommended.
Bottom Line for Occupational Therapy Practice: The goal of this research was to examine the
evidence that supports mind-body connection interventions used to increase occupational therapy
outcomes. Although this research strongly suggests beneficial effects, more research is
warranted.

Mind-body medicine can increase overall quality of life and well-being in persons of both
genders, all races, and all ages. Schure, Christopher, and Christopher (2008) found that using
mind-body medicine such as yoga, meditation, and qigong, show positive changes in ones
physical body; and positive emotional, attitudinal, and/or mental changes; increased spiritual
awareness; and interpersonal changes. They further stated that these practices increased
participants trust in themselves and increased their self-confidence. According to Hardison and
Roll (2016), practicing mindfulness with physical rehabilitation demonstrates improvements in
urinary incontinence, chronic pain and vestibular functioning. They reported that the best
outcomes in their study were shown in improvements with adaptation to illnesses or disabilities
related to self-efficacy for management of a disease, cognitive and behavioral issues, improved
quality of life, and a finding of acceptance to pain symptoms. These improvements showed
immediately and proved a maintained effectiveness. According to Ross, Friedmann, Bevan, &
Thomas (2013), Yoga, a mind-body medicine practice, proved positive results in areas of sleep,
energy level, general health, diet, attaining and maintaining healthier weight, relationships, and
happiness. This research further noted that yoga practice, at any intensity, may be beneficial for
elderly, middle-aged, adolescents, children, both genders, those with chronic health conditions,
and especially for individuals with depression. Neither of these studies suggested negative or
adverse effects from mindfulness practice.

According to Berger, Silver, and Stein (2009), mind-body interventions have proved
effective with improving mental health in children. They stated that yoga decreased negative
behaviors, improved self-perception, ability to self-calm, attention span, and self-regulation in
inner-city children with significant stressors in their life. They also suggest that the yoga
intervention improved physical aspects including, but not limited to, better balance skills,
strength, and flexibility. This study claims that implementing yoga into interventions with
children can improve emotional and physical well-being and sleep. Greeson, Webber, Smoski,
Brantley, Ekblad, Suarez, and Wolever (2011) also suggest that mind-body interventions have
proved effective in improving mental health in children and adults. Greeson et al. (2011) states
that mindfulness meditation, awareness of breathing, awareness of emotions, yoga, mindful
eating and listening, mindfulness based stress reduction therapies, and other methods, showed
significant improvements in regards to thoughts and feelings, daily experiences, stress reduction,
and overall quality of life and mental health.

Oleary and Dockray (2015) examined mindfulness based interventions and gratitude
interventions for improvements in mental health. These authors concluded that these
interventions both can significantly benefit individuals in areas of reducing stress and depression
and increasing happiness, and overall improving well-being. Oleary and Dockray (2015)
suggest that using these methods separately may be beneficial, but using the two interventions
together could catalyze improvements in overall well-being. According to Demarzo et al. (2015),
mindfulness based interventions were effective when used for treatment with mental health
disorders as well as improving quality of life in primary care patients. Waechter and Wekerle
(2015) also suggest that mind-body connection based interventions improve areas such as
emotional and physical well-being; psychological distress and PTSD symptoms among high
school students; stress and confidence during stress with high school students; anxiety and
depression among children in foster care system; depression, hopelessness, and PTSD symptoms
in children and adolescents presenting with PTSD; and self-esteem, psychological distress, and
well-being among 7th grade students.

Per the research found, using these treatment methods to improve mental health may
encourage clients to put forth more effort towards full recovery rather than resorting to
compensation. With a stable mental health condition, individuals may be more inclined to push
themselves harder, have the stamina to follow through with home therapy, and have more drive
and desire to recover thus improving outcomes. Occupational therapy practitioners can work to
implement yoga poses, tai chi, meditation, and a focus on breathing techniques into their therapy
to improve outcomes. Educating clients on the importance of aligning the breath, the body, and
the mind would be beneficial to the client as well as improving therapy output. Occupational
therapy practitioners can become certified yoga instructors to increase their knowledge on this
topic to better their practice. These methods have been shown to repeatedly work with improving
mental health and have shown good evidence for improvements of physical health.

Although this research does not directly demonstrate how occupational therapy outcomes
can be improved with mind-body connection therapies, it does demonstrate the positive impact
these therapies have on many factors that affect occupational therapy clients or outcomes. These
factors include, but are not limited to, improving overall quality of life and health, improving
mental and physical health, stress reduction, decreasing symptoms of depression and anxiety,
decreasing negative behaviors in children, helping with pain control, and decreasing symptoms
of PTSD. Occupational Therapy practitioners should not shy away from using these intervention
methods. This research provides a base for effectively using mindfulness practices to increase
occupational therapy outcomes by connecting the mind, the body, and the breath. This research
should motivate occupational therapy practitioners to examine mind-body interventions and how
they can implement them into their therapy sessions to increase occupational therapy outcomes.

Review Process:
Inclusion Criteria: male; female; pediatrics; adults; patients with/without chronic illness
(mental or physical illness); mindfulness-based intervention; occupational therapy;
physical rehabilitation; mental health rehabilitation; all levels evidence; mind-body
medicine; and mind-body connection.
Exclusion Criteria: no use of mind-body medicine.
Search Strategy:
Categories Key Search Terms
Patient/Client Population Mindbodyconnection;Occupationaltherapy;
occupationaltherapyandmindbody
connection;yogaandoccupationaltherapy;
occupationaltherapysupportingmindbody
connection;Occupationaltherapyfollow
through;Mindbodyconnectionandclient
 involvementinOccupationaltherapy;
Occupational Therapy & mindfulness
intervention; chronically ill & mind-body
intervention; inner-city children and mind-
body medicine; and adolescents & mindfulness
based intervention.
Intervention Mind-Body Connection interventions; and
Mindfulness-Based interventions.
Comparison N/A
Outcome Improved occupational therapy outcomes.

Databases and Sites Searched:

Databases: EBSCOhost databases; and ProQuest

Sites: www.caot.ca; and www.occupational-therapy.advanceweb.com

Quality Control/Peer Review Process:

This research began by completing a PICO sheet which specified the patient population,
intervention, comparison, and outcome. The cause for this research was to find evidence to
support using mind-body medicine to improve occupational therapy outcomes. Once the base
was formed, nine peer reviewed articles that met the criteria were analyzed, interpreted, and
summarized. Articles were found on EBSCOhost and ProQuest databases from the NCTC
library. Relevant information from eight of the articles reviewed was combined to form
conclusion. Upon completion of this document, 2 fellow Occupation Therapy Assistant students
completed a peer-review on the entire document, as well as an OTA instructor.

Results of Search:
Summary of Study Designs of Articles Selected for Appraisal:
Level of Evidence Study Design/Methodology of Selected Number of Articles Selected
Articles
Level I Systematic reviews, meta-analysis, 4
randomized controlled trials
Level II Two groups, nonrandomized studies (e.g., 1
cohort, case-control)
Level III One group, nonrandomized (e.g., before 1
and after, pretest, and posttest)
Level IV Descriptive studies that include analysis 1
of outcomes (single subject design, case
series)
Level V Case reports and expert opinion, which
include narrative literature reviews and
consensus statements
Qualitative 1
Limitations of the Studies Appraised:

Level I:

The Effects of Two Novel Gratitude and Mindfulness Interventions on Well-Being; Oleary
& Dockray (2015)

Small sample size at completion (group 1 29 participants, group 2 22 participants, and 10

waitlisted); study may have been underpowered to detect and effect because of small sample
size; attrition rate (43%) resulted in small sample size; limited generalizability because of lack of
diversity; occupational therapy not involved.

The Efficacy of Mindfulness-Based Interventions in Primary Care: A Meta-Analytic

Review; Demarzo, Montero-Marin, Cuijpers, Zabaleta-del-Olmo, Mahtani, Vellinga,
Vicens, Lopez-del-Hoyo, & Garcia-Campayo (2015)

The study did not include pediatric patients. The number of Randomized Control Trials (RCTs)
applying MBIs in primary care patients is limited. Most of patients were women. The MBIs were
not adapted to specific patients. Acceptance and commitment therapy was excluded.

Promoting resilience among maltreated youth using meditation, yoga, tai chi and qigong: A
scoping review of the literature; Waechter & Wekerle (2015)

Only 8 studies were included; Occupational therapy was not involved in the study;

Mindfulness Intervention in Physical Rehabilitation: A Scoping Review; Hardison & Roll

(2016)

Small amount of study articles (16) used; positive studies are limited by their study design; The
wide variability in mindfulness intervention protocols makes it challenging to reach any general
conclusions about intervention effectiveness; Many of the studies did not have a diverse and
broad sample group; A decreased interest and adherence to mindfulness intervention by male
participants was noted by one study;

Level II:

The Effects of Yoga on Inner-City Childrens Well-Being: A Pilot Study; Berger, Silver, &
Stein (2009)

The yoga and non-yoga programs were similar in structure and demographics, but were not
identical. This study did not include individuals with physical disabilities. Only included inner-
city children participants. The sample size was small (yoga group 39 participants, non-yoga
group 32 participants). The sample was not ethnically diverse.

Level III:
Changes in spirituality partly explain health-related quality of life outcomes after
mindfulness-based stress reduction; Greeson, Webber, Smoski, Brantley, Ekblad, Suarez, &
Wolever (2011)

No randomized control or comparison group. Lack of ethnic and social diversity in the sample.
Outcome measures were self-reported. Outcomes may be biased towards participants who had
prior meditative experience.

Level IV:

National Survey of Yoga Practitioners: Mental and Physical Health Benefits; Ross,
Friedmann, Bevan, & Thomas (2013)

Anonymous internet surveys are risky for recall bias and deception; participants were randomly
selected to receive the survey, but response rate was low and may have been biased by self-
selection of respondents; only participants from 41 US states included in the survey;
occupational therapy not included; cross-sectional study that relied on self-reports and lack of
comparison groups are weaker than RCTs making it impossible to draw a definite conclusion.

Qualitative:

Mind-body Medicine and the Art of Self-Care: Teaching Mindfulness to Counseling

Students Through Yoga, Meditation, and Qigong; Schure, Christopher, & Christopher
(2008)

Not occupational therapy based; sample was not diverse; self-reported information; students who
took the course had a preexisting interest which may have affected the responses; personal
characteristics may have influenced the results; although students reported that the changes they
experienced were because of the course, there was no control group in the study for comparison.

Articles Selected for Appraisal:

Berger, D. L., M.D., Silver, E. J., PhD., & Stein, R. E. K., M.D. (2009). Effects of Yoga On
Inner-City Childrens Well-Being: A Pilot Study. Alternative Therapies in Health and
Medicine, 15(5), 36-42. Retrieved from http://nctproxy.mnpals.net/login?
url=http://search.proquest.com/docview/204838431?accountid=40780
Demarzo, M. P., Montero-Marin, J., Cuijpers, P., Zabaleta-del-Olmo, E., Mahtani, K. R.,
Vellinga, A. e., & ... Vellinga, A. (2015). The Efficacy of Mindfulness-Based
Interventions in Primary Care: A Meta-Analytic Review. Annals Of Family Medicine,
13(6), 573-582. doi:10.1370/afm.1863
Greeson, J. M., Webber, D. M., Smoski, M. J., Brantley, J. G., Ekblad, A. G., Suarez, E. C., &
Wolever, R. Q. (2011). Changes in spirituality partly explain health-related quality of life
outcomes after mindfulness-based stress reduction. Journal of Behavioral Medicine,
34(6), 508-18. doi:http://dx.doi.org/10.1007/s10865-011-9332-x
Hardison, M. E., & Roll, S. C. (2016). Mindfulness interventions in physical rehabilitation: A
scoping review. The American Journal of Occupational Therapy, 70(3), 1-9.
doi:http://dx.doi.org/10.5014/ajot.2016.018069
Larkey, L., Roe, D., Weihs, K., Jahnke, R., Lopez, A., Rogers, C., & ... Guillen-Rodriguez, J.
(2015). Randomized Controlled Trial of Qigong/Tai Chi Easy on Cancer-Related Fatigue
in Breast Cancer Survivors. Annals Of Behavioral Medicine, 49(2), 165-176.
doi:10.1007/s12160-014-9645-4
O' Leary, K., & Dockray, S. (2015). The Effects of Two Novel Gratitude and Mindfulness
Interventions on Well-Being. Journal Of Alternative & Complementary Medicine, 21(4),
243-245. doi:10.1089/acm.2014.0119
Ross, A., Friedmann, E., Bevan s, M., & Thomas, S. (2013). National survey of yoga
practitioners: Mental and physical health benefits. Complementary Therapies in
Medicine, 21(4), 313-23. doi:http://dx.doi.org/10.1016/j.ctim.2013.04.001
Schure, M. B., Christopher, J., & Christopher, S. (2008). Mind-body medicine and the art of self-
care: Teaching mindfulness to counseling students through yoga, meditation, and qigong.
Journal of Counseling and Development : JCD, 86(1), 47-56. Retrieved from
http://nctproxy.mnpals.net/login?url=http://search.proquest.com/docview/219040328?
accountid=40780
Waechter, R. L., & Wekerle, C. (2015). Promoting resilience among maltreated youth using
meditation, yoga, tai chi and qigong: A scoping review of the literature. Child &
Adolescent Social Work Journal, 32(1), 17-31. doi:http://dx.doi.org/10.1007/s10560-014-
0356-2

Other Resources Utilized:

Center of Spirituality and Healing (2016). Mind-Body Therapies. Retrieved January 14, 2017,
from https://www.takingcharge.csh.umn.edu/explore-healing-practices/what-are-mind-
body-therapies

Elliott, N. (n.d.). Exploring mindfulness meditation in occupational therapy: An introduction to

basic practice. Retrieved September 03, 2016.

Highlights from the 2016 Yoga in America Study. (2016, January 13). Retrieved January 18,
2017, from
https://www.yogaalliance.org/Learn/About_Yoga/2016_Yoga_in_America_Study/Highlig
hts

Matthew, R. (2008, September 29). The Mind-Body Connection- Guiding Patients to Self-Care
and Wellness. Retrieved September 03, 2016, from http://occupational-
therapy.advanceweb.com/Article/The-Mind-Body-Connection.aspx

Sykes Wylie, M. (2015, January 29). How the Mindfulness Movement Went Mainstream -- And
the Backlash That Came With It. Retrieved January 18, 2017, from
http://www.alternet.org/personal-health/how-mindfulness-movement-went-mainstream-
and-backlash-came-it