As yoga therapy continues to establish itself as a credible part of healthcare in the United States, it is important to examine how it interfaces with Western medical environments. Ultimately, the profession primarily aims to relieve suffering and create greater and more lasting ease for those it serves. Certainly, these goals are shared by Western medical doctors and other caregivers. But, the interface with the healthcare and health education systems in the United States brings its own challenges to traditional ways of practicing and disseminating yoga, and the integration of yoga therapy into Western medical contexts only heightens divisions between “regular” yoga and dedicated yoga therapy.

Two established certified yoga therapists in the Atlanta metro area, Tzipporah Gerson-Miller, LCSW, C-IAYT, E-RYT 500, and Tra Kirkpatrick, C-IAYT, E-RYT 500, work regularly with Western medical providers and often within healthcare environments such as hospitals. As a licensed clinical social worker, Gerson-Miller straddles both healthcare contexts. Like Gerson-Miller, Dominique Harmon, LCSW, holds numerous yoga certifications and works within traditional healthcare environments.

Licensure and Insurance

Unlike Western medical practices, yoga therapy remains an unlicensed field. There are regulatory guidelines and ethical standards put forth by governing bodies, but there are no licensure requirements, and that raises legitimate questions. Licensing “holds you to a certain standard, with a strong ethical code for the safety and protection of the people you serve,” says

Gerson-Miller. Without licensure, she says, it can be like the wild, wild West: “People feel free to do what they want!”

Yet the work environments of many therapists favor licensed care, which lends greater legitimacy to the field. “Licensing can be beneficial because of where yoga therapists often find their practice placed, such as medical complexes, healthcare homes and the Veterans Administration. Licensing gives a different perception about what a yoga therapist is,” says Kirkpatrick. Gerson-Miller notes that licensure allows a therapist to accept insurance, which can increase the accessibility of yoga therapy more generally.

But those interviewed also note significant drawbacks to licensing and other supervisory protocols, chief of which is a kind of gatekeeping that might entrench certain types of care delivery over others. Because yoga therapy originated in non-Western practices, they’re concerned that some of those practices will be lost as it gets adopted within a Western model of licensure. And, if and when yoga therapy gets covered by insurance, they’re also concerned that its delivery model will be prescribed in a way palatable to large insurance companies rather than with its current characteristic flexibility and responsiveness.

Yoga Therapy in a Western Education System

And just as there are both advantages and disadvantages to incorporating yoga therapy into Western healthcare, there is also complexity that comes with yoga therapy’s move into Western university settings.

On the one hand, university degrees in yoga therapy—now available from multiple institutions—lend further credibility to the field and its taxing training. When incorporated into university curricular structures, the visibility afforded yoga therapy training helps demystify yoga, too. That means greater acceptance of its efficacy as treatment for anything from common complaints of lower back pain to oncology care. The research structures of the university contribute to that acceptance, too: the more that good quality research is conducted for yoga therapeutic protocols, the more yoga therapy will be adopted by Western healthcare professionals. 

On the other hand, universities are not the only systems of education available. Yoga therapeutic practices have their roots in indigenous knowledge and have a complicated relationship with colonialism and commercialism. Incorporating yoga therapy into a Western curricular structure risks privileging certain types of knowledge and certain modes of education and puts training in the field behind a paywall that’s inaccessible for many. “Once those Eastern practices make their way to the West—through several iterations—what’s left?” asks Gerson-Miller.

The yogic practices of teacher/student relationship, oral transmission of knowledge, the privileging of elder knowledge and long periods of mentorship are all challenged by Western universities' structures and institutional framework.

Doing Healing Work in a Mixed-Method Environment

Thus, a holistic health environment is—and will continue to become—more and more of a mixed-method environment. Aware of that context, the healing arts practitioners interviewed here stressed their high level of training and commitment to their continuous pursuit of further education. Energy medicine healer Shane Orfas, who trained at WhiteWinds Institute of Integrative Energy Medicine in Atlanta, says his training included a long period of supervision and clinical practical hours. “The levels of professionalism [have] allowed me to work side-by-side with allopathic medicine, training my language [for] a Western medical environment,” he says.

Yoga therapy practitioners also express a need to clearly define their scope of practice and to be bound by an abiding sense of responsibility to their clients through strong ethical standards. They are willing and able to work as part of a team of experts while remaining within their own areas of knowledge and expertise.

Biofield tuner Rebecca Carner prefers to work as part of a team of care providers to serve her clients. “I’ve had the delight of joining forces with many traditionally trained practitioners,” she says. “I have collaborated directly with doctors, psychiatrists, psychologists, chiropractors, massage therapists and others in order to serve my clients.” Harmon notes a similar practice: In addition to Western medical doctors such as cardiologists and psychiatrists, she also enlists expert nutritionists, acupuncturists and chefs for her most recent stress-reduction retreat. Clients benefit the most when experts in each field deliver their care.

A Holistic Approach to Relieve Suffering

Fundamentally, the healing arts, which include yoga therapy, emphasize a somatic experience as the path to relieving suffering. Thus, and yoga therapy is an embodiment practice: Yoga therapists ask their clients to feel, to be present with what is and to allow their body to be—as Gerson-Miller describes it—“part of the scaffolding” of their path toward greater ease. Harmon wants that scaffolding to include considerations of sleep, nutrition, environmental stressors and relationships. “We can do all the talk therapy around anxiety, depression and mood instability,” she shares, “but we have to consider that clients are not going to significantly improve optimal mental health without holistic assessment.”

Although it relies on the profundity and accessibility of ancient, tested wisdom and practices to serve those living with dysfunction and disease, yoga therapy has become one more type of care available in the large array of healthcare choices available to Westerners. Kirkpatrick notes that we need this yoga-based care more than ever: “Yoga is a science: the old yogis knew this. We have distilled it and diluted it, and, in some ways, it’s necessary. And… there is a place and a need for these ancient teachings to re-emerge and to show themselves as the greater path.” ❧

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Patricia Schmidt, C-IAYT, E-RYT 500, YACEP, is a certified yoga therapist specializing in pelvic health, accessible yoga and yoga for cancer support. She is a Franklin Method trainer, Roll Model method teacher and somatic movement specialist. To learn more, visit PLSYoga.com.

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This article is one of three in a special section on The New Frontiers of Yoga Therapy. Here are the other two stories.