Ramadoss and Bose (2010) conducted a pilot study on adolescents who were students of an urban public school. Their study integrated a variety of modules of Transformative Life Skills (TLS) program consisting of yoga poses and meditation that focused on stress reduction, increasing self-control and self-awareness. A population of 472 students participated in the TLS program of which 85 of them, 61.2% males and 38.8% females, were used as the control group who did not receive the TLS intervention. The students who participated in the TLS program were fairly divided into three groups according to the intensity of the program. Each yoga protocol was a structured session which lasted 15 minutes and was taught by a trained yoga teacher.
The Perceived Stress Scale (PSS-10; Cohen, Kamarck, & Mermelstein, 1983) and Tangney’s Self-Control Scale (TSCS-13; Tangney, Baumeister, & Boone, 2004) were used to assess the impact of the intervention. The data was self-reported by the students before the program, mid-program and after the program. The scales were measured and reported that there was a decrease in stress, and self-control was sustained for the students who participated in the yoga intervention. In comparison, the control group did not show any significant change in stress and data showed that they were leaning towards a decrease in self-control. The study discussed the results that showed that there was a nonsignificant change in self-control and self-awareness and lower stress levels for the 18 week TLS intervention group. Although there were no significant changes in self-control and self- awareness the scores showed that the students leaned towards either maintaining or increasing self-control. As additional evidence, teachers responded by commenting about the yoga program being a positive development for the class.
There was a similar research (Frank, Bose, & Schrobenhauser-Clonan, 2014) that used the TLS program conducted for high risk adolescents. This review intended to survey the adequacy of a TLS yoga-based wellness program that focus on social-emotional health of high-risk adolescents. There were 49 participants from an alternative education school in an urban city. The study reported the participants had a decrease in emotional arousal, and intrusive thoughts. The intervention group reported being able to concentrate better and felt lesser stress. The study recorded that the intervention group was less likely to engage in spiteful acts compared to the control group. This study suggests that the TLS program as a yoga intervention assists high school students to cope better with stress. It can be inferred that practicing yoga helped the adolescents to gain better psychological health than before the intervention.
A comparable research (Fishbein et al., 2015) to Ramadoss and Bose’s study on at risk students is one which uses a randomized control trial to find out the external validity of a yoga intervention for adolescents who are at-risk of substance abuse. This study in derived from the Affective–Behavioral–Cognitive–Dynamic (ABCD) model of development which tries to determine the effectiveness of the yoga program on the participants (Greenberg et al., 1990 ; Greenberg and Kusche, 1996). Fishbein et al. (2015) used this design as it was highly reliable and showed its effectiveness on the generalizability of the study. The ABCD model follows the concept of vertical control (Luria, 1966) which aim at the result of reducing the drug use amongst adolescents. This study examines the effects of practicing yoga and the psychological and psychophysiological effects on at-risk adolescents.
The students who were used in the study were at risk of leaving school and had failed in traditional schools. This made the sample appropriate for the study. A sample of 104 students was taken during the study out of which 19 dropped out, which resulted in 85 participants as the sample size. The high dropout rate may be seen as a limitation. The participants were from diverse backgrounds and between the age 14 to 20 years. The gender was almost equal with 54% female and 46% male students. This helped in avoiding gender biases while interpreting the scores. Researchers claimed that some tools used during the intervention, such as the Five Facet Mindfulness Questionnaire (FFMQ; Baer et al. 2006 ) could have been replaced with the Child and Adolescent Mindfulness measure (CAMM; Greco et al. 2011) that was unavailable at that time and would have been more appropriate for the age group under study. The study mentioned that it required a larger study sample. It also mentioned the ineffectiveness of the trial on behavioral regulation and mood changes.
The researchers hypothesized that substance abuse would diminish amongst students who participated in the yoga intervention. Another hypothesis was that the students would refine their cognitive processes. Adding to these hypotheses was a third hypothesis that psychophysiological responses that are related to stress would be relieved through yoga. The researchers supported their arguments with quite a few positive results. The data proved that there was a reduction in alcohol use and better social interactions with their teachers.
Another study supports the effectiveness of a feasible yoga intervention for treating alcohol dependence (Hallgren, Romberg, Bakshi, & Andréasson, 2014). In this study, 18 alcohol dependent patients are randomly assigned to participate in a yoga intervention along with their on-going treatment. The impact of the 10-week yoga intervention was assessed by the timeline follow-back (TLFB) method, Short Alcohol Dependence Data (SADD) questionnaire, Hospital Anxiety and Depression (HAD) Scale, the Sheehan Disability Scale, and the Perceived Stress Scale (PSS). The results showed that there was a decrease in alcohol consumption, although not significant. But the results also recorded lower cortisol levels in the trial group. This shows that the patients had the ability to manage stress. Conboy, Noggle, Frey, Kudesia, and Khalsa (2013) contradict these findings. Their interviews reported that many students (44%) did not feel that the yoga intervention, that they participated in, was aimed at reducing drug use. This shows that not all high school students may feel the same thing about a yoga intervention.
Noggle, Steiner, Minami, and Khalsa (2012) conducted a study to assess the psychological well-being and the effect of yoga on self-regulatory skills of high school students who practiced yoga as part of their school curriculum. The purpose of their study was to assess the psychological advantages of a yoga program led inside the school educational modules
for youths and contrast them with the standard physical training classes (PE). A randomized controlled trial (n=51) was used to create a control group who participated in Physical Education (PE) classes.
The researchers used a Kripalu style yoga intervention which was different than their previous studies, and it incorporated physical postures, breathing exercises, relaxation, and meditation. It was taught twice or thrice a week for a total of 10 weeks. The 30-minute yoga sessions were taught by certified yoga instructors which were structured with 5-minute centering, a 5-minute warm-up, 15 minutes of yoga postures/exercises, and a 5-minute closing relaxation. The control group received PE classes for 40 minutes which lasted for 10 weeks. They included history, rules, and skills for an activity followed by tournaments or games and traditional sports such as tennis, volleyball, hockey, football, ultimate frisbee, and baseball. Profile of Mood States-Short Form (POMS-SF; McNair, Lorr, & Droppleman, 1981) and Positive and Negative Affect Schedule (PANAS; Watson, Clark, Tellegen, & Sarason, 1988) for children were used along with other assessments. These assessments provide insight into the psychological well-being of the students. Both the yoga and control group members finished a self-report questionnaire 1 week before the begin of the yoga program and 1 week taking after the end of the yoga program. The meditative practices used in the Kripalu yoga intervention helped to reduce the anxiety, and enhanced concentration as well as emotion regulation. Although positive affect seemed to be unchanged in both, negative affect significantly worsened in controls (PE), while it improved in yoga students. The limitations of this study were the transferability of yogic practices in reality and whether or not schools could apply these interventions.
Conboy, Noggle, Frey, Kudesia, and Khalsa (2013) conducted a qualitative study on the perceived benefits of practicing yoga. This randomized controlled trial aimed at understanding the perspectives of individuals who were part of the yoga intervention. They concentrated on what students thought about including yoga in the school environment, its benefits and experience in participating the the study. Twenty-eight high school students participated in a 12 week yoga program which involved a structured 30-minute yoga session. The control group was enrolled in a PE course. The study aimed at exploring psychosocial well-being, self-regulatory skills, including mood or affect, perceived stress, anxiety, emotion regulation, mindfulness, self-esteem, and positive psychology. The participants completed questionnaires and face-to-face semi-structured interviews were conducted. The responses were recorded through audio files as well.
The students reported that they were able to focus better, and were more aware of their body. Many of them reported better sleep patterns, and improved mental health. Most of the students claimed to feel relaxed and less stressed. However there were mixed reviews by students in this study. The control group (PE) claimed that they enjoyed PE more because it was more active than yoga. Moveover, male participants believed that yoga was not as hardcore as PE and that they would rather play a sport than practicing yoga.
Although these studies point the way towards positive outcomes of implementing yoga interventions in high schools, there is a study that contradicts Noggle et al.’s beliefs. Daly, Haden, Hagins, Papouchis, and Ramirez (2015) analyzed the influence of practicing yoga on emotion regulation of high school students as compared to physical education (PE). Thirty-seven high school students were randomly assigned to either the yoga intervention or to PE. A structured yoga intervention took place for 16 weeks, totaling 42 sessions for 40 minutes each. PE classes included games like football and baseball along with walking and running, relays, other related activities.
Emotion regulation was assessed through the Emotion Regulation Index for Children and Adolescents (ERICA; MacDermott, Gullone, Allen, King, & Tonge, 2010). The Self-Compassion Scale (SCS; Neff, & McGehee, 2010), The Multidimensional Assessment of Interoceptive Awareness (MAIA; Mehling et al. 2012), and the Mindful Attention Awareness Scale in Adolescents (MAASA; Brown, West, Loverich, & Biegel, 2011) were used to assess self-compassion, body awareness and mindfulness, respectively. The outcome of the intervention was based on studies that were conducted earlier (Noggle, Braun, & Khalsa, 2013; Kokinakis, & Eccles, 2011) that the emotional regulation was significantly affected by yoga than PE. This study by Daly et al. did not show any significant changes in emotional regulation, body awareness, mindfulness, and self-compassion. The researchers explain that this could have been because of the awareness of negative affect that may be overpowering for adolescents which may have acted as a hindrance to accepting mindful practices leading to greater stress than before (Haden et al., 2014; Benavides and Caballero, 2009; Tharaldsen, 2012; White, 2012).
Discussion
This review methodically analyzed the methods of practicing yoga and its effectiveness on psychological well-being for adolescents in high schools. Ramadoss and Bose (2010) observed that a yoga intervention showed a decrease in stress and nonsignificant increase in self-control and self-awareness in high school students. Similar to their findings, Frank, et al. (2014), observed that high risk adolescents practicing yoga were inclined to refrain from violent acts. They suggested the adolescents had a higher sense of self-control. These findings act as evidence that adolescents practicing yoga have better psychological health. However, Fishbein et al. (2015) conducted a similar study that recorded the ineffectiveness of the trial on behavioral regulation and mood changes. Due to these contradictory findings, a definitive conclusion cannot be drawn.
The data collected by Fishbein et al. (2015), demonstrated a reduction in alcohol use and better social interactions with their teachers. This data is comparable to Hallgren et al.’s (2014) study where they observed a decrease in alcohol use and also a decrease in stress levels. These studies suggest that yoga can act as a feasible alternative treatment for at-risk adolescents. However, Conboy et al. (2013) contradicted this study by recording responses of a percentage of the participants of a yoga intervention (44%), stating that the yoga intervention did not help them reduce the use of substances and alcohol. This shows that not all high school students may feel the same thing about a yoga intervention.
According to Noggle et al. (2012), practicing yoga indicated a decrease in anxiety, and increase in concentration as well as emotion regulation. This shows that psychological well-being is positively affected by yoga interventions. However, Daly et al. (2015) contradicts Noggle et al.’s (2012) conclusion. Their study found that yoga did not demonstrate any significant changes to emotional regulation and provided an explanation that this could be due to high negative affect. This shows that psychological well-being is not affected by yoga interventions for adolescents in high schools.
Implications
The review of literature in the effectiveness of yoga interventions on psychological well-being of adolescents in high schools can point towards many directions. It will help future researchers question the importance of yoga interventions in high schools. The review points towards the findings of each study and touches on different topics, such as alcohol use, substance use, emotion regulation, self-control, self-awareness, mindfulness, stress reduction, that may help future researchers to gain a better understanding of what leads to or causes psychological well-being in adolescents. Future studies will also need to keep an eye on the control group and question what may or may not influence the findings. There is a possibility that the different styles of practicing yoga could also affect the results.
Conclusion
This literature review has evaluated the findings and data of 7 peer reviewed articles that conducted randomized controlled trials to study the influence of a yoga intervention for adolescents. The results measure psychological well-being in terms of stress and emotional regulation, along with self-control and self-awareness. Due to the contrasting findings of the studies to support the use of yoga interventions in high-school, it is difficult to say whether these interventions can be applied. Most studies reported the limitation of studying a small sample population and the unavailability of suitable psychometric tools. The studies also differ in the activities of the control group and this may act as a limitation. This paper recommends future research for the studying the psychological well-being of adolescents and the impact of yoga interventions in high schools, especially on the feature of transferability.