Perceptions of Yoga Benefits for Veterans: Implications for Social Work

Background:Chronic low back pain (cLBP) is the most frequently diagnosed musculoskeletal pain condition among Veterans (Kerns, 2013).  Long-term cLBP is associated with non-physical sequelae, such as stress, depression and family problems (IOM, 2011). Initial research on the use of yoga as a complementary and alternative medicine (CAM) approach for cLBP in Veteran populations yields promising results (Groessl, et al., 2013).  Additionally, findings have shown that yoga classes for cLBP among specialized populations with limited access to CAM encouraged participation and increased ability to manage non-physical symptoms (Keosaian, et al., 2015).  Although cLBP is a major problem for Veterans, there is a paucity of research exploring the added value of participant homogeneity in yoga classes.  Given that social workers in VA settings often must address the way cLBP impacts their clients, this study explores how homogeneity in yoga classes enhances perceived non-physical treatment effects. 

Methods:Pre- and post-intervention (4-6 weeks after classes ended) qualitative interviews were conducted with a subset of Veterans participating in an RCT comparing the effectiveness of a 12-week yoga intervention versus manualized education for cLBP.  Interviewed Veterans were from the yoga arm of the study (n=19, M age = 57, range 27-79).  This sub-study focused on descriptions of post-intervention experiences with Veteran-specific yoga classes for cLBP. Among other topics, participants described the non-physical impact of yoga in their lives. Interviews were conducted by trained qualitative researchers, supervised by the study PI, audiotaped, and transcribed verbatim. Transcripts were uploaded into NVivo, a qualitative data management program. They were read several times by two researchers who developed a codebook in consultation with the PI. All interviews were then coded by the same two researchers who met regularly to maintain consensus and avoid drift, using a general inductive approach (Thomas, 2003).

Results:Findings demonstrate that participation in yoga yielded perceptions of non-physical benefits for Veterans that extended beyond the 12-week classes.  They reported breathing and meditative practices taught in classes assisted them in managing stress in an array of real world settings (e.g. driving).  Some participants indicated improved focus and ability to manage stressful interpersonal interactions at home and in the workplace.   Several Veterans reported that improvements in their stress management skills were noticed by their spouses.  Participants identified the importance of being involved in yoga classes designed expressly for Veterans, specifically describing a level of comfort and comradery that they did not believe could be replicated in yoga offered outside of the VA.  While most participants indicated that yogic practice was overall beneficial, few continued to practice yoga after the study.  In part, this was the case because Veteran-specific yoga classes were not available in the VA service array.

Conclusion:Given the frequent occurrence of cLBP in the Veteran population and the positive non-physical benefits gained through yoga practice by participants in this study, social workers practicing in VA settings may consider Veteran-specific yoga as a means of addressing stress and/or family problems. Additionally, further research on the use of yoga for cLBP-related concerns of Veterans is indicated.