A feasibility trial evaluating a yogic style of breathing (Sudarshan Kriya Yoga) in young people with anxiety and/or depression

The BREATHE study will investigate the use an adaptation of the Sudarshan Kriya Yoga Campus Happiness Program (SKY-CHP) in a single-arm block design for young people experiencing symptoms of anxiety and/or depression. This intervention model will be delivered over 1 month; this involves 3-days of group-based learning followed by 27-days of individual practice. The Sudarshan Kriya Yoga Campus Happiness Program comes from the non-profit organization called the Art Of Living (AOL) Foundation. Instructors for the BREATHE study will be graduates of the AOL teacher training program. Up to 10 young people will be allocated to each group and will be led by the instructor and an Orygen clinician over three days. These three sessions will be live interactive videoconferencing sessions where all participants will engage with the group, instructor, and clinician over the space of three hours. Participants will be asked to have a pen and paper available for notetaking throughout the program. Participation lasts for four weeks with participants to complete a training diary at the end of each week to determine levels of compliance. This diary will be sent to the participant via a REDCap link where they can select each day of the week corresponding to their practices. REDCap is a secure web platform for building and managing online databases and surveys. Attendance at SKY-CHP sessions will also be monitored. During the 3-day SKY-CHP course you will learn the following: Day 1: Foundations of Wellbeing: Understanding the role of stress, breath, and Connectedness, and the Role of Breath and Meditation in Resilience. The facilitator will discuss the potential benefits of completing the course and participants will meet each other in small groups and introduce themselves. The facilitator will discuss the importance of connectedness and its relationship with overall wellness, mental wellbeing, resilience, stress management, and connecting with values. Following this, participants will be introduced to the eight ‘limbs’ of yoga- including Outward awareness, Inner awareness, Physical postures/stretching, Breathing techniques, Awareness/focusing of the 5 senses, Concentration of the mind, Contemplation, and Meditation. Participants share their experience with life stressors and highlight what they would like to learn in order to change or cope with these stressors and improve energy levels. Participants will learn mental awareness techniques to bring the mind to the present, and a breathing technique to bring the mind to the present. They will also learn the role of breath in guiding the mind to the present moment. Participants will learn an advanced breathwork practice including the practice of 3-stage breathing, SKY, and light meditation. Day 2: Developing wellbeing and Campus Happiness through connectedness and value-driven actions Participants share what they have noticed since the previous session in relation to how their mind works (wandering /fusion /avoidance) and their experiences in using skills taught in the previous class. Furthermore, participants share their life values with one another and how each of these values can affect their own breath. They will discuss subjective happiness through the acceptance of the present moment, and cultivated through using the breath, meditation and present moment awareness. Participants are guided through an experiential practice in small groups, that increases awareness of the mind in the present moment, of the amount of effort required for effective action, and in-turn examines the relationship between the mind and effort. Finally, the facilitator discusses the value of truly listening to others, as it can focus our attention outwards rather than inwards and allows for cultivating greater compassion and empathy. The group will then finish with the practice of 3-stage breathing, SKY, and light meditation. Day 3: Enhancing Connection, Mental Flexibility and Resilience On day 3, in pairs, participants reflect on times in their own life when mistakes were handled well, and when they were handled poorly. The facilitator will guide a meditative process where participants observe internal experiences that come up with non-acceptance (fusion/avoidance), and those that come up with the mind when practicing acceptance. Participants will then share what it was like when they did something for someone that was consistent with their values, even in the presence of unwanted internal experiences. Participants share experiences of mental flexibility that helped them overcome obstacles in life and the people and qualities they admire. In teams, participants review all the perspectives for coping with unwanted internal experiences and stressors that they learned in this course. The group will then finish with the practice of 3-stage breathing, SKY, and light meditation. Day 15: Refresher Session Participants will be invited to join an online session to refresh their memory of the SKY practice. With the instructor, participants will go through the practice in full and be able to ask any questions they have had since beginning their SKY practices. INDIVIDUAL SKY PRACTICE: Following the 3-Day SKY-CHP course, participants will continue to practice the learned techniques daily at home at a time that suits them for the following 27 days. Participants will perform the light physical yoga (5 minutes), the 3-stage breathing plus SKY breathing (10 minutes), and finish with meditation (5-10 minutes). The entire practice should take approximately 20 minutes.