As the Executive Director of the International Association of Yoga Therapists (IAYT), John Kepner has been dedicated to facilitating the creation of standards and practices for yoga teachers and practitioners who strive to bring yoga’s healing aspects into the realm of complementary medicine.
John regularly lectures on Yoga and Yoga therapy and co-taught the course on complementary and alternative medicine at the University of Arkansas College of Medicine in 2002 and 2003. His articles for The International Journal of Yoga Therapy frequently offer policy perspectives and he is the host of the Symposium on Yoga Research and the Symposium on Yoga Therapy and Research June 11-16. We are grateful that John was able to carve out some valuable time in a busy schedule to speak with us.
Rita Trieger: What do you think makes yoga therapeutic?
John Kepner: It is the student’s orientation to his or her practice.
For example, if you have lower back pain, you’re likely to attend a specialized class where the main focus is healing your back, so your orientation to the practice is for healing or wellness. Or suppose you are a heart patient and you are taking yoga as part of the Dean Ornish Program, a comprehensive program to reverse heart disease where yoga is plays an important role, then your orientation to your practice is on healing.
The great thing about yoga is that you can have multiple orientations at the same time. So even if you come to a yoga class for back care, part of your orientation may be for wellness and getting stronger and part of your orientation may be as a vehicle to become more spiritual.
RT: Can you walk us through the process that has helped establish a IAYT as a resource for the medical community as well as for yoga teachers?
JK: The medical community wants a conventional standard of evidence as well as a conventional standard of training. We have done that with IAYT.
The first step was establishing creditable professional publications. In the medical world that means a peer reviewed journal. Peer review, along with acceptance in PubMed, is key. We started the peer review process in 2005 with Kelly McGonigal as editor, and we were finally accepted into PubMed in 2011, due in large part to Kelly, and the mini peer reviewers that took place in this process. Those authors worked really hard. And by the way, a peer reviewer can be tough and not always polite!
Then you need professional conferences for continued education, standardized just like the AMA does, and to further satisfy the medical field, you need evidence-based studies. To develop those studies, you need researchers that can connect, collaborate, and learn from each other. Conventional research is very extensive, and takes hundreds of thousands of dollars; IAYT doesnt have the resources to fund the research but we can have a specialized yoga research conference, and we did, to the credit of Sat Bir Khalsa who is the visionary and guru of yoga research conferences. Researchers can get lost in a regular conference but in a stand-alone conference you know the person next to you in line or in the hallway is also a yoga researcher.
We expected 50 people at our first yoga research conference. I knew how many members we had. We were astounded when 200 people showed up. Any medical community expects to have ongoing professional education. That is what SYTAR is about: ongoing professional education for practitioners.
The last but not least part of this set of pillars is standards. Standards for the training of practitioner or teacher and standards for credentialing practitioners. Standards in yoga are tricky because yoga comes out of the gurukula tradition. Unfortunately, standards, by their very nature, can be divisive. We had many meetings with our community for many years before we even started the standards process.
A resulting and important necessity for our standards was to develop a sense of community where one can know and trust one’s colleagues.
RT: Since 2005, what is the greatest change that you have seen in the acceptance of the standards you have begun to establish, and the greatest change you have seen in yoga therapy overall?
JK: One of major things I am seeing is full-time yoga therapists on staff at some major hospitals. In fact, one of our presenters at SYTAR 2013 is Judy Bar who is the yoga services manager as part of the Center for Lifestyle Medicine. They have yoga classes for 13 different diseases.
Another thing is the explicit acceptance of the Dean Ornish Program by Medicare, which was huge. That just happened a few years ago and it’s my understanding that the program is really starting to ramp up. A major yoga teacher behind that program is Susie Amadayla, who is presenting at SYTAR, 2013.
Yoga therapists have also become an explicit part of healthy care clinics. For example, Dr. Loren Fishman who is a well-known rehabilitation doctor has yoga therapists on staff. He has patients come in, he diagnoses the problem, and often recommends the patient work with a yoga therapist, and most people are delighted to have that option. There in the same room are the doctor, the patient, and the yoga therapist.
Things like this are happening all over the country, and there are many more we don’t know about.
Many doctors nowdays also practice yoga, and that may be the most important aspect. Dr. Dilip Sarkar, who is now the president of IAYT, teaches yoga for doctors. He has remarked that even though he is constantly relating scientic evidence, the best way to explain the benefits of yoga is to get doctors to practice. A major part of yoga’s acceptance in the medical community is due to younger physicians who are used to practicing yoga.
RT: Along with the basic yoga teacher training, I’m assuming you think that it is important to have some kind of certification process to become a yoga therapist. What is the plan for that? Do you have any kind of process in place?
JK: Yes, we’re starting with the schools. The conventional process is to have accredited schools and credentialed practitioners, like with medical schools.
Schools are the future but we have limited resources so we’re starting with the process to accredit yoga therapy training programs.
When I started with IAYT in 2003 we had about five yoga therapy training programs listed on our website, now we have over 110. Over time we have seen more and more yoga therapy training programs develop, but they are teaching yoga in many different ways. In order to be creditable, you have to have standards.
For the last two and half years we invited ten very experienced yoga teachers from diverse backgrounds, to work with us and meet on a monthly basis to develop standards for the training of yoga therapists. We published those on our website last summer. The difference between our standards and the Yoga Alliance standards is that ours are based on competencies; all professional standards are based on competencies. I’m not critizing the Yoga Alliance, instead we think of this as an evolution.
We’ve established a set of competencies for entry-level yoga therapists, and our standards are roughly at the level of a professional masters degree, similar to where acupuncture started years ago. Colleges have approached us and now we can develop masters programs in part based upon these standards. In fact, there is one respected accredited university that is developing the first master’s degree in yoga therapy: the Maryland University for Integrative Health, just outside of DC. This is a landmark step in our field.
On the west coast, Meridian University has a long history of incorporating somatic practices into psychology and they also offer both a masters and PhD program in yoga therapy via their psychology department. If people take yoga therapy training programs that meet our standards, they can incorporate that work into academic programs. The synergy is there. We think that is a win for everybody.
RT: What about established teachers who have been working in the medical trenches for years–will they be able to turn thier practical knowledge into a certification?
JK: The answer is yes we will do that. We have said that we will develop what is classically called grandfather or grand-parenting principles. These will respect the original training and experience and the continuing education of these people who are really the pioneers in the field. How you do that is tricky. It takes a lot of time to be fair, and there’s also a huge amount of administrative needed. When, is the open question because we have to first focus on the accreditation process because schools are the future.
The best way to explain this is if we put experienced practitioners in two boxes. One box is people who have been practicing a long time but may not have any formal certification, because in the past there wasn’t any certification, you just did it. But over the last 10 years there have been more and more yoga therapy certification programs. Most were 300 hour programs on top of 200 hour basic yoga therapy training programs and the total of 500 hours fit nicely into the Yoga Alliance standard. That was the structure. Two-thirds of our member schools started this way.
We have about 3,000 people out there with a certification as a yoga therapist. Many are recent graduates and our principles for grandfathering them, are more explicit. Those are also published on our website called emerging grandfathering guidelines.
RT: What are the three must-have qualities for a yoga therapist to cultivate in order to create the right atmosphere for healing and to cultivate the student-teacher relationship?
JK: First you should have a solid personal practice of yoga. You should have a fair amount of technical skills, an understanding of disease processes, structural pain, and some theory on how to apply those things. You also need the basic skill of how to take that general theory and apply it to an individual. For example, a person with chronic low back pain may be a young person who is very flexible or an old person who is overweight. There are all these differences and being able to apply the theory to each individual is fundamental. Yoga is not like a pill, the same protocol is not good for everybody. People are multidimensional beings and that is a big strength of yoga. Yoga is one of the few disciplines and practices that can address the multidimensional aspects of people in practice.
You also have to have a certain skills for a therapeutic relationship between the client and student. Its not just technical skills, or knowledge, but being able to develop this therapeutic relationship. All the healing processes that I know of place emphasize this in theory, but with yoga the actual relationship between the student and teacher is a tangible quality that influences the healing process. Its not a like a doctor that just gives a pill. People are coming to you for help and they are vulnerable, and they want to be their best. People come to yoga classes because they are trying to help themselves, and yoga reminds them to bring the very best of themselves.
RT: In the healing process where do you think yoga serves the person best: as prevention, after they have been diagnosed, or as an ongoing therapy?
JK: In any healing process it is always best to start with prevention. However, people are often not motivated until something happens. How many yoga teachers’ bios start with ‘I came to yoga because I was injured or hurt?’ Injury or sickness can be a great teacher and motivator.
Yoga can also be beneficial when somebody has lost hope and is dying. Think of the person who has been diagnosed with cancer and the chemo is not working — that person is wrestling with lots of things and yoga can help the process of accepting the inevitable.
RT: What is your favorite go-to practice and what helps you?
JK: I have a yoga studio at the back of my house, in a room that is surrounded by a garden. I’ll let you in on my secret, Rolf Slovick from the Himalayan Institute does these deep relaxation CDs. They are 15 minute relaxation practices with his wonderful, melodious voice. I often go into my studio around five in the afternoon, lie on my back in a supported savasana, turn on the CD, and take a 15 minute relaxation. I like to call it a savasana cocktail. It recharges me and in the evening my mind is more alert.
RT: What do you hope for the future for IAYT? What do you see and what is the time frame?
JK: Over the next five years we should have a good accreditation process and a good credentialing process started and ongoing. What I would like to see is a continuation of the cooporative relationship the IAYT, the National Ayurvedic Medical Association and the Yoga Alliance has established. These are complementary organizations with complementary missions, and similar goals and challenges. In some sense we are helping to organize and present these important Vedic or Indian practices to the West. Yoga and Ayurveda, in my not so humble view, have so much to offer the West. All three organizations are working together in their own way to meet the needs of the west. We can work together in a harmonious fashion to help people, and help yoga teachers and Ayurveda teachers to be their best and establish good complementary careers, and in a way that is not confusing for the public.
People love yoga; yoga is well established but it is not well established as a healing practice in the West, so we have a lot of good work to do to develop yoga as a recognized respected therapy. In my view it’s important to do that in a collaborative fashion.
One of the strengths of IAYT is that from the very beginning it has been respectful of all the different yoga paths. Let me tell you about one of my visions for this; it is a new vision for me. I read this quote by Aristotle, “Where your talents and the needs of the world cross, that is your vocation.” To some extent that is an inspiring quote for the work of IAYT to help harness all the tremendous talents of people to serve the needs of the world through yoga.
For more information about IAYT, visit: www.iayt.org
Rita Trieger is a yoga therapist working in New York and Connecticut.