VALIDATION OF AN INTEGRATED YOGA MODULE AS AN ADJUNCT FOR THE MANAGEMENT OF SUBSTANCE USE DISORDER

Abstract

BACKGROUND Substance use disorder (SUD) continues to be a prevalent issue that affects individuals' physical, psychological, and social well-being. Despite the availability of various treatments, relapse rates remain high due to the complex nature of addiction, which involves not only physiological dependence but also deep-seated psychological and behavioral patterns. Traditional counselling techniques often overlook holistic approaches that promote well-being and recovery while contemporary yoga therapy tend to overlook yoga-based counselling because of the lack of structure and clinical application.

AIMS AND OBJECTIVES The aim and objective of this thesis work is on developing, validating and assessing an integrated yoga module for SUD (IYMSUD) with focus on yoga-based counselling.

METHODS The study comprised three phases. Phase 1 involved developing IYMSUD through a systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed/MEDLINE, Web of Science, Google Scholar, and SCOPUS were searched using relevant keywords. Studies were coded and qualitatively analyzed using the inductive thematic approach. Additionally, a semi-structured interview was conducted with yoga therapy experts, wherein their input was audio recorded, transcribed, coded, and qualitatively analyzed to extract themes related to YBC and SUD. Phase 2 utilized the Delphi method with three iterations involving 17 experts to validate IYMSUD. Items with a Content Validity Ratio (CVR) score of 0.99 and above were retained. In Phase 3, a feasibility assessment of IYMSUD was done in a single-arm study involving 23 adults with SUD. Participants received IYMSUD twice a week for 8 weeks alongside standard treatment (12-Step Program).

ASSESSMENT Pre- and post and follow up intervention assessments included motivation for treatment using the Motivation to seek treatment Questionnaire; anthropometric details including Body Mass Index, Blood Pressure, Respiratory Rate and Bhrahmari Rate; quality of life using the World Health Quality of Life (Bref) Questionaire, and Vedic personality traits using the Gita Inventory. Within group and between group differences was assessed at pre and post interventions.

RESULTS By reviewing 24 articles and analyzing input from experts' interviews in Phase 1, YBC themes were identified, forming the basis for the development of IYMSUD. In Phase 2, IYMSUD, incorporating yoga theory, postures, breathing practices, relaxation, advanced techniques, and YBC, met high-quality standards and was deemed feasible for implementation by the experts. In Phase 3, all yoga participants perceived IYMSUD to be satisfactory, feasible, and culturally appropriate and reported no adverse effects. The intervention group shows a significant increase in Body Mass Index (BMI) whereas the control group shows no significant change. The yoga group experiences a substantial decrease in respiratory rate and improvements are also noted in Vedic Personality scores, with the yoga group. Quality of Life (QOL) scores for the intervention group improve significantly,as well as the psychological health. Participants rated the session’s acceptability as highly acceptable and doable These results indicate the module's positive impact on motivation, health, and quality of life for individuals with SUD.

CONCLUSION This is the first study to empirically integrate counselling in a systematic method as a form of integrated yogic approach. With the strength of validity and feasibility, IYMSUD can be used as an adjunct to substitute drug treatment of SUD.