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Stress management: a randomized study of cognitive behavioural therapy and yoga

Research paper by Jens Granath, Sara Ingvarsson, Ulrica von Thiele, Ulf Lundberg. Cognitive Behaviour Therapy. 2006;35:3-10. doi: 10.1080/16506070500401292


 

In this 4-month randomized study of 37 employees (27 female, 10 male) of a large Swedish company, the investigators examined the effects of an exercise-based kundalini yoga program vs a cognitive behavior program for the management of stress. They concluded that both behavioral therapy and yoga are promising stress management tools.

Participants were randomized into either the yoga program or the cognitive behavior program. Cognitive behavior sessions were held on company premises; yoga sessions were conducted at nearby locations. Over 4 months, all participants received 10 intervention sessions. Cognitive behavior therapy was held weekly for 4 weeks, every other week for 3 weeks, and then every third week. Yoga participants received weekly sessions with a 1-week break between the sixth and seventh session.

The yoga program included 3 weeks of yoga exercises that focused on the back; 3 weeks of introductory kundalini yoga; 3 weeks of yoga to balance body, energy, and mind; and 1 week of exercises for the shoulders and neck. Each session included a 15-minute discussion of health-related topics, such as eating and exercise habits. Participants were given take-home materials on the covered themes and asked to read and practice exercises at home.

[T]he investigators . . . concluded that both behavioral therapy and yoga are promising stress management tools.

Each session in the cognitive therapy program included relaxation, psycho-education, stress management, and discussion of home assignments. Psycho-education topics included irritation/anger and the psychophysiology of stress. Stress management methods used included goal setting, time management, and assertiveness training.

Of the 37 participants enrolled, 33 completed the study (16 in the yoga program, 17 in the cognitive therapy program). Data were collected pre- and post-study via five patient-rated stress scales and by measurements of blood pressure, heart rate, urine (to measure adrenaline and noradrenaline levels), and saliva (for cortisol determinations). Of the 33 participants who completed the study, 31 were available for post-study measurements.

Analysis of questionnaire-derived data showed that perceived stress, stress behavior, and exhaustion decreased significantly in both intervention groups. Anger decreased significantly in the cognitive behavior group only, and the increase in perceived quality of life was not significant in either group.

“[D]ata showed that perceived stress, stress behavior, and exhaustion decreased significantly in both intervention groups.” -Granath et al, 2006

In the yoga group, levels of noradrenaline (the main transmitter of the sympathetic nervous system) decreased significantly post-treatment. Decrease in adrenaline was not significant for either group, and there was no significant change in either group for cortisol. Heart rate was not significantly lower after either program, but approached significance in the yoga group; conversely, mean systolic blood pressure was not decreased significantly in either group, but approached significance in the cognitive behavior group. There were no significant changes in diastolic blood pressure in either group.

Overall, no statistically significant differences between the two programs were found, leading investigators to conclude that both approaches to stress management are promising, and that further studies are needed to examine the effects of these interventions.



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