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Table 3 Consensus on importance of approaches and techniques for reducing depression or anxiety, and improving positive emotions and well-being

From: Establishing key components of yoga interventions for reducing depression and anxiety, and improving well-being: a Delphi method study

Round 1 - recommendations Round 2 -
General consensus on importance
Breath regulation - approaches & techniques For reducing For reducing
Depression Anxiety
Abdominal breathing Very important/essential Very important/essential
Focus on inhalation Important/less essential No recommendation
Focus on exhalation No recommendation Very important/essential
Comfortable holding after inhalation Important/less essential Important/Essential to AVOID
Comfortable holding after exhalation No recommendation Important/less essential
Alternate nostril breathing No recommendation Important/less essential
Right nostril breathing, especially on inhalation Important/less essential No recommendation
Left nostril breathing, especially on exhalation No recommendation Important/less essential
Cooling breath (sitali) Less or not important Important/less essential
Rapid breathing techniques, such as kapalabhati Less or not important Important/Essential to AVOID
“humming bee” breath (bhramari) No recommendation Very important/essential
Regulating the breath to be calm and steady No recommendation Very important/essential
Postures - approaches & techniques For reducing For reducing
Depression Anxiety
Coordinated flow of breath with movement Very important/essential Very important/essential
Chest and heart opening, backward bending postures and movements, that also focus on inhalation Important/less essential No recommendation
Moving repetition of postures (rather than long holding) Important/less essential No recommendation
Dynamic sequences of postures, including sun salutations Important/less essential No recommendation
A range of different postures, to keep it interesting Important/less essential No recommendation
Postures that have a calming effect, rather than energising No recommendation Very important/essential
Resting, relaxing or restorative postures NO CONSENSUS Important/less essential
Forward-bending postures No recommendation Important/less essential
Postures and movements that focus on exhalation No recommendation NO CONSENSUS
Simple, gentle sequences of postures No recommendation NO CONSENSUS
Relaxation - approaches & techniques For reducing For reducing
Depression Anxiety
Focus on abdominal breathing, lengthening exhale Not considered Very important/essential
Active focus on physical body (e.g. body-scan; progressive muscle relaxation), to shift focus away from mind and thoughts Very important/essential NO CONSENSUS
Done with visualisations, that are positive, expansive and energising, e.g. sun, open space. Very important/essential No recommendation
Done with visualisations, that have a calming effect No recommendation NO CONSENSUS
Using guided relaxation techniques, rather than self directed Important/less essential No recommendation
Restorative (passive-supported) postures NO CONSENSUS Important/less essential
With legs elevated NO CONSENSUS NO CONSENSUS
Resting between and after postures NO CONSENSUS NO CONSENSUS
Meditation - approaches & techniques For reducing For reducing
Depression Anxiety
Mindfulness (learning to focus attention on observing the present experience, without judgement) Very important/essential Very important/essential
Something for the mind to do and focus on, rather than just observation (e.g. counting, repeated words or phrases (mantra); visualisation; image or symbol; candle gazing; smiling heart) Very important/essential Important/less essential
Active meditations, e.g. moving, chanting, guided visualisations Very important/essential Important/less essential
A concept, idea or value, such as something positive, energising, confidence building, gratitude. Very important/essential No recommendation
A concept, idea or value, such as something positive, calming, confidence building, gratitude. No recommendation Important/less essential
Other components of yoga practice For reducing For reducing
Depression Anxiety
Cultivation of positive values, attitudes and behaviours (including gratitude, kindness, compassion, forgiveness) Very important/essential Very important/essential
Awareness of negative sensory input (including TV, movies, music, literature, multi-media, news) Very important/essential Very important/essential
Formulation of meaningful affirmations and intentions (samkalpa) Important/less essential Important/less essential
Visualisation and symbolic imagery techniques (bhavana) Important/less essential Important/less essential
Sound or chanting (from any suitable language or culture) Important/less essential Important/less essential
Spirituality and prayer Important/less essential Important/less essential
Repetition of meaningful words or phrases (mantra) Important/less essential Important/less essential
Symbolic gesture (nyasa & mudra) Important/less essential Important/less essential
Other components of yogic lifestyle For reducing For reducing
Depression Anxiety
Positive relationships Very important/essential Very important/essential
Developing self-empowering knowledge Very important/essential Very important/essential
Social involvement and support - linking with a supportive community (sanga) Very important/essential Very important/essential
Lifestyle factors, including diet, smoking, drugs and alcohol, sleep, work, exercise Very important/essential Very important/essential
Exposure to sunlight and natural environments Very important/essential Very important/essential
Service to others, including volunteer work Important/less essential Important/less essential
Pleasing environment, free from clutter, with good ventilation and natural light Important/less essential Important/less essential
Education about yoga teachings, and the potential benefits of yoga Important/less essential Important/less essential
Group yoga classes Important/less essential No recommendation