A pragmatic preference trial of therapeutic yoga as an adjunct to group cognitive behaviour therapy versus group CBT alone for depression and anxiety

Background: Yoga has several mechanisms that make it a promising treatment for depression and anxiety, including physical activity, behavioural activation, and mindfulness. Following positive outcomes from adapted CBT interventions incorporating mindfulness-based practices, this study explored the effects of a therapeutic yoga program as an adjunct to group-based CBT for depression or anxiety. Methods: This was a pragmatic preference trial involving adults diagnosed with depression or anxiety in a regional primary mental healthcare service (n = 59), comparing transdiagnostic group CBT (n = 27) with transdiagnostic group CBT combined with an adjunct therapeutic yoga program (n = 32). A preference recruitment design allowed eligible participants (n = 35) to self-select into the adjunct program. The Depression Anxiety Stress Scale-21 (DASS) was assessed at baseline, post-intervention, and three-months follow up. Results: CBT + Yoga was an acceptable alternative to CBT alone. Significant reductions were observed in total DASS scores and the 3 subscales of the DASS for both groups, however CBT + Yoga showed significantly lower depressive and anxiety symptoms post-intervention, compared to CBT alone. CBT + Yoga also showed sustained reductions in depressive symptoms over three-months, and more rapid reductions in depressive symptoms, compared to CBT alone. Limitations: These findings should be considered preliminary due to the moderate sample size, with a rigorous randomised control trial necessary to definitively support the integration of yoga within mental health care to augment the benefits and uptake of transdiagnostic CBT for depression and anxiety. Conclusions: Complementing other mindfulness-based practices, therapeutic yoga shows promise as an adjunct to transdiagnostic CBT.