By Dr. Elizabeth Nyang
About the author: Dr. Nyang is a LCPC (Licensed Clinical Professional Counselor) and ATCQA-certified Tai Chi Practitioner. She holds a master’s degree in counseling and a doctorate degree in counseling psychology.
When working with all my clients, I must use Cognitive Behavioral Therapy (CBT) because we are trained in graduate school to develop a theoretical orientation to use when working with clients. I integrate Tai Chi with CBT into my work with clients, and many find it very useful. Other clients prefer only to use CBT. The clients that use Tai Chi find it relaxing to use a mind-body exercise to help them lessen their focus on negative and unwanted thoughts. Usually, we learn to practice Tai Chi in silence. When helping clients, I use Tai Chi as a guided meditation to help them learn to focus their attention on their Tai Chi movements and not on unwanted thoughts.
A Client with a High Level of Stress and Anxiety from Work
A client that I worked with online was experiencing a high level of stress and anxiety because his supervisor accused him of not following office procedures during a staff meeting. I used Tai Chi as a guided meditation. I demonstrated how to do “Open and Close the Door”. I asked the client to relax his body, close his eyes, and take a deep belly breath. He did “Open the Door” with his eyes closed. As he raised his arms and hands slowly, I asked him to imagine pulling up peace and tranquility and to let that feeling of peace and tranquility enter his body as he continued to do slow belly breaths. As he closed the door, he was asked to relax his body and to imagine stress and negative thoughts floating away. As he continued the movement, he would repeat that peace and tranquility comes in when opening the door and negative thoughts go out when he closes the door. After opening and closing the door for 15 minutes, we did CBT focused talk therapy for 45 minutes. The client did this exercise at home two to three times a day for 15 minutes, and it was relaxing for him. He mentioned that it felt meditative to him, and he wanted to learn other Tai Chi forms.
A Client Who Got Fired from Job
I had another client that had ADHD and was recently fired from his office job. He mentioned that the job was too much for him emotionally. He was familiar with Tai Chi and did Tai Chi for 1-2 hours a day at home. We did talk therapy virtually. During our sessions, I used different Tai Chi movements to help him focus on building positive thoughts. For example, we used “Single Whip” to release the negative and hold onto the positive. The hand making the beak represents positive thoughts and things the client wants to hold onto, while the hand with the palm facing outward represents negative thoughts and things the client wants to release and let go of. We worked together for three months, and the client found a job that he felt more comfortable in.
A Client with Neurological Abnormality
I had one client diagnosed with MdDS or Mal de Débarquement Syndrome (a rare neurological condition that causes a feeling of rocking, swaying, or bobbing, even when there is no movement). This client was private pay and came two times a week for an hour and fifteen minutes. MdDS caused him to feel like his body was constantly rocking and moving. He found Tai Chi to be very healing. He learned to do five movements (open the door, close the door, wave hands like clouds, single whip, and white crane spreads wings). These exercises were easy for him to do in the park, where he enjoyed being around the different colors of nature, and at home.
The client mentioned that he was able to sleep better at night after our first Tai Chi session. We did 30 minutes of Tai Chi and 45 minutes of talk therapy in the office. The combination of Tai Chi and CBT was a perfect fit for him. His mental health symptoms began to lessen as we worked together for six months, and his balance also improved.
Group Sessions with Returning Citizens Recovering from Addiction Issues
I held group Tai Chi sessions for clients recovering from addictions because they did not have money to join a gym and their resources were limited. They were court-ordered to be in treatment for 12 weeks. Some of the clients attended the Tai Chi and group counseling sessions for 12 weeks while others preferred to only attend the group counseling sessions. The clients who were interested in doing Tai Chi mentioned that they used Tai Chi to help them deal with the stress of meeting with probation officers, attending group counseling sessions, issues with work, and, in some cases, stressors related to their job search.
To Tai Chi or Not to Tai Chi
CBT focuses on identifying and changing negative thought patterns and behaviors for clients who have issues with stress and anxiety. The therapist uses cognitive restructuring techniques to help individuals challenge and reframe irrational and negative thoughts.
Tai Chi is a mind-body practice emphasizing relaxation, mindfulness, and integrates body and mind. Being in a relaxed state can help lessen symptoms of stress and anxiety, and research studies are showing that Tai Chi can help.
Some clients chose not to use Tai Chi and preferred only to use talk therapy. The clients who decided to use CBT with talk therapy did lessen their symptoms. The clients who continued to use Tai Chi after counseling sessions for relaxation mentioned that Tai Chi helped them to lessen stress and feel stronger. They could do Tai Chi at home anytime and did not need to purchase any equipment.
Many of my court-ordered clients preferred to use sessions that included Tai Chi because of the connection between Tai Chi and martial arts. These clients benefited from combining both approaches, using CBT’s cognitive and behavioral strategies with Tai Chi’s mindfulness and physical relaxation.
The choice between using CBT and Tai Chi depends on personal preference and the severity of stress and anxiety symptoms. Only CBT was used with clients that had severe symptoms of stress and anxiety because research shows that CBT is very effective for helping these clients. I wanted to use all of the time allotted for the therapy session to focus on CBT.
Incorporating Tai Chi into Psychological Counseling
I describe Tai Chi, suggest its use, and demonstrate it to clients and other therapists. The clients receive an article in Psychology Today about the benefits of Tai Chi, and the therapists receive research articles on the mental health benefits of Tai Chi. The online course contains several videos describing how I use Tai Chi when working with clients and a bibliography of research articles. Many therapists and clients feel the benefits of using Tai Chi after a couple of sessions.
If you are interested in integrating Tai Chi into your private practice, do some research to understand what Tai Chi is and how it can positively impact mental health. Find creative ways to use Tai Chi. For example, prepare scripts for meditations you can use to help clients work through their specific issues. Some clients may only be interested in doing the “Tai Chi walk” for meditation. Others may want to use the “Tai Chi walk” and one or two movements to help lessen their anxiety and stress levels.
You can always contact me for advice and information on how to integrate Tai Chi into your private practice. I also teach an online Tai Chi course for Mental Health Therapists! The title of the course is Integrate Tai Chi into Your Mental Health Practice. After completing the course, the therapist will receive 6 Continuing Education credits from CE-Classes.
I can be reached at 301-309-4243 and [email protected].
