How yoga therapists work: Integrative cancer care for children

By Tonia Kulp

Yoga therapy is fully integrated into the care model at Children’s Hospital of Philadelphia (CHOP), where I work. As a yoga therapist in the integrative oncology program, I am able to follow a child from diagnosis, through treatment, survivorship, and sometimes to end of life. We see children based on a consult order, meaning a frontline clinician (physician or advanced-practice provider such as a nurse practitioner) has placed an order for service.

I meet with each patient and their family to provide an overview of services, conduct a clinical intake and assessment, and provide referrals to other members of our close-knit team. Integrative oncology operates a bit differently than other parts of the hospital in that our multi-disciplinary team consists of yoga therapy, massage therapy, acupuncture, psychology, sports medicine, physical therapy, and nutrition. Our goal is to reach every family at diagnosis to get ahead of treatment-related side-effects and provide consistent whole-person care that addresses not only physical needs, but also mental-emotional and spiritual ones.

Because many of the children are very young (we see people with cancer from birth through young adulthood), we also work directly with their caregivers, who are often fierce advocates for their children. Short-term goals may look like helping a child manage their chemo-induced nausea and vomiting. Longer-term goals may include working on compassion care: re-establishing trust in the very tired bodies that kids may feel have failed them. Working together with families with a cancer diagnosis is incredibly important, as cancer affects the entire family across the biopsychosocial-spiritual planes. The yoga therapists at CHOP work closely with partners in physical and occupational therapy, psychology, chaplaincy, nursing, and more to coordinate on both short- and long-term goals.

I melt in gratitude when a child tells me what color their grief is and where they see and feel that color in their little body. I acknowledge the enormity of every 6-month scan that every parent faces and the fear and trauma that accompany their lives. And every day I am grateful that I am welcomed into the quiet moments, the moments of peace, and the moments of joy in each family I meet.

Tonia Kulp, MS, C-IAYT, is an end-of-life doula, reiki master, and reflexologist who owns Whole Health Yoga Therapy. She has been a yoga therapist at Children’s Hospital of Philadelphia for more than 6 years and serves as adjunct faculty in the yoga therapy program at Maryland University of Integrative Health.