Changeways Clinic

The Therapist’s Toolkit: Relaxation Skills Training



Introduction

Although relaxation training is seldom a complete treatment for a client's presenting problem, it is often a significant component of the intervention. This one-day workshop provides clinicians with training in the most widely-used and most-researched relaxation strategies: diaphragmatic breathing, progressive muscle relaxation, and passive relaxation. The materials accompanying the workshop provide resources and ideas for conducting relaxation training individually and in a structured six-session group format.

Program Contents

The training session introduces clinicians to all of the core concepts, handouts, resources, and skills in the resource package. These include:

  • The nature of stress. Instruction in the basic physiology and function of the stress response, plus the rationale for controlling it using relaxation. The potential interfering effects of caffeine and other drugs is discussed.
  • Diaphragmatic breathing. Participants are given the rationale for diaphragmatic breathing, taken through a series of illustrative breathing exercises, then trained in a four-stage breathing process designed to activate diaphragmatic breathing and increase awareness of breathing styles.
  • Progressive relaxation. This is the most well-researched relaxation strategy known. It involves progression through a series of muscle groups, tensing and then relaxing each one in turn. Participants experience this exercise for themselves, then practice in dyads with each person playing the role of a client.
  • Passive relaxation. This technique is similar to progressive relaxation, but does not involve tensing the muscle groups. This technique is preferred over progressive relaxation by about a third of our clients, and is especially helpful for those with chronic pain or sleep disorders. Workshop participants have the opportunity to try this variant exercise in dyad practice.
  • Cue-controlled relaxation. Once a client has learned at least moderate relaxation skills, we would like them to notice increasing anxiety and tension before these become unmanageable, and practice an abbreviated form of the breathing exercise at that point. The workshop introduces participants to the core concepts of cue-controlled relaxation, and to the exercise sheets designed to help clients identify their own internal bodily cues and external situational cues that tension is increasing.
  • Symptom monitoring. The handout package included in the materials includes several behavioural monitoring sheets to help clients track progress and symptoms. These are introduced at the workshop.

Flexibility of the Program Protocol

The Relaxation Program documents are modular. This means that the course is readily adaptable to therapists' own styles and preferences for relaxation training. It is a relatively simple matter to add topics, blend the content into other group protocols, or replace some of the material with other strategies, such as autogenic training or Herbert Benson's relaxation response. As well, the free-standing nature of each client document means that sections of the material can easily be taught to individual clients outside of the group format.

Which clients are appropriate for the Relaxation Program?

The program is designed to be used as a component of therapy (but seldom the sole component) for a variety of client populations. It is appropriate for clients suffering from anxiety disorders, anger problems, difficulties dealing with stress, and some affective and sleep disorders. It can be a helpful adjunctive therapy for a variety of medical conditions including headache, chronic pain, certain gastrointestinal conditions, and other conditions aggravated by excessive tension. It may also be used to help clients cope with the stress created by chronic medical conditions or difficult life circumstances.

The program is written primarily for adults, though teens should have no difficulty grasping the principles and younger children may benefit with some modifications. The client materials are written at a grade six reading level. Clients functioning below this level may benefit if they have help.

The Client Materials

The Relaxation Program provides clients with 37 pages of handouts that present the concepts in a pleasant workbook-style format. These materials are written in a modular format for maximum flexibility. Therapists can use the entire set of materials with a group or an individual client, or they can pick and choose the most applicable elements.

These materials have also been translated into the traditional Chinese character set, suitable for people speaking Cantonese or Mandarin from Hong Kong or Taiwan (they will be intelligible to many from the People’s Republic as well). These materials are available upon request.

Clients would normally also be given an audio CD providing four relaxation experiences: Progressive muscle relaxation long form (about 18 minutes) and short form (about eight minutes), and passive relaxation long form and short form. Workshop participants normally have the choice of receiving either a male voice or female voice version of the CD, and they have permission to reproduce the contents for their own clients.

Translated versions of the audio CDs are also available in Cantonese, Mandarin, Spanish addressed to men, and Spanish addressed to women.

The Trainer’s Manual

The Trainer's Manual is a 185-page resource for therapists. It includes a description of the populations likely to benefit from the program, suggested training formats, extensive session notes, a set of five relaxation scripts (the four mentioned above and an Imagery Script), and the client materials.

The Training Workshop

Relaxation Program training workshops for providers are a single day in length. The workshop is designed to be interactive and experiential. Participants go through most of the relaxation exercises taught in the protocol and practice leading at least one of the exercises with others. Here is the workshop schedule:

Morning

Introductions
Why teach relaxation skills?
Appropriate populations
Diaphragmatic breathing training
Tension record-keeping
Progressive muscle relaxation
Troubleshooting

Afternoon

Passive relaxation
Dyad practice
Relaxation-induced anxiety
Cue-controlled relaxation
Identifying internal cues
Identifying external cues
Abbreviated relaxation exercises

Workshop participants each receive a copy of the 185-page Changeways Relaxation Program manual, which includes 37 pages of handouts for clients. In addition, each participant receives a CD master of the relaxation instructions and a CD-ROM with reproducible pdf masters for each of the participant documents.

Who should attend the workshop?

The workshop is intended for professional therapists (including clinical counselors, psychologists, psychiatrists, psychiatric nurses, and other trained psychotherapists).

If you plan to attend...

Workshop participants will experience most of the exercises first-hand. As well, at two points during the workshop participants will split into groups of three to practice conducting the exercises with one another. Consequently:

Please wear casual, loose-fitting clothing to the workshop.

If possible, please bring a pad of some type to lie on (a camping foamy, thermarest, exercise mat, or sleeping bag). You may also wish to bring a pillow.

How to Register

Check the Calendar for information on upcoming workshop dates, locations, and prices. Print a copy of the workshop flyer for the program you wish to attend.

If paying by credit card, you may fax the completed registration form to us at 604 871 0490. Alternatively, mail a copy of the form with cheque to us at Changeways Clinic, Suite 718, 2525 Willow Street, Vancouver BC, V5Z 3N8. Cheques are payable to "Changeways Clinic".

If you have any questions about the program or about registration, call us at 604 871 0490 or email us at
.

If you know of additional staff members who might be interested, call us and we can send out brochures. Your help in contacting others will be most appreciated.

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