The Therapist's Toolkit: Relaxation Skills Training



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.

Hosts can also choose a half-day format that includes a subset of the interventions from the longer program.

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 - whether in a group or individual format. 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.

Which clients are appropriate for the skills taught?

The skills and materials are designed to be used as components of therapy (but seldom the sole components) 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.

Clients would normally also be given audio files 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 can receive these on CD, or we can provide the host with digital versions that can be distributed to registrants.

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 usually 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

Who should attend the workshop?

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

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