Relaxation training

Boyce PM, Talley NJ, Balaam B, et al. A randomized controlled trial of cognitive behavior therapy, relaxation training, and routine clinical care for the irritable bowel syndrome. Am J Gastroenterol 2003 98 2209-2218. 

Richardson, N. J., Rogers, P. J., and Elliman, N. A., Effects of comprehensive relaxation training (CRT) on mood A preliminary report on relaxation training plus caffeine cessation. Pharmacology, Biochemistry and Behavior 52(2), 313-320,... 

Nonpharmacologic therapies include reassurance and counseling, stress management, relaxation training, and biofeedback. Physical therapeutic options (e.g., heat or cold packs, ultrasound, electrical nerve stimulation, massage, acupuncture, trigger point injections, occipital nerve blocks) have performed inconsistently. 

CBT (exposure therapy, cognitive restructuring, relaxation training, and social skills training) and pharmacotherapy are considered equally effective in SAD, but CBT can lead to a greater likelihood of maintaining response after treatment termination. Even after response, most patients continue to experience more than minimal residual symptoms. 

Psychotherapies for PTSD include anxiety management (e.g., stress-inoculation training, relaxation training, biofeedback, distraction techniques), CBT, group therapy, hypnosis, psychodynamic therapies, and psychoeducation. Psychotherapy may be used in patients with mild symptoms, those who prefer not to use medications, or in conjunction with drugs in those with severe symptoms to improve response. 

Acute Phase Treatment. Hypnotic medications are useful for short-term treatment of insomnia, but they should always be accompanied by behavioral and psychoeducational treatments, including a review of good sleep hygiene practices. It may also include more aggressive measures such as relaxation training, sleep restriction therapy, and stimulus control therapy. 

Antianxiety medications, especially benzodiazepines, can provide relief of anxiety regardless of the cause situational stress, hyperthyroidism, or manic excitement (see figure 16-D). Of course, it is crucial to recognize and treat the underlying disorder. The use of benzodiazepines should be avoided until other measures have been tried (such as psychotherapy, relaxation training) or if anxiety is severe. 

Stress management, relaxation training, yoga, massage, biofeedback, and self-hypnosis... 

Beck, J. G., Stanley, M. A., Baldwin. L. E., Deagle, E. A. (1994). Comparison of cognitive therapy and relaxation training for panic disorder. Journal of Consulting Clinical Psychology, 64, 818-826. 

Drug therapy is not always necessary or desirable for insomnia. The cause of the insomnia should be established and, where possible, underlying factors should be treated. Alternative approaches include counselling and relaxation training and avoiding stimulants, alcohol and exercise late in the evening. 

Simons, A. D. et al. (1985). Predicting response to cognitive therapy for depression The role of learned resourcefulness. Cognitive Therapy and Research 9 79-89. Sinatra, J. D. (2000). Relaxation training as a holistic nursing intervention. Holistic... 

Yung, P. M. B. et al (2004). Relaxation training methods for nurse managers in Hong Kong A controlled study. International Journal of Mental Health Nursing 13 255-61. 

Managing emotions. Individual and group interventions can assist patients in managing their emotions. Management includes techniques, such as relaxation, training, music therapy, education, and information sharing (15). 

Specific interventions that counter anxiety arousing include relaxation training (15). The mindfulness approach, as popularized by Jon Katat-Zinn (24), assists patients to focus on the here and now. Music therapy has also been shown to have positive results in reducing anxiety for patients on LTMV (25). Professional support is valuable when addressing sensitive issues, such as end-of-life decisions and advanced directives for medical care. For terminally ill patients, family members can be assisted in expressing their loss, grief, and guilt. 

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