• Introduction
• Program Contents
• Flexibility of the Model
• Which Clients are Appropriate?
• The Client Materials
• The Trainer's Manual
• The Training Workshop
• Who Should Attend the Workshop?
• If You Plan to Attend...
• How to Register

Introduction

Although relaxation training is seldom a complete treatment for a client's presenting problem, it is often a significant component of the intervention. Changeways has developed a psychoeducational group therapy protocol for training clients in a variety of relaxation techniques. This popular program has been offered at Changeways in Vancouver since 1994 and has been quite successful in helping many clients deal with their symptoms of stress and anxiety. The program has been a part of the outreach service since 1995. We offer service providers one and one half days of training in the implementation of the program with their own populations.

Program Contents

The course offered to clients runs for six sessions, an hour and a half apiece, and provides participants with training in the following:

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. Clients receive training plus an audiotape for home practice.

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.

Cue-controlled relaxation. Clients are taught the importance of recognizing two types of cues: internal bodily sensations that signal the start of an upswing in tension, and predictable external situations that are usually associated with stress. They complete exercises designed to help identify their own internal and external cues. Instruction is given in a brief relaxation exercise based on diaphragmatic breathing. Clients are then advised to practice the exercise when their internal or external cues arise.

Imagery. This broad subject is touched on briefly as a means of 1) quieting the mind during formal relaxation practice, and 2) enhancing cued relaxation in stressful situations.

Flexibility of the Program Protocol

The Relaxation Course 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, though 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. With help from a grant from the Department of Canadian Heritage, these materials have been translated into Chinese (the nonabbreviated character set common to Cantonese and Mandarin) with bilingual section headings. The translated version of the manual is available to workshop registrants upon request at no extra charge.

Clients also receive two relaxation tapes, or one CD, containing progressive relaxation instructions (long and short forms) and passive relaxation instructions (long and short). A master for reproduction is supplied in English to workshop registrants. Translated tapes are also available in Cantonese, Mandarin, and Spanish.

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, and the client materials.

The Training Workshop

Relaxation Program training workshops for providers are one and one half days long. 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:

First Half-Day

Registration
Introductions
Why teach relaxation skills?
Appropriate populations
Group exercise on stress
Drugs and relaxation
Diaphragmatic breathing training
Tension record-keeping

Second Half-Day

Teaching progressive muscle relaxation
In-session relaxation induction
Teaching passive relaxation
Triad practice: Progressive and passive relaxation

Third Half-Day

Relaxation-induced anxiety
Cue-controlled relaxation
Identifying internal cues
Identifying external cues
Teaching imagery
In-session imagery practice
Triad practice: Imagery exercise
Abbreviated relaxation exercises
Ending the group

Workshop participants each receive a copy of the 185-page Changeways Relaxation Program manual, which includes an extensive trainer's manual, five relaxation and imagery scripts, and copies of each of the documents, forms, and exercise sheets for clients. In addition, each participant receives a CD master of the relaxation instructions and photocopy masters for each of the participant documents (on CD-ROM).

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

1. Check the Calendar for information on upcoming workshop dates, locations, and prices.

2. Print a copy of the workshop flyer for the program you wish to attend.

3. 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 509, 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.

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.

Space is limited for all workshops, so register early!


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