Decker, T. W., Cline-Elsen, J., & Gallagher, M. (1992). Relaxation therapy as an adjunct in radiation oncology. Journal of Clinical Psychology, 48, 388–393.

Patients were instructed in six individual one-hour sessions on the use of progressive muscle relaxation (PMR) and were provided with a relaxation tape and written instructions. In addition to relaxation training, the session provided support focused on concerns related to cancer radiation treatment and its effects and on the physical and emotional sensations experienced. During the fourth session, cue-controlled relaxation was presented as an active coping process that included four steps:  PMR, deep breathing, pairing the relaxed state with a self-induced cue word (“calm\"), and coping with tension by self-administration of the cue-controlled relaxation response. During the last session, client concerns about cancer, treatments, stress, and relaxation were reviewed, and further questions were answered. The importance of practicing relaxation regularly at home was emphasized. The control group received usual care.

• Fifty-two women and 30 men scheduled to receive external beam radiation therapy were assigned randomly to the relaxation therapy condition or a control condition.
• Mean age was 61 years (range 37–84).
• The primary disease sites represented were breast (36%), prostate (17.5%), and colon (10%).
• Of the patients, 92% were being treated with curative intent.

Outpatient radiation treatment facility

Patients were undergoing the active treatment phase of care.

The study was a randomized, controlled trial with a usual care control group.

Profile of Mood States (POMS)

Patients receiving relaxation training reported a significant reduction in tension and anger and a trend toward less depression. Comparisons between the relaxation therapy and control groups using MANOVA indicated that there were no statistically significant differences in the pre- and posttest scores for the controls, with the exception of fatigue; patients in the control group became significantly more fatigued (p = 0.01).

• Patient adherence to relaxation exercises at home was unknown.
• Outcome assessors were not blinded to treatment assignment.
• The study had a small sample size, and no power analysis was provided.
• The study design did not include an attention-placebo condition to control for the effects of suggestion and attention.
• The relative importance of the different components of the intervention cannot be known.
• Professional training is required to deliver the supportive care and psychoeducational component of the intervention.