Progressive muscle relaxation (PMR) is a technique of alternately tensing and relaxing muscles groups in sequence throughout the body. When going through muscle groups, individuals can start with the head and neck and progress to the feet, or vice versa. Similarly individuals may do one side of the body at a time, or both sides at the same time. Listening to a prerecorded script may be used to guide individuals through the process. Addition of guided imagery to PMR involves use of mental visualization and use of imagination to enhance relaxation and alter specific experiences and may or may not include direct suggestion. Individuals may use recorded scripts to guide the creation of mental images. Guided imagery can integrate techniques founded in multiple psychological theory and hypnotherapy. PMR with guided imagery has been examined for effectiveness in patients with cancer for chemotherapy-induced nausea and vomiting, anxiety, fatigue, sleep-wake disturbances, and pain.
Cohen, M., & Fried, G. (2007). Comparing relaxation training and cognitive-behavioral group therapy for women with breast cancer. Research on Social Work Practice, 17, 313–323.
To compare the effectiveness of a cognitive-behavioral therapy (CBT) group intervention versus a relaxation and guided imagery (RGI) group training intervention.
The intervention groups received nine 90-minute weekly sessions, and the control group received standard care. The outcomes measured were psychological distress, sleep, fatigue, and health locus of control.
Oncology center in northern Israel
Patients were undergoing the active treatment phase of care.
This was a randomized, controlled trial.
GSI and perceived stress decreased in both intervention groups but not in the control group. Means of fatigue symptoms and sleep difficulties decreased in both intervention groups but only significantly in the RGI group. External health locus of control decreased more in the CBT group. No differences were observed among groups in internal locus of control. Participants in the RGI group reported significantly higher self-practice adherence at home than did those in the CBT group.
A study design with four groups—CBT, RGI, combined CBT and RGI, and control—could shed light on whether combining CBT and RGI is more advantageous than delivering either intervention individually.