Relaxation Training in Children

Description of the Strategy

Relaxation training (RT) refers to a variety of techniques and procedures used to reduce stress-related behavioral or physiological problems in children. Hypothesized to decrease both emotional and somatic reactions to stress, RT is often classified as an emotion-focused coping strategy, in contrast to more problem-focused strategies geared toward resolving and managing stressful events. Two of the more common variants of RT used with children are progressive muscle relaxation (PMR) and imagery-based relaxation (IBR).

Conceptualized as a sensory approach to relaxation, PMR attempts to directly influence somatic reactions to stress by helping children identify their own bodily sensations associated with tension and consciously relax muscles of the body on demand. To facilitate the recognition of stress-related bodily states, PMR incorporates a series of exercises that systematically instruct children to tense and relax various muscle groups in the body. Although the number and location of muscle groups used during PMR may vary, common muscle groups employed include toes, legs, hands, arms, chest, shoulders, stomach, forehead, cheeks, eyes, and nose.

Special attention should be given to preparing the child for PMR. Using developmentally appropriate language, PMR is typically introduced by explaining that the muscles in your body tighten up when you are nervous, upset, angry, or in pain, while they are loose when you are relaxed, happy, or having fun. RT is then framed as an educational strategy geared toward teaching how to recognize when the muscles of the body are tight and when they are loose. Children are then informed that the overall goal of the procedure [Page 990]is to (a) enable them to tell when they are tense and (b) relax their muscles by themselves when nervous, upset, angry, or in pain.

After presenting this rationale and clarifying any questions or concerns about the procedure, it is advisable for the therapist to model the procedure. While demonstrating how to tense and relax various muscle groups, the therapist encourages the child to ask questions so as to provide clarity on any ambiguous points. Modeling may also help alleviate any inhibitions that the child may have in assuming the bodily postures required during PMR.

After modeling PMR, the therapist instructs the child to get into a relaxed position, sitting upright in a chair or couch with the feet flat on the floor and the arms and hands at the side or in the lap. Instructions are also given to close the eyes, although it is occasionally necessary to allow highly anxious or apprehensive children to keep their eyes open during initial sessions. Deep-breathing strategies (e.g., party blower, paced counting, or blowing bubbles) are commonly incorporated into PMR as a means to further relax the child.

Once the child appears relaxed, the therapist systematically instructs the child to tense and relax various muscle groups. Age-appropriate analogies for tensing and relaxing each muscle group are often used to enhance the appeal of the process. Animals and objects such as cats, flies, mud, and lemons have been used in this manner. For example, the child is told to pretend that a fly is on the tip of the nose for several seconds, then instructed to wiggle the nose in order to get rid of it. In tensing and relaxing the arms, the child may be told to pretend to squeeze half of a lemon in each hand for several seconds and then drop it to the ground. In addition to increasing the appeal of PMR, the use of such analogies may also facilitate a better understanding of the bodily postures required during the exercises.

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