Relaxation for people with disabilities

1 Relaxation for people withdisabilitiesDr Nick HagiliassisPsychology Advisor - ScopeStress{Stress is the physiological andemotional reaction to psychologicalevents.{ Fight or flight" response.{Not all stress is { Relaxation involves a distinctphysiological state that is the distinctopposite of the way your body feels andreacts under stress and tension.{ Relaxation is incompatible with stress.{The physiological responses found in thestate of Relaxation are the opposite ofthose found in the fight or flight rate and blood pressure dropzBreathing rate decreaseszMuscle tension decreasesRelaxation{Being able to relax results from applyingspecific skills.}}}}}}}

2 {Can be used for:zTreatment of specific physical conditions ( ,muscle tension, muscle spasms, neck and backpain, high blood pressure)zAs a focussed psychological strategy for thetreatment of anxiety, depression, insomnia andmild component of a behavioural of Relaxation {Progressive muscle Relaxation (PMR)zinvolves tensing and relaxing muscle groups{Visualisation or guided imageryzinvolves asking an individual to imagine, forexample, a peaceful scene{Focussed breathingzincreasing one's awareness and control of breathingpatterns.{Autogenicszlistening to positive self-statements andaffirmations, such as "my breathing is smooth andrhythmical and I am in control.}}}}}

3 {Ti Chi, Yoga, Meditation, Self-hypnosisProgressive muscle Relaxation (PMR){Developed by Jacobson in the early 1920s.{Anxiety manifests itself through tension in themuscles; if one can reduce the muscular response,then one can also reduce the experience of stressas well.{Tightening and relaxing various muscle groupsthroughout the body, slowly, one at a time.{ Relaxation sequence is:1. Tense the muscles2. Notice the feeling in all the muscles that are tight3. Relax4. Enjoy the pleasant feelingProgressive muscle Relaxation (PMR){Preparing for PMRzAssume a comfortable positionzLoosen any tight clothingzGive yourself permission to relaxzAssume a passive, detached attitudezMake sure not to over contractzAvoid areas of recent injuryGuided Imagery (visualisation){The central theme involves working withimaginary sensations, not just visual, butauditory, feelings, smell, and taste.}}}}}}}

4 {Our body responds to the image asthough it is the real thing.{The more sensory modalities included inthe experience, the stronger the breathing{Take a slow deep breath in for 3 secondsthrough your nose, and then let thatbreath out for 3 seconds through yourmouth.{Focus your mind on your breathing andrepeat the word "relax" quietly to yourselfevery time you breathe out.{Let your breathing flow smoothly.{Imagine the tension flowing out of yourbody each time you breathe out.{Continue this way for about 5 and disability{Disability is not necessarily a barrier to benefitingfrom Relaxation { Relaxation techniques in their traditional form mayrequire modificationMay be a challenge for somepeople with involvesabstract mental processes oran understanding of complexinternal states such as'tension' and ' Relaxation Tensing muscles may bedifficult for a person with aphysical requires people to tensetheir muscles and then relaxthemChallengesTechniqueResources designed specifically forpeople with disabilities {Easy Relaxation CDScope{Incorporates aspects offocussed breathing.}}}}}}}}}}}

5 Progressive musclerelaxation and autogenics.{Modifications to thesetechniques have beenmade to ensure they areappropriate for manyindividuals with physical,learning and multipledisabilities.{Physical demands of therelaxation are relativelysimple{Uses concrete and easy tofollow languageResources designed specifically forpeople with disabilities { Relaxation : AComprehensive Manualfor Adults, Children, andChildren with SpecialNeeds Dr. Joseph and Dr. JuneGroden{Presentszself- Relaxation techniquesdesigned for adults,zmethods for teachingrelaxation to adults andolder children,zprocedures for teachingrelaxation to people withdevelopmental designed specifically forpeople with disabilities { Relaxation Techniquesfor people with SpecialNeeds Breaking theBarriers Dr.}}}}}}

6 June Groden,Dr. Joseph R. Cautela, andDr. Gerald Groden{Video{Demonstrates the use ofspecial relaxationprocedures with childrenand adolescents who havedevelopmental designed specifically forpeople with disabilities {Anger Management: AnAnger ManagementTraining Package forIndividuals withDisabilities HrepsimeGulbenkoglu and NickHagiliassis{The training programconsists of 12 fully-scripted sessions dealingwith topics such asrecognising feelings ofanger, learning to relaxand think calmly, andbeing assertive andhandling problemscompetentlyGeneral Relaxation resources{Wide range of self help books, audiocassettes, CDs{Remember that different proceduresare often necessary to produce thesame effect in different people {Specialist book storesDeveloping your own resources{Develop a Relaxation script, or identify one that youcan use as a template.}}}}}}}}

7 {Web-based scripts:zPMR technique for children{ { imagery/visualisation{ { technique { { technique with audio{ { your own resources{Keep it simple:{Example of a simplified PMR exercise:zNow its time to start your Relaxation . Breathe comfortably,slow and easy. Let's relax your muscles. Relax your (face,shoulders, arms, stomach, legs). Notice how relaxed your(face, shoulders, arms, stomach, legs) feel/s. Relaxingyour muscles leaves you feeling so calm.{Example of a simplified visualisation exercise:zPicture yourself at the beach. The rays of the sun are softand warm. You hear the sounds of the seagulls and thewaves rolling gently.}}}}}}}}}}}}

8 The waves roll in and out, in and wave makes you feel more and more relaxed. Youcan see the sand, and the waves, and the blue sky. Youcan feel the cool salt air. You take deep breaths of the airand with each breath, you feel more and more feel safe and your own resources{Make your own Relaxation tape using one of thescripts from these WebPages{Add relaxing background music or sounds{Music should not be rhythmic{When recording, speak slowly into the tape,leaving long pauses between sentences{May need 2 or 3 attempts to perfect the timing{Positioning;zsome people ( , people whose physical disabilitymeans that limbs and trunk are stiffly extended)respond better to being supported to lie on a person has a predominance of flexion (bending)of the limbs or trunk, he or she may benefit frombeing placed on their backzSitting comfortably in a chair with a tray on whichto rest elbows or forearms may also sitting, feet should be flat on the floor, or onfootrests if using a in a beanbag can facilitate in overcoming difficultiesin learning to relax (Cautela & Groden){Fast, unexpected moves or touching can lead to astartle response and increase muscle tightness.}}}}}}}

9 Gentlebut firm touch should be used. If a part must be moved,it should be moved slowly, letting muscle tightnessrelax slowly.{Keep outside stimulation and distractors to a minimum.{Facilitator's voice should be kept soft when givinginstructions.{Gentle "shaking" of the limb while asking for "relax"canhelp reduce muscle tension{When using physical prompting techniques, decreasethis tension as the person relaxes.{Gentle stroking over the limb you wish to relax canhelp reduce in overcoming difficultiesin learning to relax (Cautela & Groden){Modelling procedures may be necessary.{At times, prerequisite skills may need to be taught.}}}}}}}

10 {Chose an environment that is conducive to Relaxation ;this will differ across individuals ( , individual rooms,areas with room dividers, in a corner of the room,outside).{Consult relevant professionals, such asphysiotherapists, psychologists, occupationaltherapists, or medical practitioners.{Remember - where unsure - seek adviceTechniques in overcoming difficultiesin learning to relax (Cautela & Groden){Make sure there is a clear purpose to usingrelaxation - don't use Relaxation just for the sakeof it or indiscriminately.{Make sure Relaxation is not 'overused' for anyparticular individual.{While Relaxation can be used as a strategy initself, be aware that some situations may call fora more coordinated and multi-modal and clinical issues in the use ofrelaxation with people with disabilities {Be aware that different people respond best todifferent types of Relaxation methods.}}}}}}}