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SELF- VERSUS EXPERIMENTER-ADMINISTERED

RELAXATION TRAINING

BY

Mark F. Eddy

A THESIS

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

MASTER OF ARTS

Department of Psychology

1980

ABSTRACT

SELF- VERSUS EXPERIMENTER-ADMINISTERED
RELAXATION TRAINING

BY
Mark F. Eddy

Bandura has emphasized the importance of self-
efficacy expectations in psychological treatment. The
present study sought to increase self-efficacy expectations
during relaxation training through the self-administration
of the relaxation procedures. It was predicted that
increased efficacy expectations would produce increased
relaxation skills. Forty-three subjects from introductory
psychology courses were assigned to one of three conditions:
(1) experimenter-administered relaxation training, (2) self-
administered relaxation training, or (3) a placebo group.
Training effectiveness was assessed by the state scale
of the State-Trait Anxiety Inventory, the subjects' self-
rating, and a behavioral checklist. No significant dif-
ferences between groups were found. A check on the success
of the efficacy manipulation revealed that self-
administering the procedures did not significantly increase
efficacy expectations. The absence of differential levels

of self-efficacy precluded conclusions concerning Bandura's

Mark F. Eddy

theory. Implications for clinical practice were discussed
along with suggestions for strengthening the experimental

procedures.

TABLE OF CONTENTS

LIST OF TABLES . . . . . . . . . . . . . . . . . .
LIST OF FIGURES . . . . . . . . . . . . . . . . .
INTRODUCTION . . . . . . . . . . . . . . . . . . .
History and Development . . . . . . . . . . .
Applications of Progressive Relaxation
Training 0 O O O O O O O O O O O O O O O O 0
Physiological Effects of Relaxation
Training 0 O O O O O O O O O O I O I O O O 0
Cognitive Aspects of Relaxation Training . . .
Self-administered Treatment . . . . . . . . .
METHOD 0 O O O O O O O O O O O O O O O O O 0 O O 0
Subjects . . . . . . . . . . . . . . . . . . .
Experimenters . . . . . . . . . . . . . . . .
Measures 0 O O O O O O O I I O O O O O I O O 0
Procedure . . . . . . . . . . . . . . . . . .
HYPOTHESES C O O O O O O O O O O O O O O O O O O 0
RESULTS AND DISCUSSION . . . . . . . . . . . . . .
APPENDICES
APPENDIX
A. Body Movements Checklist . . . . . . . . .
B. Self-Report Measure . . . . . . . . . . .

C. Relaxation Rating Checklist . . . . . . .

D. Introduction to Experimenter-administered
Relaxation . . . . . . . . . . . . . . .

E. Instructions for Experimenter-
administered Relaxation Training . . . .

F. Instructions for Self-administered
Relaxation: Sessions I and II . . . . .

ii

Page

iv

13
20

25
25

25
27

31

33

52
55

61

63

67

77

APPENDIX

G. Relaxation Progress Chart

H. Rationale: Cognitive Relaxation

I. Experimenter's Manual
REFERENCE NOTE . . . . . . .

REFERENCES . . . . . . . . .

iii

Page

80

82

86

95

96

10.

11.

LIST OF TABLES

Main Effects for Groups on

Two-tailed t-test for Mean
on RXRC 12 O O O O O O O

Two-tailed t-test for Mean
on RXRC34 . . . . . . .
Two-tailed t—test for Mean
on RXRC1234 . . . . . .

Two-tailed t-test for Mean
on SSR O O O O O O O O O

Two-tailed t—test for Mean
on SAS . . . . . . . . .

Chi-square Analysis of the
Group and Attribution .

All Measures

Change Scores

Change Scores

Change Scores

Change Scores

Change Scores

Independence of

t-test of Mean Scores in Sessions 1 and 2:

Cognitive Group . . . .

t-test of Mean Scores in Sessions 1 and 2:

Self-administered Group

C O O O O O I

E-test of Mean Scores in Sessions 1 and 2:
Experimenter-administered Group . . .

Correlations of BMC with Each of Five
Relaxation Measures for Sessions 1 and 2

iv

Page

34

35

35

35

36

36

38

42

42

43

50

LIST OF FIGURES
Figure

1. Mean Scores for Sessions 1 and 2
RXRClZ' RXRC34, and RXRC1234

2. Mean Scores for Sessions 1 and 2

3. Mean Scores for Sessions 1 and 2

on the

on the SSR

on the SAS

Page

47

48
48

INTRODUCTION

History and Development

 

Progressive relaxation training encompasses a group
of behavior change techniques loosely based on Edmund
Jacobson's research on tension and neurotic anxiety (Jacob-
son, 1938, 1957, 1964, 1970). Jacobson develOped a conceptu-
alization of neurotic behavior as being a form of tension
disorder, in which the individual experiences a failure to
relax. He states that

the neurotic individual has partially lost the natural

habit or ability to relax. Usually he does not know

what muscles are tense, cannot judge accurately whether

he is relaxed, does not clearly realize that he should

relax, and does not know how. These capacities must

be cultivated or re-acquired (1938, p. 31).
Recovery, then, from a neurotic condition would be charac-
terized by a return to the normal relaxed state, a diminu-
ation of "neuromuscular excitability." While several
indirect methods for achieving this relaxation had already
been develOped, i.e., hypnosis and psychoanalysis, Jacob-
son's interest was in a more direct, physiologically-based
method for removing tension. He concluded that the tension
which characterizes neurosis is the result of the shortening
of muscle fibers, which leads to the subjective experience

of anxiety. Therefore, relaxation could be reinstated by

l

simply inducing the physiologically opposite state, the
absence of muscular contraction, since "to be excited and
to be fully relaxed are physiological opposites. Both
states cannot exist in the same locality at the same time"
(Jacobson, 1938, p. xv).

Accordingly, the method which Jacobson developed
for achieving this relaxation had as its essential feature
the elimination of all muscular contractions, even the
"residual tensions" which remain at the point at which
individuals would normally consider themselves relaxed.

It was necessary to develop in his clients a refined aware-
ness of their muscular activity, an ability to detect even
a slight degree of muscular contraction. This awareness
and localization of the sensations accompanying muscular
contractions allowed the client to attempt the elimination
of the various sources of tension, and was termed by
Jacobson the "muscle sense." Since Jacobson's technique
for identifying and removing these tensions differs in many
respects from more current methods, it will be briefly
described.

The development of the muscle sense is accomplished
by accentuating the tension sensations in each of many
small groups of muscles throughout the body. The client
is asked to steadily contract a particular muscle group
as the therapist calls attention to the accompanying sensa-
tions of tension. Passive resistance against a muscle may

be provided as a method of increasing tension sensations;

for example, the therapist might block the upward movement
of the hand in order to increase tension in the biceps.
When the sensation is clearly perceived the client is
informed that tension is "his/her doing," an active response,
and that relaxation is the Opposite of that; not doing any—
thing. The client "begins to realize that progressive
relaxation is not subjectively a positive something dif—
ferent from contraction, but simply a negative" (Jacobson,
1938, p. 49). Therefore, after a muscle has been tensed
and the accompanying sensations recognized and localized,
the client is simply asked to do the Opposite, to not tense
the muscle. Once this process has begun the therapist
allows the client to continue relaxing for 10-15 minutes on
his/her own, attempting to become more deeply relaxed.
Three specific features of Jacobson's technique are

particularly noteworthy in their deviation from current
modifications and merit special attention. (1) Jacobson's
method is extremely time consuming. Each training session
concentrates on the addition of only one or a few muscle
groups, thus protracting training to 100-200 sessions.
In addition, lengthy home practice sessions, lasting 1-2
hours, are required each day. (2) The tensing procedures
are not seen as a direct aid in the attainment of relaxa-
tion. Jacobson states instead that

contraction is performed as a rule in order to acquaint

the patient with the experience of tenseness——in order

that he may know what not to do. It is therefore not
well to have him contract during practice when alone:

he should relax from the outset and relax only (1938,
pp. 397-398).

(3) Jacobson also places an emphasis on obtaining "mental
relaxation," or the absence of mental activity, as a direct
result of muscular contraction. Mental activity is seen as
closely linked to minor contractions of the eye muscles and
vocal chords and, accordingly, relaxation of these muscles
is expected to result in the absence of the accompanying
mental activity.

Other researchers and practitioners have since
extended and modified Jacobson's methods. Perhaps most
notable among these is Joseph Wolpe (Wolpe, 1958; Wolpe &
Lazarus, 1966) who modified the original method and inte-
grated it into a systematic psychotherapeutic program.
Wolpe's early work with cats led him to conclude that a
conditioned fear reaction could be eliminated by evoking
a response incompatible with anxiety in the presence of
the fear producing stimulus. With cats, a convenient
incompatible response was the positive sensation of eating
when hungry; however with humans this was neither conveni-
ent or practical as a competing response. Wolpe then
located Jacobson's work and found in progressive relaxation
an appr0priate incompatible response for use with humans,
except that the length of training was prohibitive. As a
result, Wolpe followed Jacobson's procedure in all essen-
tial respects except that the length of training was

reduced to 6-7 sessions with home practice and training

sessions reduced to 30 and 20 minutes
might also be noted that there appears to be a contradic-
tion in Wolpe's position concerning the function of the
muscle tensing procedures. On some occasions Wolpe seems
to concur with Jacobson that tensing serves mainly as an
introduction to a muscle group rather than as part of the
relaxation process itself (Wolpe & Lazarus, 1966). However,
the contradiction lies in a transcript of relaxation
instructions contained in the same work. In this tran-
script relaxation is attained through repetitions of brief
tension—relaxation cycles more in accordance with Paul
(1966; see below) than Jacobson. It is unclear as to how
the two are to be reconciled.

Of particular importance also is the work of Paul
(1966) and Bernstein and Borkovec (1973). As indicated
above, Paul's technique involves a series of brief tension-
relaxation cycles in each muscle group, with progress to
the next group contingent on the degree of relaxation in
the current group matching that of the previous one. In
this way Paul further abbreviated Wolpe's method; all
muscle groups are now relaxed in every session as opposed
to progressively adding more muscle groups across sessions.
Bernstein and Borkovec (1973) altered Paul's methods some—
what, particularly in terms of muscle groupings, but
followed his technique closely enough to be viewed as
simply a variation of Paul. Their major contribution was a

detailed manual for the use of relaxation training.

In addition to the brevity of training, both of
these newer methods differ from Jacobson in the two other
major respects outlined earlier. First, neither of them
mention the mental relaxation which was supposed to follow
from muscular relaxation; in fact, Bernstein and Borkovec
separate mental from physical relaxation and offer methods
for achieving the former when it proves necessary. Second,
neither of them view the muscle tensing procedures as
simply a method of attaining a muscle sense, but instead
view it as an important part of the muscle relaxation pro-
cess itself. By initially requiring tensing of each muscle
group, the depth of relaxation is thought to increase:

"if the muscles are first tensed, they will relax more
deeply when they are released" (Paul, 1966, p. 118). This
is in sharp contrast to Jacobson's stand on the apprOpri-
ate use of muscle tensing.

Applications of Progressive
Relaxation Training

 

 

The major focus of the present study is the effec—
tiveness of relaxation training as a treatment in itself,
as determined by the client's skill in self-producing the
relaxed state. However, much of the research concerning
relaxation has focused on the application of this skill,
once it has been acquired, to a variety of medical and
psychological disorders. Such studies provide indirect
evidence of the success of the relaxation training proced-

ures and will be briefly reviewed.

As a physician, Jacobson often stressed the medical
applications of his work, especially the use of relaxation
as a scientifically-based method of obtaining the "rest"
often prescribed to patients. Many case studies are pre-
sented of the application of relaxation to a variety of
medical problems which may be amenable to relaxation train-
ing. Among the latter are exhaustion, toxic goiter,
"nervousness" accompanying a variety of diseases, colonic
spasm, peptic ulcer, chronic pulmonary tuberculosis, and
general use for pre- and post-operative care. Of course,
Jacobson also realized the applications of his method to
various psychological problems and suggested its use as
treatment for phobias, compulsions, and the inability to
concentrate.

More recently, other researchers have also applied
relaxation training as a treatment for medical and psycho—
logical ailments. Concerning medical or medical/psycho-
logical problems, relaxation has been used in the treatment
of insomnia (Geer & Katkin, 1966; Borkovec & Fowles, 1973;
Pendleton & Tasto, 1976), stomach pain and tranquilizer use
in an ulcer patient (Bernstein & Borkovec, 1973), high
blood pressure (Deabler, Fidel & Dilenkoffer, 1973; Shoe-
maker & Tasto, 1975), tension headaches (Lutker, 1971;
Tatso & Hinkle, 1973), symptoms of Huntington's chorea
(MacPherson, 1967), asthma (Rathus, 1973), and chronic back
pain (Scheiderer & Bernstein, 1976). Concerning more

purely psychological problems, relaxation has been applied

toward the treatment of debilitating anxiety in psycho-
logical or psychiatric interviews (Zeisset, 1968; Bernstein
& Borkovec, 1973), speech anxiety (Russel & Wise, 1976),
and test anxiety (Chang-Liang & Denny, 1976). In general,
Bernstein and Borkovec (1973) suggest it may be used for
the treatment of any high level tension response which
interferes with the performance of other behaviors. It
should also be noted that relaxation training may be applied
to a host of problems as part of other treatment packages,
most notably systematic desensitization, but also including
other treatments such as covert sensitization (Cautela,

1966) and induced anxiety (Sipprelle, 1967; Ascough, 1972).

Physiological Effects of Relaxation Training

The results of studies just cited would seem to
indicate that relaxation training is indeed an effective
treatment for a variety of ailments. However, by what
mechanisms does relaxation achieve these results? In most
instances some reference to the physiological effects of
relaxation must be made in order to answer this question,
particularly in the case of more physiologically-based ail-
ments such as high blood pressure. Accordingly, the
physiological effects of progressive relaxation training
will be briefly reviewed.

From its inception there has been interest in the
physiological underpinnings of relaxation training. Jacob-

son's strong research orientation led him to undertake

several investigations of this nature (see Jacobson, 1938).
Included among his findings were that relaxation training
resulted in decreased muscle tension in comparison to un-
treated controls (1934), relaxation reduced blood pressure
(1939) with an accompanying reduction in heart rate (1940),
and subjects who simply took daily rests failed to produce
low levels of muscular tension (1942). However, these and
other conclusions drawn by Jacobson have since been called
into question. For example, Mathews (1971) concludes that
Jacobson's results
are of little scientific value due to his neglect of
statistical procedures and of appr0priate control
groups. None of the controls used had regular contact
with the therapist or the testing environment, as did
the trained patients. It is quite possible to account
for all the reported results in terms of either adap-
tation effects or the spontaneous remission of symp-
toms over time (pp. 78-79).

Mathews' conclusions have been partially supported
by the difficulty of more recent researchers to consistently
verify specific claims concerning physiological effects of
relaxation training. At the extreme, some have even sup-
ported the position that progressive relaxation may have no
autonomic effects whatsoever. Greenwood and Benson (1977),
in a paper supporting a more meditative approach to relaxa-
tion, conclude that

the unclear function [in systematic desensitization] of
abbreviated training in progressive relaxation may be

a result of the ineffectiveness of this relaxation
method as a competitive response to anxiety. Results

from initial studies of abbreviated training in pro-
gressive relaxation have been inconsistent and generally

10

do not support the contention that muscular relaxation,
as produced by progressive relaxation, reduces autonomic
nervous system activity (p. 338).

Although such a conclusion may be somewhat pre-
mature, a review of the literature would seem to concur with
Mathews (1971) that the results of physiological research
on relaxation training have been equivocal. In an early
study, Grossberg (cited by Mathews & Gelder, 1969) compared
three methods of attaining relaxation; listening to tape-
recorded relaxation instructions, listening to music, and
simply making a conscious effort to relax (self-relaxation).
Monitoring forehead and forearm EMG, skin resistance, and
heart rate as physiological indices of relaxation, Grossberg
found no significant differences between groups. Similarly,
Benjamin, Marks, and Huson (1972) also found no significant
differences between relaxation and control groups in heart
rate; however, they did report significant differences in
skin conductance fluctuations. Paul (1969), in an often-
cited study, achieved more positive results; he found that
relaxation produced a significantly greater reduction in
heart rate, muscle tension, and respiratory rate than did
self-relaxation controls, although there were no significant
results regarding skin conductance. In a departure from the
typical use of normal subjects, Mathews and Gelder (1969)
report two studies involving psychiatric patients. In the
first study, 10 patients served as subjects, five receiving
relaxation training and five receiving sessions which did

not include relaxation. No significant differences between

11

groups were found on forearm blood flow, forearm EMG, or
skin conductance. A second similar study also revealed no
significant differences between groups on heart rate,
respiration rate, and EMG activity, although significant
differences did occur in the reduction of skin conductance.

Other studies have supported the effectiveness of
relaxation training in the reduction of physiological arousal,
but have failed to establish its superiority over control
procedures. For example, Lehrer (1972) in a desensitiza-
tion analogue study, reported significant reductions in
heart rate, skin potential levels, skeletal activity, EMG,
and frequency of skin potential responses, as a result of
relaxation training. However, this group differed signifi-
cantly from a "no instructions" control group only on heart
rate. Similarly, Israel and Beiman (1977) found significant
reductions in heart rate and integrated muscle tension
recorded from the frontalis muscle as a result of relaxation,
yet found no significant differences on these measures in
comparison to a self-relaxation control. Also, in a related
study, Janda and Cash (1976) found significant reductions
in forehead EMG and heart rate although they failed to
include a control group in their design.

It is apparent, then, that considerable confusion
still remains concerning the physiological effects of relaxa-
tion training. Perhaps this is best highlighted by a sum—
mary of the previously cited studies concerning one physio-

logical measure: heart rate. Grossberg (cited by Mathews

12

& Gelder, 1969), Mathews and Gelder (1969), Benjamin, Marks
and Huson (1972), and Israel and Beiman (1972) all concur
that relaxation training produces no significant reductions
in heart rate in comparison to controls. Contrasting this
are the results of Paul (1969) and Lehrer (1972) who did
find significant reduction in heart rate in comparison to
controls. Further confusion is added by Israel and Beiman
(1977) who report significant pre-post reductions in heart
rate without accompanying differences from control groups.
Such differences as these are most likely accounted for by
variation in the relaxation procedures utilized. Training
procedures may differ on such variables as length of total
training, length of tension-release cycles, the role of
suggestion, and the use of "live" versus tape-recorded
relaxation instructions. It seems unlikely that training
procedures which vary widely on these and other variables
will produce similar outcomes.

Also relevant to the discussion of the physiological
correlates of relaxation is the relationship between objec-
tive and subjective relaxation. It should be noted that it
does not follow from a failure to produce physiological,
objective relaxation, that one has also failed to produce
a subjective state of relaxation in the client. That is,
the cognitive and physiological realms are not in perfect
correspondence. For example, Janda and Cash (1976) failed
to find any significant correlations between self-reports

and physiological measures of the degree of relaxation.

13

Paul and Trimble (1970), in a comparison of live and
recorded relaxation instructions, found the two modes to be
equally effective in terms of self-report but found live
instructions superior to taped in physiological outcome.
Similarly, Paul (1969) found relaxation and hypnosis to be
comparable in terms of self-report, although physiologically,
relaxation was superior. Thus, the inconclusive outcomes

of physiological studies of relaxation should not be taken
to indicate that the subjects did not experience a subjec-
tive decrease in arousal.

Returning to the question posed earlier concerning
the mechanism through which relaxation training affects
improvement in medical and psychological disorders, the
studies just reviewed point to the conclusion that, although
the physiological effects of relaxation may be important,
other factors which do not rely on positing a specific
physiological effect of training must also be considered.
One such factor, as indicated above, is the cognitive

effect of training in progressive relaxation.

Cognitive Aspects of Relaxation Training

 

Relaxation training, like other forms of behavioral
or psychological therapy, is often used to effect a specific
form of behavior change in the client. One approach, then,
to uncovering cognitive aspects of relaxation training is
to first discuss cognitive aspects of behavior change in

general and then apply it to the specific case. Although

14

there are many theories of behavior change, one which ade-
quately accounts for the cognitive aspects of change is
Bandura's (1977) self-efficacy theory.

Bandura points out that there have been two diver-
gent trends in the field of behavior change. On the one
hand, behavior has been viewed as acquired and regulated by
cognitive processes; on the other hand, the most effective
behavior change procedures have been based on performance,
not cognition. Bandura attempts to reconcile these contra—
dictory trends by positing a behavior change mechanism in
which cognitive events are created and altered by the per-
ception of one's own behavior, i.e., by one's performance.
Bandura presents the viewpoint that

changes achieved by different [psychotherapeutic]

methods derive from a common cognitive mechanism.

The apparent divergence of theory and practice can

be reconciled by postulating that cognitive processes

mediate change, but that cognitive events are induced

and altered most readily by experience of mastery

arising from effective performance (p. 191).
In this way the effectiveness of the performance-based
therapies can be viewed as the result of effecting apprOpri-
ate performance, which leads to cognitions of mastery or
self-efficacy, which in turn results in behavior change.
The creation or strengthening of these expectations of per-
sonal efficacy, then, plays a central role as the mechanism
through which behavior change occurs.

Care should be taken to distinguish the concept of

self-efficacy from two related concepts: response-outcome

expectancies and internal locus of control (Bandura, 1977).

15

Concerning the former, a response-outcome expectancy is the
expectation that a given response will lead to a specific
outcome. Self—efficacy, however, refers to "the conviction
that one can successfully execute the behavior required to
produce the outcomes" (Bandura, 1977, p. 193). That is,
one may have the correct expectation that a specific behav-
ior will result in the desired outcome, but that is distinct
from the conviction that one can successfully execute that
behavior. Similarly, concerning internal locus of control,
an individual with an accurate internal locus of control
may realize that if a behavior is to occur he/she is the one
responsible for its occurrence, but again, this is distinct
from being certain that one can perform the behavior.
Bandura goes on to suggest four sources of informa-
tion concerning one's self-efficacy and their accompanying
modes of induction.

(1) Performance accomplishments. This is a partic-

 

ularly influential source of efficacy information in that

it is based on personal mastery experiences. These success-
ful performances raise mastery expectations which, although
they may arise from specific behavioral performances, are
readily generalizable to a variety of situations. Modes of
induction include participant modeling, performance desensi-
tization, and self-instructed performance.

(2) Vicarious experiences. In contrast to the per-

 

sonal experience of mastery mentioned above, self-efficacy

expectations can also be derived from observing others'

16

successful performance, the implication being that "if
others can do it, so can I." This is a less dependable
source of information than the first since it relies on
social comparison rather than personal accomplishment;
accordingly expectations derived from vicarious experience
alone are likely to be weaker than those derived from per-
formance accomplishments. Induction may occur via live or
symbolic modeling.

(3) Verbal persuasion. This is a widely used method

 

due to its ease of application and ready availability.
Individuals may be persuaded that they can perform success-
fully even if they have failed to do so in the past. This
source of information is also likely to produce compara-
tively weak expectations, since the expectations may have
no experiential base. Modes of induction include sugges-
tion, interpretive treatments, and self-instruction.

(4) Emotional arousal. Emotional arousal generated

 

by stressful situations can contain information concerning
efficacy in that, due to the detrimental effects of high
arousal on performance, one is more likely to expect suc-
cess when not aroused. Therefore, if one experiences high
levels of emotional arousal in the face of stressful

events, one is likely to conclude that he/she is lacking

in efficacious behaviors and will not succeed. On the other
hand, if one experiences low levels of arousal one is

likely to conclude that he/she possesses the apprOpriate

efficacious behaviors and will succeed. This latter

17

conclusion will result in self-efficacy expectations. Modes
of induction include relaxation training, biofeedback, and
symbolic desensitization.

However, regardless of source, the degree to which
information concerning self-efficacy actually increases
efficacy expectations depends on the manner in which it is
cognitively processed (Bandura, 1977). For example, con-
sider the impact of efficacy information derived from suc-
cessful performance; it can either be interpreted and
accepted as such, and thus increase efficacy expectations,
or it can be attenuated in any of several ways. For
instance, a discrimination process may occur in which one
believes that one's successful performance was situation
specific; a different situation may have resulted in an
inadequate performance. A second possibility is that one
may attribute the cause of one's successful behavior to an
external source, such as the therapist, and conclude that
it was not one's own actions, but the therapist's, which
produced the successful behavior.

These considerations suggest the relevance of a
related area of study from social-psychological research.
In an article discussing the applicability of social-
psychological principles to the field of behavior change,
Kopel and Arkowitz (1975) discuss research findings concern-
‘ ing attribution. Attribution theory centers around the
manner in which people interpret the behavior of others,

particularly focusing on perceived causality in

18

interpersonal perception. This same kind of analysis, how-
ever, can be applied to the individual attempting to explain
his/her own behavior. The authors point out that
in general, the research in this area has demonstrated
that perceived causality (causal attribution) may play
an important role in the interpretation of our behavior.
Thus, perceiving a change in one's own behavior as pri-
marily caused by oneself (self-attribution) appears to
be associated with different subsequent behavioral
effects compared to instances where the behavior change
is explained by the influence of extrinsic controlling
factors (external attribution) (p. 179).
For example, Storms and Nisbett (1970) conducted a study in
which insomnia was conceptualized as the result of labeling
bedtime autonomic arousal as anxiety or sleeplessness. If
subjects were instead led to attribute this arousal to a
pill ingested prior to bedtime, they reported a decreased
latency in sleep onset, presumably because they did not
interpret their arousal as anxiety. In a related study of
insomnia, Davison, Tsujimoto, and Glaros (1973) gave sub-
jects identical doses of chloral hydrate along with various
self-management treatments. One group (self-attribution)
was led to believe that the drug dosage was insufficient to
account for any changes in sleep onset latency. The other
group (external attribution) was led to believe they had
received a strong, optimal dosage of the drug. In the
post-treatment period in which no drug was administered,
the self-attribution group maintained therapeutic gains to

a greater extent than the external attribution group.

Cognitive factors, then, in the form of attributions as

19

well as efficacy expectations apparently play an important
role in behavior and behavior change.

Bandura's line of reasoning concerning the import-
ance of efficacy expectations in behavior change in general
can now be applied to relaxation training in particular.

It seems apparent from the studies cited earlier that
relaxation training has some kind of physiological effect,
although it is not clear what the specific autonomic
changes may be or if they are any greater than those cre-
ated by control procedures. However, it may be the case
that the specificity or comparative size of the effect is
not as important as the cognitive processes which accompany
it. The effective performance (some form of diminuation of
physiological arousal) results in positive information con-
cerning self-efficacy; that is, one learns to expect that
in anxiety-laden situations one will have the c0ping skill
necessary to overcome or allay the anxiety. This may then
lead to behavior change, such as approaching previously
avoided stimuli, reducing anxiety responses which are due
to fears of becoming anxious, or may even simply serve as
reinforcement for the continuation of relaxation training.
This process clearly fits into Bandura's model concerning
self-efficacy; a performance-based therapy leads to cog—
nitions of self-efficacy which in turn leads to behavior
change. With regard to Bandura's sources of efficacy infor-
mation, relaxation training could be included in the most

influential group, performance accomplishments, since it

20

is based on personal mastery experiences. In addition, as
Bandura points out, it would also provide information in
the form of emotional arousal in the sense that one is less
likely to expect effective performance when highly aroused,
and relaxation training provides a readily available tool

for overcoming that arousal.

Self-administered Treatment

 

This application of self-efficacy theory would sug-
gest that the effectiveness of relaxation training, both as
a treatment in itself and in its applications to other dis-
orders, could be increased by raising the client's expecta-
tions of self-efficacy. One method of raising these expec-
tations would be to design the training program in such a
way as to place the responsibility for the behavior change
procedures on the client, rather than the therapist. In
this way, the usual efficacy expectations which occur as a
result of successful performance would be augmented by the
realization that "I did it myself"; that the client, not
the therapist, is the one responsible for the efficacious
behavior. In attribution terms, designing the training
program in such a way as to maximize the client's oppor-
tunity to attribute his/her ability to relax to his/her own
efforts, rather than the therapist's, will result in
increased training effectiveness. Bandura (1977) acknowl-
edged the role of self-instruction in creating efficacy

expectations by including it as a mode of induction for two

21

of his four sources of efficacy information: performance
accomplishments and verbal persuasion.

Much of Jacobson's work also seems to point to
forms of relaxation training which place the responsibility
for effective learning on the client (see especially Jacob-
son, 1957, 1964). Jacobson persistently refers to relaxa-
tion training as an educative process, one which will
"require the doctor to don the mantle of the educator"
(1964, p. 2). This emphasis on relaxation training as
"nervous re-education" places much of the responsibility
for change on the client since

no teacher can assume responsibility for what his pupil
will do in carrying out a skill according to his indi-
vidual learning powers. Sometimes I say to my patient,
"You will be on your own. I can show you how to drive
a car, but the responsibility when you drive will be on
your shoulders! If you ask me for reassurance that you
will learn to relax, my reply is that your request is
out of place. You would not demand that the dean of
any school guarantee that you will become a good pupil.
There, as here, the responsibility should and must be
yours" (Jacobson, 1964, p. 50).
This orientation led to several developments in Jacobson's
work, including books or manuals intended for at least some
degree of self-instruction (1957, 1964) as well as a new
form of instruction in relaxation termed "self-operations
control" through which "the individual learns to run his
organism according to what he believes are its best inter-
ests. Thus he becomes his own engineer . . ." (1964, pp.
28-29).

Other researchers have developed relaxation programs

which are more truly self-administered; the role of the

22

therapist is greatly de-emphasized or perhaps even omitted.
These self-management approaches have clients train them-
selves in relaxation rather than be trained by the thera-
pist. Unfortunately, empirical investigations of such self-
administered programs are rare, being limited mainly to
studies of live versus tape-recorded instructions (Paul &
Trimble, 1970; Riddick & Meyer, 1973). However, more com-
prehensive studies have been made of a related procedure
which includes self-administered relaxation as one compon-
ent: self-administered systematic desensitization. Several
of these studies will be briefly reviewed.

Self-administered systematic desensitization has
been successfully applied to both client and subject popu-
lations. Concerning the former, one of the early attempts
at self-administration was made by Migler and Wolpe (1967)
in the treatment of a phobic client via a specially modified
tape recorder. The client conducted the treatment sessions
at home, successfully completing his hierarchy in seven
sessions. (It should be noted that he had received several
sessions of preliminary recorded relaxation training.)

Other case studies involving self-administered desensitiza-
tion include treatment of a female shark phobic (Krop &
Krause, 1976) and an 18-year old male with interpersonal and
sexual anxieties (Arkowitz, 1974). Evans and Kellam (1973)
conducted an experimental study using therapy clients as
subjects and found tape-recorded desensitization to be as

effective as standard therapist-administered

23

desensitization on clients' self-report and a psychiatrist's
rating. Also Baker and Cohen (1973), in a study of clients
volunteering for treatment in response to a newspaper ad,
found that although there were no significant physiological
changes, self-treated and therapist-treated clients both
improved significantly on self-report measures and did not
differ significantly from each other. Similarly, Marshall,
Presse, and Andrews (1976) found self-administered desensi-
tization to be effective in terms of self-report, but not
in terms of a behavior rating scale. It should also be
noted, however, that Branham and Katahn (1974) failed to
achieve success with phobic clients described as "not ideal
candidates for desensitization therapy."

Concerning normal subject populations rather than
client populations, similar results have been achieved.
Kahn.and Baker (1968) and two studies by Phillips, Johnson,
and Geyer (1972) report no differences between self-
administration and therapist-administration on the basis
of self-report. Cotler (1970), though lacking a therapist—
administered group, found that a self-administered group
improved significantly more than controls on both behavioral
and self-report measures.

It should be kept in mind, however, that the rele-
vance of these studies to the effectiveness of self-
administered relaxation training as a treatment in itself
must be tempered by research indicating that relaxation is

not necessarily an essential component of desensitization

24

(see Yates, 1975). Reliable conclusions regarding self-
administered relaxation can only be drawn from research
designed specifically for that purpose. The present study
is an attempt to fill this need by providing a comparison
of self- and experimenter-administered relaxation training.
Specifically, it is being postulated that as a result of
heightened efficacy expectations, subjects who self-
administer the relaxation procedures will be more success-
ful in their ability to produce the relaxed state than sub-
jects in the experimenter-administered condition. Both
self- and other—report measures will be used as indicators

of the degree of relaxation.

METHOD

Subjects

Forty-three college students from introductory
psychology classes served as subjects. Subjects partici-
pated on a voluntary basis and received points toward
their course grade for their participation. Subjects were

randomly assigned to groups and experimenters.

Experimenters

 

All relaxation training and evaluation was con-
ducted by six undergraduate experimenters; three male and
three female. Experimenters received instruction and prac-
tice in administering the treatment procedures and two per-
formance measures of relaxation (Body Movements Checklist

and Relaxation Rating Checklist).

Measures
The Body Movements Checklist (BMC) was employed
to assess the subjects' initial activity level immediately
preceding relaxation training. This checklist was designed
specifically for use in this study and allows an observer
to record the presence or absence of movement in each of

four general sections of the body: head and neck, arms,

25

26

trunk, and legs. Interrater reliability of .99 was
obtained for this measure. A copy of the BMC is included
in Appendix A.
Three different types of measures were used to
assess the subject's degree of relaxation following the
relaxation training period. A copy of each instrument is
included in the appendices.
(1) Objective self-report. The State-Trait Anxiety
Inventory (Speilberger, Gorsuch & Lushene, 1970) was used
as an objective self-report of the subject's degree of
relaxation. The inventory separates anxiety into two dis-
tinct concepts: first, "state anxiety," defined as
a transitory emotional state or condition of the human
organism that is characterized by subjective, consciously
perceived feelings of tension and apprehension, and
heightened autonomic nervous system activity (p. 3),

and secondly, "trait anxiety," conceptualized as
relatively stable individual differences in anxiety
proneness, that is, to differences between people in
the tendency to respond to situations perceived as
threatening with elevations in [state anxiety] intensity
(p. 3).

Since the present study is concerned with short
term anxiety reduction, only the state anxiety scale (SAS)
was used. The scale consists of 20 items regarding the
subject's current emotional experience, such as, "I feel
calm," or "I am jittery." Subjects are asked to rate the
degree to which these statements describe their present

feelings on a four point scale ranging from "not at all"

to ”very much so." The authors report that the scale has a

27

high degree of internal consistency (ranging from .83 to
.92) and low test-retest reliability, as would be expected
considering the transitory nature of the concept being
measured. In addition, the validity of the SAS has been
established through demonstrations of its ability to

reflect differences between various stressful and nonstress-
ful conditions (see Speilberger, Gorsuch & Lushene, 1970).

(2) Subjective Self-Report (SSR). Goldfried and

 

Davison (1976) describe a simple technique in which the
subject is asked to rate his/her degree of relaxation on a
scale of 1-100, where 1 represents a state of absolute calm
and 100 represents a state of extreme anxiety. This measure
was included as item 21 of the SAS.

(3) Relaxation Rating Checklist (RXRC). The RXRC

 

(Pretzer, Note 1) was developed to enable an observer to
objectively rate a subject's degree of relaxation during
relaxation training. The form consists of 10 items con-
cerning the subject's behaviors and body postures (such as
the position of the head) and allows the rater to simply
check the response which most accurately describes the sub-
ject. Interrater reliability of .92 was obtained for the

RXRC.

Procedure

 

The subject is greeted and asked to sign a form
giving consent to participate in the experiment. Each sub-

ject is then taken individually to an experiment room and

28

is seated in a reclining chair facing a one-way mirror.
The experimenter provides the following instructions:
We are conducting an investigation of the ways in
which people can achieve deep relaxation. Before we
begin the relaxation session itself, I'd like you to
take just a couple minutes to become accustomed to being
in this room. Go ahead and push back the recliner to
a position in which you are comfortable. OK, I'm going
to leave the room now and will return shortly to con-
tinue the experiment. Please notice that during this
experiment we will both be observed through this one-
way mirror by another experimenter.
The experimenter leaves the room and the rater positioned
behind the one-way mirror completes the BMC using four 15-
second time sample observations; that is, for a period of
two minutes there will be alternating 15-second time inter-
vals, one for observing and one for recording observations.
Following this, the experimenter is informed concerning
which experimental group the subject is in, returns to the
room, and the subject receives one of three treatment con-

ditions.

(l) Experimenter-administered relaxation. The

 

experimenter states that during the remainder of the session
the subject will be learning and practicing a method of
becoming relaxed. The first seven minutes are devoted to
the presentation of the introduction and rationale of
relaxation training followed by approximately 25 minutes of
relaxation training. Both segments will be read from a
script included in Appendices D and E. At two points dur-
ing the relaxation session, once toward the middle and once

toward the end, the rater completes the RXRC on the subject

29

(again using two lS-second time sample observations), after
which the subject him/herself is asked to complete the SAS
and SSR. At the conclusion of the session the subject is
loaned a relaxation training cassette tape and home prac-
tice is emphasized. To increase the salience of the
experimenter's role in the training and to further emphasize
the importance of home practice, the subject is also
informed that on the third or fourth day following the ses-
sion he/she will receive a 5-10 minute telephone progress
check from the experimenter.

(2) Self-administered relaxation. The experimenter

 

informs the subjects individually that during the remainder
of the session he/she will be teaching him/herself a method
of becoming relaxed. Each subject is given a set of
written instructions containing directions on how to pro-
ceed (see Appendix F). Briefly, the subject is directed

to a closed container located in the experiment room con-
taining the appropriate tapes, tape recorder, and forms.
The subject then receives the same introduction and training
as the experimenter-administered group, except that all
directions and information are presented in written or
recorded form. The subjects in this group are also pro—
vided a home practice tape, differing from the tape used by
the first group in that it includes instructions for sub-
jects to rate their degree of relaxation (as in the SSR)

at the end of each session and record it on a graphing form

provided with the tape (see Appendix G). Subjects are also

30

informed that these anonymous graphs will be collected at
the close of the following week's session. The purpose of
this manipulation is to increase the salience of the sub-
ject's personal control and accomplishment and to further
emphasize the importance of home practice; subjects in
this group will not receive a telephone contact from the
experimenter.

(3) Control group. The experimenter introduces and

 

explains a placebo relaxation procedure in which the sub-
ject is asked to concentrate on pleasant thoughts and
images and to use thought-stopping to block out all others
(see Appendix H). This training period lasts 25 minutes
and twice during training the rater completes the RXRC on
the subject (as with the other two groups), after which
the subject is asked to complete the SAS and SSR. The sub-
ject is then asked to practice this procedure for 25 minutes
each day at home and to keep a record of the degree of
relaxation obtained (as in the SSR): he/she is also informed
that these anonymous records will be collected the follow—
ing week. No tapes, forms, or telephone contacts are pro-
vided.

Each subject is instructed to return one week from
the initial appointment. At this time each group of sub-
jects will receive the same adaptation period, relaxation

period, and measures as before.

HYPOTHESES

The following predictions were made.

(1) The self-administered group will have a greater
pre-post increase in ability to relax than the experimenter-
administered group. Specifically, the self-administered
group will have a greater pre-post change in the predicted
direction on the RXRC, SAS, and SSR than the experimenter-
administered group.

(2) The two experimental groups will each present
a greater pre-post increase in ability to relax than the
control group. Specifically, the two experimental groups
will each have a greater pre-post change in the predicted
direction on the RXRC, SAS, and SSR than the control group.

(3) The initial activity level during the adapta-
tion period will predict the degree of relaxation obtained
during the relaxation period for all three groups. Spe-
cifically, the scores on the BMC will correlate with the
scores on the RXRC, SAS, and SSR in such a way as to indi-
cate a negative correlation between initial activity level
and success of relaxation. That is, higher levels of
initial activity (as indicated by the BMC) will be corre-

lated with less successful relaxation and lower levels of

31

32

initial activity will be correlated with more successful

relaxation.

RESULTS AND DISCUSSION

A total of 43 subjects completed the experiment,
15 each in the experimenter- and self-administered groups,
and 13 in the cognitive group. One subject failed to
return for the second session, resulting in an attrition
rate of 2%.

The statistical analyses were based on data from
six measures: the average of the two administrations of
the RXRC taken toward the middle of each session
(RXRClz), the average of the two administrations of the
RXRC taken toward the end of each session (RXRC34),

the average of all four administrations of the RXRC

(RXRC and the single administrations of the SSR, SAS

1234)'
and BMC taken each session. Change scores for each subject
were computed by subtracting the score obtained in the
second session from the score obtained in the first ses-
sion on all measures except the BMC. These change scores
were used as indices of the degree of success in achieving
relaxation. The relative size of the change scores for
each of the three groups was compared through one-way anal-

yses of variance (Table 1). No main effect for group

emerged on any of the five measures.

33

34

Table 1

Main Effects for Groups on All Measures

 

 

de dfbet Mss MSbet F
RXRC12 39 2 18.00 36.25 2.01
RXRC34 39 2 8.09 .22 .03
RXRC1234 4O 2 4.71 10.04 2.13
SSR 40 2 224.95 281.04 1.25
SAS 40 2 33.11 60.83 1.84

 

Individual comparisons between groups were also
performed for each measure (Tables 2-6). Although no sig-
nificant differences in mean change scores were found in any
of these comparisons, three trends were identified. On
the RXRC12 and RXRC1234, the difference between the cogni-
tive and self-administered groups approached significance
(t(25) = 1.80, p < .10; t(26) = 2.04, p < .10), but not in
the predicted direction. On the SAS, the difference between
the cognitive and experimenter-administered groups also
approached significance (t(26) = 1.70, p = .10) in favor of
the experimenter-administered group, as predicted.

As a whole, these results indicate that neither of
the hypotheses concerning differential effectiveness of the
three treatment conditions were supported (Hypotheses 1 and

2). No significant differences were found between groups

35

Table 2

Two-tailed t-test for Mean Change
Scores on RXRC12

 

 

 

 

 

 

 

 

IX-YI df 5
cog vs. self 3.27 25 1.80*
cog vs. exp 2.20 25 1.14
self vs. exp 1.07 28 1.02

*p < .10.
Table 3
Two-tailed t-test for Mean Change
Scores on RXRC
34

li-fl df t
cog vs. self .23 25 .18
cog vs. exp .03 25 .02
self vs. exp .20 28 .24

Table 4
Two-tailed t-test for Mean Change
Scores on RXRC1234

li-Yl df t
cog vs. self 1.70 26 2.04*
cog vs. exp .98 26 1.10
self vs. exp .72 28 1.00

 

*p < .10.

36

Table 5

Two-tailed t—test for Mean Change.
Scores on SSR

 

 

 

IX-YI df

cog vs. self 6.54 26

cog vs. exp 8.71 26

self vs. exp 2.17 28
Table 6

Two-tailed t-test for Mean Change
Scores on SAS

 

 

IX-Yl df
cog vs. self .94 26
cog vs. exp 3.94 26
self vs. exp 3.00 28

 

*p = .10.

37

on any of the measures of relaxation skills. Experimenter-
and self-administered treatments were equally effective,
and neither was more effective than the control procedure
involving none of the essential elements of progressive
relaxation training. These findings are consistent with
studies of relaxation training utilizing physiological
measures as the dependent variable. As indicated earlier,
such studies have been unable to differentiate reliably
between relaxation training and control conditions using
a variety of physiological variables (Benjamin, Marks &
Huson, 1972; Lehrer, 1972; Israel & Beiman, 1977).

These results, however, appear to be inconsistent
with expectations based on Bandura's cognitively oriented
theory of behavior change. As noted previously,.self-
efficacy theory states that a common element in all success-
ful behavior change procedures is the client's conviction
that he/she can successfully accomplish the necessary
changes in his/her behavior. If this self-efficacy expec-
tation is the essential element in behavior change, it was
reasoned that increasing this expectation would also
increase the effectiveness of the change procedures. The
method selected for producing this increased efficacy expec-
tation was to allow one group to self-administer the relax-
ation procedures.

The responses to item 22 of the Self-Report Measure
(session 2) were analyzed to provide a check on the success

of this manipulation. Each subject was asked to identify

38

the essential component(s) in his/her learning to relax:
either the environment, the experimenter, or him/herself.
Identifying one's own effort as the essential component

was interpreted as evidence of self-efficacy expectations.
Accordingly, the self-administered group was expected to
demonstrate more self-attribution of success than the other
two groups. The results of the chi-square analysis of the
responses to this item, however, indicate that the two
dimensions (groups and essential component) are independent
of one another (see Table 7). The self-administered group
appears to have experienced no more expectations of self-
efficacy than any other (52(2) = 1.84, p'> .05). In fact,
the majority of subjects in each group made efficacy

to themselves.

Table 7

Chi-square Analysis of the Independence
of Group and Attribution

 

 

 

To Self Not to Self
Self 10 5
Cog 9 4
Exp 13 2
x2 = 1.34.

The intended test of the hypotheses required dif—
ferential levels of efficacy expectations. The analysis

just presented, however, indicates that this differentiation

39

was not achieved. Since all groups experienced equivalent
efficacy expectations, it would appear that the intended
test of the hypotheses was not accomplished. As a result,
conclusions concerning Bandura's theory cannot be drawn
from the results of this study. The basic question of this
study, concerning the effect of manipulating efficacy expec-
tations through self-administering the relaxation procedures
remains unanswered. Identifying potential sources of this
failure to produce heightened efficacy expectations may sug-
gest strategies for improving the experimental procedures.
Two potential sources will be discussed.

First, the nature of relaxation training itself
may have served to undermine the experimental manipulation.
To a greater extent than in therapy procedures based solely
on verbal exchange, clients receiving relaxation training
are responsible for their own treatment. Regardless of the
method selected for administering the procedures, there
remains a potentially significant self—change component.
When practicing at home, apart from the therapist's direct
influence, clients must decide when, where, or if treatment
is to take place and actively guide themselves through the
procedures. In this respect, most forms of relaxation
induction (except chemical means) have the potential for
being experienced as basically a self-induced change.
Accordingly, most forms of relaxation induction have the
potential for producing self—efficacy expectations. Con-

ceivably, then, the equivalent levels of self-attribution

40

expressed by the three groups may simply reflect the self-
change component common to all three relaxation procedures.
The problems surrounding this inherent self-change
component might be attenuated by further increasing the
perceived importance or salience of the experimenter and
the subject in the experimenter- and self-administered
treatments, respectively. This could be attempted in two
ways. First, specific instructions could be provided
which emphasized either the importance of the experimenter's
or subject's role in the training procedures. In the
experimenter-administered group, subjects could be informed
of the training, experience, and expertise of the experi-
menter and the importance of the experimenter's role in
treatment. The experimenter might emphasize the necessity
for appropriate delivery of the relaxation instructions and
the passive obedience of the subject. In the self-
administered group, contrasting instructions could be pro-
vided, introducing the experimenter as a relatively
untrained paraprofessional whose role in treatment would
be limited. The experimenter might emphasize the import-
ance of self-change in the efficacy of the procedures.
Second, additional contact with the experimenter might be
required of the experimenter-administered group to "offset
the negative effects of solitary home practice" and further
emphasize the experimenter's role. Subjects in the self-
administered group might be required to return and complete

a brief questionnaire not relevant to the relaxation

41

procedures, to control for additional time spent with the
experimenter. However, while these two procedures might
effectively produce differential levels of self-efficacy
expectations, such manipulations would remove the experi-
mental relaxation procedures even further from their typical
clinical counterpart. Thus, the generalizability of

results to an actual treatment situation would be limited.

In addition to difficulties associated with the
nature of relaxation training, a second potential source
of failure to produce differential efficacy expectations
concerns the brevity of the one-week period allotted for
relaxation training. Since successful behavioral perform—
ance has been suggested as a particularly influential
source of efficacy expectations (Bandura, 1977), further
analyses of the data from the five relaxation measures
were performed to determine if any significant increase in
relaxation skill had occurred between sessions 1 and 2 for
any of the groups. Significant positive change would indi-
cate that the necessary successful performance had taken
place.

Considering each group separately, the mean score
on each of the five relaxation measures in session 1 was
compared to the mean score in session 2, using a two-tailed
t—test for correlated means. Tables 8-10 summarize the
results of these analyses. The cognitive group was suc-
cessful in achieving significant increases in relaxation

skills as measured by the RXRC 4 (5(12) = 2.73, p < .05);

123

42

Table 8

t-test of Mean Scores in Sessions 1 and 2:
Cognitive Group

 

 

 

 

 

RXRC12 RXRC34 RXRC1234 SSR SAS
|i—§| 3.50 .49 1.96 2.96 .92
df ll 11 12 12 12
t 1.85* .42 2.73** .50 .58
*p < .10. **p < .05.
Table 9
t—test of Mean Scores in Sessions 1 and 2:
Self-administered Group
RXRC12 RXRC34 RXRC1234 SSR SAS
|i-§| .23 .30 .27 9.50 1.87
df 14 14 14 14 14
E .38 .45 '.57 3.64* 1.44

 

*p < .01.

43

Table 10

t-test of Mean Scores in Sessions 1 and 2:
Experimenter-administered Group

 

 

 

RXRC12 RXRC34 RXRC1234 SSR SAS

[i-Yl 1.30 .67 .98 11.67 4.87

df 14 14 14 14 14

3 1.51 1.49 1.80* 3.68*** 2.94**
*p < .10. **p < .05. ***p < .01.

in addition, a trend toward increased relaxation was
obtained in the RXRC12 (t(ll) = 1.85, p < .10). However,
no significant results or trends were obtained on either
of the self-report measures. On the other hand, the self-
administered group demonstrated significant change on one
of the self-report measures (SSR: t(l4) = 3.64, p < .01),
but not on any of the measures derived from the RXRC. The
strongest improvement was made by the experimenter-
administered group, in which significant improvement in
relaxation skills was obtained on both self-report measures
(t(l4) = 3.68, p < .01; t(l4) = 2.94, p < .05 for the SSR
and SAS, respectively) and a trend was obtained on the
RXRc1234 (E(14) = 1.80, p < .10).

As these analyses indicate, it is possible that the
one-week training period was insufficient to allow the
initial successful performance to occur. In fact, although

subjects may have experienced relaxation during their

44

initial relaxation session, the absence of further improve-
ment as the week progressed may have been disappointing

and interpreted as failure. Clinical experience suggests
that clients often find their first relaxation experience
extremely successful, with immediately ensuing sessions
experienced as less successful, or even unsuccessful, in
comparison. This interpretation is made more likely in
light of the implicit demands of a pre-post measurement
which strongly suggest that change is expected, particularly
positive change. It may also be suggested that the rela-
tive inexperience of the experimenters (undergraduate psy-
chology and non-psychology majors) might have served to
inhibit the potential success of the procedures. It might
prove beneficial, therefore, to provide a more intensive
training experience for those administering the relaxation
treatments.

One other factor affecting the outcome of this
study will be considered: the appropriateness of the
measures used to assess the acquisition of relaxation
skills. Other studies of self-administered treatments
have regarded relaxation training as merely a component of
some broader treatment program. The success of these
treatment programs has not been determined solely in terms
of the client's acquisition of relaxation skills, but in
terms of some application of those skills to the client's
presenting problem, i.e., approaching a phobic object.

Therefore, a study of relaxation training as a self-contained

45

treatment might also benefit from an assessment of the sub-
ject's relaxation skills in terms of an application of those
skills. For example, the subject may be presented with a
stressful situation either in vivo, or more simply, in
imagination. In the latter case, the relevant dependent
variable might be the length of time spent imagining the
stressful situation before the image is voluntarily termi-
nated. It might be expected that subjects with greater
relaxation skills would be able to maintain the image
longer than those whose relaxation skills are less well-
developed. Dependent variables of this sort would also
have the advantage of being more directly relevant to
clinical p0pu1ations, who typically do not enter treatment
merely to acquire relaxation skills, but to learn how to
apply those skills to their life situation.

Although the results of this study do not support
the predictions made earlier, they still bear some relevance
to clinical practice. The results suggest that a simple
placebo accompanied by a plausible rationale may be as
effective as either self- or experimenter-administered pro-
gressive relaxation training. At the same time, the
placebo treatment is much less time-consuming and complex.
Therefore it is worth considering that the most efficient
route to teaching relaxation may be to dispense with the
more complex procedures and opt for the simplest techniques

available. This approach would provide adequately for the

46

client's needs at minimal cost to both client and thera-
pist.

The results described to this point are presented
graphically in Figures 1, 2, and 3. It can be seen that
during the first session the cognitive group scored high-
est on all measures (indicating least relaxation),
followed in each case by the experimenter- and then self-
administered groups. These results support predictions made
earlier concerning the expected order of effectiveness of
the three treatments: the self-administered treatment was
most effective, the coqnitive treatment was least effective,
and the experimenter-administered treatment fell in-between.
However, in the second session no consistent ordering of
groups was obtained. This suggests that any additional
beneficial effects derived from self-administering the pro-
cedures may be short-lived; other factors associated with
continued practice soon interfere. The identification of
these other factors is purely speculative, but they may
include: (a) differing levels of motivation generated by
the three treatment approaches, (b) individual differences
in personal attributes of the subjects, i.e., locus of
control, and (3) an interaction of these or other variables.
Conclusions based on this data must be viewed cautiously,
however, since none of the reported differences achieved
statistical significance.

It may also be noted that each of the figures reveal

a consistent increase in relaxation skills for all three

47

 

 

 

 

 

 

 

A. RXRC12 B. RXRC34
a i- 8 r
7 - 7 -
6 P 5 "
5 I “Q 5 b Q
4 p 4 '- .- ~
~ -o
3 i- 3 *-
2 I- 2 b
1 - 1 I-
1 . 1 1 n
1 2 1 2
Session Session
C. RCRC1234
8 i-
7 ..
6 I-
5 - 5‘ ~ 8 = --—
4 - " =
3 - E = "I'll"
21-
1 ..
1 1
1 2
Session

Figure 1. Mean scores for sessions 1 and 2 on the RXRC12, RXRC“, and RXRC1234.

48

24"

20 b
18 -
16 -
14 .-
12 ..
1O

 

S =-—--

58%

 

”:50“
ITer

 

4

1

”L

Session
Figure 2. Mean scores for sessions 1 and 2 on the SSR.

 

818233888228

18-
16b
14-
12- s=---

10- =—

Moose
Ufi

 

l l
1 2
Session

Figure 3. Mean scores for sessions 1 and 2 on the SAS.

49

treatment conditions. Although these increases generally
failed to achieve statistical significance, their con—
sistency seems to indicate a common element responsible
for the behavior change in all conditions. Two potential
common elements may be suggested: (1) the basic self-
change nature of the relaxation procedures, with its
accompanying increase in efficacy expectations, and
(2) the demand characteristics inherent in any experimental
procedure which is directly or indirectly indicated to be
relaxation inducing. However, regardless of the nature
of the element responsible for the change, the statistical
insignificance of the increase in relaxation skills sug-
gests that this element(s) alone may be insufficient to
produce any notable results.

The final hypothesis of the study, concerning the
relationship between initial level of physical movement
and later depth of relaxation, was also unsupported. A
negative relationship between these variables had been pre-
dicted, i.e., with greater initial levels of physical
movement, relaxation would be less successful. However,
the data suggest just the opposite: greater initial levels
of movement were associated with greater success in
relaxation. The data were collapsed across groups and
correlations between the BMC and the five relaxation
measures were computed separately for sessions 1 and 2.
These results are summarized in Table 11. One correlation

was significant (£(41) = -.32, p < .05) and two

50

Table 11

Correlations of BMC with Each of Five
Relaxation Measures for
Sessions 1 and 2

 

 

 

RXRC12 RXRC34 RXRC1234 SSR SAS
Session 1 .15 -.32** -.06 -.13 .01
Session 2 -.30* -.19 -.28* .06 .08
*p < .10. **p < .05.
correlations approached significance (£(42) = -.30, p < .10;
£(42) = -.28, p < .10) although none of these results were

in the predicted positive direction. In fact, the majority
of the correlations (60%) were in the negative direction.
Conclusions based on these results must be viewed as tenta-
tive at best, however, being based on statistical trends
rather than significant relationships. In addition,
statistical regression alone may be sufficient to explain
the findings.

In conclusion, the central issue of this study con-
cerning the effect of manipulating efficacy expectations
through self-administering the relaxation procedures,
remains unresolved. One week of relaxation training pro-
duced no significant differences between treatment groups
or consistent pre-post differences across sessions. On
the basis of these results alone, it might be concluded
that brief self-administered relaxation training is not a

useful procedure. However, it must be taken into

51

consideration that (a) 29 relaxation procedure proved effec-
tive during the one-week training period, and (b) the
manipulation designed to increase efficacy expectations in
the self-administered groups was unsuccessful. Therefore,
the basic questions concerning self-administered relaxation
training remain unanswered: (1) Can self-administering the
procedures increase efficacy expectations? (2) Do increased
efficacy expectations result in increased treatment effec-
tiveness? (3) Is the inherent self-change nature of relax-
ation training sufficient to prevent additional experi-
mentally produced efficacy expectations from having any
effect on performance? Such questions are significant and
relate to the issue of finding the most effective means of
delivering relaxation training and other treatment pro-
cedures to those who may benefit from them. As such, they
are empirical issues and require further research in order

to be resolved.

APPENDICES

APPENDIX A

BODY MOVEMENTS CHECKLIST

APPENDIX A

BODY MOVEMENTS CHECKLIST

Body Movements Checklist Scoring Criteria

General criteria. Any movement which occurs during the 15

 

second interval should be recorded with the following
exceptions:
(l) Movements due to breathing, coughing, sneezing, etc.
(2) Movements of one body part which occur solely as
the passive accompaniment of movement of another
body part, i.e., if the subject bends forward at
the waist, the arms will move forward also solely
as a result of being attached to the trunk; only

the trunk movement should be recorded.

Specific criteria.

(1) Head and neck: any movement of the subject's head

 

and/or neck.

(2) Right and left arms: any movement of the subject's

 

arms, hands, or fingers.
(3) Trunk: the subject's shoulders, chest, back,
stomach, or hips break either of two planes; a

vertical (vertical if the subject was standing or

52

53

sitting upright) plane passing through the spine
and breastbone, separating the right from left
sides of the trunk, and a vertical plane, perpen-
dicular to the first, which separates the front
and back sides of the trunk.

(4) Right and left legs: any movement of the subject's

 

legs or feet.

54

Body Movements Checklist

Subject # Experimenters

 

Day

 

 

Time

 

Code: P = present; score 1
A = absent; score 0

 

H_E_A_D_ ARMS .LRLM 532.95. my:
Period 1 P_A_ P_A_ P_A_ P___A_ _
Period 2 P__A;__ P__A__ P__A;__ P__A;_ _____
Period 3 P__A__ P__A_ P_A_ P_A_ __
Period 4 P__A;_ P__A__ P__A__ P__A__

TOTAL

APPENDIX B

SELF—REPORT MEASURE

APPENDIX B

SELF-REPORT MEASURE

Self-Report Measure
(Session 1)

DIRECTIONS: A number of statements which peOple have used
to describe themselves are given below. Read each state-
ment and then circle the appropriate number to the right
of the statement to indicate how you feel right now, that
is, at this moment. There are no right or wrong answers.
Do not spend too much time on any one statement but give
the answer which seems to describe your present feelings
best.

0

m

q M

236:3

.69

«32

m a:

888

Z 09 Z

l. I feel calm . . . . . . . . . . . . l 2 3

2. I feel secure . . . . . . . . . . 1 2 3

3. I am tense . . . . . . . . . . . 1 2 3

4. I am regretful . . . . . . . . . 1 2 3

5. I feel at ease . . . . . . . . . l 2 3

6. I feel upset . . . . . . . . . . . 1 2 3
7. I am presently worrying over possible

misfortunes . . . . . . . . . . . . 1 2 3

8. I feel rested . . . . . . . . . . . 1 2 3

9. I feel anxious . . . . . . . . . l 2 3

. . . . . . . . l 2 3

10. I feel comfortable

a VERY MUCH SO

:5

b

11.
12.
13.
14.
15.
l6.
17.
18.
19.
20.

21.

I feel self-confident
I feel nervous . . . .
I am jittery . . . . .
I feel "high strung" .
I am relaxed . . . .
I feel content . . . .
I am worried . . . .
I feel over-excited and
I feel joyful . . . . .

I feel pleasant . . . .

Please rate your present degree

scale of 1-100 where:

1 = a state of absolute calm;
could be
50 = neither relaxed or anxious
100 = a state of absolute tension;

you could be

Your present degree of relaxation

56

"rattled"

i—‘J
2 a
m
B :1:
fit 3
a 2
O 0
Z (I)
. . 1 2
O O O l 2

. . . 1 2

. . . l 2

of relaxation on a

as relaxed as you

as anxious as

 

w MODERATELY SO

DJ

'9 VERY MUCH so

in

57

Self-Report Measure
(Session 2; Form A)

DIRECTIONS: A number of statements which people have used

to describe themselves are given below.
ment and then circle the appropriate number to the right
of the statement to indicate how you feel right now, that
is, at this moment. There are no right or wrong answers.

Read each state-

Do not spend too much time on any one statement but give
the answer which seems to describe your present feelings

best.

1. I feel calm . . . . . .

2. I feel secure . . .

3. I am tense . . . . . .
4. I am regretful . . . .
5. I feel at ease . . . .

6. I feel upset . . . . .

7. I am presently worrying
misfortunes . . . . . .

8. I feel rested . . . . .
9. I feel anxious . . . .
10. I feel comfortable . .
11. I feel self-confident .
12. I feel nervous . . . .
13. I am jittery . . . . .
14. I feel "high strung" .
15. I am relaxed . . . . .

16. I feel content . . . .

over possible

id NOT AT ALL

l-'

N SOMEWHAT

N

N

g) (s MODERATELY SO

-b VERY MUCH SO

.5

58

#4 NOT AT ALL

“’ SOMEWHAT

u: MODERATELY SO
b VERY MUCH SO

17. I am worried . . . . . . . . . . . . . .

l-'
N
w
b

18. I feel over-excited and "rattled" . . . .

19. I feel joyful . . . . . . . . . . . . . . l 2 3

.b

20. I feel pleasant . . . . . . . . . . . . . 1 2 3 4

21. Please rate your present degree of relaxation on a
scale of 1-100 where:

1 = a state of absolute calm; as relaxed as you
could be
50 = neither relaxed or anxious
100 = a state of absolute tension; as anxious as you

could be

Your present degree of relaxation =

 

We are interested in finding out what factors helped
you obtain whatever degree of relaxation skills you

have acquired from your relaxation training. Please
answer the following two questions as accurately as

possible.

22. I would attribute my degree of success in learning to
relax to (please check pg many pg apply):

a. My own effort

b. Setting in which I relaxed at home

c. Experimenter's skill

d. Quiet experimental room, reclining chair

 

23. The thing that was most significant of all in my learn-
ing to relax was

 

DIRECTIONS:

is, at this moment.

best.

10.
11.
12.
13.
14.
15.

16.

59

Self-Report Measure
(Session 2; Form B)

I feel calm . . . . . .
I feel secure . . . . .
I am tense . . . . . .
I am regretful . . . .
I feel at ease . . . .
I feel upset . . . . .

I am presently worrying
misfortunes . . . . . .

I feel rested . . . . .
I feel anxious . . . .
I feel comfortable . .
I feel self-confident .
I feel nervous . . . .
I am jittery . . . . .
I feel "high strung" .
I am relaxed . . . . .

I feel content . . . .

over possible

H NOT AT ALL

1.:

}...i

SOMEWHAT

MN

N

Read each state-

SO

w MODERATELY

00

w

A number of statements which peOple have used
to describe themselves are given below.
ment and then circle the apprOpriate number to the right
of the statement to indicate how you feel right now, that
There are no right or wrong answers.
Do not spend too much time on any one statement but give
the answer which seems to describe your present feelings

P VERY MUCH SO

.b

b

17.
18.
19.
20.

21.

22.

23.

60

H NOT AT ALL
SOMEWHAT

w MODERATELY SO

9 VERY MUCH SO

N

I am worried . . . . . . . . . . . . . .

|._i
N
L»)
oh

I feel over-excited and "rattled" . . .
I feel joyful . . . . . . . . . . . . . . l 2 3 4
I feel pleasant . . . . . . . . . . . . . 1 2 3 4

Please rate your present degree of relaxation on a
scale of 1-100 where:

l = a state of absolute calm; as relaxed as you
could be
50 = neither relaxed or anxious
100 = a state of absolute tension; as anxious as you

could be

Your present degree of relaxation =

 

We are interested in finding out what factors helped
you obtain whatever degree of relaxation skills you

'have acquired from your relaxation training. Please

answer the following two questions as accurately as
possible.

I would attribute my degree of success in learning to
relax to (please check as many as apply):

 

a. Experimenter's skill

b. Quiet experimental room, reclining chair
c. My own effort

d. Setting in which I relaxed at home

The thing that was most significant of all in my learn-
ing to relax was .

APPENDIX C

RELAXATION RATING CHECKLIST

APPENDIX C

RELAXATION RATING CHECKLIST

Relaxation Rating Checklist (RXRC)
Second Revision

Movement during 15 second interval:
A. Of entire body, arm, leg, or head.
1. None.
2. One or two.
3. Three or more.

 

w

. Of hand, fingers, feet, or face.
1. None.
2. One or two.
3. Three or more.

0

. Eyeblinks:

1. None.

2. One or two eyelid twitches.

3. Three or more eyelid twitches.

4. Eyes blinking open once.

5. Eyes blinking open more than once.
6. Eyes remaining open.

 

Position at end of observation period:

D. Head:
1. Leaning to one side.
2. Upright.
E. Lips:
l. Parted.
2. Closed.
F. Hands:

1. Both Open with fingers curled.

2. One or both closed into a loose fist.
3. One or both Open with fingers straight.
4. One or both closed into a tight fist.
5. One or both grasping arm of chair.

 

61

62

Unsupported body parts at end Of observation period:

G. Head:
1. Supported.
2. Unsupported.

H. Shoulders:
1. Supported.
2. Unsupported.

 

I. Arms:

1. Both supported.
2. One unsupported.
3. Two unsupported.

 

L;

. Legs:

1. Both supported.
2. One unsupported.
Two unsupported.

3.

APPENDIX D

INTRODUCTION TO EXPERIMENTER-

ADMINISTERED RELAXATION

APPENDIX D

INTRODUCTION TO EXPERIMENTER-

ADMINISTERED RELAXATION

Before we begin the relaxation training itself,
I'd like to take a few minutes to describe what we'll be
doing and Offer an explanation of how the training works.
Basically what the training involves is tensing and then
relaxing various groups of muscles all throughout your
body, paying close attention to the contrasting feelings
of tension and relaxation. It may seem odd to you that we'll
be tensing muscles when we really want to relax them, so
I'll try to explain to you why this helps. It might seem
that the best way to relax a muscle would be to simply
focus attention on it and just let the muscle go; and, of
course, to a certain extent this would work. However, to
produce a much larger reduction in tension, it's been found
that the best thing to do is to first produce tension and
then suddenly release it, giving yourself sort of a running
start into relaxation. It's kind of like a pendulum; if
you want to make the pendulum swing far to the right into

relaxation, a good way to do that is to first pull the

63

64

pendulum far to the left into tension and then suddenly
release it so it swings way back into relaxation.

I also want to emphasize at this point that relaxa-
tion is a skill just like any other skill and in order to
get good at it you'll have to practice it--just like you'd
have to practice your tennis game in order to play well.
The procedures I'll be showing you will have no effect
unless you practice them. When you practice at home, if
you don't have a recliner you should lie down on your bed
or couch and dim the lights; try to practice when no one
else is around.

I'd like to start by briefly mentioning the muscle
groups we'll be tensing and relaxing when we start the
relaxation training. Don't be concerned about memorizing
the various muscle groups now, since I have a tape record-
ing for you to take home and use the first few days until
you learn them. In general, we'll be using 18 muscle
groups, starting with the arms, moving up to the head, and
then straight on down to the legs. Usually, the way to
tense each of these muscles will be fairly Obvious, but
since some of them aren't so obvious I'll quickly demon-
strate. The forearm muscles are tensed simply by making
a tight fist; the biceps by bending up at the elbow and
tensing. The triceps are a little trickier--you extend
your arms, palms up, and tense them as though you were
trying to turn your elbows inside out. After the arms,

we'll move up to the face; the forehead muscles are tensed

65

by raising the eyebrows up high, the eye muscles by squint-
ing your eyes tightly shut, the jaws by simply biting your
teeth together, your throat and tongue by pressing your
tongue hard against the roof of your mouth, and finally
your lips by pursing them and pressing them tightly
together.

Next are the neck and torso muscles. The neck is
tensed by pressing your head against the back of the chair,
and your shoulders by shrugging them up high and then mov-
ing them forward and back. The chest is tensed by taking
in a deep breath and holding it, and the stomach by simply
making the muscles hard. The lower back muscles are a
little trickier—-you tense these muscles by arching your
lower back, making a hollow place between your back and the
chair.

Finally we come to the lower body muscles. The
thighs and buttocks are tensed by straightening your legs
slightly and flexing the thigh and buttock muscles. And
lastly, the calves are tensed by pointing your toes down
away from your face and tensing, and the shins are tensed
by pointing the toes up toward your face and tensing.

Alright, those are the muscle groups we'll be
using. Do you have any questions so far? OK, before we
begin there are a few things I'd like you to remember.
During the training itself, I'll direct you as to what
muscle group to tense and when to tense it. For example,

I'll say, "Tense your right hand and forearm now." Then

66

I'll signal you when to relax; I'll say, "And now relax."
When I give you this signal let all the tensions go at
once; don't let it out slowly since this will spoil the
running start into relaxation. Also, it's best if you
don't move around much or talk during training, since this
introduces unnecessary tension. And finally, I'll ask you
to keep your eyes closed during the entire session to help
you concentrate. Of course, if you begin to feel uncom-
fortable having your eyes closed, you can simply Open your
eyes, look around briefly, and then close them again. If
you have contact lenses, I suggest you take them out. OK,

if you're ready, we'll begin.

 

APPENDIX E

INSTRUCTIONS FOR EXPERIMENTER-administered

RELAXATION TRAINING

APPENDIX E

INSTRUCTIONS FOR EXPERIMENTER-administered

RELAXATION TRAINING

(Adapted from Wolpe and Lazarus, 1966)
18 muscle groups
7-10 seconds tension
25-35 seconds relaxation

Total time: 25-30 minutes

Note: Certain words are capitalized in order to help you
keep your place during clinical sessions; it is not meant

to imply vocal emphasis.

Settle back as comfortably as you can. Just take
a minute and let yourself relax all over to the best of
your ability. Now as you relax like that, clench your

RIGHT FIST NOW; just clench your fist tighter and tighter,

 

study the tension. Keep it clenched and notice the feel-
ings in your right fist and forearm.

And now RELAX. Let the fingers of your right hand
become loose and limp and Observe the contrast in your
feelings. Just try to let go more and more and allow the

muscles to relax on their own.

67

68

Once again, clench your RIGHT FIST NOW. Hold it,

 

notice the tension again, feel the muscles pull across your
knuckles and on into your forearm. Study it.

Now REEAK. Your fingers straighten out and you
notice the difference in your feelings once again; the
muscles in your right hand and forearm growing loose and
relaxed.

Now let's repeat that with your left fist. Clench
your LEFT FIST NOW. Clench it tighter, feel the muscles
pull, study the sensations, hold it.

And now REEAK, again enjoying the contrast. Simply
let the good feelings of relaxation flow into your left
forearm and hand. Just let the muscles go.

Again clench your LEFT FIST NOW. Hold it, study the

 

feelings of tension in your left fist and on into your
forearm.

And now REEAK. Feel the difference. Simply allow
the relaxation to continue for awhile.

This time clench BOTH FIST NOW. Tighter and

 

tighter, both fists tense, both forearms tense, study the
sensations.

And now BEEAK. Let your fingers straighten out and
feel the relaxation. There's nothing for you to do, nothing
for you to work at, just give it your easy attention and

let the muscles relax more and more.

69

Next, bend your elbows and tense BOTH BICEPS NOW,

 

tense them hard and study the sensations as your biceps
ball up and become tense. Hold it, study it.

And now RELAK. Let your arms straighten out and
feel the relaxation flowing through your biceps. Continue
relaxing these muscles more and more. Just let the relaxa-
tion develop.

Again, bend your elbows and tense BOTH BICEPS NOW,

 

tense them hard and study the sensations as your biceps
ball up and become tense. Hold it, study it.

And now RELAE. Let your arms straighten out and
feel the relaxation flowing through your biceps. Continue
relaxing these muscles more and more. Just let the
relaxation develop.

Next we'll move on to the triceps muscles. Tense

your TRICEPS NOW. Straighten your arms like you were going

 

to turn your elbows inside out, notice the tension along
the back of your arms, study it.

And now BELAK. Let your arms drop and feel the
relaxation developing in your triceps and flowing on down
into your biceps, forearms, and hands. Muscles feeling
loose and limp.

Again, tense your TRICEPS NOW. Straighten out your

 

arms, feel the tension in the triceps muscles along the
back of your arms. Hold it.
Now RELAX. Get your arms back into a comfortable

position, and concentrate on pure relaxation in your arms

70

without any tension. Your arms begin to feel comfortably
heavy as you allow them to relax further and further.

Even when your arms seem fully relaxed, try to go that
extra bit further; try to achieve deeper and deeper levels
of relaxation. Your arms feeling warm, heavy, relaxed.

Next we'll move to the muscles of your forehead.
Tense your FOREHEAD muscles Egg. Raise your eyebrows as
high as you can; feel your forehead wrinkle up. Notice
the tension and study it.

And now EEEEE. Let your forehead muscles smooth
out. Picture the entire forehead and scalp becoming
smoother and smoother as the relaxation increases.

Again, tense your FOREHEAD muscles Egg. Raise your
eyebrows up high, as high as you can, like you were trying
to touch your scalp with them. Hold it.

And now EEEEE. Allow the forehead and scalp to
smooth out once again. Feel the warm relaxation flowing
down your forehead as the muscles grow more and more deeply
relaxed.

Now we'll move on to your eyes. Squint your EXEE
together 393. Close them tightly, feel the tension in the
muscles all around your eyes and in your upper cheeks,
Observe it.

Now EEEEE. Keep your eyes closed gently and com-
fortably together and notice the good feeling as the

muscles relax and unwind, growing loose and limp.

71

Next I'll ask you to clench your jaws. Clench your
EEEE together EQE. Bite your teeth together tightly, study
the tension throughout your jaws. Hold it.

Now EEEEE. Let your jaws hang limp and allow your
lips to part slightly. Appreciate the relaxation in your
jaws.

Next press your TONGUE hard against the roof of your
mouth EQE. Press it. Look for the tension. Look for it
at the base of your tongue and perhaps even into your
throat. Study it.

Now EEEEE. Let your tongue return to a comfortable
and relaxed position. Let it lie loose and limp in your
mouth.

Now we'll move on to your lips. Press your EEEE
together EQE. Press them together tighter and tighter so
you can almost see your lips turning white around the
edges.

And now EEEEE. Notice the contrast between tension
and relaxation. Feel the relaxation all over your face,
all over your forehead and scalp, eyes, jaws, lips, tongue
and throat. Notice how the relaxation grows deeper and
deeper.

Next attend to your neck muscles. Press your head
against the back of the chair Egg. Press it back as far as
it will go and feel the tension. Roll it to the right and
feel the tension shift; roll it to the left and feel it

shift again.

72

And now EEEEE. Let your head return to a comfort-
able position as the relaxation flows deep into your neck
muscles. Just let it develop. It feels as though if a
warm breeze were to blow through the room it would gently
rock your head from side to side.

Next shrug your SHOULDERS up NOW. Shrug them

 

high. Now move them forward like you were going to press
them together. Now pull your shoulders back like you were
going to touch your shoulder blades together. Study it.

And now EEEEE.*** Drop your shoulders once more
and let the relaxation spread deep into your shoulders and
right into your upper back muscles. Relax your neck and
throat, and let the relaxation flow into your jaws, tongue,
lips, and forehead, as the pure relaxation takes over and
grows deeper, deeper, ever deeper. Feel the comfortable
heaviness that accompanies relaxation. Breath eaSily and
freely in and out. Notice how the relaxation increases as
you exhale.

Next are the muscles of the EEEEE. Inhale deeply
and hold your breath EQE. Feel the tension, notice it all
across your chest and in your lungs. Study it.

Now EEEEE. Let the walls of your chest let go and
push the air out automatically. Continue relaxing and
breathe freely and gently. Just feel the relaxation and

enjoy it.

***Rater completes RXRC here.

73

Again, inhale deeply and hold your breath Egg. Feel
the tension in your rib cage and all across your chest.
Study the sensations carefully. Hold it.

And now EEEEE. Feel the tensions dissolve and
appreciate the relief. Just breath normally in and out as
you continue relaxing your chest and lungs. Merely allow
the relaxation to proceed on its own.

Now let's pay attention to your abdominal muscles,
your stomach area. Tighten your STOMACH muscles Egg.
Tighten them up, make your stomach hard. Feel the muscles
pull across your abdomen. Study it.

Now EEEEE. Feel the tension dissolve as the
stomach muscles grow loose and limp. Continue breathing
normally and easily and feel the gentle massaging action
all over your chest and stomach.

Again, tense your STOMACH muscles Egg. Feel these
muscles pull across your stomach. Notice the tense, tight
feeling in your stomach. Hold it.

And now EEEEE. Let the tension dissolve as the
relaxation grows deeper and deeper. Each time you breath
out, notice the rhythmic relaxation both in your lungs and
in your stomach. Notice how your chest and stomach relax
more and more deeply.

Next direct your attention to your lower back. Arch
up your BACK NOW. Arch your back, make your lower back quite
hollow and feel the tension in the muscles all up and down

your spine. Hold it.

 

74

Now EEEEE. Let yourself sink back down deep into
the chair. Notice the loose warm feeling in the muscles
along your spine as they relax further and further.

Again, arch your EEgE up Egg. Feel the tension as
the muscles all along your spine pull tight. Observe the
sensations. Hold it.

And now EEEEE. Once again let yourself sink back
into the chair deeper and deeper as the relaxation con-
tinues. Relax your lower back and let the relaxation
spread to your stomach, chest, shoulders, flow into your
arms and on into your neck, jaws, tongue, lips, eyes, and
forehead. These parts relaxing further and further, ever
further.

Next flex the muscles of your BUTTOCKS and THIGHS
Egg. Straighten your legs out and make these muscles hard.
Feel these large muscles pull and become tense, study the
tension.

And now EEEEE. Notice the difference as the relaxa-
tion flows into your buttocks and on into your thighs.
There's nothing for you to do but allow the relaxation to
develop on its own.

Again, tense the BUTTOCKS and THIGHS NOW. Feel the

 

muscles pull and become hard. Study the tension, observe
it carefully, hold it.

And now EEEEE. Feel the relaxation flowing into
your buttocks and thighs, becoming more and more deeply

relaxed.

75

Next, tense your EEEEE muscles by pointing your feet
and toes away from your face Egg. Tighten up these muscles.
Feel the tension in your calves, study it. Hold it tight.

Now EEEEE. Feel the calves become loose and heavy.
Appreciate the good feeling of relaxation.

This time tense your EEEE muscles by pointing your
feet and toes up toward your face Egg. Feel the muscles
along your shin bone pull and become tense. Study the
sensations of tension in these muscles. Hold it.

And now EEEEE.*** Let the muscles along your shins
become loose and relaxed. Keep relaxing for awhile. Let
yourself relax further all over. Let the relaxation spread
through your legs, up through your stomach, chest, and
shoulders, on through your neck and facial muscles, and down
your arms and hands. Feel how heavy and relaxed you have
become.

Now I'm going to count backwards from 5 to 1. With
each descending number you will begin to feel more and more
deeply relaxed. (Note: Count backwards, timing your count-
ing to coincide with the rhythm of the client's exhalations.)

To close the relaxation period, I'll ask you to
start moving various muscles. When you get up you will
feel refreshed, like you just had a brief nap; peaceful and

very calm.

***Rater completes RXRC here.

 

76

Now begin wiggling your fingers, hands, and feet.
Move your arms and legs. Move your head and now open your

eyes.

 

APPENDIX F

INSTRUCTIONS FOR SELF-administered

RELAXATION: SESSIONS I AND II

 

APPENDIX F

INSTRUCTIONS FOR SELF-administered

RELAXATION: SESSIONS I AND II

Instructions for Self-administered
Relaxation: Session I

These instructions and all the other materials
which you will be using this session are provided for you SO
that YOU CAN TEACH YOURSELF TO RELAX, to have control over
feelings of tension or anxiety. Please follow the direc-
tions carefully and in order, and everything will go
smoothly.

Step 1. Locate the box sitting on the table next
to the wall. Remove the casette recorder and tape marked
"Introduction and Rationale."

Step 2. Play the "Introduction and Rationale" tape
and listen carefully.

Step 3. Locate a second tape in the box marked
"Relaxation Instructions" and a form entitled "Self—Report
Measure." Before you play the tape, please notice that
the first 60 seconds of the tape are b1ank--this is to give
you enough time to get seated in the recliner and push it

back to a comfortable position. BE SURE TO TAKE THE FORM

77

 

78
ENTITLED ”SELF-REPORT MEASURE” BACK TO YOUR CHAIR WITH YOU
AND SET IT BESIDE THE CHAIR.

Please be sure to keep your eyes closed until the
end of the 25 minute tape. The tape will end with the sen-
tence "Please rate your degree of relaxation on a scale of
l to 100 and mark it on your progress chart." For right
now you can ignore that statement.

Step 4. Begin playing the tape and follow its
instructions--simply do what it asksgyou to do.

Step 5. Pick up the "Self-Report Measure" form.
Read the directions carefully and answer the questions.

Step 6. Locate a form in the box entitled
"Relaxation Progress Chart" (it has a graph on it). Please
take it home and after each home practice session chart
how relaxed you are (the tape will remind you to do this).
Also take home the tape entitled "Relaxation Instructions"

to use when you practice.

The experimenter will return in a moment. Thank you.

79

Instructions for Self-administered
Relaxation: Session II

During this session you will again have the oppor-
tunity to teach yourself to relax. Please follow the direc-
tions carefully and in order and everything will go
smoothly.

Step 1. Locate the box sitting on the table next
to the wall. Remove the cassette recorder and tape marked
"Relaxation Instructions." Also locate and remove the
form entitled "Self-Report Measure." Please notice that the
first 60 seconds of the tape are blank--this is to give
you enough time to get seated in the recliner and push it
back to a comfortable position. BE SURE TO TAKE THE FORM
ENTITLED "SELF-REPORT MEASURE" BACK TO YOUR CHAIR WITH YOU
AND SET IT BESIDE THE CHAIR.

Please be sure to keep your eyes closed until the
end of the 25 minute tape. The tape will end with the
sentence "Please rate your degree of relaxation on a scale
Of l to 100 and mark it on your progress chart." For right
now you can ignore that statement.

Step 2. Play the tape and follow its instructions—-
simply do what it asks you to do.

Step 3. Pick up the "Self-Report Measure" form.

Read the directions carefully and answer the questions.

The experimenter will return in a moment. Thank you.

 

APPENDIX G

RELAXATION PROGRESS CHART

APPENDIX G

RELAXATION PROGRESS CHART

 

100

 

90

 

80

 

70

 

60

 

50

 

40

 

30

 

20

 

10

 

 

 

 

 

 

 

 

 

 

1 2 3 4 5 6

Day of Practice

80

81

Directions:

 

You will have 6-8 Opportunities to practice relaxa-
tion during the week, depending on whether or not you prac-
tice at home on the same days you come into the laboratory.
For each day of practice please chart how relaxed you were
at the end of your practice session using a scale of l to
100, where

l
100

a state of absolute calm; as relaxed as you can be.
a state of absolute tension; as tense as you can be.

Do not put your name on this graph. Please turn it
in along with the "Relaxation Instructions" tape when you
come in for your second session.

 

APPENDIX H

RATIONALE: COGNITIVE RELAXATION

APPENDIX H

RATIONALE: COGNITIVE RELAXATION

One of the ways to achieve and maintain relaxation
is through controlling the content of thoughts; first to
eliminate unpleasant thoughts and images and, second, to
create pleasant thoughts and images. Let's begin by talk-
ing about the second component of controlling thought con-
tent; creating pleasant thoughts and images. It seems to
make sense that if you're concentrating on enjoyable
thoughts, it would be quite difficult at the same time to
be thinking about the kind of unpleasant, anxiety pro-
voking thoughts which interfere with relaxation and produce
tension. Thus, pleasant thoughts are incompatible with
unpleasant thoughts. For example, if you're thinking about
a really enjoyable meal you've had recently with someone
you really like, remembering preparing for the meal, what
you had to eat, visualizing what your friend was wearing,
how the food looked, or even re-experiencing how it tasted,
it's difficult, if not impossible, to also be thinking about
the last time you performed poorly on an exam which you
really needed to do well on. Of course, these happy or
pleasant thoughts and images vary for each individual; for
some they may involve events which occurred in the distant

82

 

83

past, like some event from elementary school or a trip you
took with your family. On the other hand, they might
involve some event or person from the present; a really
successful date, a good party, or some academic achieve-
ment about which you are pleased. Or finally, your plea-
sant image may involve some person or event which has not
yet or never will happen, such as the kind of date you'd
really like to have, what you'd do if you won a million
dollars, or what life would be like if you were finally
done with school and well-established in a good job.

Of course, as you may be thinking already, it's
difficult to keep up a steady flow of pleasant thoughts and
images; some unpleasant or anxiety provoking thought
always seems to begin to interfere with and ruin the relax-
ation you've developed. So you must also be equipped with
some kind of method of fighting off those intrusive
thoughts which interfere with concentrating on pleasant
thoughts. As with many things in psychology, there is a
method for dealing with these unwanted thoughts which on
the surface seems too simple, too obvious. Your initial
reaction might be that it would never work, however there
has been evidence to suggest that in actuality it does
work. The technique which I am referring to has been used
by a psychologist named Joseph Cautela and is called
thought-stopping. This technique was originally develOped
for working with people with a specific kind of problem--

those who had very troublesome thoughts which kept

 

84

recurring "against the person's will." For example, a
person might have a recurring thought that he/she was

going to faint. Dr. Cautela would teach the client that
whenever this thought came to mind, whenever the client
first thought he/she was going to faint, that the client
should think the word "stop" inside his/her head; it would
be like screaming the word "stop" except that the client
would only be shouting it inside his/her head. And Dr.
Cautela found that his clients were able to overcome
troublesome thoughts by mentally shouting "stop" whenever
they began to occur. We're going to use the same technique
here; when you're concentrating on your pleasant thoughts,
and an unpleasant or even neutral thought begins to creep
in, as soon as you notice it, mentally shout the word "stop"
and then go back to concentrating on pleasant thoughts
again. At first it may not work so well; you might have to
constantly be using your thought-stopping. But as you prac-
tice, and practice is of utmost importance, you will find
it necessary to use it less and less. When you practice

at home, if you don't have a recliner you should lie down
on your bed or couch and dim the lights; try to practice
when no one else is around.

What I'd like for you to do then is to take the
next 20-25 minutes and concentrate on any pleasant or happy
thoughts and images which you may choose. They can be
past, present, or future, real or imaginary, just as long

as they are pleasant. And if you have any unpleasant

85

thoughts, or even just neutral thoughts, which interfere
with the pleasant thoughts, be sure to use your thought-
stopping. Do you have any questions? If you're wearing
contacts please take them out. OK, I'd like you to just
shut your eyes to help you concentrate better. GO ahead
and begin. I am going to leave the room and will return

when the time is up.

 

 

APPENDIX I

EXPERIMENTER'S MANUAL

APPENDIX I

EXPERIMENTER'S MANUAL

The purpose of this manual is to explain exactly
what you will be doing as an experimenter in this study.

If you have any questions at all, please be sure to ask,
since the smooth running of this experiment depends to a
large degree on you and the other experimenters.

Overview. Perhaps a quick overview of the experi-
ment, without going into any details, will help present the
main idea of the study. In general, an experimenter will
contact the subjects by telephone and set up an appointment
time. When the subject arrives, he/she will first be given
two minutes to simply get accustomed to the experiment room,
while an experimenter Observes through a one-way mirror and
notes the subject's degree of physical activity. Then the
subject receives one of three treatments: (1) experimenter-
administered relaxation training, where you train the sub-
ject to relax via muscle tension and release, (2) self-
administered relaxation training, where the subject trains
him/herself in the same procedure, or (3) cognitive relaxa-
tion training, which utilizes an approach to relaxation

emphasizing control of thought content. During the course

86

87

of this relaxation period, the experimenter behind the
mirror observes and records the subject's degree of relaxa-
tion on two different occasions. Following the relaxation
period, the subject completes a self-report measure rating
his/her degree of relaxation. Each subject is then asked
to practice at home and return at the same time the follow-
ing week to more or less repeat the same procedures. 80
essentially we'll take one week to run subjects through
their first session, a second week to run them through their
second (return) session, and then repeat this process for

a new group of subjects during the third and fourth weeks.

Purpose of the experiment. The research literature

 

is quite unclear as to which, if any, of these three pro-
cedures is superior in producing relaxation. The purpose
of this study, then, is to determine which is more effec-
tive and how this relates to a predisposition to movement
and other factors.

Now to explain in a little more detail.

Obtaining subjects. Subjects will be introductory

 

psychology students signing up for the experiment to earn
course credit. You and the other experimenter working
with you (one to interact with the subject and one to
observe behind the mirror) will set up an appointment with
him/her. Your phone conversation should include the
following information: (1) your name and the name of the
experiment, (2) the time of the appointment (this will have

to be negotiated) and where to meet you, (3) a reminder

88

that this is an appointment for the same day and time for
two consecutive weeks, (4) a reminder that the subject
will be expected to take 20-25 minutes each day to prac-
tice, and (5) a thank you. For example, you might say:

Hello, this is calling about the relaxa-
tion training experiment you signed up for in your
psychology class. I'd like to set up a time with you
in which we could meet. How about 3 O'clock Friday
afternoon? OK, good, I'll meet you in room 4 Olds
Hall. I'd also like to remind you Of a couple of
things you've already read on the sign-up sheet.
First, in order to receive credit for the experiment,
I'll also need to meet with you at 3 O'clock the
following Friday. (At this point you might have to
change the appointment time.) Second, in order for
you to get any benefit from the relaxation training,
you'll be expected to take 20-25 minutes each day to
practice at home--that's one reason why this experi-
ment is worth as many credit hours as it is. One
other thing; if you wear contact lenses please bring

a container to put them in. Do you have any questions?
OK, thanks a lot and I'll look forward to seeing you
on Friday.

Adaptation period. One experimenter (called the

 

first experimenter) will meet the subject and ask him/her
to complete the consent form. The subject will then be
escorted to the experiment room and seated in a reclining
chair facing a one-way mirror. The other experimenter
(called the second experimenter) has already seated him/
herself in the observation room behind the mirror. The
first experimenter then provides the following instructions:

We are conducting an investigation of the ways in

which peOple can achieve deep relaxation. Before

we begin the relaxation session itself, I'd like

you to just take a couple minutes to become accus-

tomed to being in this room. GO ahead and push back

the recliner to a position in which you are comfortable.

OK, I'm going to leave the room now and will return
shortly to continue the experiment. Please notice that

89
during this experiment we will both be observed through
this one-way mirror by another experimenter.
The first experimenter then leaves the room. As soon as the
door is shut, the second experimenter completes the Body
Movements Checklist (BMC) on the subject to get a measure
of the subject's general degree of activity (you will

receive training with this later on). This measure is com-

“L

pleted by taking eight alternating 15 second intervals; 15

seconds to observe movements, 15 seconds to record them, 15

seconds to observe, 15 seconds to record, etc., for the two *‘
minute period. The second experimenter will have a tape

which will "beep" at 15 second intervals so he/she will

not need to keep looking at a stopwatch.

Relaxation training. The first experimenter then

 

re-enters the room (you will need a watch) and the subject
receives one of three treatments.

(1) Experimenter-administered relaxation. The

 

first experimenter informs the subject that the rest of
the session will be spent learning and practicing a method
of becoming relaxed. The experimenter presents the intro—
duction and rationale to relaxation training (see attached
sheets: "Introduction to Experimenter-administered
Relaxation"). It is not necessary to memorize this
"speech" (or any of the other "speeches" in this study);
you should be able to deliver it smoothly and naturally,
but it is quite alright if you refer to your written copy.

Following this, the relaxation procedure itself is

90

presented and should be read directly from the transcript
(see attached sheets: "Instructions for Experimenter-
administered Relaxation .raining"). The second experimenter
should follow along closely on his/her copy of the relaxa-
tion instructions and when a set of 3 asterisks is reached
should complete the Relaxation Rating Checklist (RXRC)

on the subject for one minute using 15 second intervals, as
with the BMC (you will receive training in this later on).
You will find two sets of asterisks; one on page 4 and one
on page 7.

When the first experimenter is done reading the
relaxation instructions, he/she gives the subject a self-
report measure to fill out on which the subject indicates
his/her degree of relaxation. When the subject has
finished, the first experimenter then says:

OK, that's about all for today. I have a relaxation
training tape I'm going to loan you for this week,
containing the same instructions I just read to you.
It is very important for you to practice relaxing once
each day in order for the procedure to have a chance
to work--if you don't practice each day it may not have
any effect. In three or four days I'll call you on
the telephone to see how things are going for you. SO
unless you have any questions, I'll see you again next
(day) at (time) and will sign your experiment card
then.

(2) Self-administered relaxation. The first
experimenter states:

During the rest of this session you will have the
Opportunity to teach yourself and practice a method
of becoming relaxed. I have a sheet of instructions
which will direct you to a tape recorder and tapes
located here in the room, and will tell you exactly

how to proceed. (Hand the instructions to the sub—
ject--see attached sheets: "Instructions for

 

91,

Self-administered Relaxation: Session I"). I am going
to leave the room again and will check through the one-
way mirror so I'll know when you're finished. Then I'll
come back in and we'll finish up. If you have any ques-
tions just try to figure them out as best you can.

The first experimenter then leaves the room and the
subject carries out the instructions. The second experi-
menter should again follow along carefully with the tape
and complete the RXRC at the points marked with an asterisk
in the relaxation training transcript (just like with the
experimenter-administered group). When the relaxation tape
is over the subject completes the self-report measure. The
experimenter then re-enters the room and says:

OK, that's about all for today. As the instruction
sheet said, be sure to take the tape and progress chart
home with you. It is very important for you to prac-
tice relaxing once each day in order for the procedure
to have a chance to work-~if you don't practice each
day it may not have any effect. So unless you have any
questions, I'll see you again next (day) at (time) and
will sign your experiment card then. Remember to bring

the tape and progress chart back next week.

(3) Cognitive relaxation. The first experimenter

 

states that he/she will be explaining to the subject a
method of becoming relaxed. The first experimenter then
presents the introduction and rationale of the cognitive
relaxation procedure (see attached sheets: "Rationale:
Cognitive Relaxation"). The experimenter then leaves the
room and the second experimenter begins timing when the
door is shut. After lg minutes have elapsed, the second
experimenter completes the RXRC on the subject as in the
other groups; after a total of gag minutes have elapsed,

the second experimenter again completes the RXRC. When

 

 

92

the 25 minute period has elapsed, the first experimenter
re-enters the room and gives the subject the self-report
relaxation measure. The experimenter should then say:

OK, that's about all for today. I would like for you
to practice this procedure each day for about 25
minutes. This daily relaxation practice is very
important in order for the procedure to have a chance
to work--if you don't practice each day it may not have
any effect. After each practice session record how
relaxed you became on a scale of 1-100; do not put your
name on this record and bring it with you next week.

SO unless you have any questions, I'll see you again
next (day) at (time) and will sign your experiment

card then.

 

The second session. The second session will proceed
in a manner very similar to the first, except that certain
portions may be omitted or replaced. The "speech" intro-
ducing the adaptation period should be presented as follows.

During this session we will be doing much the same thing
as we did last week. As before, I'd like to begin by
having you just take a couple minutes to become accus-
tomed to being in this room. Go ahead and push back
-the recliner to a position in which you are comfortable.
OK, I'm going to leave the room now and will return
shortly to continue the experiment. Please notice that
during this experiment we will both be Observed through
this one-way mirror by another experimenter.
The first experimenter leaves the room and the second
experimenter makes the ratings as before. When the experi-
menter returns, the subject receives the same type of
relaxation as he received the first session.

(1) Experimenter-administered relaxation. The
experimenter informs the subject that:

This week we'll be doing the same relaxation procedure
we did last week; the one you've been practicing.

Unless you have any questions, I'd like to go ahead and
begin. OK, if you're wearing contact lenses please take

93

them out. If you're ready, then close your eyes and
we'll begin.

The experimenter then reads the relaxation instructions
while the second experimenter completes the RXRC as before.
Following the relaxation period, the subject completes
the self—report measure.
(2) Self-administered relaxation. The experimenter
states:
This week we'll be doing much the same thing as we did
last week. Here is an instruction sheet telling you
exactly what to do. If you have contact lenses, please
be sure to remove them before relaxing. Unless you have
any questions I'll go ahead and leave the room and
return when you are done.
The subject then follows the instructions (see attached
sheet: "Instructions for Self-administered Relaxation:
Session II"), and the second experimenter completes the
RXRC as before. The first experimenter then returns after
the subject completes the self-report measure.
(3) Cognitive relaxation. The experimenter informs
the subject that:
This week we'll be doing the same relaxation procedure
as we did last week; the one you've been practicing.
Unless you have any questions, I'd like to go ahead
and begin. OK, if you're wearing contact lenses please
take them out. If you're ready, then close your eyes
and begin. I'll return in 25 minutes.
The experimenter then leaves the room, and the second
experimenter completes the RXRC as before. The first

experimenter then returns and the subject completes the

self-report measure.

94

At this point, materials such as tapes, graphs,
etc., should be collected from the subject. The experi-
menter then signs the subject's experiment card and thanks

him/her for participating.

REFERENCE NOTE

REFERENCE NOTE

1J. Pretzer, The Relaxation Rating Checklist.
Unpublished measure, 1978.

95

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