Interventions used to promote relaxation at our Day Hospital

In a recent post I wrote that I’d had the most amazing job as senior nurse in our Day Hospital (DH) and wrote of the visualisation techniques we used with our patients. If you’re a nurse or student nurse, the following activities and interventions might interest you in particular. However, if you’d just like a short relaxation exercise, scroll down to relaxation tips.

Evidence based therapeutic groups that promote relaxation

Well-attended art therapy — Creativelywildartstudio.com
  • Art — you don’t have to be Picasso – just paint what you feel. This group was well attended and any patient topics that arose here would later be picked up and discussed during a patient’s therapeutic time with their named nurse.
  • We had a celebrated local artist who worked alongside one of our nurses and patients each week. This artist had the patients’ artwork framed and organised two exhibitions in well know banks in the City of London. Yes, there was one or two celebs in attendance and most of the patient’s artwork sold. One elderly lady was delighted, of course, with the £350 she got for one of her paintings.
  • Weekly swimming at the local pool; it’s well documented that exercise can boost your mood.
  • We had our own gym with two instructors. Even the staff joined in — four of us (two staff, two patients) did a charity run for cancer and we each romped home in less than 40 minutes.
  • Groups would often visit a local garden centre that grew seedlings and plants with people who have mental health problems – many patients found it relaxing and best of all, they really enjoyed seeing their seedlings grow
  • We’d play charades and other board games to keep patients occupied when they didn’t have another of their activities going on — Chris Mounsher says playing games, especially as you get older is beneficial as an active brain is at lower risk of cognitive decline. A study in the New England Journal of Medicine showed that playing board games was associated with a reduced risk of dementia and Alzheimer’s disease. The old adage ‘use it or lose it’ seems to have some truth after all.

Evidence based therapeutic interventions used to promote relaxation

Seated massage — Anon
  • Visualisation (previous post)
  • Indian head massage (you can do this without patients’ having to remove any clothing)
  • Seated massage — a well populated intervention which patients had to queue for unfortunately
  • We had a yoga teacher come in twice a week
  • Basic Cognitive Behavioural Therapy (CBT) skills for patients who experienced depression, anxiety, panic attacks, OCD and phobias in small groups or for individuals
  • We had therapeutic one to one’s with patients on a weekly basis using mainly CBT techniques but I often popped into my virtual mental health toolbox to find other evidence based techniques I could use
  • Guided Relaxation was carried out each day by one or two nurses who had attended evidence-based training in relaxation techniques.

There are various relaxation techniques such as breathing, body scan, guided imagery and mindfulness and depending on the various mood of the attendees, we’d pick an appropriate method for that session. Outcomes were monitored using Beck’s Anxiety Inventory (BAI) and/or Beck’s Depression Inventory (BDI).

This group was always very well-attended and patients both enjoyed and benefited from the relaxation group.

You’ll note that our activities and interventions were designed to promote, amongst other benefits, relaxation.

Let’s talk about relaxation

Effects of stress on your body — Medindia.net

It’s impossible to avoid all the various stresses that life throws at us; those small irritations like late trains, traffic jams or babysitter not turning up to more troublesome worries like losing your job, facing unemployment or the imminent death of a loved one.

Stress impacts on both the body and the mind. It doesn’t matter what causes it – stress floods your body with hormones — your breathing gets quicker, your heart thuds, your muscles tense and you might find you need to use the bathroom – now. However, while we can’t stop the stressors, we can develop healthier ways of responding to them.

One way is to invoke the “relaxation response,” through a technique first developed in the 1970s at Harvard Medical School by cardiologist Dr. Herbert Benson, editor of the Harvard Medical School Special Health Report Stress Management: Approaches for preventing and reducing stress.

The relaxation response is the opposite of the stress response. It’s a state of profound rest that can be reached in many ways. With regular practice, you’ll be able to elicit the relaxation response quickly, as and when the need arises.

I’ve previously mentioned, as with any new skills, you must practice, practice, practice. Imagine trying to drive down a motorway if you’ve only ever practiced driving once.

There are various relaxation techniques such as breathing, body scan, guided imagery and mindfulness and depending on the various mood of the attendees, we’d pick an appropriate method for that session. Outcomes were monitored using Beck’s Anxiety Inventory (BAI) and/or Beck’s Depression Inventory (BDI).

This group was always very well-attended and patients both enjoyed and benefited from the relaxation group.

Relaxation tips

I’m aware of the difficulty of trying to relax, I know it’s not an easy skill to pick up on your own. But there are a few thing you can start to do immediately:

Relax quickly —Stop, think & breath
  • Stop what you’re doing – now and just for a moment
  • Exhale — puff outwards lightly for 3-5 seconds and let your breathing slow naturally, don’t think about it too much
  • Let your shoulders down from your ears — do this now
  • Unclench your teeth and wiggle your jaw a couple of times — ensure you now have a gap between your teeth
  • Let your body slouch naturally into your seat — let your stomach muscles droop and sag (don’t worry that anyone can see you)
  • Uncross your legs and place your feet flat on the floor
  • Unclench your fists and let them rest naturally on your thighs

Just doing these things can immediately start the relaxation response because, and remember this, your body cannot be relaxed and tense at the same time. So if your body is relaxed, it’s telling your brain that you’re relaxed. If you’re tense your brain presume danger and it gets you ready for the fight or flight response.

— Image by Hot yogini

You could try to practice the above exercise regularly; at home, at work, on the bus or train (don’t worry, nobody would even notice and guess what, you don’t even have to sit cross legged).

Once you’ve been able to master this technique you might want to go to youtube to find short relaxation videos (I’m showing my age here), with visuals and sound, to start with.

Don’t beat yourself up if you think you couldn’t do it. Stop and try again another time. Don’t give up if you think it didn’t work. Stop and try again another time. Keep going and don’t stop — try to find a relaxation video or cd that works for you.

But do keep the short exercise above in mind and practice this whenever possible. I used to do this 10-20 times a day, honestly — in bed, at work, at uni or in my car before I switched the engine on. And now I can do it whenever I need it.

Now I know I’m going to get the relaxation haters but I’d still like to know about your experiences.

Author: mentalhealthfromtheotherside.wordpress.com

Mum to two amazing sons. Following recovery from a lengthy psychotic episode, depression, anxiety and anorexia, I decided to train as a Mental Health Nurse and worked successfully in various settings before becoming a Ward Manager. I am a Mental Health First Aid Instructor and a Mental Health Awareness Trainer, Mental Health First Aid Youth and Mental Health Armed Forces Instructor. Just started my mental health from the other side blog.

29 thoughts on “Interventions used to promote relaxation at our Day Hospital”

  1. Aha! I’m starting to do it. I ‘hear’ you say it sometimes ‘drop your shoulders’ and wiggle the jaw (that is because I’m in pain). I mean that it does help when practiced on the regular.
    I love love love all the activities you and the staff implemented for the patients! Sounds incredible. We did some of those too but definitely not that many.
    One thing that was positive was dog walking (with dogs from a shelter) and the fact that we had a dog on the ward ❤ that was so fun to have him around; We also had bunnies and three cats but those were from one lady. Some birds in cages and occasionally a guinea piggie or fishies in the tank. I wanted chickens too but there was no consensus yet (meaning nobody liked my splendid idea) 😄

    Liked by 1 person

  2. Like Kacha mentioned, animals are great for relaxation. I used to take them to work sometimes, and patients responded so well to them.

    I remember being fairly anti-group when I’ve been hospitalized before. My last hospitalization they were quite annoyed with me because I refused to attend any groups. I don’t tend to respond well to being told what to do, though.

    Liked by 1 person

    1. I agree with you both, I’m sure there’s lots of benefits from being around animals.

      Oh, I understand. Of course we had patients who didn’t like group work. I didn’t like it when I went to group therapy for the abuse stuff – their ‘good cop’, ‘bad cop’ tactics just bugged the hell out of me. And some of the other attendees ‘topping’ someone else’s ‘story’ – don’t me started lol.

      I wouldn’t like being told what to do either – You’d have thought they’d have more effective ways to encourage people to attend groups or do one to one’s with you.

      Liked by 1 person

  3. I think I’m physically incapable of relaxation! I’ve tried guided relaxation and progressive muscle relaxation over the years, and I can’t do it! It’s been a problem my whole life! I just live with it, though!

    Liked by 1 person

      1. That’s great!! yeah, I mean, I’m not even aware of it. It’s become something that I don’t even notice anymore, so it’s not all that big a deal, I hope? Huh, I can’t keep my feet flat on the floor, though. I have short legs, so I have a footstool under my computer table! But anyway, I love your continued descriptions of what must be the mental hospital from heaven. Ohh! I’d love to be hospitalized there if I were to become unwell again! It sounds divine!!

        Liked by 1 person

  4. The relaxation techniques are something I did in my pilates class and like you say, it does take practise.
    I have slacked over the last frw years and with the year I had last year, I do need to get doing it a little bit more than I have been doing.

    Liked by 1 person

    1. Just letting you know this was me that left comment. For some strange reason I came up anom, even though I am logged in.

      From Liz at mywellbeingandlearningjourney.wordpress.com

      Liked by 1 person

      1. Yes it was odd to say I could see I was signed in. I have not experienced it before, hence I put my name and blog link in comment. But that one turned out ok and you could see it was me. First with everything with WordPress I suppose.

        Liked by 1 person

  5. I was always relaxing wrong, and I know that sounds silly but I just couldn’t do it. Finally, a councilor I was seeing was able to explain it in just the right way. I have to do so many checks a day but it’s been working! I can relax so much faster than I ever thought I’d be able to. I find my jaw clenches and my shoulders stiffen lots. Practice makes progress 😀 Meditation for me is a must even if it’s only 3 minutes at a time

    Liked by 1 person

      1. I actually like Jackson Pollock. The organized disorganization acts as a kind of catharsis. I have a Jackson Pollock print in my bedroom. Though I like the paintings of Jackson Pollock I would in all probability just have flicked the colors around.

        Liked by 1 person

  6. I try to be aware of when I’m getting into stress mode, but sometimes it sneaks up on me. One time I was walking to work and it was really cold, so I started walking fast and breathing in short shallow bursts. I started to feel frightened and couldn’t figure out why. Then I realized I was moving and breathing as if I were running from some danger. Forcing myself to slow down and take deep breaths took away that sense of fear. It was amazing to see the principle of the brain following the body in action!

    Liked by 1 person

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