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.