Trauma Response: physical, emotional, & behavioral reactions to stimuli that trigger memory of prior trauma or add new trauma

Polytrauma: experiences of repeated trauma, typically co-occurring with other traumatic experiences and involving injury to the body

Resilience: the ability to recover and thrive in the face of trauma, stress or adversity

Protective Factors: characteristics that are associated with a lower likelihood of problem outcomes or reduce negative impacts of a risk factor

• includes personal (physical health & temperament) & contextual (social experiences, family income, community resources) factors

Interoception: a sensory system that processes physiological body signals such as heart rate, breathing, temperature, muscle tension, pain, etc.

Stress: physical & emotional reaction that people experience when encountering a challenging situation or perceived threat 

Stressor: a stimulus that triggers a stress response

Audience: Client 

Diagnosis(es)/Condition(s): Trauma & Stress-related disorders, Mood disorders, Anxiety disorders, Schizophrenia, ASD, ADHD, I/DD

Age Range/Population: All ages

Purpose: The purpose of this deep relaxation technique is to reduce stress and anxiety through the active contraction and progressive release of muscles, helping participants achieve a state of complete relaxation. By activating the body's relaxation pathways, PMR has been shown to alleviate stress and contribute to a reduction in symptoms of depression and anxiety, which are symptoms often associated with high stress and trauma (Toussaint et al., 2021). PMR promotes improved body awareness by helping individuals recognize the physical sensations associated with tension and relaxation, empowering them to gain greater control over their emotional and physiological responses. PMR requires minimal materials, space, and time, it is an accessible and effective intervention for use immediately. After repeated use, the reduction of symptoms will persist beyond the implementation period. 

Instructions: To start, find a quiet, comfortable place where the client can sit or lie down without distractions or interruptions. The client will close their eyes or focus on a fixed spot if they feel comfortable. They will begin with deep, slow breaths, through their nose and mouth, and begin to follow the script. They will be guided through a repeated sequence for each body area until the full body is relaxed and loose. The client can then reflect on how they feel between and after. This can be adapted for independent use by having a recording of the script playing to use outside of sessions. Children could also use this intervention by changing the language to be more fun and simpler for them to understand. 

Rationale & Impact on Function: Trauma and stress can create barriers to clients' engagement and performance in occupations, especially when left unattended. The physical symptoms associated with these disorders often exacerbate emotional distress, making it difficult for the individual to engage in daily activities, social roles, or work-related tasks. This technique aims to reduce physical tension and psychological stress by promoting awareness and control over bodily tension.  By limiting the effects of stress and trauma, clients can regain control over their educational pursuits, employment, social participation, health management, leisure exploration, and even ADLs & IADLs.

Reference: Progressive muscle relaxation script. (2017). Therapist Aid. https://www.therapistaid.com/therapy-worksheet/progressive-muscle-relaxation-script

Toussaint, L., Nguyen, Q.A., Roettger, C., Dixon, K., Offenbacher, M., Kohls, N., Hirsch, J., & Sirois, F. (2021). Effectiveness of progressive muscle relaxation, deep breathing, and guided imagery in promoting psychological and physiological states of relaxation. Evidence-Based Complementary &Alternative Medicine, 2021(1), 5924040.  https://doi.org/10.1155/2021/5924040