In the early 1900s, physician Edmund Jacobson began doing research on tension and relaxation and quickly learned that the long-term effects of tension could result in a number of problematic and potentially life-threatening conditions and disorders. Among these are fatigue, sleeplessness, excessive perspiration, tension headache, gastric disorders (e.g., constipation, diarrhea, ulcers, indigestion), general feelings of uneasiness, tightness in the chest, labored breathing, and various heart problems. Early on, Jacobson maintained that tension disorders might in fact be "more common than the common cold." Jacobson's research eventually led to the development of a relaxation procedure that he referred to as progressive relaxation. This procedure involved the systematic tensing and relaxing of each of the body's major muscle groups while the therapist provided concurrent instructions for the trainee to observe the differences he/she felt between relaxation and tension.

During ensuing years, other researchers have made additional modifications to Jacobson's and Wolpe's procedures. One such modification, behavioral relaxation training (BRT), developed by Schilling and Poppen, is of particular interest. Like PRT, BRT is a systematic procedure for relaxing each of the major muscle groups; however, unlike PRT, BRT does not require the trainee to contract his/her muscles. Instead, the therapist models both relaxed and unrelaxed behaviors and asks the trainee to imitate the relaxed positions; manual guidance and verbal prompts are used as needed. An additional modification to Jacobson's procedure is the practice of pairing a word such as calm or relax with the trainee's relaxed response. Doing so establishes the verbal cue as a setting condition for achieving an overall state of relaxation. Once established, external verbal cues can be utilized to help trainees control levels of arousal in those situations that can be anticipated to trigger such responses.

My personal experience, both as a volunteer at the Biobehavioral Relaxation Training Clinic at the Community Resource Center in Tucson, Arizona and as a behavioral counselor and consultant at Counseling & Consulting Services, has shown PRT to be an effective intervention for dealing with behavioral problems in persons with developmental disabilities. PRT ultimately provides consumers with self-management techniques that are useful for addressing problems related to anger, anxiety, stress, panic disorders, hyperactivity, and fear. It can also be utilized as a component of an overall treatment program designed to reduce the occurrence of self-injurious behaviors, property destruction, aggression, inappropriate sexual behaviors, and disruptive behaviors. Once an individual has mastered progressive relaxation techniques, the skill can be transferred to environments and situations outside of the training setting, particularly when a trainee has been taught to relax to a verbal cue. A further advantage is that PRT programs can be implemented in group settings, making it a valuable treatment option for facilities experiencing staffing limitations.

For several of our clients, PRT has resulted in the reduction and/or elimination of psychotropic medications prescribed as treatment to reduce the occurrence of problematic behaviors. This last point is especially important due to the significant side effects associated with long-term administration of behavior-modifying medications. These side effects include abnormal involuntary movement disorders such as tardive dyskinesia and tardive akathisia, Parkinsonism, agitation, anemia, blurred vision, constipation, diarrhea, drowsiness, muscle rigidity, aggression, anxiety, inability to sleep, and many more. By contrast, PRT training has not been associated with any significant side effects.

Progressive muscle relaxation is a valuable coping skill that can be utilized by persons with developmental disabilities for self-management of a number of behavioral problems that would typically interfere with participation in employment, education, and leisure activities. In addition, improvement of social skills and subsequent increases in the frequency of positive interactions with peers, family members, and other care providers clearly indicate that PRT can contribute to the overall improvement in the quality of life of persons with developmental disabilities.

Caine, A., & Hatton, C. (1998). Working with people with mental health problems.

E. Emerson, C. Hatton, J. Bromley, & A. Caine, (Eds.), Clinical psychology and people with intellectual disabilities (pp. 210-230). New York: John Wiley & Sons.

Ferreira, J. B. (2004). Personal interview, Biobehavioral Relaxation Training Clinic at the Community Resource Center in Tucson, Arizona.

Jacobson, E. (1978). You must relax: Practical methods for reducing the tensions of modern living (5th ed.). New York: McGraw-Hill.

Martin, G., & Pear, J. (2002). Behavior modification: What it is and how to do it (7th ed.). Upper Saddle River, NJ: Prentice Hall.

Poppen, R. (1998). Behavioral relaxation training and assessment (2nd ed.). Thousand Oaks, CA: SAGE Publications.