Effects of metronome-conditioned relaxation,metronome-induced relaxation,and progressive muscle relaxation on insomnia

Although several controlled studies have indicated that relaxation can be effectively employed in the treatment of insomnia (Borkovec and Fowles, 1973; Steinmark and Borkovec. 1974; Haynes et al., 1974), the relaxation training procedures thus far utilized have typically necessitated several hours of therapist-client contact. The possibility of a more efficient relaxation procedure for treating insomniacs suggests an attractive alternative to the tense-relax instructions of progressive muscle relaxation (Jacobson, 1938). Brady (1973) has reported that the sound of a metronome set at 60 beats per min is inherently relaxing, and although he has only reported on the effects of the metronome when paired with verbally-induced relaxation (both general suggestions of relaxation and instructions to tense and relax successive muscle groups), he has successfully employed this technique in the treatment of borborygmi (rumbling noises in the abdomen) and essential hypertension (Brady, 1973; Brady, Luborsky and Kron, 1974). If the sound of the metronome alone, which would require minimal therapist-client contact, is sufficient to induce relaxation, the efficiency with which relaxation can be achieved in the treatment of insomnia, as well as other tension-related disorders. may be greatly enhanced.The present study was designed to assess the relaxation-inducing properties of (a) Brady's metronome-conditioned relaxation (metronome plus verbal relaxation instructions), (b) progressive muscle relaxation and (c) metronome-induced relaxation (the sound of a metronome alone) in the treatment of insomnia. In order to provide an evaluation of the effectiveness of relaxation techniques with a broader population than was sampled in previous investigations of this nature, this study included employed adults as well as college students in the subject pool. In addition to its implications for treating insomnia, this study was designed to yield an independent test of the hypothesis that a 60 beat per min metronome sound has the capacity by itself to induce relaxation.     

A self-administered program for public speaking anxiety.

Therapist-administered desensitization was compared with a take-home manual for self-administering desensitization, where the self-administering subjects had varying degrees of contact with therapists. These treatments were compared with an attention-placebo procedure and no-treatment controls. None of the treatment procedures had any effect on behavioural manifestations of anxiety in public-speaking phobics, but all treatment subjects showed greater reductions in subjective anxiety than either of the control groups. The drop-out rate was greatest for the no-contact manual group indicating the value of brief supervision in its use. The implications of the failure to change overt behaviour in view of Paul's (1966) earlier findings, are discussed.     

A three-year follow-up of older adult participants in a memory-skills training program

This study examined the long-term effects of participation in a self-taught memory training program. In all, 27 memory training and 13 nontraining participants were assessed at approximately 3-year follow-ups. Assessment of these groups prior to the introduction of training had revealed nonsignificant differences in memory performance but marked differences in level of memory complaints, with training participants evidencing higher levels of complaints. The current assessment again demonstrated overall nonsignificant differences in memory performance but significant differences in memory complaints between the two groups. More specifically, the training group evidenced significant decreases in memory performance over the 3-year interval, but no significant changes in memory complaints were observed for either group. Thus, memory training appeared to have little long-term effect on memory functioning. Future research should explore long-term maintenance strategies in memory training with older adults.     

VR-based conversation training program for patients with schizophrenia: a preliminary clinical trial.

Schizophrenia is a devastating mental illness and is characterized by hallucinations and delusions as well as social skills deficits. Generally, social skills training designed to help patients develop social skills includes role-playing, but this form of training has typical shortcomings, which are largely due to a trainer's difficulties to project emotion. Virtual reality (VR)-based techniques have the potential to solve these difficulties, because they provide a computer-generated but realistic three-dimensional world and humanlike avatars that can provide emotional stimuli. In this paper, we report on a method of implementing virtual environments (VEs) in order to train people with schizophrenia to develop conversational skills in specific situations, which could overcome the shortcomings of or complement conventional role-playing techniques. The paper reports the efficacy of the proposed approach in a preliminary clinical trial with 10 patients with schizophrenia.     

Skills training and self-administered desensitization in the reduction of public speaking anxiety.

The aim is to test the following hypotheses. Since desensitization targets only “feelings” of anxiety, and skills training targets only overt behaviors, the predictions based on the earlier findings (Marshall, Presse and Andrews, 1976; Paul, 1966) are as follows: (a) the combination of skills training and desensitization will be more effective than desensitization alone, but no more effective than skills training alone, in reducing behavioral manifestations of anxiety; (b) the combination will be more effective than skills training alone, but no more effective than desensitization alone, in reducing subjective distress; (c) skills training will be more effective than desensitization in reducing behavioral manifestations of anxiety; and (d) desensitization will be more effective than skills training in reducing subjective distress.     

Designed experience: a multiple, goal-directed training program in family therapy.

A family-therapy training program, one of three main branches of the "Boston model," is described in detail. Salient features of the program include planned integration of a multiplicity of experiential and cognitive learning modes; grounding in a unified, theoretical framework that is neither eclectic nor limited to a single school of thought; focus on nonpathological process in families; and systematic structuring in terms of specific, articulated, training objectives. The goal-directed design process by which training units are developed is explained.     

The efficacy of relaxation training with children

This paper reviews studies that have examined the efficacy of relaxation training techniques in the treatment of childhood disorders. Methodological problems encountered in doing research in this area resemble those found in working with an adult population: imprecise definitions of subject populations and use of a variety of dependent variables from one study to another. Findings suggest that relaxation training is at least as effective as other treatment approaches for a variety of learning, behavioral, and physiological disorders when it is continued over an extended period of time and is augmented by other supportive measures. Needs for future research include better follow-up studies and further investigations with a behaviorally disruptive population.The author would like to express his appreciation to Tricia O'Malley, Shirley Vickery, and Jim Evans for their useful suggestions in an earlier version of this paper, and particularly to Kathy Paget and two anonymous reviewers for their valuable editorial assistance and comments in preparing the final draft.     

A follow-up program for suicide attempters: evaluation of effectiveness.

Suicide attempters are a high-risk group in relation to ultimately completing suicide and are usually "treated and released" with little or no follow-up care. A 4-month follow-up outreach program for suicide attempters seen in the emergency room was developed with an emphasis on continuity and quantity of "treatment" received. Suicide attempters were randomly assigned to the "follow-up outreach" or "normal" treatment programs. Measures for the evaluation of effectiveness were (a) incidence of suicide reattempts and purposive accidents and (b) prevalence of drug misuse and excessive use of alcohol. The experimental group showed a statistically significant reduction in suicide reattempts and excessive use of alcohol, while the reduction of drug abuse, although not statistically significant, did conform to a trend indicating improvement. Purposive accidents occured at a relatively equal rate among both groups.