Applied relaxation

Domain II · Behavioural & cognitive · Lars-Göran Öst · 1987 · Sweden

What it is

Applied relaxation is a manualised CBT coping-skills treatment, developed in Sweden for phobias, panic and generalised anxiety, in which the client learns to notice the earliest signs of anxiety and switch on a relaxation response fast enough (the target is 20–30 seconds) to use it in almost any…

Format

• Format. Individual, weekly sessions of about 50–60 minutes, usually 10–15 sessions in total. Öst's own trials used about 12–13 sessions (Öst, 1985 case studies; Öst & Breitholtz, 2000: 12 weekly sessions). Borkovec's GAD versions used 12–14 longer sessions of 90–120 minutes. Dugas et al. (2009)…
• Session structure. Andersson & Kaldo use the same order each session: check-in, agenda, review of homework and practice records, new skill taught and rehearsed in session, and next homework set.

Who practises it, and how they are trained or regulated

• Robertson gives about 10–12 training sessions after assessment. The Andersson & Kaldo tinnitus version compresses the steps into 6–10 sessions and has no separate differential stage.
• Version followed: Lars-Göran Öst's applied relaxation (AR) as described in Öst (1987), the six-stage sequence (progressive, release-only, cue-controlled, differential, rapid relaxation, then application training) plus self-observation before and a maintenance programme after. Öst's 1987 paper itself is not drawn on; stage contents and timings below come from a detailed secondary summary of it (Robertson, 2011) and…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Clients who rush. Pacing should be slow enough to feel each area. It is working when tension drops to near the level reached with tension-release, in roughly half the time.
• Records filled in retrospectively just before the session, and "before" ratings that are already near zero (practising only when calm is fine early on, but note it). It is working when…
• Dropping practice once symptoms improve (Andersson & Kaldo flag clients who feel they no longer need to practise). It is working when the client uses the skill spontaneously months later.
• Hyperventilation from too many deep breaths in a row. Watch for forgetting; use more visible cues or phone reminders. Watch for clients who use the cue but skip the scan. It is working when…
• Over-tensing (pain, cramp). Use moderate tension and skip injured areas. Watch for breath-holding during tensing and for sleepiness. It is working when the client can identify tension in specific…

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.