For this project, select an organization that has leveraged Cloud Computing technologies in an attempt to improve profitability or to give them a competitive advantage. Research the organization to understand the challenges that they faced and how they intended to use Cloud Computing to overcome their challenges. Once you have chosen an organization, this will be the organization you use throughout the remainder of the course. This paper should be written in third-person. The third-person point of view belongs to the person (or people) being talked about. The third-person pronouns include he, him, his, himself, she, her, hers, herself, it, its, itself, they, them, their, theirs, and themselves (Not I, we, us, our). 

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Guided Imagery and Progressive Muscle Relaxation in Group Psychotherapy

Hannah K. Greenbaum

George Washington University

PSYC 3170: Clinical Psychology

Dr. Tia M. Benedetto

October 1, 201

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Guided Imagery and Progressive Muscle Relaxation in Group Psychotherapy

A majority of Americans experience stress in their daily lives (American Psychological

Association, 2017). Thus, an important goal of psychological research is to evaluate techniques

that promote stress reduction and relaxation. Two techniques that have been associated with

reduced stress and increased relaxation in psychotherapy contexts are guided imagery and

progressive muscle relaxation (McGuigan & Lehrer, 2007). Guided imagery aids individuals in

connecting their internal and external experiences, allowing them, for example, to feel calmer

externally because they practice thinking about calming imagery. Progressive muscle relaxation

involves diaphragmatic breathing and the tensing and releasing of 16 major muscle groups;

together these behaviors lead individuals to a more relaxed state (Jacobson, 1938; Trakhtenberg,

2008). Guided imagery and progressive muscle relaxation are both cognitive behavioral

techniques (Yalom & Leszcz, 2005) in which individuals focus on the relationship among

thoughts, emotions, and behaviors (White, 2000).

Group psychotherapy effectively promotes positive treatment outcomes in patients in a

cost-effective way. Its efficacy is in part attributable to variables unique to the group experience

of therapy as compared with individual psychotherapy (Bottomley, 1996; Yalom & Leszcz,

2005). That is, the group format helps participants feel accepted and better understand their

common struggles; at the same time, interactions with group members provide social support and

models of positive behavior (Yalom & Leszcz, 2005). Thus, it is useful to examine how stress

reduction and relaxation can be enhanced in a group context.

The purpose of this literature review is to examine the research base on guided imagery

and progressive muscle relaxation in group psychotherapy contexts. I provide overviews of both

guided imagery and progressive muscle relaxation, including theoretical foundations and

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historical context. Then I examine guided imagery and progressive muscle relaxation as used on

their own as well as in combination as part of group psychotherapy (see Baider et al., 1994, for

more). Throughout the review, I highlight themes in the research. Finally, I end by pointing out

limitations in the existing literature and exploring potential directions for future research.

Guided Imagery

Features of Guided Imagery

Guided imagery involves a person visualizing a mental image and engaging each sense

(e.g., sight, smell, touch) in the process. Guided imagery was first examined in a psychological

context in the 1960s, when the behavior theorist Joseph Wolpe helped pioneer the use of

relaxation techniques such as aversive imagery, exposure, and imaginal flooding in behavior

therapy (Achterberg, 1985; Utay & Miller, 2006). Patients learn to relax their bodies in the

presence of stimuli that previously distressed them, to the point where further exposure to the

stimuli no longer provokes a negative response (Achterberg, 1985).

Contemporary research supports the efficacy of guided imagery interventions for treating

medical, psychiatric, and psychological disorders (Utay & Miller, 2006). Guided imagery is

typically used to pursue treatment goals such as improved relaxation, sports achievement, and

pain reduction. Guided imagery techniques are often paired with breathing techniques and other

forms of relaxation, such as mindfulness (see Freebird Meditations, 2012). The evidence is

sufficient to call guided imagery an effective, evidence-based treatment for a variety of stress-

related psychological concerns (Utay & Miller, 2006).

Guided Imagery in Group Psychotherapy

Guided imagery exercises improve treatment outcomes and prognosis in group

psychotherapy contexts (Skovholt & Thoen, 1987). Lange (1982) underscored two such benefits

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by showing (a) the role of the group psychotherapy leader in facilitating reflection on the guided

imagery experience, including difficulties and stuck points, and (b) the benefits achieved by

social comparison of guided imagery experiences between group members. Teaching techniques

and reflecting on the group process are unique components of guided imagery received in a

group context (Yalom & Leszcz, 2005).

Empirical research focused on guided imagery interventions supports the efficacy of the

technique with a variety of populations within hospital settings, with positive outcomes for

individuals diagnosed with depression, anxiety, and eating disorders (Utay & Miller, 2006).

Guided imagery and relaxation techniques have even been found to “reduce distress and allow

the immune system to function more effectively” (Trakhtenberg, 2008, p. 850). For example,

Holden-Lund (1988) examined effects of a guided imagery intervention on surgical stress and

wound healing in a group of 24 patients. Patients listened to guided imagery recordings and

reported reduced state anxiety, lower cortisol levels following surgery, and less irritation in

wound healing compared with a control group. Holden-Lund concluded that the guided imagery

recordings contributed to improved surgical recovery. It would be interesting to see how the

results might differ if guided imagery was practiced continually in a group context.

Guided imagery has also been shown to reduce stress, length of hospital stay, and

symptoms related to medical and psychological conditions (Scherwitz et al., 2005). For example,

Ball et al. (2003) conducted guided imagery in a group psychotherapy format with 11 children

(ages 5–18) experiencing recurrent abdominal pain. Children in the treatment group (n = 5)

participated in four weekly group psychotherapy sessions where guided imagery techniques were

implemented. Data collected via pain diaries and parent and child psychological surveys showed

that patients reported a 67% decrease in pain. Despite a small sample size, which contributed to

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low statistical power, the researchers concluded that guided imagery in a group psychotherapy

format was effective in reducing pediatric recurrent abdominal pain.

However, in the majority of guided imagery studies, researchers have not evaluated the

technique in the context of traditional group psychotherapy. Rather, in these studies participants

usually met once in a group to learn guided imagery and then practiced guided imagery

individually on their own (see Menzies et al., 2014, for more). Thus, it is unknown whether

guided imagery would have different effects if implemented on an ongoing basis in group

psychotherapy.

Progressive Muscle Relaxation

Features of Progressive Muscle Relaxation

Progressive muscle relaxation involves diaphragmatic or deep breathing and the tensing

and releasing of muscles in the body (Jacobson, 1938). Edmund Jacobson developed progressive

muscle relaxation in 1929 (as cited in Peterson et al., 2011) and directed participants to practice

progressive muscle relaxation several times a week for a year. After examining progressive

muscle relaxation as an intervention for stress or anxiety, Joseph Wolpe (1960; as cited in

Peterson et al., 2011) theorized that relaxation was a promising treatment. In 1973, Bernstein and

Borkovec created a manual for helping professionals to teach their clients progressive muscle

relaxation, thereby bringing progressive muscle relaxation into the fold of interventions used in

cognitive behavior therapy. In its current state, progressive muscle relaxation is often paired with

relaxation training and described within a relaxation framework (see Freebird Meditations, 2012,

for more).

Research on the use of progressive muscle relaxation for stress reduction has

demonstrated the efficacy of the method (McGuigan & Lehrer, 2007). As clients learn how to

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tense and release different muscle groups, the physical relaxation achieved then influences

psychological processes (McCallie et al., 2006). For example, progressive muscle relaxation can

help alleviate tension headaches, insomnia, pain, and irritable bowel syndrome. This research

demonstrates that relaxing the body can also help relax the mind and lead to physical benefits.

Conclusion

Limitations of Existing Research

Research on the use of guided imagery and progressive muscle relaxation to achieve

stress reduction and relaxation is compelling but has significant limitations. Psychotherapy

groups that implement guided imagery and progressive muscle relaxation are typically

homogeneous, time limited, and brief (Yalom & Leszcz, 2005). Relaxation training in group

psychotherapy typically includes only one or two group meetings focused on these techniques

(Yalom & Leszcz, 2005); thereafter, participants are usually expected to practice the techniques

by themselves (see Menzies et al., 2014). Future research should address how these relaxation

techniques can assist people in diverse groups and how the impact of relaxation techniques may

be amplified if treatments are delivered in the group setting over time.

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