CLINICAL PSYCHOLOGY

MSc SEM IV

By
Prof. Archana and Prof. Akshara a
Assistant Professor
Department of Psychology
Center for Distance and Online Education,
Jain (Deemed-to-be University),
Bengaluru.
Contents
Jacobson’s Progressive Muscle Relaxation (JPMR) - by Prof. Archana

Systematic Desensitization - by Prof. Akshara

For Conduction: (In the other PPT)

Bell’s Adjustment Inventory - by Prof. Dhruthi

Emotional Maturity Scale - by Prof. Dhruthi
NEO - Five Personaality Inventory - by Prof. Dhruthi
RELAXATION TECHNIQUES
Relaxation training procedures are strategies that people use to decrease the autonomic
arousal that they experience as a component of fear and anxiety problems - tense
muscles, rapid heart rate, cold hands, and rapid breathing.

The person engages in specific relaxation behaviors that result in bodily responses
opposite to the autonomic arousal - decreases in muscle tension, heart rate, and breathing
rate and warming of the hands.

Apart from mental and physical relaxation, the individual develops a feeling of control
and starts assuming responsibility for management of his life and health.
Jacobson’s Progressive Muscle Relaxation (JPMR)
Dr Edmund Jacobson invented this technique in the 1920’s
It is a type of relaxation technique that focuses on sequential

tightening and relaxing of each of the major muscle groups in the

body.
It is also known as progressive relaxation therapy
It involves tightening of one muscle group, while keeping rest of

the body relaxed and then releasing the tension.

By concentrating on specific areas, tensing and relaxing them, one

can become more aware of their body and physical sensations.

Muscle pain, tension and stiffness are common
symptoms brought on by stress and anxiety.

Jacobson’s Progressive Muscle Relaxation

Technique have reverse effect on the body eliciting
the relaxation response, lowering the heart rate,
calming the mind and reducing bodily tension.

It can also help a person become more aware of

how their physical stress may be contributing to
their emotional state
CONDUCIVE ENVIRONMENT

Quite room
No major distraction
Loose clothing
Remove any articles of clothing or jewelry that might interfere with the
relaxation exercises.
PROCEDURE
First, get into a physically comfortable position
either sitting on a chair or lying down (rug, mat or
bed)

Keep the eyes closed.

Avoid stray thoughts & extra movements of the

body

Tense (5 seconds) and release the tension & focus

on relaxation (10 seconds) of each muscle group
(1:2 ratio)

Relax by taking three deep breaths inhaling

through nose and exhaling through mouth after
each step
As you exercise from head to toe, observe the changes like the tension & the
development of light & soothing sensations.

The decreased level of tension or relaxed state of the muscles is pleasant and easily
discriminable

Repetition of the process until all of the muscle groups have been tensed and relaxed.

Once people have practiced JPMR several times, they can begin to relax themselves
without tensing and relaxing each muscle group.
BENEFITS

Reduces Anxiety and tension

Reduced blood pressure
Decreased muscle tension
Feeling of well being
Decreases frequency of migraine attacks
Improves Sleep
CONTRAINDICATIONS

Not suitable for individuals with high blood pressure or other cardiovascular
problems as the isometric contractions involved in contract-relax methods can
temporarily increase blood pressure.

If there are any injuries, or a history of physical problems, any form of chronic
medical or psychological health problem, it is advisable to consult the doctor before
beginning.

In some individuals’ relaxation techniques may enhance the action of certain drugs
SYSTEMATIC DESENSITIZATION
Exposure therapy
Graded exposure: The psychologist helps the client construct an exposure fear

hierarchy, in which feared objects, activities or situations are ranked according

to difficulty (habituation)

Flooding: Begin exposure with the most difficult tasks.

Systematic desensitization - combined with relaxation exercises to make them

feel more manageable and to associate the feared objects, activities or

situations with relaxation.

Systematic Desensitization
It is a therapeutic technique that is used to help
individuals overcome anxiety, phobias, and

other fear-based responses.

It was developed by Joseph Wolpe in the 1950s

and is based on the principles of classical
conditioning.

Works well when we know the anxiety triggers.

SD Theoretical Bases
Based on principles of classical conditioning

Counter conditioning through reciprocal

inhibition
SD Theoretical Bases
Reciprocal inhibition : Wolpe introduced the concept of reciprocal inhibition, which

suggests that it is difficult for an individual to experience two conflicting emotional or

physiological responses simultaneously.

In the context of systematic desensitization, the relaxation response is incompatible

with the anxiety response. By pairing relaxation with the anxiety-provoking

stimulus, the goal is to inhibit the anxiety response.
SD - Procedure
3 steps

Relaxation Training
Construction of Fear Hierarchy

Desensitization or Exposure
Phase 1 - Relaxation
The first step is to teach the client relaxation techniques.

The common relaxation techniques are

◦ Breathing techniques, e.g. square breathing
◦ Progressive Muscle Relaxation
◦ Meditation
◦ Visualization or Mental Imagery
Phase 2 – Fear Hierarchy
Subjective Units of Distress Scale (SUDS): A
self-report scale - measure the subjective

intensity of a person's emotional or distress

level in response to a specific stimulus or

situation. (0-100)
Phase 2 – Fear Hierarchy
Why rate anxiety?
Helps decide where to start.

It keeps track of progress.

Phase 3 - Exposure
Invivo (external cue exposure) vs Invitro (internal cue exposure)

Exposure practice requires repetitive, prolonged exposures to the anxiety

itself.
Limitations
In vitro exposure depends on clients abilities (Individual differences).

It is a slow process.
It is highly effective only where the problem is a learned anxiety of specific

objects/situations.

Treats the symptoms not the causes. (Eg. Social Anxiety)