Relaxation Training Group Research Articles

Salivary testosterone and cortisol response in acute stress modulated by seven sessions of mindfulness meditation in young males

Stress is an established risk factor for negative health outcomes. Salivary cortisol and testosterone concentrations increase in response to acute psychosocial stress. It’s crucial to reduce stress for health and well-being through evidence-based interventions. Body-mind interventions such as meditation and Tai Chi have shown reduced cortisol levels but mixed results in testosterone concentration after stress. To address this research gap, we conducted a pilot randomized controlled trial to examine the modulating effects of a short-term (seven 20-minute sessions) mindfulness meditation on testosterone and cortisol in response to acute stress. Using one form of mindfulness meditation – Integrative Body-Mind Training (IBMT) and an active control–relaxation training (RT), we assessed salivary cortisol and testosterone concentrations at three stages of stress intervention – rest, stress, and an additional 20-min IBMT or RT practice. We found increased cortisol and testosterone concentrations after acute stress in both groups, but testosterone rise was not associated with cortisol rise. Moreover, an additional practice immediately after stress produced higher testosterone concentrations in the IBMT group than the RT group, whereas cortisol concentration increased in the RT group than in the IBMT group at the same time point. These findings indicate that brief mindfulness intervention modulates a dual-hormone profile of testosterone and cortisol in response to acute stress presumably via the co-regulation of hypothalamus-pituitary-adrenal and hypothalamus-pituitary-testicular axes.

Combined mind-body intervention for premenstrual dysphoric disorder: A randomized controlled trial

In this study, we aimed to examine the effectiveness of relaxation training in women with PMDD through a randomized controlled design. Sixty-three women were recruited and randomized to relaxation training or control groups. The outcome measurements, administered at baseline and post-training, included the Premenstrual Symptoms Screening Tool (PSST), Hospital Anxiety and Depression Scale (HADS), Nottingham Health Profile (NHP), and Sheehan Disability Scale (SDS). The intervention group received 12 sessions of relaxation training, including progressive muscle relaxation and guided imagination. While there were significant differences within the group in the relaxation training group, no significant differences were found in the control group. Relaxation training had a positive effect on reducing premenstrual symptoms, anxiety, depression and disability and improving quality of life in women with PMDD. More research is necessary to recommend relaxation training as a primary and long-term treatment and to understand how it should be included in a comprehensive treatment plan.

Col Kirpal Singh Award

Background :Course of Alcohol Dependence Syndrome(ADS) is known for its relapsing nature. Additional interventions with empirical evidence are worthy of consideration. Spiritual interventions, Breathing and Relaxation Training, like Sudarshan Kriya is recommended for stress management, and has shown to positively affect outcomes in stress-related disorders. The aim of this study was to assess the effect of an intervention of Breathing and Relaxation Training, on drinking behaviour in patients of ADS.Method:Eighty in-patients diagnosed with ADS were included after obtaining informed consent, in this prospective study and were randomized into two groups. They were administered AUDIT at admission and 6-months after discharge. The Study group(n=40) underwent a 6-day intervention of Breathing and relaxation Training (Sudarshan Kriya) apart from the standard therapy. 'WHO-5 Well-Being Index' was administered before and after the training. The Control group was exposed to the standard therapy for ADS. A follow-up on monthly basis and finally at 6-month interval was done to assess alcohol consumption status.Results:Socio-demographically both the groups were comparable. The breathing and relaxation training(study) group had a significant rise in 'WHO-5 Well-Being Index' (p<0.001). AUDIT scores were significantly lower in the Study group(11.20 ± 2.81) than the Control group(15.30 ± 4.05) after 6 months(p< 0.001). The Study group also reported fewer days of drinking (p=0.004) and reduced overall drinking(p<0.001).Conclusion:The addition of Breathing and Relaxation Training(Sudarshan Kriya) in the management of ADS provided additional therapeutic benefits in the form of fewer days of drinking and reduced total alcohol consumption.

Comparing the Effectiveness of Muscle Relaxation Training and Mindfulness Training on Fear and Resilience in Patients With Dental Anxiety

Introduction: Patients with dental anxiety avoid receiving medical care. This anxiety poses a threat to oral health. The present study aimed to investigate the effectiveness of muscle relaxation training and mindfulness training on fear and resilience in patients with dental anxiety. Methods: This was a clinical trial (pretest-posttest design and a control group). The statistical population comprised all patients with dental anxiety who went to dental clinics in the city of Ahvaz in 2018-2019. The research sample included 45 patients with dental anxiety selected through convenience sampling. The participants were randomly divided into two experimental (muscle relaxation training and mindfulness training) and one control group (n=15 each). The research tools included the Dental Fear Survey (DFS), the Connor-Davidson Resilience Scale (CD-RISC), and the Modified Dental Anxiety Scale (MDAS). Multivariate analysis of covariance was used to analyze the data. Results: The mean±standard deviation (SD) of the post-test scores of fear and resilience were 49.53±9.67 and 84.80±7.89 in the muscle relaxation training group and 58.26±12.67 and 55.60±8.83 in the mindfulness training group, which were significantly different from the control groups (83.80±3.50 and 40.46±5.65). Muscle relaxation training reduced fear and increased resilience in patients with dental anxiety in the experimental groups compared to the control group (P&lt;0.001). Furthermore, in terms of fear and resilience in patients with dental anxiety, muscle relaxation training and mindfulness training were significantly different (P&lt;0.001). Conclusion: In addition to decreasing fear, muscle relaxation training and mindfulness can increase resilience in patients with dental anxiety. Also, muscle relaxation training was more effective than mindfulness training in reducing fear and increasing resilience in patients with dental anxiety.

Effect of Balance Training Versus Stretching Relaxation Exercise in Memory and Spatial Cognition Enhancement on Healthy Adults

Abstract Background Physical exercise has been shown to improve cognitive functions. However, it is still unknown which type of exercise affects cognition. In the present study, we tested the hypothesis that demanding balance training program improves memory and spatial cognition. Objective To test the effect of balance training versus stretching relaxation exercise on memory and spatial cognition in cognitive enhancement. Patients and Methods Participants randomly assigned into 2 groups, 40 participants in balance training group and 40 participants in stretching relaxation training group: Participants trained in groups of 10–12 individuals. Each group trained four times a week for 6 weeks. Each session lasts for 50 minutes. Training groups instructed by the same professional trainers. Each participant took part in 24 training sessions in total. All participants advised not to change their habitual level of physical activity throughout the intervention period. Results Balance performance improved only in the balance group from pre- to post-training from 85.8±3.0 to 95.0±2.2. Only the balance group improved in memory in wechsler IQ test from 94.6±2.6 to 108.0±4.5 and spatial cognitive abilities in spatial reasoning from 17.5±5.0 to 26.2±5.2. Finally, none of the two groups displayed changes in mismatch negativity test. The findings suggest that systematic balance training is capable of enhancing some cognitive functions, such as memory and spatial cognition. Conclusion In sum, we are able to conclude that 6 weeks of balance training in healthy adults has positive effects on memory and spatial cognition, and an increase in cardiorespiratory fitness does not seem to be necessary to induce beneficial effects of physical exercise on cognition. From an applied perspective, balance training might represent a promising alternative intervention for individuals who are not able to participate in aerobic training following health restrictions.

Effect of computerized biofeedback relaxation on stress related physiological parameters

Background: Mental health diseases such as insomnia, anxiety, stress and depression all have a close relationship with the autonomic nervous system. The physiological parameters of autonomic activity viz. galvanic skin resistance, electromyography, respiration and pulse rate can be regulated with the help of computerized biofeedback relaxation training. The main objective of this study was to see the effect of computerized biofeedback relaxation training on psychophysiological parameters of autonomic activity.Methods: In the present study 40 high stress post graduate students were selected. All participants were randomly divided into two group i.e. computerized biofeedback relaxation training (group-1) and placebo group (group-2). Forehead muscle tension, respiration rate, pulse rate and galvanic skin resistance were assessed, and inventories measuring stress were administered pre-randomization. Descriptive, Paired sample ‘t’ test, F-test and Mann-Whitney U test were used to analyze the data with the help of SPSS 16 version.Results: Biofeedback group reported a significant change in muscle tension (p=0.27), respiration rate (p=0.01) and galvanic skin response (p=0.35) after relaxation but at the same time control group reported moderate increase in muscle tension. Additionally, the computerized biofeedback group was able to maintain the stress level while the control group had a significant increase in the stress level over the 10 days of relaxation training.Conclusions: Biofeedback relaxation useful alternative therapy for management of stress and emotional disturbance in graduate students. During a stressful period this may also be helpful to promote overall psychological health.

Impact of breathing and relaxation training (Sudarshan Kriya) on cases of alcohol dependence syndrome.

Background:Alcohol abuse is a public health problem and the course of alcohol dependence syndrome (ADS) is known for its relapsing nature. Additional interventions with empirical evidence are worthy of consideration. Breathing and Relaxation Training, like Sudarshan Kriya (SK) is recommended for stress management, and have been shown to positively affect outcomes in stress-related disorders. The aim of this study was to assess the effect of an intervention of Breathing and Relaxation Training, on drinking behavior in patients of ADS.Methodology:Eighty in-patients diagnosed with ADS were included after obtaining informed consent, in this prospective study and were randomized into two groups. They were administered Alcohol Use Disorder Identification Test (AUDIT) at admission and 6-months after discharge. The Study group (n = 40) underwent a 6-day intervention of Breathing and relaxation Training (SK) apart from the standard therapy. “WHO-5 Well-Being Index” was administered before and after the training. The Control group was exposed to the standard therapy for ADS. A follow-up on a monthly basis and finally at 6-month interval was done to assess alcohol consumption status.Results:Socio-demographically both the groups were comparable. The breathing and relaxation training (study) group had a significant rise in “WHO-5 Well-Being Index” (P < 0.001). There was a significant reduction in AUDIT scores after 6 months in both groups. AUDIT scores were significantly lower in the study group (11.20 ± 2.81) than the control group (15.30 ± 4.05) after 6 months (P < 0.001). The study group also reported fewer days of drinking (P = 0.004) and reduced overall drinking in the intervening period (P < 0.001).Conclusion:The addition of Breathing and Relaxation Training (SK) in the management of ADS provided additional therapeutic benefits in the form of fewer days of drinking and reduced total alcohol consumption.

The Effects of Applied and Sport-Specific Mindful Sport Performance Enhancement Training on Mindfulness Skills, Flow, and Emotional Regulation in National Competitive Swimmers

These case studies examined the effects of mindful sport performance enhancement (MSPE) programs on competitive swimming performance, flow experience, and emotional regulation. Sixteen national competitive adolescent swimmers were randomly allocated into MSPE (n = 9) and relaxation training (n = 7) groups for 8 weeks. In the second phase of the intervention, the 16 participants were evenly split into an MSPE group for swimming and a control group for 5 weeks. The participants completed measures of trait and state flow, and mindfulness pre- and postintervention. The data analysis revealed that mindfulness had significant effects on both action–awareness merging and clear goals subscales. Further analysis revealed that the MSPE for swimming group significantly improved in terms of presence relative to the control group. In conclusion, general and sport-specific mindfulness interventions can psychologically benefit adolescent competitive swimmers.

Study protocol of a multicenter randomized controlled trial of mindfulness-based intervention versus relaxation to reduce emotional exhaustion in medical students in France: the \u201cMust prevent\u201d study

BackgroundMedical students are exposed to an emotionally exhausting training/work environment and to stressful academic demands. Consequently, psychopathologies, burnout and suicidal ideation are frequent in this population. These factors can also affect their empathy and quality of care. Therefore, the development and implementation of programs to promote resilience to stress specifically in medical students and the evaluation of their efficiency are a priority. Here, we describe the protocol of the first French study to assess the long-term effectiveness and acceptability of a mindfulness-based intervention (MBI) compared with relaxation training (RT) to reduce emotional exhaustion in medical students.MethodsThis multicenter randomized controlled trial (“Must prevent”) plans to enroll 612 students in the fourth and fifth year of medical studies from nine French universities. After inclusion, they will be assigned randomly to the MBI or RT group. Both interventions are structured around an 8-week program that includes one group class per week and daily at-home exercises. The primary endpoint is the emotional exhaustion score assessed with the Maslach Burnout Inventory at month 12 of the follow-up. Secondary endpoints include anxiety-depressive symptomatology, suicidality, psychoactive substance use, depersonalization, psychological and physical pain, empathy, emotional regulation, self-compassion, mindfulness, quality of life, and program acceptability. Evaluations will be done before and immediately after the 8-week intervention, and at month 6 and 12 of the post-intervention follow-up.DiscussionIf the proposed interventions are well accepted and useful to decrease negative emotions and/or increase wellbeing among medical students, they should be disseminated among this population and even included as part of the training on emotional skills needed for the routine medical practice.Trial registrationThis trial is registered under the number NCT04026594 (July 18, 2019).

The effects of Mindful Sport Performance Enhancement (MSPE) training on mindfulness, and flow in national competitive swimmers

There are limited studies examining the effects of a mindfulness intervention for a specific sport population group. The aim of this applied study was to investigate the effects of a mindful sport performance enhancement (MSPE) program on the mindfulness and flow of adolescent swimmers. Sixteen competitive adolescent swimmers were split into MSPE (n = 9) and relaxation training (RT) (n = 7) groups for eight weeks. Participants completed measures of trait and state flow mindfulness pre and post intervention. Paired t test results revealed that the MSPE group improved trait flow characteristics and global trait flow. ANCOVA analysis also revealed significantly higher effects on global trait flow and the action-awareness merging and clear goals subscales for the MSPE group compared to the RT group. These results suggested that sport orientated mindfulness interventions can psychologically benefit competitive youth swimmers. The study indicates that further research could consider applied designs to investigate in more detail the experiences this population has with specific mindfulness exercises.

Interventions for drug-using offenders with co-occurring mental health problems.

Interventions for drug-using offenders with co-occurring mental health problems.

Exercise-induced neuroplasticity: Balance training increases cortical thickness in visual and vestibular cortical regions

Physical exercise has been shown to induce structural plasticity in the human brain and to enhance cognitive functions. While previous studies focused on aerobic exercise, suggesting a link between increased cardiorespiratory fitness and exercise-induced neuroplasticity, recent findings have suggested that whole-body exercise with minor metabolic demands elicits beneficial effects on brain structure as well. In the present study, we tested if balance training, challenging the sensory-motor system and vestibular self-motion perception, induces structural plasticity. Thirty-seven healthy adults aged 19–65 years were randomly assigned to either a balance training or a relaxation training group. All participants exercised twice a week for 12 weeks. Assessments before and after the training included a balance test and the acquisition of high-resolution T1-weighted images to analyze morphological brain changes. Only the balance group significantly improved balance performance after training. Cortical thickness was increased in the superior temporal cortex, in visual association cortices, in the posterior cingulate cortex, in the superior frontal sulcus, and in the precentral gyri in the balance group, compared to the relaxation group. Moreover, there was evidence that the balance training resulted in decreased putamen volume. Improved balance performance correlated with the increase of precentral cortical thickness and the decrease in putamen volume. The results suggest that balance training elicits neuroplasticity in brain regions associated with visual and vestibular self-motion perception. As these regions are known for their role in spatial orienting and memory, stimulating visual-vestibular pathways during self-motion might mediate beneficial effects of physical exercise on cognition.

Effects of progressive muscle relaxation training on sleep and quality of life in patients with pulmonary resection.

The inadequate quality and nature of sleep is a commonly reported problem among hospitalized patients. The purpose of this study is to examine the effects of progressive muscle relaxation training program on sleep quality, sleep state, pain, and quality of life in patients who underwent pulmonary resection. Our study was planned as a single-blind prospective randomized controlled trial. The study was conducted on 26 patients who underwent surgery by using posterolateral thoracotomy method. Progressive muscle relaxation training were given to the training group with a therapist two times a day. Sleep quality, daytime sleeping, pain, and quality of life were respectively evaluated in the morning before the surgery and 1week after the surgery by using Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, visual analogue scale, and Euro Quality of Life-5D (EQ-5D). There is no significant difference between preoperative groups in the total Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Euro Quality of Life-5D, and visual analogue scale scores (p > 0.05). The intra-group change in the study group showed a significant deterioration in the Euro Quality of Life-5D and visual analogue scale scores (p < 0.05). There was a significant deterioration in the total Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, EQ-5D, and visual analogue scale scores in the control group (p < 0.05). The Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Euro Quality of Life-5D scores showed significant improvements in the relaxation training group after treatment at 1week (p < 0.05). Progressive muscle relaxation prevents a decline in patient-reported sleep quality following pulmonary resection.

Effects of relaxation and stress management training on fibromyalgia symptoms in women

This study compared the effectiveness of relaxation training and stress management training in treating anxiety, depression, stress, and pain in women with fibromyalgia. Twenty-two women with fibromyalgia participated in this randomized, controlled trial. They were assigned to stress management (n=7), relaxation training (n=7), and control (n=8) groups. All participants completed the Depression, Anxiety, and Stress Scale (DASS-42) and the Visual Analog Scale (VAS) for pain. The stress management group participated in eight weekly two-hour sessions of a stress management program; the relaxation group participated in eight weekly sessions of relaxation training. Then, participants completed the DASS-42 and VAS again. Analyses of Covariance (ANCOVA) and post hoc analyses were used to compare the participants’ pre- and post-therapy responses and the two treatment types. Both relaxation training and stress management training were found to be effective in treating patients’ anxiety (P= 0.005), depression (P= 0.006), stress (P= 0.002), and pain (P= 0.001). Post hoc analyses indicated that participants in the treatment groups showed improvement compared with those in the control group (all P values< 0.01). However, there was no significant difference in effectiveness between the relaxation training and the stress management training. The relaxation training and stress management training both significantly improved women’s fibromyalgia symptoms (depression, stress, anxiety, and pain).

A Brief Mindfulness Intervention Is Associated with Negative Outcomes in a Randomised Controlled Trial Among Chemotherapy Patients

Emotional distress is common during chemotherapy, and supportive interventions during this time are often required. Mindfulness-based interventions appear promising amongst cancer survivors, but scant research has been conducted amongst patients undergoing acute treatment. This trial compared the efficacy of a brief mindfulness-based intervention (bMBT) with relaxation therapy on reducing distress amongst chemotherapy patients. Sixty-eight people receiving first-line chemotherapy at Auckland City Hospital were randomised to bMBT (n = 32) or relaxation training groups (n = 36). In both conditions, participants attended three 90-min weekly sessions. Overall distress (distress thermometer (DT); impact thermometer (IT)), cancer-related stress (Impact Events Scale–Cancer (IES-C)), cancer symptom distress (Memorial Symptom Assessment Scale–Short Form (MSAS-SF)) and social avoidance (SA) were assessed at enrolment, post-intervention and at 3-month follow-up. Both groups reported reductions in overall and cancer-related stress over time. Immediately post-intervention, however, bMBT (but not relaxation training) participants reported increased symptom distress, marginally increased social avoidance and decreased quality of life. So whilst overall distress and cancer distress declined in both groups, the mindfulness intervention was associated with increased symptom distress and social avoidance and reduced quality of life. This report presents a randomised controlled trial of a mindfulness-based intervention during chemotherapy and suggests that care is needed in employing mindfulness-based interventions in acute health treatment contexts.

Baduanjin Mind-Body Intervention Improves the Executive Control Function.

This study aims at comparing the effects of the Baduanjin mind-body (BMB) intervention with a conventional relaxation training program on enhancing the executive function. The study also attempts to explore the neural substrates underlying the cognitive effect of BMB intervention using near-infrared spectroscopy (NIRS) technique. Forty-two healthy college students were randomly allocated into either the Baduanjin intervention group or relaxation training (control) group. Training lasted for 8 weeks (90 min/day, 5 days/week). Each participant was administered the shortened Profile of Mood States to evaluate their mood status and the flanker task to evaluate executive function before and after training. While performing the flanker task, the NIRS data were collected from each participant. After training, individuals who have participated in BMB exercise showed a significant reduction in depressive mood compared with the same measure before the intervention. However, participants in the control group showed no such reduction. The before vs. after measurement difference in the flanker task incongruent trails was significant only for the Baduanjin intervention group. Interestingly, an increase in oxygenated hemoglobin in the left prefrontal cortex was observed during the Incongruent Trails test only after the BMB exercise intervention. These findings implicate that Baduanjin is an effective and easy-to-administering mind-body exercise for improving executive function and perhaps brain self-regulation in a young and healthy population.

Impacts of relaxation training on psychological health in young nurses

Objective To understand mental health of young nurses and coping style, to explore the influence about relaxation training to their mental health. Methods A total of 90 nurses within five years work experience were randomly divided into stretch-release relaxation, cognitive relaxation training group and non-intervention group. Do a survey by symptom checklist-90(SCL-90) and simplified coping style questionnaire (SCSQ) before and after training. Results The total scores of both two relaxation training groups (SCL-90) significantly decreased after six months training to (142.54±26.86) and (142.51±25.96), and it had statistical significance comparing with non-intervention group (P<0.01); the score of positive coping style in nurses was statistically significant after training (33.62±4.55) (P<0.01). Conclusions Relaxation training can enhance mental health of young nurses and guide nurses to adopt positive coping style, lower negative emotions, so it is worthy of applying and recommending in paramedics. Key words: Nurses; Relaxation training; Psychological health

Brief cognitive-behavioral and relaxation training interventions for breast cancer: A randomized controlled trial.

Women with breast cancer (BCa) report elevated distress postsurgery. Group-based cognitive-behavioral stress management (CBSM) following surgery improves psychological adaptation, though its key mechanisms remain speculative. This randomized controlled dismantling trial compared 2 interventions featuring elements thought to drive CBSM effects: a 5-week cognitive-behavioral training (CBT) and 5-week relaxation training (RT) versus a 5-week health education (HE) control group. Women with stage 0-III BCa (N = 183) were randomized to CBT, RT, or HE condition 2-10 weeks postsurgery. Psychosocial measures were collected at baseline (T1) and postintervention (T2). Repeated-measures analyses of variance (ANOVAs) tested whether CBT and RT treatments improved primary measures of psychological adaptation and secondary measures of stress management resource perceptions from pre- to postintervention relative to HE. Both CBT and RT groups reported reduced depressive affect. The CBT group reported improved emotional well-being/quality of life and less cancer-specific thought intrusions. The RT group reported improvements on illness-related social disruption. Regarding stress management resources, the CBT group reported increased reliability of social support networks, while the RT group reported increased confidence in relaxation skills. Psychological adaptation and stress management resource constructs were unchanged in the HE control group. Nonmetastatic breast cancer patients participating in 2 forms of brief, 5-week group-based stress management intervention after surgery showed improvements in psychological adaptation and stress management resources compared with an attention-matched control group. Findings provide preliminary support suggesting that using brief group-based stress management interventions may promote adaptation among nonmetastatic breast cancer patients.

The benefit of heart rate variability biofeedback and relaxation training in reducing trait anxiety.

Previous research studies have indicated that biofeedback treatment and relaxation techniques are effective in reducing psychological and physical symptoms (Hammond, 2005; Manzoni, G. M., Pagnini, F., Castelnuovo, G., & Molinari, E., 2008). However, dearth of studies has compared heart rate variability (HRV) biofeedback treatment and relaxation training to reduce trait anxiety. The objective of this study was to determine the effect of HRV biofeedback treatment and relaxation training in reducing trait anxiety compared to control group without any treatment using students in a science and engineering university of South Korea. For the present study, a total of 15 graduate students with moderate level of trait anxiety were recruited for 4 individual sessions every two weeks. They were randomly assigned into three groups: biofeedback treatment (n = 5), relaxation training (n = 5), and no treatment control group (n = 5). Our results revealed significant difference in change score of trait anxiety between the HRV biofeedback treatment and the no treatment control group. However, no significant difference was found between the relaxation training group and the no treatment control group. In addition, there was no significant difference between the HRV biofeedback treatment and the relaxation training. Results of the present study indicate that there is potential benefit in utilizing HRV biofeedback treatment for stress management programs and/or anxiety reduction treatment.

Reducing Irrational Beliefs and Pain Severity in Patients Suffering from Non-Cardiac Chest Pain (NCCP): A Comparison of Relaxation Training and Metaphor Therapy.

BackgroundPatients suffering from non-cardiac chest pain (NCCP) can interpret their chest pain wrongly despite having received a correct diagnosis. The objective of this study was to compare the efficacy of the relaxation method with metaphor therapy for reducing irrational beliefs and pain severity in patients with NCCP.MethodsUsing a randomized controlled trial, 33 participants were randomly divided into a relaxation training group (n= 13), a metaphor therapy group (n = 10), and a control group (n = 10), and were studied for 4 weeks. The two tools used in this research were the Brief Pain Inventory (BPI) index for determining the degree of pain and the short version of the Jones Irrational Belief Test. Metaphor therapy and a relaxation technique based on Öst's treatment were used as the interventions. The collected data were analyzed with a multivariate analysis of covariance (MANCOVA), a Chi-square test, and the Bonferroni procedure of post-hoc analysis.ResultsThe relaxation training method was significantly more effective than both metaphor therapy and the lack of treatment in reducing the patients' beliefs of hopelessness in the face of changes and emotional irresponsibility, as well as the pain severity. Metaphor therapy was not effective on any of these factors. In fact, the results did not support the effectiveness of metaphor therapy.ConclusionsRegarding the effectiveness of the relaxation method as compared with metaphor therapy and the lack of treatment in the control group, this study suggests that relaxation should be paid greater attention as a method for improving the status of patients. In addition, more studies are needed to determine the effectiveness of metaphor therapy in this area.