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Constant stress is one of the defining features of modern life, and the source of many common health problems. Stress plays an obvious role in nervousness, anxiety, and insomnia, but it is also thought to contribute to a vast number of other illnesses.
In the past, most people engaged in many hours of physical exercise daily, an activity that reduces the effects of psychological stress. Life was also slower then and more in harmony with the natural cycles of day and season. Today, however, our bodies are relatively sedentary, while our minds are forced to respond to the rapid pace of a society that never stops. The result is high levels of stress and reduced ability to cope with it.
There are several ways to mitigate the damage caused by stress. Increased physical exercise can help, as can simple, common sense steps like taking relaxation breaks and vacations. If these approaches don’t have adequate results, there are more formal methods that may be helpful.
This article discusses a group of stress-reduction techniques often called relaxation therapies. In addition to these methods, yoga, Tai Chi, hypnosis, massage, and biofeedback can also help induce a relaxed state. For potentially helpful herb and supplement options, see the Stress article.
What Are Relaxation Therapies? TOP
There are many types of relaxation therapies, and they use a variety of techniques. However, most of them share certain related features.
In a great many relaxation techniques, one begins by either lying down or assuming a relaxed, seated posture in a quiet place and closing the eyes. The next step differs depending on the method. In autogenic training, relaxation response, and certain forms of meditation, one focuses one’s mind on internal sensations, such as the breath. Guided-imagery techniques employ deliberate visualization of scenes or actions, such as walking on a quiet beach. Progressive relaxation techniques involve gradual relaxation of the muscles. Finally, some schools of meditation incorporate the repetition of a phrase or sound silently or aloud.
All of these techniques are best learned with the aid of a trained practitioner. The usual format is a group class supplemented by regular home practice. If you are diligent enough, experience suggests that you can develop the ability to call on a relaxed state at will, even in the middle of a very stressful situation.
What Are Relaxation Therapies Used for? TOP
Relaxation therapies are most commonly tried in medical circumstances in which stress is believed to play a particularly large role. These include insomnia, surgery, chronic pain, and cancer treatment support.
What Is the Scientific Evidence for Relaxation Therapies? TOP
Although many studies have been performed on relaxation therapies, most of them suffer from inadequate design. To be fair, there are considerable difficulties in the path of any researcher who wishes to scientifically assess the effectiveness of a relaxation therapy such as hypnosis. There are several factors involved, but the most important is fairly fundamental: it isn’t easy to design a proper double-blind, placebo-controlled study of relaxation therapy. Researchers studying the herb St. John’s wort, for example, can use placebo pills that are indistinguishable from the real thing. However, it’s difficult to design a form of placebo relaxation therapy that can’t be detected as such by both practitioners and patients.
One very clever method used by some researchers involves the use of intentionally neutral visualizations. Instead of imagining lying in bed and sleeping peacefully, patients in the placebo group might be told to visualize something like a green box. The problem here is that researchers teaching the visualization method to participants may inadvertently convey a sense of disbelief in the placebo treatment. This can be solved by using relatively untrained people who are themselves deceived by experimenters to teach the method, but the practical obstacles are significant.
For this reason, many studies of relaxation therapy have made major compromises to the double-blind, placebo-controlled model. Some randomly assigned participants to receive either relaxation therapy or no treatment. In the best of these studies, results were rated by examiners who didn’t know which participants were in which group (in other words, “blinded observers”). However, it isn’t clear whether benefits reported in such studies are due to the relaxation therapy or less specific factors, such as mere attention.
Other studies have compared relaxation therapies to different techniques, such as hypnosis or cognitive psychotherapy. However, the same difficulties arise when trying to study these latter therapies, and the results of a study that compares an unproven treatment to one that is also imperfectly documented are not very meaningful
Even less meaningful studies of relaxation therapies simply involved giving people the therapy and monitoring them to see whether they improved. For at least a dozen reasons, such open-label trials prove nothing at all, and we do not report them here. (The reasons are discussed in the article Why Does This Database Rely on Double-blind Studies?)
Given these caveats, the following is a summary of what science knows about the medical benefits of relaxation therapy.
The Possible Benefits of Relaxation Therapy
Numerous controlled studies have evaluated relaxation therapies for the treatment of insomnia.1 These studies are difficult to summarize because many involved therapy combined with other methods such as biofeedback, sleep restriction, and paradoxical intent (trying not to sleep). The type of relaxation therapy used in the majority of these trials was progressive muscle relaxation (PMR). Many of these trials used the clever form of placebo treatment described above; others simply compared relaxation therapy to no treatment.
Overall, the evidence indicates that relaxation therapies may be somewhat helpful for insomnia, although not dramatically so. For example, in a controlled study of 70 people with insomnia, participants using progressive relaxation showed no meaningful improvement in the time to fall asleep or the duration of sleep, but they reported feeling more rested in the morning.2 In another study, 20 minutes of relaxation practice was required to increase sleeping time by 30 minutes.3
A review article published in 2002 found 15 published controlled trials that evaluated relaxation therapies for the treatment of asthma.4 Most of the studies were rated as very poor or poor quality. Overall the results failed to demonstrate improvement, although a muscular relaxation technique called Jacobsen’s relaxation did show a hint of benefit.
There is a fair amount of evidence in support of relaxation therapies as means to treat the symptoms of anxiety, at least in the short-term.23-25,59,64,70,74 In a 2008 review of 27 studies, researchers concluded that relaxation therapies (including Jacobson's progressive relaxation, autogenic training, applied relaxation, and meditation) were effective against anxiety.75 However, these favorable findings should be tempered by the fact that not all of the studies were randomized, controlled trials.
It seems intuitive that relaxation should lower blood pressure. Indeed, many studies have evaluated the benefits of relaxation therapies for hypertension and related cardiovascular risks.33-36,57,67 The results, however, have been mixed at best. In a review of 25 studies of various relaxation therapies for high blood pressure (totaling 1,198 participants), researchers found that those studies employing a control group had no significant effect on lowering blood pressure compared to sham (placebo) therapies.68 On the other hand, a separate review of nine randomized trials concluded that the regular use of transcendental meditation may significantly reduce both systolic and diastolic blood pressure compared to a control.69 Similarly, an analysis of 17 randomized controlled trials of various relaxation therapies, found that only transcendental meditation resulted in significant reductions in blood pressure; biofeedback, progressive muscle relaxation, and stress management training produced no such benefit.71 In addition, a trial of 86 patients with hypertension suggested that daily, music-guided slow breathing reduced systolic blood pressure measured over a 24-hour period.80
Other conditions that have at least minimal supporting evidence for response to relaxation therapies include the following:
In many cases the results are marginal at best, and contradictory outcomes between trials are common.
One study suggests that the use of visualizations prior to surgery cannot only reduce the need for pain medications, it can also help prevent hematomas (collections of blood under the skin).48 However, more study would be needed to verify this somewhat difficult-to-believe result. A more easily accepted study found that either relaxation therapy or aerobic exercise can improve symptoms of fatigue after cancer surgery, and that each approach is about as effective as the other.52
Cancer Treatment Support
A study found that cancer patients exposed to empathetic care along with self-hypnotic relaxation experienced significantly less pain and anxiety during an uncomfortable, invasive procedure than similar patients receiving only empathetic or usual care. These interesting results suggest that pain under these circumstances is more effectively relieved when the patient relies on his or her own self-coping abilities rather than someone else’s kindness.73
Researchers in Taiwain have also studied the role of relaxing music in reducing cancer pain. One hundred and twenty-six hospitalized patients were randomly selected to listen to music for 30 minutes and take pain medication or just take the medication. Patients were given the choice of folk songs, Buddhist hymns (Taiwanese music), plus harp, or piano (American). The group who listened to music experienced significantly more pain relief compared to the group that did not.82
A 2012 review of the literature found evidence to support the use of relaxation therapies in people with cancer.93 The review, which included 19 studies involving 1,118 patients, focused on minfulness-based stress reduction therapies, like yoga, relaxation exercises, and meditation. The researchers reported that these interventions resulted in improved mood and quality life. Without proper control groups, however, it is unclear whether or not the therapies themselves directly contributed to these benefits.
Numerous studies have also investigated the benefits of relaxation therapies on patients with HIV. A careful review of 35 randomized trials found that relaxation therapies may be generally helpful at improving the quality of life of HIV-positive patients and in reducing their anxiety, depression, stress, and fatigue.72 These interventions, though, had no significant effect on the growth of the virus, nor did they influence immunologic or hormonal activity. Subsequently, however, a small study involving 48 HIV patients found that mindfulness meditation—a popular method for inducing the relaxation response—slowed the loss of the specific immune cells destroyed by the virus, though more research needs to be done to confirm this result.76
The standard treatment for HIV is highly active antiretroviral therapy (HAART). Often people who take HAART have gastrointestinal (GI) side effects, like diarrhea and nausea. In one study, 130 HIV patients on HAART were randomized to receive 1 of 4 treatments: acupuncture plus relaxation therapy, acupuncture plus health education, sham acupuncture plus relaxation therapy, or sham acupuncture plus health education.87 After 4 weeks of treatment, the people in the acupuncture plus relaxation group experienced a greater improvement in their GI symptoms compared to the other groups.
A careful review of 20 trials found psychological interventions such as cognitive behavioral therapy, biofeedback, relaxation and coping were associated with reduced chronic headache or migraine pain in 589 children as compared to sham (placebo), standard therapies, waiting list control or other active treatments.79
A review of 8 randomized trials involving 483 people with schizophrenia found that music therapy along with standard care helped to improve various measures of their mental state more than standard care alone.90 These results, however, varied considerably across different studies depending on the quality and number of music therapy sessions.
Other Types of Relaxation Therapies
Some studies have evaluated highly specific guided visualizations, rather than general relaxation. For example, it has been suggested that a systematic program of imagining microscopic soldiers shooting down one’s cancer cells can improve the chances of surviving cancer. Unfortunately, despite much enthusiasm shown by some patients and practitioners, there is still no meaningful evidence to support this appealing idea at present.49 Nonetheless, there is some evidence from a set of small trials that specific immune-oriented visualizations can provide enhanced protection against herpes flare-ups and winter colds.50
Transcendental Meditation (TM)
Contrary to common claims, published evidence does not demonstrate that transcendental meditation (TM) improves mental functioning.53 There is a bit of evidence, however, that TM might be helpful for improving exercise capacity and general quality of life in people with congestive heart failure.60
How to Choose a Relaxation Therapist TOP
There is no widely accepted license for practicing relaxation therapy. However, it is often practiced by therapists and psychologists.
Safety Issues TOP
There are no known or proposed safety risks with relaxation therapies.
References[ + ]
1. Morin CM, Hauri PJ, Espie CA, et al. Nonpharmacologic treatment of chronic insomnia. Sleep. 1999;22:1134-1156.
2. Espie CA, Lindsay WR, Brooks DN, et al. A controlled comparative investigation of psychological treatments for chronic sleep-onset insomnia. Behav Res Ther. 1989;27:79-88.
3. Freedman R, Papsdorf JD. Biofeedback and progressive relaxation treatment of sleep-onset insomnia: a controlled, all-night investigation. Biofeedback Self Regul. 1976;1:253-271.
4. Huntley A, White AR, Ernst E. Relaxation therapies for asthma: a systematic review Thorax. 2002;57:127-131.
5. McKinney CH, Antoni MH, Kumar M, et al. Effects of guided imagery and music (GIM) therapy on mood and cortisol in healthy adults. Health Psychol. 1997;16:390-400.
6. Kanji N, Ernst E. Autogenic training for stress and anxiety: a systematic review. Complement Ther Med. 2000;8:106-110.
7. Carlson C, Hoyle R. Efficacy of abbreviated progressive muscle relaxation training: a quantitative review of behavioral medicine research. J Consult Clin Psychol. 1993;61:1059-1067.
8. Gaston-Johansson F, Fall-Dickson JM, Nanda J, et al. The effectiveness of the comprehensive coping strategy program on clinical outcomes in breast cancer autologous bone marrow transplantation. Cancer Nurs. 2000;23:277-285.
9. Renzi C, Peticca L, Pescatori M. The use of relaxation techniques in the perioperative management of proctological patients: preliminary results. Int J Colorectal Dis. 2000;15:313-316.
10. Deisch P, Soukup SM, Adams P, et al. Guided imagery: replication study using coronary artery bypass graft patients. Nurs Clin North Am. 2000;35:417-425.
11. Hattan J, King L, Griffiths P. The impact of foot massage and guided relaxation following cardiac surgery: a randomized controlled trial. J Adv Nurs. 2002;37:199-207.
12. Tusek DL, Church JM, Strong SA, et al. Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery. Dis Colon Rectum. 1997;40:172-178.
13. Mandle CL, Jacobs SC, Arcari PM, et al. The efficacy of relaxation response interventions with adult patients: a review of the literature. J Cardiovasc Nurs. 1996;10:4-26.
14. Leserman J, Stuart EM, Mamish ME, et al. The efficacy of the relaxation response in preparing for cardiac surgery. Behav Med. 1989;15:111-117.
15. Mandle CL, Domar AD, Harrington DP, et al. Relaxation response in femoral angiography. Radiology. 1990;174:737-739.
16. Lyles JN, Burish TG, Krozely MG, et al. Efficacy of relaxation training and guided imagery in reducing the aversiveness of cancer chemotherapy. J Consult Clin Psychol. 1982;50:509-524.
17. Troesch LM, Rodehaver CB, Delaney EA, et al. The influence of guided imagery on chemotherapy-related nausea and vomiting. Oncol Nurs Forum. 1993;20:1179-1185.
18. Syrjala KL, Donaldson GW, Davis MW, et al. Relaxation and imagery and cognitive-behavioral training reduce pain during cancer treatment: a controlled clinical trial. Pain. 1995;63:189-198.
19. Speca M, Carlson LE, Goodey E, et al. A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosom Med. 2000;62:613-622.
20. Zeltzer L, LeBaron S. Hypnosis and nonhypnotic techniques for reduction of pain and anxiety during painful procedures in children and adolescents with cancer. J Pediatr. 1982;101:1032-1035.
21. Walker LG, Walker MB, Ogston K, et al. Psychological, clinical and pathological effects of relaxation training and guided imagery during primary chemotherapy. Br J Cancer. 1999;80:262-268.
22. Baider L, Peretz T, Hadani PE, et al. Psychological intervention in cancer patients: a randomized study. Gen Hosp Psychiatry. 2001;23:272-277.
23. Wachelka D, Katz RC. Reducing test anxiety and improving academic self-esteem in high school and college students with learning disabilities. J Behav Ther Exp Psychiatry. 1999;30:191-198.
24. Thompson MB, Coppens NM. The effects of guided imagery on anxiety levels and movement of clients undergoing magnetic resonance imaging. Holist Nurs Pract. 1994;8:59-69.
25. Kabat-Zinn J, Massion AO, Kristeller J, et al. Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry. 1992;149:936-943.
26. Fors EA, Sexton H, Gotestam KG. The effect of guided imagery and amitriptyline on daily fibromyalgia pain: a prospective, randomized, controlled trial. J Psychiatr Res. 2002;36:179-187.
27. Carrol D, Seers K. Relaxation for the relief of chronic pain: A systematic review. J Adv Nursing. 1996:27:476-487.
28. Fernandez E, Turk DC. The utility of cognitive coping strategies for altering pain perception: a meta-analysis. Pain. 1989;38:123-135.
29. Rusy LM, Weisman SJ. Complementary therapies for acute pediatric pain management. Pediatr Clin North Am. 2000;47:589-599.
30. Kanji N. Management of pain through autogenic training. Complement Ther Nurs Midwifery. 2000;6:143-148.
31. Nielson WR, Weir R. Biopsychosocial approaches to the treatment of chronic pain. Clin J Pain. 2001;17:S114-S127.
32. Esplen MJ, Garfinkel PE, Olmsted M, et al. A randomized controlled trial of guided imagery in bulimia nervosa. Psychol Med. 1998;28:1347-1357.
33. Castillo-Richmond A, Schneider RH, Alexander CN, et al. Effects of stress reduction on carotid atherosclerosis in hypertensive African Americans. Stroke. 2000;31:568-573.
34. Mandle CL, Jacobs SC, Arcari PM, et al. The efficacy of relaxation response interventions with adult patients: a review of the literature. J Cardiovasc Nurs. 1996;10:4-26.
35. Barnes VA, Treiber FA, Turner JR, et al. Acute effects of transcendental meditation on hemodynamic functioning in middle-aged adults. Psychosom Med. 1999;61:525-531.
36. Alexander CN, Schneider RH, Staggers F, et al. Trial of stress reduction for hypertension in older African Americans. II. Sex and risk subgroup analysis. Hypertension. 1996;28:228-237.
37. Keefer L, Blanchard EB. The effects of relaxation response meditation on the symptoms of irritable bowel syndrome: results of a controlled treatment study. Behav Res Ther. 2001;39:801-811.
38. Freedman RR, Woodward S. Behavioral treatment of menopausal hot flushes: evaluation by ambulatory monitoring. Am J Obstet Gynecol. 1992;167:436-439.
39. Goodale IL, Domar AD, Benson H. Alleviation of premenstrual syndrome symptoms with the relaxation response. Obstet Gynecol. 1990;75:649-655.
40. Kabat-Zinn J, Wheeler E, Light T, et al. Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA). Psychosom Med. 1998;60:625-632.
41. Lundgren S, Stenstrom CH. Muscle relaxation training and quality of life in rheumatoid arthritis. A randomized controlled clinical trial. Scand J Rheumatol. 1999;28:47-53.
42. Stenstrom CH, Arge B, Sundbom A. Home exercise and compliance in inflammatory rheumatic diseases-a prospective clinical trial. J Rheumatol. 1997;24:470-476.
43. Stenstrom CH, Arge B, Sundbom A, et al. Dynamic training versus relaxation training as home exercise for patients with inflammatory rheumatic diseases. A randomized controlled study. Scand J Rheumatol. 1996;25:28-33.
44. Page SJ, Levine P, Sisto S, et al. A randomized efficacy and feasibility study of imagery in acute stroke. Clin Rehabil. 2001;15:233-240.
45. Ter Kuile MM, Spinhoven P, Linssen AC, et al. Autogenic training and cognitive self-hypnosis for the treatment of recurrent headaches in three different subject groups. Pain. 1994;58:331-340.
46. Spinhoven P, Linssen AC, Van Dyck R, et al. Autogenic training and self-hypnosis in the control of tension headache. Gen Hosp Psychiatry. 1992;14:408-415.
47. Shaw L, Ehrlich A. Relaxation training as a treatment for chronic pain caused by ulcerative colitis. Pain. 1987;29:287-293.
48. Omlor G, Kiewitz S, Pietschmann S, et al. Effect of preoperative visualization therapy on postoperative outcome after inguinal hernia surgery and thyroid resection. Zentralbl Chir. 2000;125:380-386.
49. Spiegel D, Moore R. Imagery and hypnosis in the treatment of cancer patients. Oncology (Huntingt). 1997;11:1179-1189.
50. Gruzelier JH. A review of the impact of hypnosis, relaxation, guided imagery and individual differences on aspects of immunity and health. Stress. 2002;5:147-163.
51. Tusek DL, Cwynar R, Cosgrove DM. Effect of guided imagery on length of stay, pain and anxiety in cardiac surgery patients. J Cardiovasc Manag. 1999;10:22-28.
52. Dimeo FC, Thomas F, Raabe-Menssen C, et al. Effect of aerobic exercise and relaxation training on fatigue and physical performance of cancer patients after surgery. A randomised controlled trial. Support Care Cancer. 2004 Aug 26. [Epub ahead of print]
53. Canter PH, Ernst E. The cumulative effects of Transcendental Meditation on cognitive function—a systematic review of randomised controlled trials. Wien Klin Wochenschr. 2003;115:758-766.
54. Haase O, Schwenk W, Hermann C, et al. Guided imagery and relaxation in conventional colorectal resections: a randomized, controlled, partially blinded trial. Dis Colon Rectum. 2005 Jun 27. [Epub ahead of print]
55. Blumenthal JA, Sherwood A, Babyak MA, et al. Effects of exercise and stress management training on markers of cardiovascular risk in patients with ischemic heart disease: a randomized controlled trial. JAMA. 2005;293:1626-34.
56. Bastani F, Hidarnia A, Kazemnejad A, et al. A randomized controlled trial of the effects of applied relaxation training on reducing anxiety and perceived stress in pregnant women. J Midwifery. 2005;50:36-40.
57. Paul-Labrador M, Polk D, MD, Dwyer JH, et al. Effects of a randomized controlled trial of Transcendental Meditation on components of the metabolic syndrome in subjects with coronary heart disease. Arch Intern Med. 2006;166:1218-1224.
58. Baird CL, Sands LP. Effect of guided imagery with relaxation on health-related quality of life in older women with osteoarthritis. Res Nurs Health. 2006 Sep 14. [Epub ahead of print]
59. Arias AJ, Steinberg K, Banga A, et al. Systematic review of the efficacy of meditation techniques as treatments for medical illness. J Altern Complement Med. 2006;12:817-832.
60. Jayadevappa R, Johnson JC, Bloom BS, et al. Effectiveness of transcendental meditation on functional capacity and quality of life of African Americans with congestive heart failure: a randomized control study. Eth Dis. 2007;17:72-77.
61. Zaborowska E, Brynhildsen J, Damberg S, et al. Effects of acupuncture, applied relaxation, estrogens, and placebo on hot flushes in postmenopausal women: an analysis of two prospective, parallel, randomized studies. Climacteric. 2007;10:38-45.
62. Morone NE, Greco CM, Weiner DK. Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study. Pain. 2007 May 31. [Epub ahead of print]
63. Van der Veek PP, Van Rood YR, Masclee AA. Clinical trial: short- and long-term benefit of relaxation training for irritable bowel syndrome. Aliment Pharmacol Ther. 2007;26:943-952.
64. Evans S, Ferrando S, Findler M, et al. Mindfulness-based cognitive therapy for generalized anxiety disorder. J Anxiety Disord. 2007 Jul 22. [Epub ahead of print]
65. Pradhan EK, Baumgarten M, Langenberg P, et al. Effect of mindfulness-based stress reduction in rheumatoid arthritis patients. Arthritis Rheum. 2007 Sep 28. [Epub ahead of print]
66. Carrico DJ, Peters KM, Diokno AC. Guided imagery for women with interstitial cystitis: results of a prospective, randomized controlled pilot study. J Altern Complement Med. 2008 Jan 16.
67. Dusek JA, Hibberd PL, Buczynski B, et al. Stress management versus lifestyle modification on systolic hypertension and medication elimination: a randomized trial. J Altern Complement Med. 2008 Mar 3.
68. Heather OD, Fiona C, Fiona RB, et al. Relaxation therapies for the management of primary hypertension in adults. Cochrane Database Syst Rev. 2008;CD004935.
69. Anderson JW, Liu C, Kryscio RJ. Blood pressure response to transcendental meditation: a meta-analysis. Am J Hypertens. 2008;21:310-316.
70. Lahmann C, Schoen R, Henningsen P, et al. Brief relaxation versus music distraction in the treatment of dental anxiety: a randomized controlled clinical trial. J Am Dent Assoc. 2008;139:317-324.
71. Rainforth MV, Schneider RH, Nidich SI, et al. Stress reduction programs in patients with elevated blood pressure: a systematic review and meta-analysis. Curr Hypertens Rep. 2007;9:520-528.
72. Scott-Sheldon LA, Kalichman SC, Carey MP, et al. Stress management interventions for HIV+ adults: A meta-analysis of randomized controlled trials, 1989 to 2006. Health Psychol. 2008;27:129-139.
73. Lang EV, Berbaum KS, Pauker SG, et al. Beneficial effects of hypnosis and adverse effects of empathic attention during percutaneous tumor treatment: When being nice does not suffice. J Vasc Interv Radiol. 2008;19:897-905.
74. Nyklicek I, Kuijpers KF. Effects of mindfulness-based stress reduction intervention on psychological well-being and quality of life: Is increased mindfulness indeed the mechanism? Ann Behav Med. 2008 Jun 6.
75. Manzoni GM, Pagnini F, Castelnuovo G, et al. Relaxation training for anxiety: a ten-years systematic review with meta-analysis. BMC Psychiatry. 2008 Jun 2.
76. Creswell JD, Myers HF, Cole SW, et al. Mindfulness meditation training effects on CD4+ T lymphocytes in HIV-1 infected adults: A small randomized controlled trial. Brain Behav Immun. 2008 Jul 19.
77. Jorm AF, Morgan AJ, Hetrick SE. Relaxation for depression. Cochrane Database Syst Rev. 2008;CD007142.
78. Hanstede M, Gidron Y, Nyklicek I. The effects of a mindfulness intervention on obsessive-compulsive symptoms in a non-clinical student population. J Nerv Ment Dis. 2008;196:776-779.
79. Eccleston C, Palermo T, Williams A, Lewandowski A, Morley S. Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database of Systematic Reviews. 2009;CD003968.
80. Modesti PA, Ferrari A, Bazzini C, et al. Psychological predictors of the antihypertensive effects of music-guided slow breathing. J Hypertens. 2010 May;28(5):1097.
81. Lahmann C, Röhricht F, Sauer N. Functional relaxation as complementary therapy in irritable bowel syndrome: a randomized, controlled clinical trial. J Altern Complement Med. 2010 Jan;16(1):47.
82. Huang ST, Good M, Zauszniewski JA. The effectiveness of music in relieving pain in cancer patients: a randomized controlled trial. Int J Nurs Stud. 2010;47(11):1354-1362.
83. Shinozaki M, Kanazawa M, Kano M, Endo Y, Nakaya N, Hongo M, Fukudo S. Effect of autogenic training on general improvement in patients with irritable bowel syndrome: a randomized controlled trial. Appl Psychophysiol Biofeedback. 2010;35(3):189-198.
84. Segal ZV, Bieling P, Young T, et al. Antidepressant monotherapy vs sequential pharmacotherapy and mindfulness-based cognitive therapy, or placebo, for relapse prophylaxis in recurrent depression. Arch Gen Psychiatry. 2010;67(12):1256-1264.
85. Esmer G, Blum J, Rulf J, Pier J. Mindfulness-based stress reduction for failed back surgery syndrome: a randomized controlled trial. J Am Osteopath Assoc. 2010;110(11):646-652.
86. Chiesa A, Serretti A. Mindfulness-based interventions for chronic pain: a systematic review of the evidence. J Altern Complement Med. 2011;17(1):83-93.
87. Chang BH, Sommers E. Acupuncture and the relaxation response for treating gastrointestinal symptoms in HIV patients on highly active antiretroviral therapy. Acupunct Med. 2011;29(3):180-187.
88. Söderberg EI, Carlsson JY, Stener-Victorin E, Dahlöf C. Subjective well-being in patients with chronic tension-type headache: effect of acupuncture, physical training, and relaxation training. Clin J Pain. 2011;27(5):448-456.
89. Gaylord SA, Palsson OS, Garland EL, et al. Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial. Am J Gastroenterol. 2011;106(9):1678-1688.
90. Mössler K, Chen X, Heldal TO, Gold C. Music therapy for people with schizophrenia and schizophrenia-like disorders. Cochrane Database Syst Rev. 2011;12:CD004025.
91. Lerman R, Jarski R, Rea H, Gellish R, Vicini F. Improving symptoms and quality of life of female cancer survivors: a randomized controlled study. Ann Surg Oncol. 2012;19(2):373-378.
92. Hoffman CJ, Ersser SJ, Hopkinson JB, Nicholls PG, Harrington JE, Thomas PW. Effectiveness of mindfulness-based stress reduction in mood, breast- and endocrine-related quality of life, and well-being in stage 0 to III breast cancer: a randomized, controlled trial. J Clin Oncol. 2012 Apr 20;30(12):1335-1342.
93. Musial F, Büssing A, Heusser P, Choi KE, Ostermann T. Mindfulness-based stress reduction for integrative cancer care: a summary of evidence. Forsch Komplementmed. 2011;18(4):192-202.
94. Hartmann M, Kopf S, Kircher C, et al. Sustained effects of a mindfulness-based stress-reduction intervention in type 2 diabetic patients: design and first results of a randomized controlled trial (the Heidelberger Diabetes and Stress-study). Diabetes Care. 2012;35(5):945-947.
Last reviewed September 2012 by EBSCO CAM Review Board
Last Updated: 9/17/2012
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