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Topic’s Name
Student’s Name, Roll Number
Department of Psychology, Government Post Graduate College, Haripur
PSY3701 Psychological Assessment (Lab)
Ma’am Zainab Sheikh
December 5, 2020
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APA Style
APA style is a writing style and format for academic documents such as scholarly
journal articles and books. It is commonly used for citing sources within the field
of behavioral and social sciences. It is described in the style guide of the American
Psychological Association (APA), which is titled the Publication Manual of the American
Psychological Association. The guidelines were developed to aid reading comprehension in
the social and behavioral sciences, for clarity of communication, and for "word choice that
best reduces bias in language" (American Psychological Association, 2020).
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Student Title Page
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Student
title page
element Format Example
Place the title three to four lines down from
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it in bold font. Capitalize major words of
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desired. There is no maximum length for Impact of Gender on the
titles; however, keep titles focused and Evaluation of Humor in
Paper title include key terms. Romantic Relationships
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names. Center author names on their own
line. If there are two authors, use the word
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Author Center the affiliation on the next double- Department of Psychology,
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number number and name on the next double- PSY 201: Introduction to
and name spaced line after the author affiliation. Psychology
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Provide the due date for the assignment.
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Assignmen the date format commonly used in your October 18, 2020
t due date country. 18 October 2020
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APA Style is used by writers in many disciplines around the world for concise,
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Format of Headings
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Level Format
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Flush Left, Bold, Title Case Heading
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Flush Left, Bold Italic, Title Case Heading
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Indented, Bold, Title Case Heading, Ending With a Period. Text begins
on the same line and continues as a regular paragraph.
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Indented, Bold Italic, Title Case Heading, Ending With a Period. Text
begins on the same line and continues as a regular paragraph.
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Author–Date Citation System
Use the author–date citation system to cite references in the text in APA Style. In this
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reference list entry. The following table shows the basic in-text citation styles:
In-text citations may be parenthetical or narrative.
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In parenthetical citations, use an ampersand (&) between names for a work with two
authors or before the last author when all names must be included to avoid ambiguity. In
narrative citations, always spell out the word “and.”
Number of Authors to Include in In-Text Citations
The format of the author element of the in-text citation changes depending on the number of
authors and is abbreviated in some cases.
For a work with one or two authors, include the author name(s) in every citation.
For a work with three or more authors, include the name of only the first author plus
“et al.” in every citation (even the first citation).
The following table shows the basic in-text citation styles:
Author type Parenthetical citation Narrative citation
One author (Luna, 2020) Luna (2020)
Two authors (Salas & D’Agostino, 2020) Salas and D’Agostino (2020)
Three or more
authors (Martin et al., 2020) Martin et al. (2020)
Group author with
abbreviation (National Institute of Mental National Institute of Mental
First citation a Health [NIMH], 2020) Health (NIMH, 2020)
Subsequent citations (NIMH, 2020) NIMH (2020)
Group author
without abbreviation (Stanford University, 2020) Stanford University (2020)
Define the abbreviation for a group author only once in the text, choosing either the
parenthetical or the narrative format. Thereafter, use the abbreviation for all mentions of the
group in the text.
Further Guidelines for In-Text Citations
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Each in-text citation must correspond to only one reference list entry. Do not include
suffixes such as “Jr.” in the in-text citation. For works with an unknown author (see Section
9.12), include the title and year of publication in the in-text citation. Chapter 10 of the
Publication Manual (7th ed.) includes more than 100 reference examples, each of which
includes examples of the parenthetical and narrative citations
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Sample
Guided Imagery and Progressive Muscle Relaxation in Group Psychotherapy
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Hannah K. Greenbaum
Department of Psychology, The George Washington University
PSYC 3170: Clinical Psychology
Dr. Tia M. Benedetto
October 1, 2019
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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 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
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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 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.
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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.
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
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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
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.
Progressive Muscle Relaxation in Group Psychotherapy
Limited, but compelling, research has examined progressive muscle relaxation within
group psychotherapy. Progressive muscle relaxation has been used in outpatient and inpatient
hospital settings to reduce stress and physical symptoms (Peterson et al., 2011).
Progressive muscle relaxation has also been examined as a stress-reduction
intervention with large groups, albeit not therapy groups. Rausch et al. (2006) exposed a
group of 387 college students to 20 min of either meditation, progressive muscle relaxation,
or waiting as a control condition. Rausch et al. (2006) concluded the following:
A mere 20 min of these group interventions was effective in reducing anxiety to
normal levels
. . . merely 10 min of the interventions allowed [the high-anxiety group] to recover
from the stressor. Thus, brief interventions of meditation and progressive muscle
relaxation may be effective for those with clinical levels of anxiety and for stress
recovery when exposed to brief, transitory stressors. (p. 287)
Thus, even small amounts of progressive muscle relaxation can be beneficial for people
experiencing anxiety.
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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.
Future research should also examine differences in inpatient versus outpatient
psychotherapy groups as well as structured versus unstructured groups. The majority of
research on the use of guided imagery and progressive muscle relaxation with psychotherapy
groups has used unstructured inpatient groups (e.g., groups in a hospital setting). However,
inpatient and outpatient groups are distinct, as are structured versus unstructured groups, and
each format offers potential advantages and limitations (Yalom & Leszcz, 2005). For
example, an advantage of an unstructured group is that the group leader can reflect the group
process and focus on the “here and now,” which may improve the efficacy of the relaxation
techniques (Yalom & Leszcz, 2005). However, research also has supported the efficacy of
structured psychotherapy groups for patients with a variety of medical, psychiatric, and
psychological disorders (Hashim & Zainol, 2015; see also Baider et al., 1994; Cohen &
Fried, 2007). Empirical research assessing these interventions is limited, and further research
is recommended.
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Directions for Future Research
There are additional considerations when interpreting the results of previous studies
and planning for future studies of these techniques. For example, a lack of control groups and
small sample sizes have contributed to low statistical power and limited the generalizability
of findings. Although the current data support the efficacy of psychotherapy groups that
integrate guided imagery and progressive muscle relaxation, further research with control
groups and larger samples would bolster confidence in the efficacy of these interventions. In
order to recruit larger samples and to study participants over time, researchers will need to
overcome challenges of participant selection and attrition. These factors are especially
relevant within hospital settings because high patient turnover rates and changes in medical
status may contribute to changes in treatment plans that affect group participation (L. Plum,
personal communication, March 17, 2019). Despite these challenges, continued research
examining guided imagery and progressive muscle relaxation interventions within group
psychotherapy is warranted (Scherwitz et al., 2005). The results thus far are promising, and
further investigation has the potential to make relaxation techniques that can improve
people’s lives more effective and widely available.
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