A plethora of relaxation strategies have been developed and are appropriate to try. Individuals vary substantially in what works to help them relax. The role of the practitioner is to provide a range of ideas and explore them with the client until he or she finds one or more techniques that work best and which they can do on their own.

Controlled breathing – Breathing too fast is an indicator of high stress. The controlled breathing exercise involves developing awareness of a fast breathing rate; learning to take slow controlled breaths by breathing in through the nose, out through the mouth, and relaxing on the out breath; then stabilising the breathing rate at approximately 10 breathes per minute (or 6 seconds per breath) 

Progressive muscle relaxation – This exercise involves tensing and relaxing different muscle groups one after the other to help reduce physical and mental tension. The young person should be guided through the exercise several times initially, then encouraged to try it on their own.

Grounding – Grounding exercises help the person detach from emotional pain for short periods when it becomes overwhelming. The principle is to shift attention from internal feelings to the outside world. There are at least two main types of grounding exercises. Mental grounding uses cognitive techniques. Examples include (a) Describing objects in the environment in detailing using all your senses; (b) Describing an everyday activity in detail such as eating or washing; (c) Using grounding statements such as “I am Tom. I am 21 years old. I am safe here. Today is…”; (d) Say the alphabet slowly; (e) Count backwards from 20; (f) Think of a place where you have found calm and peaceful and describe this place and what you were doing; (g) Think of things to look forward to doing in the next few days. Physical grounding uses stimulation of the physical senses to draw attention away from the internal emotions: (a) Run cool or warm water over your hands; (b) Touch objects around you as you say their names; (c) Do some stretches – developing a set that can be worked through in a routine may be more ‘containing’ for some people; (d) Rub nice smelling moisturising cream into the hands and arms and notice the feel and the smell.

Mindfulness – Mindfulness is a technique for focusing on what is happening in the present moment without being drawn in by distractions. Mindfulness can be applied to any task that you do, but is especially suited to routine activities such as doing the washing up or cleaning your teeth. A good exercise to start with is mindfulness of walking.  Key principles and components of this exercise include: (a)  Paying attention as though it is the first time you have ever done it; (b) Moving slowly and deliberately, breaking the movements down into small steps; (c) Being aware of all the physical and other sensations that you would not normally attend to such as the bottoms of your feet, the weight of your body when it is still and when it moves, sensations in your muscles as you move them; (d) Repeating the movements, perhaps paying attention to different parts of the body with each repetition; (e) Maintaining the exercise for 10 minutes, noticing when the mind wanders and bringing it back gently. As with other relaxation exercises it is best to guide the client through it several times to gauge their comfort and ability to manage it on their own. Other mindfulness exercises can be found here.

See Practice Elements G4i to G4ii for more advanced options designed for Distress tolerance.