Effectiveness of relaxation techniques ‘as an active ingredient of psychological interventions’ to reduce distress, anxiety and depression in adolescents: a systematic review and meta-analysis

Abstract

Background Adolescent depression and anxiety are among the leading contributors to health burden worldwide. ‘Relaxation Techniques (RTs)’ are a “set of strategies to improve physiological response to stress” and are frequently cited as an active ingredient of trans-diagnostic, psychosocial interventions for scaling-up care for preventing and treating these conditions in adolescents. However, there is a little evidence on the effectiveness of ‘relaxation techniques’ for this age group. Aim As a part of the Wellcome Trust’s Active Ingredients commission, we did a systematic review and meta-analysis to evaluate the effectiveness of RTs to reduce the symptoms of distress, anxiety and depression in young people, aged 14 to 24 years old, globally. Methods We searched 10 academic databases to include 65 Randomized Controlled Trials (RCTs) of relaxation-based interventions for young people with the symptoms of anxiety and depression. Primary outcomes were reduction in symptoms of distress, anxiety and/or depression. We employed the Cochrane risk of bias tool and GRADE (Grading of Recommendations, Assessment, Development and Evaluations) guidelines to assess certainty of outcomes pertaining to anxiety, depression and distress. Standardized mean difference was estimated using effect size. Results The analysis of 65 RCTs with 8009 young people showed that RTs were highly effective in treating anxiety (pooled effect size of (Standardized Mean Difference-SMD) − 0.54 (95% CI − 0.69 to − 0.40); moderately effective in reducing distress (SMD = − 0.48, 95% CI − 0.71 to − 0.24) and had only a weak effect on improving depression in young people (SMD = − 0.28 (95% CI − 0.40% to − 0.15). Face-to-face delivered relaxation techniques yielded higher effect size (SMD = − 0.47, 95% CI − 0.64 to − 0.30) compared to online delivery (SMD = − 0.22, 95% CI − 0.48 to 0.04) for anxiety. Conclusion Most of the included studies were from High Income Countries (HICs) and had a high risk of bias. Further high-quality studies with low risk of bias, especially from low resource settings are needed to evaluate the evidence for effectiveness of RTs as an active ingredient of psychological interventions to reduce the symptoms of distress, anxiety and depression in young people.

Evaluating the Effectiveness of a Self-Management Program on Patients Living with Chronic Diseases

“…A growing body of evidence indicates that these techniques could reduce the effects of stress and improve symptom management in individuals with chronic illnesses. 33 , 34 Participants reported that they regularly use distraction as an essential cognitive approach to manage stress and pain or even sleep problems. The CDSMP highlights that distraction techniques can provide short-term relief, but do not address the underlying causes of the symptoms.…”

Does a program‐based cognitive behavioral therapy affect insomnia and depression in menopausal women? A randomized controlled trial

“…Identifying stressful situations, managing emotional stress, and learning coping mechanisms are all made easier for menopausal women by CBT. They are given a variety of integrated techniques by CBT that they can use to improve their sleep and lessen symptoms of depression (Hamdani et al., 2022).…”

Implication of cognitive-behavioral stress management on anxiety, depression, and quality of life in acute myocardial infarction patients after percutaneous coronary intervention: a multicenter, randomized, controlled study

“…(2) CBSM intervention helped patients to manage their emotional problems and build their confidence by expressing their troubles with other participants, which was helpful to establish supportive relationships with others and increase their confidence, thereby attenuating anxiety and depression [ 30 ]. (3) The relaxation training session of CBSM intervention allowed patients to refresh their minds, eliminate fatigue, and regain strength, which would further result in the reduction of anxiety and depression [ 32 , 33 ].…”