Cognitive Therapy of Anxiety Disorders

271

From

Cognitive Therapy of Anxiety Disorders: Scienc

e and Practice

by David A. Clark and Aaron T. Beck. Copy

right 2010 by The Guilford Press. Permission to photocopy

this appendix is granted to purchasers of this book fo

r personal use only (see copyright page for details).

aPPENDIX 7.4

Weekly Progressive Muscle Relaxation Record

Name:

Date:

Instructions:

Two 15-minute relaxation sessions should be scheduled daily. U

se the chart below to record your progress in achieving a relaxed

state with each of the muscle groups. Make a check mark (



) if you successfully relaxed a muscle group during a practice session and m

ark

an (

X) if you had difficulty relaxing the muscle group. At the bottom of the column, r

ate the overall level of relaxation achieved in the practice

session from 0 (“unable to relax at all”) to 50 (“moderately relaxed but conscio

us of some tension”) to 100 (“so completely relaxed that I fell

asleep”).Day of Week:

Day one

Day Two

Day Three

Day Four

Day Five

Day Six

Day Seven

Practice session:

1

2

1

2

1

2

1

2

1

2

1

2

1

2

1. Dominant arm 2. Nondominant arm 3. Forehead 4. Eyes and nose 5. Jaw and neck 6. Shoulders and back 7. Chest 8. Stomach 9. Dominant leg10. Nondominant leg11. Rate overall level of relaxation

(0 –100)