A nurse is teaching a client who has generalized anxiety disorder about ways to help manage stress. Which of the following instructions should the nurse give the client about using progressive relaxation?

Progressive muscle relaxation is a specific evidence-based technique developed by Edmund Jacobson in which the individual systematically tightens a group of muscles for several seconds, notices the sensation of tension, then releases the tension and notices the contrast of relaxation before moving on to the next muscle group. This process progresses through the major muscle groups of the body. It is particularly effective for anxiety disorders because it teaches the client to recognize and reduce physiological tension, activating the parasympathetic nervous system and lowering overall arousal. The instruction to tighten a muscle group, release the tension, and then move to the next one is the precise description of this technique and is therefore the correct answer. Picturing stress being pushed down and out of the feet describes a guided imagery or visualization technique, not progressive relaxation. Thinking about a positive outcome to a stressful situation describes cognitive restructuring or positive reframing. Focusing on a pleasant memory and expressing emotions in writing combines elements of guided imagery and journaling, which are different therapeutic approaches. Only the description of deliberately tensing and then releasing muscle groups accurately defines progressive muscle relaxation.