Anxiety occurs in hospitalized patients for many reasons, including fear of specific procedures, worry about the future, and lack of control.
Guided imagery is a mind-body exercise based on prompting patients to formulate meaningful mental pictures to achieve relaxation and reduce anxiety. It can be delivered at the bedside in 10-15 minutes by a wide range of trained health care providers at a low cost. Many guided imagery scripts include elements such as asking the patient to sit or lie in a comfortable position, quieting the mind, removing negative thoughts and images, and calling to mind a vivid image or scenario that is calming and relaxing (a "safe place"). The content of a guided imagery script can include softly played, peaceful music while the patient focuses on a safe place where they feel secure and relaxed. Alternatively, the imagery script may involve more active, physical sensations, such as playing and winning a tennis match. Guided imagery can be performed by trained professionals or by using audio recordings, and can be performed daily or as needed by the patient.
Guided imagery has been shown to reduce anxiety and use of anxiolytics, to improve patient satisfaction in a diversity of medical settings, and to significantly reduce anxiety and worry among patients facing different procedures. There is little research yet to support its helpfulness for advanced cancer patients.
Guided imagery can rarely prompt negative emotional reactions, including situations of patient vulnerability and susceptibility. It is contraindicated in patients with post-traumatic stress disorder, and in those who have hallucinations or delusions, delirium, or severe obsessive-compulsive disorder.
Guided imagery should be initiated in health care settings by a clinician who is trained in its proper use, who is comfortable with professional therapeutic boundaries, and who can respond appropriately to negative emotional reactions.
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Adapted from Cooper K and Stollings S. Palliative Care Network of Wisconsin. Fast facts and concepts #211. Internet. Accessed on February 19, 2020.