title: Teacher-led relaxation response curriculum in an urban high school: impact on student behavioral health and classroom environment.
abstract: BACKGROUND
  Recent data suggest that severe stress during the adolescent period is becoming a problem of epidemic proportions. Elicitation of the relaxation response (RR) has been shown to be effective in treating anxiety, reducing stress, and increasing positive health behaviors.
  
  
  OBJECTIVE
  The research team's objective was to assess the impact of an RR-based curriculum, led by teachers, on the psychological status and health management behaviors of high-school students and to determine whether a train-the-trainer model would be feasible in a high-school setting.
  
  
  METHODS
  The research team designed a pilot study.
  
  
  METHODS
  The setting was a Horace Mann charter school within Boston's public school system.
  
  
  METHODS
  Participants were teachers and students at the charter school.
  
  
  METHODS
  The team taught teachers a curriculum that included (1) relaxation strategies, such as breathing and imagery; (2) psychoeducation regarding mind-body pathways; and (3) positive psychology. Teachers implemented this curriculum with students.
  
  
  METHODS
  The research team assessed changes in student outcomes (eg, stress, anxiety, and stress management behaviors) using preintervention/postintervention surveys, including the Perceived Stress Scale (PSS), the State-Trait Anxiety Inventory-Form Y (STAI-Y), the stress management subscale of the Health-promoting Lifestyle Profile II (HPLP-II), the Rosenberg Self-Esteem Scale (RSES), the Locus of Control (LOC) questionnaire, and the Life Orientation Test-Revised (LOTR). Classroom observations using the Classroom Assessment Scoring System (CLASS)-Secondary were also completed to assess changes in classroom environment.
  
  
  RESULTS
  Using a Bonferroni correction (P < .007), the study found that students experienced a significant reduction (P < .001) in measures of state-level anxiety on the STAI from pre- to postintervention. The study also found an increase in the use of stress management behaviors at that point. Using a Bonferroni correction (P < .007), the study found that students had significantly less perceived stress (P < .001), less state anxiety (P < .001) and trait anxiety (P < . 001), and increased use of positive stress management behaviors (P < .004) at the follow-up assessment in the fall of the following year. Using a Bonferroni correction (P < .002), the study found a significant increase in overall classroom productivity (eg, increased time spent on activities and instruction from pre- to postintervention).
  
  
  CONCLUSIONS
  This study showed that teachers can lead an RR curriculum with fidelity and suggests that such a curriculum has positive benefits on student emotional and behavioral health and on classroom functioning.
authors.forename: H Kent
authors.initials: HK
authors.lastname: Wilson
authors.forename: Matthew
authors.initials: M
authors.lastname: Scult
authors.forename: Marilyn
authors.initials: M
authors.lastname: Wilcher
authors.forename: Rana
authors.initials: R
authors.lastname: Chudnofsky
authors.forename: Laura
authors.initials: L
authors.lastname: Malloy
authors.forename: Emily
authors.initials: E
authors.lastname: Drewel
authors.forename: Eric
authors.initials: E
authors.lastname: Riklin
authors.forename: Southey
authors.initials: S
authors.lastname: Saul
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Fricchione
authors.forename: Herbert
authors.initials: H
authors.lastname: Benson
authors.forename: John W
authors.initials: JW
authors.lastname: Denninger
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011594:Psychometrics; D012064:Relaxation Therapy / Q000193:education*; D012574:Schools; D013315:Stress, Psychological / Q000523:psychology / Q000628:therapy; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data*; D014505:Urban Population; D055815:Young Adult