Discussion response – Guided Imagery – 2 replies

Hi please create a reponse to the following TWO posts (300 words each). Please add new information or relevant information. Review and critically assess the posts. Students must respond with at least 2 scholarly (within 5 years) references to exceeded expectations.

**master level work**

Post # 1: 

Guided imagery (GI) is often identified as a relaxation-based practice involving various sensory processes in the brain to create vivid mental images of specific places, events, or behaviors. (Mitchell et al., 2021). Professionals have compared this practice to meditative daydreaming that invites joyous and relaxing experiences. Dr. Benson has provided insight by his various studies on monks and meditation. He found that in one meditative practice they decrease oxygen consumption by about 60%. GI has found to illicit a positive effect on anxiety, depression, hypertension, cardiac irregularities, stress, and physiologic functioning (Mitchell et al., 2021).  
GI has proven to be useful in patients who have been diagnosed with cancer and undergo various procedures and treatments that experience increased levels of anxiety. Nguyen et al.(2018) found that there is strong evidence for GI in anxiety management in numerous contexts in 86% of the participants. The NCCIH states that the American Society of Clinical Oncology endorsed that relaxation techniques were recommended to improve mood, decrease depression, and reduce anxiety. Avoiding or using guided imagery with great caution should be considered in those patients who suffer severe post-traumatic stress disorder i.e. military personal. The NCCIH also states that relaxation techniques may cause or worsen symptoms in this population and should consult with their health care providers prior to engaging in this practice.  
Two guided imagery methods that I would employ on a cancer patient with anxiety are palming and nature-based guided imagery. Palming involves placing the palm of the hands over the eyes initially imagining a color related to stress i.e. red or orange then changing to a more relaxing color i.e. blue. Nature-based GI uses language as a script that envisions a scene with water or the sun while imagining smells, sounds, and textures that incorporate all the senses. This process inadvertently relaxes the muscles creating a state of calm and relaxation (Nguyen et al., 2018). As an APRN, guided imagery would be an accessible tool to use at the bedside for the patient that exhibits increasing anxiety.

Post # 2 

Guided imagery uses recall of pleasant sights, smells, sounds, tastes or somatic sensations to create a positive cognitive and emotional state that can prevent pain or other sort of distress. Some of the most popular mind- body therapies is imagery, relaxation, hypnosis and yoga (Strada & Portenoy, 2021). Guided imagery practitioners use words to create states of focused attention to alter the experience of pain. Guided imagery can be directive or interactive. Directive is when therapists suggest images to the patient and interactive is when the therapist does not provide a specific image, but only suggests the feeling that should be elicited by the image (Strade & Portenoy, 2021). Guided imagery uses recall of pleasant sights, smells, sounds, tastes or somatic sensations to create positive cognitive and emotional state to prevent pain or distress. 
One example of how guided imagery would be useful is in pediatric population with anxiety, depression and stress. An example of where guided imagery has been used, but has not shown much success is burn patients. Prior to a painful procedure, such as wound care for burn patents, clinicians have the patient elicit a “safe” or “favorite” place to go, and then the clinician cues the patient with the details they provided and encourage them to imagine it during the wound care process. Although this has been done, there has been little evidence that suggests guided evidence is actually effective in reducing the sensory and emotional components of pain (Wiechman & Sharar, 2021). Since studies have shown that guided imagery has been beneficial in managing stress and anxiety in pediatric patients, I would use it in this population with both interactive and directive imagery. For example If a pediatric patient has social anxiety and can’t present projects in front of a class, I would use directive guided imagery and come up with an image for the child to imagine when looking out into the classroom and I would teach them to use these skills when they’re on their own. Another example would be to use interactive guided imagery for a pediatric patient receiving chemotherapy. I would teach them that while sitting in the infusion unit receiving therapy that they close their eyes and image they are sitting on a beach chair on the beach and how that would make them feel. Studies have shown that guided imagery can help in managing anxiety, stress and depression (Guided Imagery for Kids, 2021). When teaching and doing these guided imageries with my patients, the goal would be in the end that they learn to perform the imagery on their own and when the stress or anxiety present sit self wherever they are, they can do it.

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