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Applied Relaxation for GAD — MRCPsych Paper B MCQ

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ModerateAnxiety & Stress-Related DisordersApplied Relaxation for GADMRCPsych Paper B

A 45-year-old man with generalised anxiety disorder has marked functional impairment despite completing guided self-help. He is considering a therapist-delivered applied relaxation programme that includes progressive muscle relaxation and applying relaxation skills in anxiety-provoking situations. Under the NICE CG113 stepped-care model, how is applied relaxation classified?

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Correct answer: A — An individual high-intensity psychological intervention at step 3

Applied relaxation is an individual high-intensity psychological intervention at step 3 of the NICE stepped-care model. For GAD with marked functional impairment or an inadequate response to step 2 interventions, NICE recommends offering either a high-intensity psychological intervention or drug treatment. If the psychological option is chosen, either CBT or applied relaxation should be offered. Guided self-help and psychoeducational groups are low-intensity step 2 interventions, excluding A and E. Drug treatment is a separate step 3 treatment mode rather than a classification of applied relaxation, excluding C. Step 4 highly specialist care is reserved for complex, treatment-refractory GAD, excluding D.

Reference: NICE. Generalised anxiety disorder and panic disorder in adults: management (CG113), recommendations 1.2.17–1.2.20. Published 2011; last updated 2020. https://www.nice.org.uk/guidance/cg113/chapter/Recommendations