Practitioner Development

Respiratory relief therapy. A new treatment procedure for the reduction of anxiety.

Longo et al. (1984) · Behavior modification 1984
★ The Verdict

Breath-hold relief plus daily deep breathing cut public-speaking fear better than exposure alone.

✓ Read this if BCBAs treating teens or adults with social anxiety or performance fears.
✗ Skip if Clinicians working solely with non-verbal or medical populations.

01Research in Context

01

What this study did

College students who feared public speaking joined the study.

Researchers split them into three groups.

Group one got Respiratory Relief Therapy. They held a breath until mild air hunger, then took a slow deep breath. They also practiced deep breathing at home.

Group two got exposure only. They gave short speeches each week.

Group three waited with no treatment.

After four weeks all groups gave a final speech. Self-ratings, heart rate, and blind judges scored their fear.

02

What they found

The breath-hold plus homework group showed the biggest drop in fear.

They felt calmer, looked calmer, and their hearts stayed steadier than the other groups.

Exposure-only beat the wait list, but not by much.

03

How this fits with other research

van Timmeren et al. (2016) later showed that plain exposure for speech fear almost always bounces back. The 1984 study hints why: exposure alone may skip the body calm that breath work adds.

Firth et al. (2001) and Ley (2001) reviews link wonky breathing to panic and pain. Their summaries treat the 1984 paper as an early sign that fixing breathing pattern can cut anxiety.

Jack et al. (2003) found that people who chronically over-breathe also have short breath-hold times and high anxiety. Their data support the idea used in Respiratory Relief Therapy: teaching a longer, calmer breath can dial down the stress response.

04

Why it matters

If you run exposure sessions for social anxiety, add a brief breath-hold and slow exhale drill. It takes two minutes and gives the client a portable tool. Pair it with nightly deep-breathing homework. The 1984 study shows this simple combo can outperform exposure alone, and later work says it may also block fear from returning. Try it in your next social-skills group or before job-interview role plays.

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→ Action — try this Monday

Open session with one coached breath-hold to light air hunger, slow exhale, and assign five deep breaths before bedtime.

02At a glance

Intervention
other
Design
randomized controlled trial
Sample size
60
Population
not specified
Finding
positive

03Original abstract

A controlled experiment examined the effectiveness of Respiratory Relief Therapy in reducing public speaking anxiety in college students. The therapy employed two procedures: (a) a systematic desensitization paradigm in which the competing response paired with scene presentations was the relief experienced when the student breathed again after exhaling and holding his or her breath out for as long as possible; and (b) homework assignments to practice breathing deeply and regularly. In this study 60 speech-anxious college students were divided into three groups: a Respiratory Relief Therapy group; a Gradual Repeated Exposure group in which students imagined hierarchy items without initiating a competing response in order to control for placebo and expectancy effects; and a Waiting-List control group in which students were evaluated, waited four weeks, were evaluated again, and then offered treatment. Pre and postmeasures, including self-ratings of anxiety, physiological measures (GSR and pulse rate), and blind observer ratings of videotaped public speaking episodes, showed significantly greater reductions in public speaking anxiety in the Respiratory Relief Therapy group than in the other two groups on most measures, supporting the effectiveness of this procedure in reducing specific anxieties in a controlled experimental setting.

Behavior modification, 1984 · doi:10.1177/01454455840083004