Telephone-guided imagery rehearsal therapy for nightmares: Efficacy and mediator of change.
Journal of Sleep Research June 1, 2021 Jaap Lancee, Marieke Effting, Anna E Kunze
Telephone-guided imagery rehearsal therapy for nightmares, delivered by postgraduate students, produced large improvements in nightmare frequency, nightmare distress, and insomnia severity compared with a wait-list condition. 70 adults with nightmare disorder were randomized to three treatment sessions over 5 weeks or to a wait list. Effects were sustained at 3- and 6-month follow-up. No significant effects were found on nights with nightmares per week, anxiety, or depression. The treatment effect was mediated by increased mastery at mid-treatment, supporting mastery's mechanistic role in imagery rehearsal therapy. The findings indicate that imagery rehearsal therapy can be effectively delivered in a guided self-help format with minimal therapist training, improving scalability and cost-effectiveness.