Telephone-guided imagery rehearsal therapy for nightmares: Efficacy and mediator of change.
Jaap Lancee, Marieke Effting, Anna E Kunze
Journal of Sleep Research June 1, 2021 DOI: 10.1111/jsr.13123 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 70 |
| Population | Adults with nightmares according to DSM-5 |
| Intervention | Imagery rehearsal therapy |
| Duration | 3 sessions over 5 weeks, with 3- and 6-month follow-up |
| Topics | Dreaming |
| Keywords | Imagery rehearsal treatment Mastery Nightmares Self-help |
| Key findings | Telephone-guided imagery rehearsal therapy significantly reduced nightmare frequency, nightmare distress, and insomnia severity compared to a wait-list condition, with effects sustained at 3- and 6-month follow-up. |
Abstract
The currently best-supported psychological treatment for nightmares is imagery rehearsal therapy. The problem, however, is that not enough trained practitioners are available to offer this treatment. A possible solution is to conduct imagery rehearsal therapy in a guided self-help format. In the current study, 70 participants with nightmares according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders were randomized to either telephone-guided imagery rehearsal therapy (n = 36) or a wait-list condition (n = 34). Participants in the imagery rehearsal therapy condition received three sessions over the course of 5 weeks. Every treatment session was followed by telephone support delivered by postgraduate students. Participants who received imagery rehearsal therapy showed larger improvements on nightmare frequency (d = 1.03; p < .05), nightmare distress (d = 0.75; p < .05) and insomnia severity (d = 1.12; p < .001) compared with the participants in the wait-list condition. The effects were sustained at 3- and 6-month follow-up. No significant effects were observed on the number of nights with nightmares per week, anxiety and depression. In line with earlier reports, the treatment effect was mediated by the increase of mastery at mid-treatment, underlining the mechanistic value of mastery in imagery rehearsal therapy. The present study demonstrates that it is possible to deliver imagery rehearsal therapy in a self-help format supported by unexperienced therapists and with relatively little time investment. This opens possibilities in terms of cost-effectiveness, scalability and dissemination of imagery rehearsal therapy in the treatment of nightmares.
Comparable studies
Other randomized controlled trials on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Efficacy of a Cognitive‐Behavioral Treatment for Insomnia and Nightmares in Afghanistan and Iraq Veterans With PTSD Combat veterans of Operation Enduring Freedom and/or Operation Iraqi Freedom (mean age... | 2013 | Randomized controlled trial | n = 40 |
| Lucid Dreaming Treatment for Nightmares: A Pilot Study Chronic nightmare sufferers | 2006 | Randomized controlled trial | n = 23 |
| Testing the involvement of the prefrontal cortex in lucid dreaming: A tDCS study Participants spending three consecutive nights in a sleep laboratory | 2013 | Randomized controlled trial | n = 19 |
| Pre-sleep treatment with galantamine stimulates lucid dreaming: A double-blind, placebo-controlled, crossover study Adults with high dream recall and an interest in lucid dreaming | 2018 | Randomized crossover trial | n = 121 |
| Studies with lucid dreaming as add-on therapy to Gestalt therapy Adults with nightmares (ICD-10: F51.5) at least twice a week | 2015 | Randomized controlled trial | n = 32 |
Citations in the library
Cited by 12
- The relationships between insomnia, nightmares, and dreams: A systematic review Sleep Medicine Reviews April 16, 2024
- Psychosocial treatments for nightmares in adults and children: a systematic review BMC Psychiatry April 21, 2023
- The Effectiveness of Imagery Rescripting Interventions for Military Veterans With Nightmares and Sleep Disturbances: A Systematic Review and Meta‐Analysis Clinical Psychology & Psychotherapy July 1, 2024
- Efficacy of a web application as a self-help intervention for nightmares: a randomized controlled trial Somnologie: Schlafforschung und Schlafmedizin April 30, 2026
- Nightmare Relief: Implementing Imagery Rehearsal Therapy in Counseling Journal of Mental Health Counseling April 1, 2025
and 7 more in the library
Cites 15
- Aetiology and treatment of nightmare disorder: State of the art and future perspectives Journal of Sleep Research January 29, 2019
- Prevalence and Correlates of Frequent Nightmares: A Community-Based 2-Phase Study Sleep June 1, 2010
- Prevalence of Nightmare Disorder in Psychiatric Outpatients Psychotherapy and Psychosomatics 2013
- Increased Mastery Elements Associated With Imagery Rehearsal Treatment for Nightmares in Sexual Assault Survivors With PTSD. Dreaming December 1, 2004
- Comparative efficacy of imagery rehearsal therapy and prazosin in the treatment of trauma-related nightmares in adults: A meta-analysis of randomized controlled trials. Sleep Medicine Reviews April 1, 2020
and 10 more in the library