Exposure, relaxation, and rescripting treatment for trauma-related nighmares.

Trauma victims often have sleep problems like nightmares, which are linked to other distress symptoms. Efforts to treat trauma-related nightmares have grown, moving from mostly case studies to controlled trials. The most empirically supported treatment is imagery rehearsal therapy (IRT), which includes relaxation, limited exposure to nightmare content, rewriting the nightmare, and rehearsing the new version. This article describes a modified IRT that adds an enhanced exposure component, trauma themes, and sleep habit changes. A case study and case series were completed on this variant, and a randomized clinical trial is currently underway. Guidelines for application with clients are provided.

Study at a glance

Abstract

Trauma victims frequently report sleep disturbances, including nightmares, following traumatic events. Research indicates that nightmares are associated with the level and severity of other indices of distress. The recognition of the prominence of trauma-related nightmares, in prevalence and impact, has in part heightened efforts to develop and assess techniques to alleviate these difficulties. The majority of such previous efforts were predominantly case studies or uncontrolled group studies; however, recently several controlled studies have been conducted. The treatment with the most empirical support is generally called imagery rehearsal therapy (IRT). This treatment commonly involves relaxation procedures, limited exposure to the nightmare content, rewriting the content of the nightmare, and rehearsal of the altered content. This article provides a description of a modified version of IRT that incorporates all these techniques, with an enhanced exposure component and the addition of trauma themes and alteration of sleep habits. Guidelines for application with clients are outlined. A case study and case series were completed on this variant of IRT and a randomized clinical trial is currently underway.