Conquering nightmares on the phone: one-session counseling using imagery rehearsal therapy

Abstract Background Since people with nightmares rarely seek help, low-threshold interventions and self-help methods are needed. Among different treatment approaches for nightmares, imagery rehearsal therapy (IRT) is the method of choice.

Objective: In the current study, the authors tested whether IRT is also effective when applied in a short version, within the scope of a single session of telephone counseling.

Methods: The nightmare frequency and nightmare distress of 28 participants was investigated before and 8 weeks after one session of telephone counseling. The 30-minute session included information on nightmare etiology as well as a short version of IRT. The session was followed by an 8‑week period of self-practice. Participants were either part of a student group or part of a group of patients from a sleep laboratory. Within-group and between-group differences were assessed. There was no control group.

Results: The intervention significantly reduced nightmare frequency and nightmare distress in the total sample and in both samples individually analyzed. Effect sizes were very high compared to those of waiting-list control groups of similar studies.

Conclusion: We were able to show that a one-session intervention can be enough to achieve significant relief from nightmares. As nightmares are underdiagnosed and undertreated, this approach might help to provide a low-threshold intervention for nightmare sufferers.