Group treatment with Imagery Rehearsal Therapy (IRT) for refugees and Danish civilians with PTSD: A clinical pilot study of acceptability and treatment outcomes
Ida Sophie Poschmann, Hinuga Sandahl, Sabina Palić, Jessica Carlsson
International Journal of Dream Research October 20, 2025 DOI: 10.11588/ijodr.2026.2.113670 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Mixed-methods pilot study Qualitative Peer reviewed |
|---|---|
| Sample size | 18 |
| Population | Male refugees (n=6), female refugees (n=6), and Danish civilians (n=6) with PTSD |
| Intervention | Imagery Rehearsal Therapy (IRT) |
| Duration | Three 12-week IRT groups |
| Topics | PTSD |
| Key points | Group-based IRT was generally perceived as acceptable, with similar attendance across groups. Homework adherence and treatment outcomes were most encouraging among Danish civilians and male refugees, while female refugees showed less improvement on standardized measures but described benefits from the group process, particularly normalization and social support. |
Abstract
Imagery Rehearsal Therapy (IRT) is an established treatment targeting nightmares and sleep disturbances in posttraumatic stress disorder (PTSD). However, group-based IRT has not previously been investigated among trauma-affected refugees. This study explored group-based IRT among refugees and Danish civilians with PTSD.
Objective: This clinical pilot study examined (1) adherence and acceptability and (2) changes in PTSD symptoms, sleep, functioning, and well-being.
Method: Eighteen participants took part in three 12-week IRT groups comprising male refugees (n = 6), female refugees (n = 6), and Danish civilians (n = 6). A mixed-methods approach included assessment of session attendance and homework adherence, standardized self-report measures, weekly sleep logs, and post-treatment qualitative evaluation interviews.
Results: Group-based IRT was generally perceived as acceptable, with similar attendance across groups. Homework adherence was highest among Danish civilians, followed by male refugees, and lowest among female refugees. Treatment outcomes were most encouraging among Danish civilians and male refugees, although individual treatment trajectories varied. Female refugees showed less improvement on standardized outcome measures but described benefits from the group process, particularly normalization and social support. Across groups, qualitative findings highlighted perceived benefits related to increased mastery and the generalization of treatment strategies, while social challenges and cognitive difficulties were described as barriers to engagement.
Conclusion: Group-based IRT appears acceptable and feasible for selected patients with PTSD. The findings support further investigation of group-based IRT in larger controlled studies and suggest that flexible adaptations may be needed to address the diverse needs of trauma-affected refugee populations.