Imagery Rehearsal Therapy Analysis

Through these studies, we have seen that IRT appears to be at least as effective as other treatment modalities and can be a viable option for clinicians helping clients reduce trauma-related nightmares (Casement & Swanson, 2012; Krakow et al., 2001; Lu et al., 2009; Seda et al., 2015). Imagery Rehearsal Therapy is a Cognitive Behavioral Therapy intervention which several of the researchers sought to compare to other treatment modalities. Casement and Swanson (2009) compared the effects of IRT alone against a combination of CBTI and IRT. Unsurprisingly, the combination of CBTI and IRT was found to be more effective than IRT alone. Since CBTI and IRT combined would have the ability to address a wider variety of sleep symptoms, the combination
Unfortunately, the reviewed research shows massive gaps in testing IRT with varying populations. In all the studies examined, IRT was researched with predominantly White populations; other demographic variables were scarce and inconsistently documented (Casement & Swanson, 2012; Krakow et al., 2001; Lu et al., 2009; Seda et al., 2015). The lack of documentation and research with varying populations means that further research will be needed before IRT can be recommended for specific groups of persons.
Along with understanding the evidence for IRT, it is also important to consider where IRT fits within Herman’s (1997) tri-phasic model. Imagery Rehearsal Therapy seeks to address nightmares which are a symptom of PTSD. The presence of nightmares has the ability to create dysregulation for trauma survivors. Since learning to calm nightmares through imagery rehearsal can help persons with trauma stay within the window of tolerance, IRT best fits within Phase I of Herman’s (1997) tri-phasic model which focuses on creating safety within the
Research shows IRT to be as effective as other treatment options and has been rated a Level A treatment due to the amount of evidence which exists for the therapy; these factors make IRT a plausible option for helping persons experiencing trauma-related nightmares (Aurora et al., 2010; Casement & Swanson, 2012; Krakow et al., 2001; Lu et al., 2009; Seda et al., 2015). Unfortunately, research which was located for IRT poorly tracks demographic information which means that further research will be needed before IRT can be recommended for diverse populations (Casement & Swanson, 2012; Krakow et al., 2001; Lu et al., 2009; Seda et al., 2015). Limited training options were located for learning IRT; however, Kakrow and Zadra (2006) outline a protocol for implementing IRT with clients which makes dissemination to therapists relatively easy. The combination of these factors makes Imagery Rehearsal Therapy a relatively good option for clinicians working with persons experiencing trauma-related