Imagery rehearsal therapy

1. Introduction

Version followed: Barry Krakow's imagery rehearsal therapy (IRT) for chronic nightmares. Sources: Krakow et al. 2001 (JAMA RCT, three group sessions), Krakow & Zadra 2006 (Behavioral Sleep Medicine, about four sessions of roughly 2 hours each; only the abstract is drawn on), and Krakow's 2021 practice interview (Carlat Psychiatry Report). Where the six-session individual Dutch protocol (van Schagen, Lancee, Spoormaker 2012; trial: van Schagen et al. 2015) differs, it is named as such. [source: Krakow & Zadra 2006 abstract; Carlat 2021; van Schagen et al. 2015]

IRT is a brief cognitive-imagery treatment that targets nightmares directly, whether they follow trauma or occur on their own. You do not have to treat the underlying trauma first. In Krakow's model, nightmares may begin as a way of processing a stressful event but can persist as a learned, habitual behaviour that works like a sleep disorder and in turn fuels insomnia. [source: Carlat 2021; Krakow quoted in Jamaica Observer 2001] Change comes from new learning, not desensitisation. The patient picks a nightmare, changes it in any way they wish while awake, and rehearses the changed version ("a new dream") in daytime imagery. They do not rehearse the nightmare itself. [source: Carlat 2021; NBC/AP 2010] Krakow and Zadra regard chronic nightmares as possibly a primary sleep disorder, not only a symptom of a psychiatric condition. [source: Krakow & Zadra 2006 abstract]

Scope note: IRT is a nightmare-focused add-on. It is not a trauma-memory processing treatment, and it does not interpret dreams. [source: NBC/AP 2010: Krakow did not ask patients to interpret symbolism]

2. Framework

Versions and formats

Version	Format	Sessions	Content sequence
Krakow et al. 2001 RCT (sexual-assault survivors with PTSD)	Group	3 sessions, about 7 hours in total	S1: nightmares as trauma-induced and also learned or habit-sustained; pleasant-imagery practice. S2 (about 1 week later): IRT on one self-selected nightmare, then apply it to other troubling nightmares in the following weeks. S3: group progress review; sharing; whether imagery could help other PTSD symptoms.
Krakow & Zadra 2006	Usually group	About 4 sessions of about 2 hours	Main points and rationale per session are in the full article [uncertain: full text]
Krakow clinic practice (2010, 2021)	4 group sessions plus 1–10 individual sessions as needed; Krakow says 3–5 sessions usually work	Education → imagery training (about 2 sessions) → select, write, change and rehearse (session 3) → refine
Dutch individual protocol (van Schagen et al.)	Individual, 6 × 1 hour, every 2 weeks, added to usual care	S1: rationale, homework, safe/pleasant-place imagery. S2: least distressing nightmare written down, ending changed, new version written and imagined in session. S3–5: add helpful elements or rescript other nightmares. S6: evaluation, triggers, coping.

[source: Psychiatric News 2001; Jamaica Observer 2001; Carlat 2021; NBC/AP 2010; Krakow & Zadra 2006 abstract; van Schagen et al. 2015]

Across the studies in Casement & Swanson's 2012 meta-analysis, IR protocols ran 3–10 sessions (most IRT protocols 3–6) of about 60–200 minutes (most 60–120), mostly in groups. [source: Casement & Swanson 2012]

Phases, goals and criteria for moving on. The phase labels below are a synthesis of the sequences above. Movement criteria are not stated in the sources and are marked [synthesis].

Assessment and suitability. Goal: confirm that the nightmares are frequent and distressing enough to treat, screen for other sleep disorders, and check stability. Move on when the patient is stable enough for brief imagery work (see readiness in §4.1). [source: Carlat 2021] [synthesis for the criterion]
Education (rationale). Goal: the patient understands nightmares as a learnable, changeable habit and accepts that the nightmare can be targeted directly. Move on when the patient can state the rationale in their own words and agrees to try. [source: Psychiatric News 2001; Carlat 2021] [synthesis for the criterion]
Imagery skills training. Goal: the patient can form vivid, multisensory, pleasant or neutral images and can step out of unwanted images. Move on when they can hold a neutral scene and use the stop-and-breathe or shift skill. Krakow notes some patients need extended practice. [source: Carlat 2021] [synthesis for the criterion]
Select, change and rehearse one nightmare. Goal: one written new dream that the patient rehearses in daytime imagery at home. [source: all versions]
Extend and refine. Goal: the new dream evolves, other nightmares are addressed one at a time, and imagery is generalised to daytime mood if useful. [source: Psychiatric News 2001; Carlat 2021; van Schagen et al. 2015]
Consolidation. Goal: review gains, triggers and coping, and plan continued rehearsal when nightmares recur (Dutch session 6). [source: van Schagen et al. 2015] [synthesis: relapse plan detail]

Expected time course. Krakow reported that about 70% of patients had significant reductions after 2–4 weeks of regular use, and that no 2001 participant became completely nightmare-free. Set expectations for reduction, not elimination. [source: NBC/AP 2010; Jamaica Observer 2001]

3. Guiding principles

Target the nightmare directly. Treat chronic nightmares as a problem in their own right. Practical meaning: you can start IRT without first resolving the trauma, and you should correct the belief that trauma must be fixed first. [source: Carlat 2021; Krakow & Zadra 2006 abstract]
Nightmares as learned habit. Practical meaning: frame the work as retraining a habit ("unlearning"), not as uncovering meaning. [source: Carlat 2021; Psychiatric News 2001]
New learning, not desensitisation. Practical meaning: do not have the patient relive, retell repeatedly or rehearse the nightmare. Rehearse only the new dream. [source: Carlat 2021]
Minimal contact with nightmare content. Practical meaning: the nightmare is written down once only, because repeated writing could overstimulate the patient. [source: Carlat 2021] (Other protocols such as ERRT and IRET deliberately add exposure. That is a different version; see §4.13.) [source: Casement & Swanson 2012]
Patient-generated change. Practical meaning: give the open instruction "Change the nightmare any way you wish" and do not supply the content. [source: Carlat 2021; NBC/AP 2010]
The changed version is "a new dream". Practical meaning: refer to it as a separate new dream, not the old nightmare with a fix. [source: NBC/AP 2010]
No interpretation. Practical meaning: do not analyse symbolism. If a patient wants meaning-work, discuss it as a separate goal. [source: NBC/AP 2010]
Small doses, one dream at a time. Practical meaning: work on one nightmare first and add others later. Brief, regular rehearsal is enough. [source: Jamaica Observer 2001; Carlat 2021; Psychiatric News 2001]
Daytime rehearsal, flexible dose. Practical meaning: rehearsal does not have to be at bedtime. Krakow's current practice sets no fixed time or length. [source: Carlat 2021] [uncertain: the 2001 trial reportedly instructed 5–20 min/day, so name the version you follow]
Imagery is a trainable skill. Practical meaning: build it with neutral or pleasant scenes before touching nightmare material. [source: Carlat 2021; Psychiatric News 2001]
Screen for sleep disorders. Practical meaning: nightmares can signal sleep-disordered breathing, which is common in PTSD and missed in young, thin patients. Refer for sleep assessment when indicated. [source: Carlat 2021; NBC/AP 2010]
Stability before imagery work. Practical meaning: refer unstable PTSD (frequent flashbacks, dissociation, panic) to a trauma-experienced therapist, and take care with severe depression or suicidality. [source: Carlat 2021]
Adjunct, not replacement. Practical meaning: IRT can run alongside other treatment (2001 controls continued their care; Dutch IRT was added to usual care). Coordinate with the patient's other clinicians. [source: Jamaica Observer 2001; van Schagen et al. 2015]

4. Intervention inventory

All example therapist language below is illustrative wording written for this guide, unless it is a short quoted phrase with a citation.

4.1 Screening, suitability and readiness

Purpose / when: Before any imagery work. Decide whether IRT is indicated, whether it is safe now, and whether another sleep disorder needs assessment.
Steps:
1. Establish frequency and distress. Krakow treats a nightmare at least weekly as likely to bother the patient. Research protocols used thresholds such as at least 3 nightmares a month with daytime distress (Dutch trial). [source: Carlat 2021; van Schagen et al. 2015]
2. Ask whether the patient thinks about the nightmare content during the day. A "yes" suggests they would benefit from intervention. [source: Carlat 2021]
3. Screen for sleep-disordered breathing and other sleep problems (snoring, witnessed apnoeas, daytime sleepiness, insomnia). Krakow reports high apnoea rates even in moderate PTSD and in patients who look low-risk. Refer to sleep medicine for assessment when indicated. [source: Carlat 2021; NBC/AP 2010]
4. Check stability. If PTSD is unstable (frequent flashbacks, dissociation, panic), refer to a PTSD-experienced therapist first. Take care with severe depression or suicidality. [source: Carlat 2021] Complete a standard suicide-risk assessment and safety plan where indicated. [synthesis]
5. Note exclusions used in research. The Dutch trial excluded psychotic disorder, acute psychiatric crisis, severe addiction, intellectual disability or neuropsychiatric syndrome, and previous IRT. [source: van Schagen et al. 2015] These were research exclusions, not absolute clinical contraindications. Adapted IR has been piloted in people with psychotic symptoms (Sheaves et al. 2015, abstract only). [uncertain]
6. Readiness criteria before choosing a trauma nightmare: the patient can do neutral imagery, can step out of an unwanted image (§4.4), has no current crisis, and has a clinician available between sessions. [synthesis]
Example language (illustrative): "How many nights a week do you wake from a bad dream? And during the day, do the images come back to you?"
Watch for: Nightmares that persist despite good rehearsal (re-check for sleep disorders). Disclosures of current danger. Dissociation during the interview.

4.2 Psychoeducation: nightmares as a learned, treatable habit

Purpose / when: First session, and again whenever motivation dips. It gives the rationale for targeting the nightmare directly.
Steps:
1. Explain that nightmares may start as a reaction to, or a way of processing, a stressful event. [source: Carlat 2021]
2. Explain that they can become habit-sustained, a learned pattern that keeps going on its own and disturbs sleep. [source: Psychiatric News 2001; Carlat 2021]
3. Explain that this habit can be targeted directly, without first resolving the trauma. Gently challenge the belief that the trauma must be treated first, using cognitive restructuring if needed. [source: Carlat 2021]
4. Describe the plan: build imagery skills, change one nightmare into a new dream, and rehearse the new dream while awake. [source: Psychiatric News 2001; Carlat 2021]
5. Set realistic expectations: reduction rather than elimination, usually over weeks. [source: Jamaica Observer 2001; NBC/AP 2010]
Example language (illustrative): "Many people find their nightmares started with something frightening but then kept going like a groove the mind keeps falling into. We are going to lay down a new groove while you are awake."
Watch for: The patient restating the idea in their own words. Fear that changing the dream means denying what happened. Validate the experience and separate the nightmare habit from the memory. [synthesis]

4.3 Imagery skills training (pleasant and neutral imagery)

Purpose / when: Before any nightmare work, in about two sessions in Krakow's practice or in session 1 of the 2001 trial. It builds the ability to create vivid images and gives practice with benign content. [source: Carlat 2021; Psychiatric News 2001]
Steps:
1. Have the patient sit comfortably and close their eyes, or lower their gaze if they prefer. [synthesis]
2. Guide a neutral, familiar scene with full sensory detail. Krakow's examples are driving from home along a familiar route, or a walk to the beach. [source: Carlat 2021]
3. Prompt sight, sound, smell, touch and movement. Pace slowly. [source: Carlat 2021 (full sensory detail)] [synthesis: pacing]
4. Move on to pleasant scenes. The Dutch protocol uses a safe or pleasant place. [source: Psychiatric News 2001; van Schagen et al. 2015]
5. Debrief: ask what was vivid, what was hard, and whether any unwanted images appeared. Assign brief home practice. [synthesis]
Example language (illustrative): "In your mind's eye, picture leaving your front door and getting into the car. What do you see on the dashboard? What do you hear as you pull out?"
Watch for: "My screen is black" (no imagery; see §5). Intrusion of trauma images (use §4.4). Increasing vividness and confidence across practice.

4.4 Managing unpleasant images during imagery

Purpose / when: Teach it during skills training and use it whenever an unwanted or distressing image appears in session or at home.
Steps:
1. Basic skill: stop the imagery, open the eyes, take a few relaxed breaths, and return to imagery only when ready. [source: Carlat 2021]
2. Advanced skill: acknowledge the distressing image, then deliberately shift attention to a pleasant one. Krakow notes some patients need months of coaching to master this. [source: Carlat 2021]
3. Add grounding if the patient is dissociating: orient to the room, the date and physical sensations, and pause the exercise. [synthesis]
4. Close by checking the patient's current distress and state before they leave. [synthesis]
Example language (illustrative): "If anything you don't want shows up, just open your eyes and take a couple of easy breaths. You're in charge of when we go back in."
Watch for: Shorter recovery time and more confident use of the shift skill. Persistent dissociation means pausing IRT and reviewing readiness (§4.1).

4.5 Selecting the target nightmare

Purpose / when: After imagery skills are adequate (session 2 of the 2001 trial; about session 3 in Krakow's practice; session 2 of the Dutch protocol).
Steps:
1. Krakow version: the patient picks any nightmare, including a trauma nightmare. [source: Carlat 2021]
2. Dutch version: start with the least distressing nightmare. [source: van Schagen et al. 2015]
3. Work on one nightmare at a time and address others in later weeks. [source: Psychiatric News 2001; Jamaica Observer 2001]
4. If a highly traumatic nightmare proves too much, start with a less distressing one or a neutral dream (see §4.7). [source: Carlat 2021] [synthesis: offering a less distressing choice up front for less stable patients]
Example language (illustrative): "Pick one bad dream to start with. It doesn't have to be the worst one. Many people start with one that's easier to handle."
Watch for: Pressure (from you or the patient) to start with the worst nightmare before skills are in place.

4.6 Writing the nightmare once, then changing it any way you wish

Purpose / when: This is the core IRT step. It creates the new dream.
Steps:
1. The patient writes the chosen nightmare down once only. Repeated writing could overstimulate them. Some protocols have it described to the therapist instead. [source: Carlat 2021; NBC/AP 2010]
2. Give the open instruction: "Change the nightmare any way you wish." (Krakow). Leave it open so that the ideas come from the patient. [source: Carlat 2021; NBC/AP 2010]
3. The patient writes out the changed version in full. [source: Psychiatric News 2001; van Schagen et al. 2015] The Dutch protocol specifically has the ending changed to a satisfactory outcome. [source: van Schagen et al. 2015]
4. Call the result "a new dream". It is not a corrected nightmare, and the old one is not what you are working on. [source: NBC/AP 2010]
5. Do not interpret symbolism, and do not steer content toward "realistic" solutions. [source: NBC/AP 2010] [synthesis: no steering]
Range of changes reported: small changes to setting or objects (a fast black car chased by eyeballs became a slow white Cadillac, with the eyeballs turned to floating bubbles); confronting an attacker; or a completely new dream unrelated to the nightmare (a dream about birds). [source: NBC/AP 2010]
Example language (illustrative): "Now, any way you like, change this dream. It can be a small change or a completely different story. There's no right answer, and the ideas are yours."
Watch for: The patient rehearsing or re-reading the nightmare text (discourage this). New versions that still end in harm (invite further changes). Relief or interest as signs of engagement.

4.7 Neutral-dream or fantasy fallback

Purpose / when: When the patient cannot change a trauma nightmare, or resists changing the dream at all.
Steps: Switch the rehearsal target to a neutral dream or a pleasant fantasy and rehearse it as in §4.8. Return to nightmare-derived scripts later if wanted. [source: Carlat 2021] [synthesis: returning later]
Example language (illustrative): "Let's set this one aside for now and build a calm dream from scratch. That still trains the same skill."
Watch for: Whether nightmare frequency falls even with non-nightmare content. Krakow frames IRT as new learning, so this is expected to help. [source: Carlat 2021] [uncertain: the size of benefit with fully unrelated content is not quantified in the sources]

4.8 In-session rehearsal of the new dream

Purpose / when: Straight after writing the new dream. It shows the patient how to rehearse and lets you check for problems.
Steps:
1. Help the patient into a relaxed state (brief breathing or the pleasant scene from §4.3). [source: Psychiatric News 2001 (rehearsed in a relaxed state)]
2. The patient imagines the new dream from start to finish with sensory detail, with eyes closed. [source: Psychiatric News 2001; van Schagen et al. 2015]
3. Open the eyes. Ask how vivid it was, whether any old nightmare elements intruded, and how they feel now. [synthesis]
4. If the nightmare intruded, use §4.4, then revise the new dream so it holds up (for example, add more distance or a different setting). [synthesis]
Example language (illustrative): "Settle in, and when you're ready, run the new dream in your mind from the beginning, like watching a film you chose. Take your time with the details."
Watch for: Being able to complete the new dream without the nightmare taking over. Calm or positive affect afterwards.

4.9 Home rehearsal

Purpose / when: Between sessions. This is the main active ingredient in Krakow's model.
Steps:
1. The patient rehearses the new dream in daytime imagery. It does not have to be linked to bedtime. [source: Carlat 2021]
2. Dose, by version:
  - Krakow current practice: the therapist does not set a time or length. In trials, the average was under 5 minutes every other day, often about 1 minute. [source: Carlat 2021]
  - 2001 trial: 5–20 minutes a day was reported (from a press report). [source: Jamaica Observer 2001] [uncertain]
  - Dutch protocol: the new dream is generally imagined several times a day. [source: van Schagen et al. 2015]
3. The patient rehearses only the new dream, never the nightmare. [source: Carlat 2021]
4. Allow the new dream to evolve over time. [source: Carlat 2021]
5. Suggest an optional simple log (rehearsals, nightmares per week, distress) to review in session. [synthesis] (The Dutch trial used a nightmare diary as a research measure, not as therapy. [source: van Schagen et al. 2015])
Example language (illustrative): "Most days, find a moment, even a minute or two, to run the new dream through your mind. Morning, lunch break, whenever suits you. Just the new dream, not the old one."
Watch for: Rehearsal happening at all, even briefly. Nightmare frequency and intensity falling over 2–4 weeks. [source: NBC/AP 2010] Changed nightmare content, and waking with the new dream rather than in terror (for example, waking "knowing I've dreamed of birds"). [source: NBC/AP 2010]

4.10 Extending and refining (further nightmares; adding helpful elements)

Purpose / when: After the first new dream is in regular rehearsal (2001 trial: following weeks; Dutch: sessions 3–5).
Steps:
1. Review rehearsal and nightmare changes. [source: Psychiatric News 2001; van Schagen et al. 2015]
2. Either add helpful elements to the existing new dream, or apply the same procedure (§4.5–4.9) to another nightmare. [source: van Schagen et al. 2015; Psychiatric News 2001]
3. Keep the number of active new dreams small. [synthesis]
Example language (illustrative): "Is there anything you'd like to add to the new dream to make it feel even better? Or is there another bad dream you'd like to take on next?"
Watch for: Overloading with too many scripts. Some nightmares changing on their own once the first one has shifted (ask about this). [synthesis]

4.11 Group review and generalising imagery to other symptoms

Purpose / when: Final session of the 2001 group protocol.
Steps: Members share progress and experiences. Discuss whether imagery skills could help other PTSD symptoms. Some participants used imagery to create more positive images or to manage daytime moods and negative thoughts. [source: Psychiatric News 2001]
Example language (illustrative): "Some people find the same skill helps during the day, swapping in a calmer image when an upsetting one shows up. Has anyone tried that?"
Watch for: Group members comparing trauma details. Keep the focus on the method, not the trauma narratives. [synthesis]

4.12 Consolidation: triggers, coping and relapse plan

Purpose / when: Final session (Dutch session 6).
Steps: Evaluate the treatment. Discuss nightmare triggers (for example stress, anniversaries, alcohol, sleep loss) and coping strategies. Plan to restart rehearsal or write a new dream if nightmares recur. [source: van Schagen et al. 2015 (evaluation, triggers, coping)] [synthesis: example triggers and restart plan]
Example language (illustrative): "If a bad dream comes back after a hard week, you know what to do: write a new version and start rehearsing again."
Watch for: The patient's confidence that they can apply IRT on their own. Krakow's patients do much of the work on their own with his self-help manual, Turning Nightmares into Dreams. [source: NBC/AP 2010]

4.13 Related variants (named for version clarity; not Krakow IRT)

Purpose / when: To recognise protocols that differ from Krakow IRT.
Content:
- ERRT (Exposure, Relaxation and Rescripting Therapy; Davis) and IRET (Imagery Rescripting and Exposure Therapy; Long et al.) add deliberate exposure to the original nightmare, such as reading the nightmare narrative aloud to the therapist or group, in one study daily for a week. [source: Casement & Swanson 2012]
- CBT-I plus IRT adds sleep restriction, stimulus control and sleep hygiene, either before IR (at least 3 sessions in some studies) or alongside it. It improved sleep quality more but did not change nightmare frequency or PTSD symptoms more. [source: Casement & Swanson 2012]
- The meta-analysis found no significant outcome difference between protocols with and without exposure. [source: Casement & Swanson 2012]
Watch for: If you use an exposure variant, you are no longer following Krakow's minimal-exposure instruction. Readiness, consent for exposure, grounding and closure then become essential. [synthesis]

5. Handling problems

Cannot form images ("My screen is black"). Extend imagery practice with neutral scenes and give more therapist-guided imagery sessions. [source: Carlat 2021] Try other senses first (sounds, movement, touch) or an eyes-open version. [synthesis]
Cannot change a trauma nightmare, or resists changing the dream. Switch to a neutral dream or a fantasy (§4.7). [source: Carlat 2021] Explore the resistance: does changing the dream feel like denying or disrespecting what happened? Explain that the memory is not being altered; only the nighttime habit is being retrained. [synthesis]
Belief that the trauma must be treated first. Use education and cognitive restructuring. [source: Carlat 2021]
Patient wants the dream interpreted. Explain that IRT deliberately does not interpret. Meaning-focused dream work, which some (for example Jungian) clinicians favour, is a separate approach and can be offered or referred separately. [source: NBC/AP 2010] [synthesis: how to offer it]
Overwhelm or distress during imagery. Stop, open the eyes, take relaxed breaths, and resume only when ready. Later, teach the acknowledge-and-shift skill. [source: Carlat 2021] Do not push through. End sessions with the patient grounded and oriented. [synthesis]
Dissociation or flashbacks in session. Pause the imagery. Ground the patient to the present (room, date, feet on floor, naming objects). Once they are stable, review readiness. Frequent flashbacks, dissociation or panic call for referral to PTSD-experienced care. [source: Carlat 2021 (referral criterion)] [synthesis: grounding steps]
Memory material appears. Treat any images as the patient's experience, not as evidence to verify or explore. Never use IRT imagery to search for or "recover" memories. Do not add detail through suggestion. [synthesis, consistent with the IRT principle of not working on nightmare content]
Non-adherence to rehearsal. Normalise very brief practice. In Krakow's trials, an average of under 5 minutes every other day, often about 1 minute, was enough. Let the patient choose when to practise, since it does not have to be at bedtime. [source: Carlat 2021] Use problem-solving, cues and a simple log. [synthesis] Note that attrition in imagery rehearsal studies averaged about 26–27%, so build engagement early. [source: Casement & Swanson 2012]
The new dream turns bad during rehearsal. Stop, use §4.4, and revise the new dream: change more of it, or start a fully new pleasant dream. [synthesis]
Nightmares persist despite good rehearsal. Re-screen for sleep-disordered breathing and other sleep disorders and refer for sleep assessment. Krakow highlights how often apnoea is missed. [source: Carlat 2021; NBC/AP 2010] Consider whether insomnia needs CBT-I components (§4.13). [source: Casement & Swanson 2012] Check medication, alcohol and substance effects with the prescriber. [synthesis]
Partial response. Expect reduction rather than total elimination. [source: Jamaica Observer 2001] Keep rehearsing, refine the dream, and take on other nightmares one at a time. [source: Psychiatric News 2001; van Schagen et al. 2015] Krakow noted about 30% did not report significant improvement. [source: NBC/AP 2010] For trauma symptoms beyond nightmares, offer a recommended trauma-focused therapy. [synthesis]
Suicidality or severe depression. Use caution. [source: Carlat 2021] Assess risk with standard practice, safety-plan, and prioritise risk management over IRT. Nightmares are worth asking about as part of the risk picture. [synthesis]
Ruptures (for example, the patient feels dismissed because the trauma isn't being discussed). Name it, validate it, and re-link to the agreed goal. Offer to coordinate with or refer to trauma-focused therapy and agree the scope together. [synthesis]
Group-format problems (members sharing graphic content, comparing trauma). Set ground rules up front: share new dreams and progress, not nightmare or trauma details. Redirect gently. [synthesis]
Psychosis. Psychotic disorder was a research exclusion. [source: van Schagen et al. 2015] An adapted IR case series (4–6 sessions) was reported feasible and acceptable, but nightmare frequency did not fall. Adapt only with psychosis expertise. [source: Sheaves et al. 2015 abstract] [uncertain]

Sources

Sources:

Books and articles cited as further reading (not drawn on in full):

Krakow, B., & Zadra, A. (2006). Clinical management of chronic nightmares: Imagery rehearsal therapy. Behavioral Sleep Medicine, 4(1), 45–70. [uncertain: session-by-session content]
Krakow, B., Hollifield, M., Johnston, L., et al. (2001). Imagery rehearsal therapy for chronic nightmares in sexual assault survivors with PTSD. JAMA, 286(5), 537–545. [details taken from press reports and abstract]
Krakow, B., & Zadra, A. (2010). Imagery rehearsal therapy: Principles and practice. Sleep Medicine Clinics. [uncertain]
Krakow, B. (self-help manual). Turning Nightmares into Dreams. [uncertain]
van Schagen, A. M., Lancee, J., & Spoormaker, V. I. (2012). Dutch IRT treatment manual and patient workbook. [uncertain]

Further reading (not drawn on): the full texts of Krakow & Zadra 2006 and of Krakow et al. 2001. Their exact per-session wording and timings are therefore [uncertain].

← Previous · VI-043Imagery rescripting Next · VI-045 →Exposure, Relaxation and Rescripting Therapy