Imagery Rescripting as treatment for complicated PTSD in refugees: a multiple baseline case series study

This study tested the effectiveness of Imagery Rescripting (ImRs) for complicated war-related PTSD in refugees. Ten adult patients in long-term supportive care with a primary diagnosis of war-related PTSD and Posttraumatic Symptom Scale (PSS) score > 20 participated. A concurrent multiple baseline design was used with baseline varying from 6 to 10weeks, with weekly supportive sessions. After baseline, a 5-week exploration phase followed with weekly sessions during which traumas were explored, without trauma-focused treatment. Then 10 weekly ImRs sessions were given followed by 5-week follow-up without treatment. Participants were randomly assigned to baseline length, and filled out the PSS and the BDI on a weekly basis. Data were analyzed with mixed regression. Results revealed significant linear trends during ImRs (reductions of PSS and BDI scores), but not during the other conditions. The scores during follow-up were stable and significantly lower compared to baseline, with very high effect sizes (Cohen's d = 2.87 (PSS) and 1.29 (BDI)). One patient did clearly not respond positively, and revealed that his actual problem was his sexual identity that he couldn't accept. There were no dropouts. In conclusion, results indicate that ImRs is a highly acceptable and effective treatment for this difficult group of patients.