Imagery Rescripting in Asylum Seekers

  • Research type

    Research Study

  • Full title

    Imagery rescripting for the treatment of traumatic stress in asylum seekers: A case series

  • IRAS ID

    184339

  • Contact name

    Craig Steel

  • Contact email

    c.steel@reading.ac.uk

  • Duration of Study in the UK

    1 years, 6 months, 1 days

  • Research summary

    UK based asylum seekers are likely to have suffered severe traumatic events before leaving their country of origin. Many of these will require treatment for subsequent mental health problems, such as posttraumatic stress disorder
    (PTSD). PTSD is a mental health problem which involves suffering from distressing memories of traumatic events, along with lack of sleep and irritability.
    Government guidelines suggest trauma focused cognitive behaviour therapy (TfCBT) should be offered to people suffering from PTSD.
    TfCBT contains a number of phases within the intervention, with a major emphasis placed on the ‘reliving’ of traumatic events. Reliving involves a detailed exploration of all aspects of the trauma that was suffered, it is highly emotional but considered necessary in order to reduce the number of intrusive memories (or flashbacks) of the traumatic events.
    However, it is widely considered that asylum seekers and other individuals who have suffered from severe, long-term trauma exhibit what is frequently called ‘complex reactions to trauma’ and do not fit the patient profile of those who took part in the clinical trials of TfCBT.
    In recent years, an alternative intervention to ‘reliving’ has been developed and undergone some evaluation. Imagery rescripting (ImRs) involves working with the distressing intrusive images of traumatic events which are characteristic of
    PTSD. Unlike ‘reliving’, ImRs does not require a repeated detailed discussion of the distressing elements of a traumatic event. The intervention focuses on the patient being encouraged to imagine a rewritten version of the trauma
    narrative in which they feel less distressed and more empowered. For example, this may involve a patient engaging in an intense imagery exercise in which they imagine themselves standing up to an abuser. Although ImRs falls within the framework of cognitive behaviour therapy there has been limited evaluation of ImRs as a stand alone treatment.
    There are clear benefits in that ImRs is brief and more acceptable to patients.
    Given the potential benefits of ImRs in the treatment of complex PTSD, both for the NHS and patients, it is important to conduct further research into this intervention. The current study aims to evaluate the outcomes of an Imagery
    Rescripting approach within a case series (N=15) using a randomised period of baseline and a 10week period of intervention. The study will be conducted within the Forced Migration Trauma Service based within Central and North West London NHS Trust. The information obtained will provide the basis for a future randomised controlled trial.

  • REC name

    South Central - Berkshire B Research Ethics Committee

  • REC reference

    15/SC/0402

  • Date of REC Opinion

    4 Aug 2015

  • REC opinion

    Further Information Favourable Opinion