Imagery rescripting and eye movement desensitisation and reprocessing for treatment of adults with childhood trauma-related post-traumatic stress disorder: IREM study design
Open accessAbstract
BACKGROUND: Post-traumatic stress disorder (PTSD) that originates from childhood trauma experiences can develop into a chronic condition that has lasting effects on an individual's functioning and quality of life. While there are evidence-based guidelines for treating adult onset PTSD, treatments for adults with childhood trauma-related PTSD (Ch-PTSD) are varied and subject to ongoing debate. This study will test the effectiveness of two trauma-focused treatments, imagery rescripting (ImRs) and eye movement desensitisation and reprocessing (EMDR) in participants with Ch-PTSD. Both have been found effective in treatment of adult PTSD or mixed onset PTSD and previous research indicates they are well-tolerated treatments. However, we know less about their effectiveness for treating Ch-PTSD or their underlying working mechanisms. METHODS: IREM is an international multicentre randomised controlled trial involving seven sites across Australia, Germany and the Netherlands. We aim to recruit 142 participants (minimum of n = 20 per site), who will be randomly assigned to treatment condition. Assessments will be conducted before treatment until 1-year follow-up. Assessments before and after the waitlist will assess change in time only. The primary outcome measure is change in PTSD symptom severity from pre-treatment to 8-weeks post-treatment. Secondary outcome measures include change in severity of depression, anger, trauma-related cognitions, guilt, shame, dissociation and quality of life. Underlying mechanisms of treatment will be assessed on changes in vividness, valence and encapsulated belief of a worst trauma memory. Additional sub-studies will include qualitative investigation of treatment experiences from the participant and therapists' perspective, changes in memory and the impact of treatment fidelity on outcome measures. DISCUSSION: The primary aims of this study are to compare the effectiveness of EMDR and ImRs in treating Ch-PTSD and to investigate the underlying working mechanisms of the two treatments. The large-scale international design will make a significant contribution to our understanding of how these treatments address the needs of individuals with Ch-PTSD and therefore, potentially improve their effectiveness. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12614000750684 . Registered 16 July 2014.
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Imagery rescripting is a highly effective evidence-based stand-alone trauma processing technique for post-traumatic stress disorder and a range of other disorders.
“ImRs is an ST technique that is a highly effective evidence-based stand-alone trauma processing technique for post-traumatic stress disorder (PTSD) and a range of other disorders (1–5).”
From Timing of imagery rescripting during schema therapy for borderline personality disorder: the LUCY trial (2023) · cites this paper as [5]
The Background describes growing evidence that ImRs is efficacious for PTSD and reports good treatment effects for social anxiety, phobias, bulimia nervosa, and depression. The Methods describe ImRs as a treatment in its own right. However, this study is a trial design, and the paper’s more cautious account does not substantiate the claim that ImRs is already ‘highly effective’ across those disorders. (LLM, conf=0.85)
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Mirbagheri, A. M., Zanjani, Z., Omidi, A., & Azadchehreh, M. J. (2024) · Iranian Journal of Psychiatry and Clinical Psychology · doi:10.32598/ijpcp.29.4.4660.1 · Cited by 1 · see citing works
Eye Movement Desensitization and Reprocessing desde la propuesta de valoración de Mario Bounge
Armijos, M. D. L. C., López, J. P. V., Valdivieso, M. J. E., Espinoza, R. E. G., Ávila, C. G. M., Villavicencio, E. I. G., & Martínez-Suárez, P. C. (2021) · Investigatio · doi:10.31095/investigatio.2021.16.3 · Cited by 1 · see citing works
Reescritura de Imágenes para el Tratamiento del Estrés Postraumático: Análisis y Revisión
Miguel-Álvaro, A., & Crespo, M. (2019) · Clínica y Salud · doi:10.5093/clysa2019a19
Ordening en overzicht van technieken voor traumaverwerkingstechnieken
Stöfsel, M. (2020) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-2501-6_6
de Haan, K. B. (2020) · UWA Profiles and Research Repository (UWA) · doi:10.26182/dv0a-9f71
Stöfsel, M. (2020) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-2501-6_9
Werken met traumatische herinneringen en de complexe posttraumatische-stressstoornis
Lee, C. W., & de Haan, K. B. (2022) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-2791-1_7
Self-citationEMDR Therapy for Complex Posttraumatic Stress Disorder
Dominguez, S. K., & Martin, K. M. (2023) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780192898357.013.48
Berman, N. C. (2026) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2026.05.004
- Authors
- Boterhoven de Haan, K. L., Lee, C. W., Fassbinder, E., Voncken, M. J., Meewisse, M., Van Es, S. M., Menninga, S., Kousemaker, M., & Arntz, A.
- Affiliations
- The University of Western Australia (AU)
- University of Lübeck (DE)
- Maastricht University (NL)
- GGZ Noord-Holland-Noord (NL)
- PsyQ (NL)
- University of Amsterdam (NL)
- Venue
- BMC Psychiatry
- Published
- 2017-05-04
- Volume
- 17
- Issue
- 1
- Pages
- 165-165
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC5418842
- OpenAlex
- W2610649989
- Cited by
- 41
- References
- 62
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 8 · 2023: 6 · 2022: 2 · 2021: 10 · 2020: 9 · 2019: 2 · 2018: 2
- FWCI
- 4.40
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by)
- UvA-DARE (University of Amsterdam) (submittedVersion, cc-by)
- UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- EMDR Research Foundation
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- childhood trauma, post-traumatic stress disorder, imagery rescripting, EMDR, trauma-focused psychotherapy, treatment effectiveness, therapeutic mechanisms, depression, dissociation, trauma-related cognitions, guilt and shame, quality of life, intervention fidelity
- MeSH terms
- Exposure to Violence, Adolescent, Adult, Aged, Australia, Eye Movements, Female, Germany, Humans, Male, Middle Aged, Netherlands, Quality of Life, Research Design, Stress Disorders, Post-Traumatic, Young Adult, Eye Movement Desensitization Reprocessing
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