Brief cognitive therapy of nightmares and post-traumatic ruminations in a man with a learning disability

This is a case study of the treatment of two recurrent nightmares, one of which was accompanied by congruent post-traumatic daytime ruminations, in a man with a mild to moderate learning disability.

Treatment was by a cognitive intervention in which the patient was taught new positive endings to his dream stories.

Both of the nightmares, as well as the post-traumatic ruminations, responded to treatment, and gains were maintained at 12-month follow-up.

Cognitive treatment of nightmares can be successful even in a patient with very limited intellectual abilities. The discussion considers the factors that may have been responsible for the success of the intervention in a man who would not be considered an obvious candidate for cognitive therapy.