Enhancing trauma-focused therapy (EMDR) with Imagery Rescripting for childhood abuse-related PTSD: a case study

Introduction: Childhood sexual and physical abuse (CSPA) can lead to a heightened risk to develop a posttraumatic stress disorder (PTSD). Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) show limited efficacy for CSPA-related PTSD. Highlighting the need for alternative approaches, such as Imagery Rescripting (ImRs), which, when integrated into standard treatment, may improve therapeutic outcomes for these individuals.Objective: This case report demonstrates the effectiveness of integrating Imagery Rescripting (ImRs) into standard EMDR treatment for PTSD when progress stalls. It focuses on a 25-year-old Dutch male of Indonesian and Surinamese descent with CSPA-related PTSD.Method: The client completed a total of 30 sessions, which included five psychoeducation sessions, four EMDR sessions, followed by five ImRs sessions and an additional five EMDR sessions. The final sessions focused on evaluating treatment outcomes, enhancing self-esteem, and implementing relapse prevention strategies. Various questionnaires assessing PTSD and psychological symptoms were administered at baseline, during and after treatment.Results: After following a combination of EMDR and ImRs treatment, symptoms progressively decreased. By the end of treatment, the client had recovered from PTSD, with his Global Severity Index (GSI) score nearing the clinical cut-off score. This treatment success was maintained during a three-month follow-up period.Conclusions: The integration of ImRs and EMDR seemed crucial for this client's recovery from CSPA-related PTSD. Future research should identify which clients benefit most from EMDR, ImRs, or a combination of both. Long-term studies are needed to assess the sustained efficacy of integrating ImRs into trauma treatment.