Imagery rescripting for generalized anxiety disorder: A case series

This is the first clinical pilot to explore the feasibility, acceptability and preliminary efficacy of imagery rescripting in individuals with a diagnosis of generalized anxiety disorder (GAD).

Participants with GAD (N = 18) attended assessment and 10 weekly sessions of imagery rescripting with a psychologist in person or via Telehealth. The protocol was based on Arntz's phased protocol and common rescripting procedures with adaptations to target the future orientation of worry. Measures of trait worry and GAD symptoms were administered pre-baseline (before a two-week baseline monitoring period), pre-, mid- and post-treatment, and at 3-month follow-up.

As hypothesized, linear mixed models revealed large change over time between baseline and post-treatment on all measures (PSWQ: d = -1.18; GAD-7: d = -1.04; PHQ-9: d = -.79), and no significant change in these measures between baseline and pre-treatment. Results were maintained at follow-up. Change in PSWQ and GAD-7 scores were clinically and reliably significant for over half the sample (59% and 53%, respectively). On a measure of credibility of the intervention completed after the first session, participants reported a mean score of 36.34 (SD = 6.38) out of 45. On a measure of patient satisfaction post-treatment, participants reported a mean score of 8.94 (SD = 1.35) out of 12, indicating high credibility and satisfaction. No adverse experiences were reported.

This pilot provides evidence that imagery rescripting is feasible and acceptable and improves symptoms of anxiety and worry in individuals with GAD. Future studies should evaluate the intervention in a randomized controlled trial.