Imagery Rehearsal Therapy (IRT) is associated with reduced nightmare severity and depressive, anxiety and suicidal symptoms in adults with Major Depressive Episode.
International journal of clinical and health psychology : IJCHP January 1, 2026 Julia Maruani, Nathan Martins, Emmanuelle Clerici et al.
Imagery rehearsal therapy (IRT) is associated with greater reductions in nightmare severity, depressive symptoms, anxiety, and suicidal ideation compared to sleep education therapy in adults with both major depressive episodes and nightmare disorder. In a non-randomized controlled study of 53 adults, those receiving four weekly group-based IRT sessions showed significantly larger improvements across nightmare frequency, emotional and diurnal impacts, and nocturnal disturbances than those who received a single sleep education session followed by a waitlist. IRT was also linked to decreased depressive and anxiety symptoms and reduced suicidal ideation. Treatment-resistant depression predicted greater emotional improvement from nightmares, while higher nightmare frequency predicted less benefit. The findings suggest IRT should be integrated into treatment plans for this high-risk population.