Imagery rescripting and eye movement desensitisation and reprocessing as treatment for adults with post-traumatic stress disorder from childhood trauma : randomised clinical trial

Investigation of treatments that effectively treat adults with post-traumatic stress disorder from childhood experiences (Ch-PTSD) and are well tolerated by patients is needed to improve outcomes for this population.


The purpose of this study was to compare the effectiveness of two trauma-focused treatments, imagery rescripting (ImRs) and eye movement desensitisation and reprocessing (EMDR), for treating Ch-PTSD.


We conducted an international, multicentre, randomised clinical trial, recruiting adults with Ch-PTSD from childhood trauma before 16 years of age. Participants were randomised to treatment condition and assessed by blind raters at multiple time points. Participants received up to 12 90-min sessions of either ImRs or EMDR, biweekly.


A total of 155 participants were included in the final intent-to-treat analysis. Drop-out rates were low, at 7.7%. A generalised linear mixed model of repeated measures showed that observer-rated post-traumatic stress disorder (PTSD) symptoms significantly decreased for both ImRs (d = 1.72) and EMDR (d = 1.73) at the 8-week post-treatment assessment. Similar results were seen with secondary outcome measures and self-reported PTSD symptoms. There were no significant differences between the two treatments on any standardised measure at post-treatment and follow-up.


ImRs and EMDR treatments were found to be effective in treating PTSD symptoms arising from childhood trauma, and in reducing other symptoms such as depression, dissociation and trauma-related cognitions. The low drop-out rates suggest that the treatments were well tolerated by participants. The results from this study provide evidence for the use of trauma-focused treatments for Ch-PTSD.

Katrina L. Boterhoven de Haan, Christopher W. Lee, Eva Fassbinder, Saskia M. van Es, Simone Menninga, Marie-Louise Meewisse, Marleen Rijkeboer, Margriet Kousemaker and Arnoud Arntz | 2020
In: Journal of Psychiatry ; ISSN: 0002-953X | 217 | 5 | 609-615
Adults, Early Childhood Trauma, Effectiveness, EMDR (Eye Movement Desensitization and Reprocessing), Evidence based practice (EBP), Imagery Rehearsal Therapy (IRT), Posttraumatic Stress Disorder, Psychotherapy, Psychotrauma, PTSD (en), Quality of Life, Randomized Clinical Trial, Trauma Focused Cognitive Behavioral Therapy, Treatment