Face-to-face imagery rescripting as a treatment adjunct for day patients with an eating disorder: A randomised controlled pilot study

Abstract

Imagery rescripting (IR) has been widely used to treat various mental health problems, however, little is known about its usefulness in eating disorders. The primary aim of this pilot study was to evaluate the feasibility of using a face-to-face imagery rescripting as a treatment adjunct among day patients with an eating disorder. Our secondary aim was to investigate within-group effect size changes between groups in order to ensure the suitability of IR in this population. Twelve participants were recruited from the Statewide Eating Disorders Services and were randomly assigned to either treatment as usual (TAU) or treatment as usual plus imagery rescripting (TAU + IR). Participants in the TAU + IR group received a one-hour face-to-face imagery rescripting session with a postgraduate trainee therapist within their first week of treatment. Outcome measures, including psychological distress, eating disorder symptoms, self-compassion and dysfunctional attitudes, were measured at baseline and 4 weeks. Overall, feasibility was promising with all participants completing the protocol and assessment once randomised, but no one completed seven days of home practice. Recruitment was slow with less than 50% agreeing to be randomised. TAU demonstrated a quicker reduction in symptoms than the TAU + IR group. Possible explanations include the timing of the imagery rescripting session was not appropriate for this group of patients, IR has a longer term effect that cannot be observed in merely four weeks, or the current form of imagery rescripting is not appropriate to use with this group of patients. Future research is needed to clarify whether imagery rescripting is indeed appropriate to use for eating disorder patients, and if so, how it can best be delivered (e.g., time point, content, targeted population).