This pilot RCT compared two single-session Imagery Rescripting (IR) protocols in 40 adults with high trait anxiety: rescripting a distressing autobiographical memory from the perspective of the current self (n=19) vs. a trusted supportive other (n=21), with outcomes assessed at baseline, post-intervention, and 1-week follow-up.
Both conditions produced significant, sustained reductions in trait anxiety (baseline M=46.90 → follow-up M=41.00; d=1.13 from baseline to follow-up) and maladaptive core belief ratings (perceived truth, distress, daily impact), with no significant difference between intervening-agent conditions. Reductions in core belief truth and daily impact were significantly associated with reductions in trait anxiety. Attachment orientation did not moderate outcomes.
- Small pilot sample (n=40) was underpowered for small-to-moderate interaction effects, so null between-condition differences are preliminary. - No waitlist or active control group, limiting attribution of change to IR specifically. - Attachment measure showed low internal consistency (α=0.57–0.68), reducing sensitivity to detect moderation effects.
A single session of IR—whether led by the patient's current self or a trusted supportive other—appears to reduce trait anxiety and update maladaptive core beliefs in high-anxiety adults. Clinicians who find self-directed rescripting difficult for a patient (e.g., highly self-critical individuals) may consider the supportive-other format as a viable alternative, pending larger trials.
Explore related topics
