# A Journey Through Time – Study Protocol for a Randomized Controlled Trial Testing the Add-on Effects of Imagery Rescripting to Ongoing Cognitive Behavioural Therapy in Patients With Depressive Disorders

## TL;DR

This study tests if adding imagery rescripting to ongoing cognitive behavioral therapy improves depression treatment outcomes.

## Contribution

The novel contribution is evaluating imagery rescripting as an add-on to standard CBT for depression in a randomized controlled trial.

## Key findings

- Imagery rescripting targets distressing memories linked to depression.
- The study will assess if adding three ImRs sessions improves CBT outcomes.
- Depressive symptoms will be measured using the BDI-II at multiple time points.

## Abstract

Patients with depression often report recurring memories of stressful events from the past (e.g. experiences of rejection, emotional or physical abuse). These distressing memories, commonly dating back to childhood, can contribute to the development and maintenance of depression through their impact on cognitive schemas. The method of imagery rescripting (ImRs) addresses distressing memories and the associated emotions directly: With therapeutic support, patients recall the respective memory and modify the memory during imagination in such a way that the emotional quality and meaning of the memory changes. In this randomized trial, we will assess the impact of a three-session ImRs intervention within standard cognitive behaviour therapy (CBT) for depression, comparing it to an active control intervention (imagery relaxation).

Sixty-six patients with MDD who are currently receiving treatment (CBT) will be randomized to either (1) the experimental condition (ImRs) or (2) the control condition (imagery relaxation). Reduction of depressive symptoms, measured by the Beck Depression Inventory (BDI-II) is the primary outcome. The BDI-II will be assessed at baseline, post-intervention, and at 4-week and 8-week follow-ups.

This study will help to clarify whether adding three ImRs sessions improves the effectiveness of CBT for depression. We outline the next steps for future research and highlight the potential of this novel intervention for depression.

Most patients with depression report distressing memories, making them a key treatment target.Imagery Rescripting (ImRs) may enhance CBT by reducing negative emotions tied to distressing memories.This RCT tests ImRs as an add-on to CBT for depression.

Most patients with depression report distressing memories, making them a key treatment target.

Imagery Rescripting (ImRs) may enhance CBT by reducing negative emotions tied to distressing memories.

This RCT tests ImRs as an add-on to CBT for depression.