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Title: Treatment of Survivor Guilt after trauma using imagery rescripting
Author: Medin, Evelina
ISNI:       0000 0004 8498 5010
Awarding Body: Royal Holloway, University of London
Current Institution: Royal Holloway, University of London
Date of Award: 2015
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Survivor Guilt (SG) is a complex emotional reaction that transpires from surviving a fatal trauma. SG is a poorly understood clinical phenomenon, and no studies have investigated psychological treatment options for SG. Imagery Rescripting (IR) is a transdiagnostic technique that involves mental manipulation of imagery, with the aim of updating the meaning and emotional valence. IR is considered a particularly useful technique for guilt and shamebased PTSD. However, PTSD researchers have not investigated the stand-alone effect of IR, or determined the active ingredients of IR. The present study was a proof-of-concept trial of treatment of SG using IR. A dismantling design was used to evaluate IR as a separate experiential technique, delivered as an add-on to standard trauma-focused treatment. Fourteen participants with PTSD and self-reported SG after a fatal trauma, attended two consecutive imagery sessions. The exploration session focused on elaborating imagery. The rescripting session used IR to modify imagery in whatever way participants felt would be helpful. The results revealed significant improvements in cognitive and emotional SG components, and distress from SG imagery, that were attributable to the rescripting session. Weekly outcome measures failed to detect effects. Observations indicated that treatment responders more commonly experienced SG relating to the meaning of survival (rather than regrets about actions) and changed SG imagery by imagining the deceased in the afterlife. The rescripting process was also explored using a coding framework to advance understanding of variables that predict effective IR. Observations indicated enhanced IR effects when: therapists provided substantial guidance; changes were made directly to the imagery sequence; imagery was active but not overly vivid or emotionally charged; and the rescripted imagery was compelling and evoked a high level of new thoughts, feelings and sensations. These findings have important implications for SG treatment, and for clinical application of IR.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available