Enhancing trauma-focused therapy (EMDR) with Imagery Rescripting for childhood abuse-related PTSD: a case study

Dec 19, 2025European journal of psychotraumatology

Improving trauma therapy for childhood abuse PTSD by adding imagination-based memory changes: a case study

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Abstract

A 25-year-old male with childhood sexual and physical abuse-related recovered by integrating into standard treatment.

The client underwent a total of 30 therapy sessions, consisting of psychoeducation, EMDR, and Imagery Rescripting.
Symptoms of PTSD progressively decreased throughout the treatment process.
By the end of treatment, the client's Global Severity Index score was near the clinical cut-off.
Treatment success was maintained during a three-month follow-up period.
The integration of Imagery Rescripting with EMDR appeared essential for the client's recovery.

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Childhood sexual and physical abuse (CSPA) can lead to a heightened risk to develop a (PTSD). Cognitive Behavioral Therapy (CBT) and (EMDR) show limited efficacy for CSPA-related PTSD. Highlighting the need for alternative approaches, such as (ImRs), which, when integrated into standard treatment, may improve therapeutic outcomes for these individuals.This case report demonstrates the effectiveness of integrating Imagery Rescripting (ImRs) into standard EMDR treatment for PTSD when progress stalls. It focuses on a 25-year-old Dutch male of Indonesian and Surinamese descent with CSPA-related PTSD.The client completed a total of 30 sessions, which included five psychoeducation sessions, four EMDR sessions, followed by five ImRs sessions and an additional five EMDR sessions. The final sessions focused on evaluating treatment outcomes, enhancing self-esteem, and implementing relapse prevention strategies. Various questionnaires assessing PTSD and psychological symptoms were administered at baseline, during and after treatment.After following a combination of EMDR and ImRs treatment, symptoms progressively decreased. By the end of treatment, the client had recovered from PTSD, with his Global Severity Index (GSI) score nearing the clinical cut-off score. This treatment success was maintained during a three-month follow-up period.The integration of ImRs and EMDR seemed crucial for this client's recovery from CSPA-related PTSD. Future research should identify which clients benefit most from EMDR, ImRs, or a combination of both. Long-term studies are needed to assess the sustained efficacy of integrating ImRs into trauma treatment. Introduction: Objective: Method: Results: Conclusions:

Key numbers

21 points

Symptom Improvement

Client's PSS score decreased from 24 to 3 post-treatment.

2.3 to 1.1

Global Severity Index Reduction

GSI score decreased from 2.3 at intake to 1.1 at three-month follow-up.

30 sessions

Session Count

Client completed 30 sessions combining and .

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Enhancing trauma-focused therapy (EMDR) with Imagery Rescripting for childhood abuse-related PTSD: a case study

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