Imagery Rescripting in Primary Care
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-70
SponsorUniversity of Amsterdam
About this trial
In the current study we aim to investigate the feasibility, acceptability, and effectiveness of ImRs offered by mental health assistants within primary care to reduce depressive symptoms. In a single-case experimental design (SCED) study, the following hypotheses will be tested:
1. ImRs results in a reduction of depressive symptoms compared to baseline, and this reduction lasts up to six months. 2. Patients with complaints of depressive symptoms find ImRs an acceptable form of intervention when offered by mental health assistants within a general practice setting.
Participants will wait for 2-4 weeks and then receive 5 sessions of ImRs over a period of 10 weeks. During these sessions, negative memories related to their depressed feelings are rescripted.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Main complaint of depressive feelings, as indicated by both the mental health assistant and the patient.
HADS score for the depression subscale ≥ 11.
Ability to understand, read, write and speak Dutch or English.
Age between 18 and 70.
Disqualifiers
Acute suicide risk (BDI-II-item9 score of 3).
If the mental health assistant suspects that the patient may have a primary diagnosis of bipolar disorder, psychosis, substance use disorder, low IQ, or if the patient suffers from serious neurological problems such as dementia, then the patient is not included. There will not be a formal assessment of a primary diagnosis.
Trial design
Design model
Single group
Treatments tested in this trial
Imagery Rescripting
BehavioralDuring ImRs, the patient brings a negative memory to mind and changes, together with the therapist, the outcome of the memory into a more positive
Treatment groups
12 Participants
are divided into 1 treatment groupGroup A: Imagery RescriptingExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Depressive symptom severity
Depressive symptom severity is assessed with the PHQ-2 (Kroenke et al., 2003). The PHQ-2 consists of the first two items of the PHQ-9 and measures the frequency of depressed mood and anhedonia in the past week. Scores range from 0-6 and higher scores mean more depressive symptoms.
Time frame
16-18 weeks, twice a week2
Self-esteem
Self-esteem will be measured with a single question "How have you felt about yourself in the past week?" Participants rate this question on a scale from -100 (very negative) to +100 (very positive).
Time frame
16-18 weeks, twice a week3
Dysfunctional core beliefs
Participants will formulate these negative beliefs about themselves or the world/other people together with the mental health assistant during the first session and then rate how convincing these beliefs are on a scale from 0 (not at all convincing) -100 (very convincing).
Time frame
16-18 weeks, twice a week + 3 month and 6 month follow-upSecondary outcomes
1
Hospital Anxiety and Depression Scale
Measures depressive and anxious symptoms on a 14 item scale (Zigmond \& Snaith, 1983). Scores range from 0-21 per scale (Anxiety and Depression) and higher scores reflect higher symptom severity.
Time frame
Baseline, pre-treatment, 4-weeks post-treatment, 3 month follow-up, 6 month follow-up2
Rosenberg Self-Esteem Scale
Measures self-esteem with 10 items scored on a 4-point scale, scores range from 0 to 30, and higher scores reflect higher self-esteem (Rosenberg, 1965).
Time frame
Baseline, pre-treatment, 4-weeks post-treatment, 3 month follow-up, 6 month follow-up3
Suicidal thoughts
Suicidal thoughts are measured using item 9 of Beck's depression inventory (BDI-II)
Time frame
Baseline, pre-treatment, 4-weeks post-treatment, 3 month follow-up, 6 month follow-up4
Emotional memory
We will measure the following characteristics of the reported memories that will be rescripted: Vividness, Emotional Intensity, Emotional Impact, Intrusivity. These characteristics will be assessed with subscales of the Memory Experiences Questionnaire (MEQ; Vividness and Emotional Intensity) and two added subscales (Emotional Impact, Intrusivity). These measures are based on a previous study that these indices of a negative emotional memory related to depression scores (Stemerding et al., 2025). Each aspects is scored from 1-5 and higher scores mean stronger vividness, emotional intensity, emotional impact and intrusiveness.
Time frame
Pre-treatment, 4-weeks post-treatment, 3 month follow-up, 6 month follow-upOther outcomes
1
Acceptability
We assess the acceptibility of the intervention using six questions that are formulated to measure how the participants feel about the intervention. An example is "To what extent would you recommend this intervention to a friend or family member that experiences symptoms similar to yours?". These items are assessed on a 9 point likert scale ranging from "not at all" to "very much".
Time frame
4- weeks post-treatmentSponsors and contacts
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University of Amsterdam
Lead sponsor
UvA Huisartsen
Collaborator
Source ClinicalTrials.gov