Investigating Imagery Rescripting as a Treatment for Unipolar Depression

INTERVENTION: Treatment will be an imagery rescripting (ImR) intervention following the protocol established by Wheatley and colleagues (Brewin et al., 2009; Wheatley et al., 2009; Wheatley & Hackmann, 2011). ImR is a collection of imagery techniques that alter negative meanings associated with autobiographical memories of distressing experiences. Those in the immediate treatment condition will receive three individual weekly (60‐90 minute) sessions delivered via an internet videoconferencing platform (Zoom). The first treatment session involves participants providing a detailed account of the chosen memory or image, including sensory experience, emotions, cognitions and meanings associated with events. Participants will be asked what they need to happen in the imagery to reduce the distress associated with events, then guided to visualise this modification or alternative outcome (e.g., introducing safety, control, compassion, nurturance). Subsequent sessions will involve replication of the rescript with modifications as necessary, and rescripting of additional intrusive memories/images that are identified. Following the three‐week waitlist period, participants in the waitlist control condition will be offered the same three‐session ImR intervention. Treatment will be delivered by fully registered psychologists and clinical psychologists under the supervision of an experienced clinical psychologist. All treating psychologists will be thoroughly trained in the administration of the treatment protocol by the project investigators. All sessions will be recorded and at least 10% of sessions will be randomly selected for treatment fidelity. CONDITION: Mental Health ‐ Depression unipolar depression; ; unipolar depression PRIMARY OUTCOME: Patient Health Questionnaire 9‐Item (PHQ‐9) (Kroenke et al., 2001)[Baseline; Post‐completion of treatment period; 1‐month post‐completion of intervention follow‐up] SECONDARY OUTCOME: Appraisals of Intrusive Memories Scale (Newby & Moulds, 2010)[Baseline ; Post‐completion of treatment period ; 1‐month post‐completion of intervention follow‐up] Diagnostic Interview for Anxiety Mood, OCD, and Related Neuropsychiatric Disorders ‐ Mood Disorders Module (Tolin et al., 2018)[Baseline ; Post‐completion of treatment period ; 1‐month post‐completion of intervention follow‐up'] Early Maladaptive Schemas (EMS) assessed using the Young Schema Questionnaire Revised (Yalcin et al., 2022).[Baseline ; Post‐completion of treatment period ; 1‐month post‐completion of intervention follow‐up] Memory, Imagery and Encapsulated Meaning Ratings (Norton et al., 2021)[Baseline ; Before each treatment session ; After each treatment session ; 1‐month post‐completion of intervention follow‐up] Repetitive Thinking Questionnaire 10 (McEvoy et al., 2014)[Baseline ; Post‐completion of treatment period ; 1‐month post‐completion of intervention follow‐up] Ruminative Response Scale (Nolen‐Hoeksema & Morrow, 1991)[Baseline ; Post‐completion of treatment period ; 1‐month post‐completion of intervention follow‐up'] Schema Modes assessed using the Schema Mode Inventory II (Bamelis et al., 2011).[Baseline ; Post‐completion of treatment period ; 1‐month post‐completion of intervention follow‐up] The Depression Anxiety Stress Scales – Short Form (Lovibond & Lovibond, 1995)[Baseline ; Post‐completion of treatment period ; 1‐month post‐completion of intervention follow‐up] Visual Analogue Mood Rating[Baseline ; Before each treatment session ; After each treatment session ; 1‐month post‐completion of intervention follow‐up] Work and Social Adjustment Scale (Mundt et al., 2002)[Baseline ; Before each treatment session ; 1‐month post‐completion of intervention follow‐up] INCLUSION CRITERIA: 1. Adult (minimum 18 years old) 2. English speaking 3. Able and willing to provide written informed consent 4. Meets Diagnostic and Statistical Manual (DSM‐5‐TR, 2022) criteria for a current principal diagnosis of Major Depressive Disorder and/or Persistent Depressive Disorder (as assessed via the Diagnostic Interview for Anxiety Mood, OCD, and Related Neuropsychiatric Disorders [DIAMOND]; Tolin et al., 2018).