The role of mental imagery in reducing psychological distress

  • Hayley Knagg

Student thesis: Doctor of Clinical Psychology


Recent years has seen an emergence of research suggesting that utilising mental imagery techniques in the treatment of psychological distress has a number of benefits, and therefore may possibly be an interesting and acceptable treatment option. This thesis aimed to investigate the role of mental imagery in the treatment of those who experience depression and suicidal ideation and/or behaviour. Paper One reports a systematic review which synthesised and evaluated evidence for mental imagery interventions for adults with depression. Findings highlighted large variations in the type of mental imagery interventions, with some promise in the apparent efficacy of imagery interventions focusing on Cognitive bias modification (CBM) principles which counter maladaptive cognitions linked with depression. Due to the heterogeneity of the studies, small sample sizes and limited methodological quality of papers, it was difficult to draw firm conclusions. It is recommended for future larger scale studies, to use a more rigorous methodological design (i.e. randomised control trials; RCTs to further investigate this line of treatment before future reviews take place. Paper Two investigated the feasibility and acceptability of delivering a brief Broad-Minded Affective Coping (BMAC) intervention with University students experiencing suicidal ideation. The mental imagery in students’ study (MISST) was a single arm pilot study which also explored changes in suicidal ideation and emotional states experienced during the intervention and at six and 12-weeks follow up. The study consisted of six weekly individual sessions, conducted face to face via an online video platform (ie; zoom). Twelve participants were recruited, and retention was high. Effect sizes indicated reductions in suicidal ideation and improvements in other measures associated with psychological distress. The delivery of the BMAC intervention appeared feasible and acceptable given the high attendance and study completion with high levels of client satisfaction. The results of this study offers promise to continue larger scale research in this field. Finally, Paper Three presents a critical reflection of the research conducted for this thesis. This paper critically appraises the planning, implementation and interpretation of the systematic review and empirical study presented in the preceding papers of this thesis. Clinical implications, recommendations for future research, and personal reflections on the research process as a whole are discussed.
Date of Award31 Dec 2021
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorDaniel Pratt (Supervisor) & Jasper Palmier-Claus (Supervisor)

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