The role of imagery-based techniques in cognitive–behavioural therapy for adults with eating disorders

Disorder-specific and transdiagnostic cognitive–behavioural models and treatments primarily target surface-level maintaining factors in order to effect symptom change. Despite this approach resulting in the most effective evidence-based approach for most eating disordered patients, a significant proportion of sufferers fail to benefit from such treatments. This conclusion suggests that deeper-level causal factors might also need to be addressed in some cases. Theoretical and empirical findings are considered in terms of the clinical applicability of imagery-based techniques and their ability to enhance cognitive–behavioural treatment of the eating disorders. Imagery techniques (particularly, but not only, imagery rescripting) are proposed as a means to enhance current treatments and improve existing outcomes. Potential treatment targets include core beliefs, emotional regulation difficulties and body image disturbance. The existing literature is limited but early indications suggest that imagery rescripting is effective in modifying core beliefs in this population, and that other imagery-based methods are potentially beneficial. Areas for further clinical application and investigation are identified. ► Imagery techniques (particularly imagery rescripting) may enhance the cognitive–behavioural treatment of eating disorders. ► Suggested treatment targets include core beliefs, emotional regulation difficulties and body image disturbance. ► Preliminary indications suggest imagery rescripting is effective in modifying core beliefs in this population. ► Other imagery-based methods may be also potentially beneficial. ► Areas for further clinical application and investigation are identified.