Free Therapist Training›Schema Therapy Toolkit›Imagery Rescripting Guide
Last updated: November 11, 2026
Imagery rescripting is an experiential technique in which a client relives a painful memory, often from childhood, and a helper enters the image and changes its course so that the child's needs are met. The session guide is for clinicians trained in the technique: it sets out the structure of a session and the decisions the clinician makes along the way, and it is never a script for a client to follow alone.
A completed session record for an invented client shows the guide in use. The guide is part of Sentio's free schema therapy toolkit and comes as a PDF and an editable Google Doc.
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What Is in the Imagery Rescripting Session Guide?
The guide has three parts: checks to make before the session, the eight phases of a session with what the clinician does and decides at each, and a session record. It follows the updated treatment protocol (Arntz, 2025), so its timing and its choice of helper may differ from older descriptions of the technique. Copy it as it stands or adapt it to your setting and records.
Before the session
| Check | Notes |
|---|---|
| The client understands the rationale and agrees to the exercise | |
| Dissociation assessed, and a response agreed in advance (grounding objects, slow breathing, whether a light touch is acceptable) | |
| Current risk reviewed, with a plan in place | |
| Enough session time left for the exercise, the closing and the debrief |
Structure of the session
| Phase | What the clinician does | Decision point |
|---|---|---|
| 1. Rationale and consent | Explains in a sentence or two why the exercise links a current feeling to a memory and changes what the memory means. | If the client declines, revisit the rationale or choose another intervention. |
| 2. Starting point | Asks for a recent situation that carried the feeling, in the present tense: what the client sees, feels and senses in the body. | When a known memory is already the focus, start with the memory itself. |
| 3. Bridge to the memory | Asks the client to let the current scene go, keep the feeling, and notice any image from childhood that comes. | Accept the painful image that arrives; the search is free and associative. If a positive memory comes up, ask the client to let it go and wait for another. |
| 4. Childhood image | Has the client describe the scene in the present tense from the child's position: who is there, what happens, what the child feels and needs. | Keep it brief and non-graphic. Begin rescripting once the most difficult moment has been reached and felt; if the client dissociates severely, step in earlier. |
| 5. Rescripting | A helper enters the image, stops what is happening and meets the child's need. When a caregiver is confronted, the helper names the child's loyalty to that caregiver and how confusing the moment is. | The therapist rescripts in early sessions and hands over to the client's Healthy Adult in later ones, as it grows stronger; the therapist steps in powerfully whenever the child cannot be protected any other way. |
| 6. The child's experience | Asks what the child feels now and what else the child needs, and continues until the child feels fine and no need is left unmet. | Finish with a positive experience or activity, and suggest one if the child does not. |
| 7. Closing | Brings the client back to the room and grounds attention in the present. | Do not end the session while the client is still in strong distress. |
| 8. Debrief and homework | Links what happened to the client's schemas and modes and agrees what the client will do before the next session. | If the client feels guilty about confronting a caregiver in the image, discuss it now. |
Session record
| Field | Entry |
|---|---|
| Date and session number | |
| Starting point: current situation or feeling | |
| Childhood image (one or two lines, non-graphic) | |
| The child's needs, as identified | |
| Who rescripted, and what changed in the image | |
| The child's response | |
| Distress before and after, 0 to 10 | |
| Debrief: links to schemas and modes | |
| Homework and follow-up |
What Does a Completed Imagery Rescripting Session Record Look Like?
Lena, 36, is an accountant who came to therapy for low mood and exhaustion after a year of fourteen-hour workdays. After small mistakes her Punitive Critic (or Punitive Parent) mode, which she calls "the judge," tells her she is useless, and when sadness comes up she goes on "autopilot," her Detached Protector mode. Lena and every detail of her case are invented.
The record comes from an early session, so the therapist does the rescripting. Before the session, the therapist confirmed that Lena understood the rationale and agreed to the exercise, that the plan for "autopilot" was in place (a cushion to hold, slow breathing, no touch), that there was no current risk, and that 35 minutes remained for the exercise, the closing and the debrief.
Session record
| Field | Entry |
|---|---|
| Date and session number | Week 8, session 8; Lena's first imagery rescripting session |
| Starting point: current situation or feeling | At Monday's team meeting, her manager pointed out an error in a report. Lena felt hot with shame, her throat tightened, and "the judge" called her useless. |
| Childhood image (one or two lines, non-graphic) | At about eight, "little Lena" cried after a mistake in a school recital, and her father told her to stop being dramatic and sent her to her room alone. The most difficult moment: his words, and being sent away. |
| The child's needs, as identified | Comfort and company while she cried, and to hear that mistakes are allowed and her feelings matter. Core needs: secure attachment, and freedom to express valid needs and emotions. |
| Who rescripted, and what changed in the image | The therapist, as planned for early sessions, while Lena stayed in the child's perspective. Once the most difficult moment had been reached and felt, the therapist entered the scene, told her father firmly that crying is normal and that Lena needs comfort, said to "little Lena" that she loves her dad and that this can feel confusing, took "little Lena" to a quiet park she likes, comforted her, and told her that mistakes are allowed and her feelings matter. |
| The child's response | At first she said she was "being silly." As the therapist stayed with her, she cried, then leaned in and said she felt warm. Asked what else she needed, she wanted to know that the therapist would still like her after another mistake; once told so, she said she felt fine and chose to end by singing her favorite song with the therapist. |
| Distress before and after, 0 to 10 | 8 before rescripting, at the most difficult moment; 2 at the end of the rescripting. |
| Debrief: links to schemas and modes | Lena heard her father's tone in "the judge" and saw "autopilot" as how she learned to stop crying (Emotional Inhibition, Emotional Deprivation, Punitiveness). She felt guilty about the confrontation; the therapist explained that the image stands up for what "little Lena" needed and leaves room for Lena's love for her father. |
| Homework and follow-up | When "the judge" speaks after a mistake, Lena will pause and tell "little Lena" what the therapist said. Next session: ask about the effects of this rescripting and write a flashcard with its message. |
What Is Imagery Rescripting?
Imagery rescripting changes what a painful memory means by changing what happens in it. The client brings a scene to mind, often from childhood, as if it were happening now; a helper then enters the image, stops what is happening and gives the child what was missing. Arntz and Weertman (1999) described it as one of two experiential methods for changing core schemas through childhood memories, the other being role-play of childhood interactions with key figures, and gave clinical protocols for both. Arntz (2012) later reviewed the clinical trials and basic studies of the technique and set out a research agenda.
Lockwood (2009), writing for the International Society of Schema Therapy, describes several uses of imagery in schema therapy, two of them central to this guide. Early in treatment, calling up childhood memories and dialogues with significant others helps clarify the client's schemas and modes. In the change phase, rescripting revises painful memories so that needs can be met, and the therapist may step into the image to give, for a time, the healthy parenting the child lacked; with trauma, the aim is safety and protection more than exposure. The events themselves stay as they were, but the memory now carries the experience of a need being met (Arntz, 2025).
How Does an Imagery Rescripting Session Run?
A session moves from a present feeling to a childhood memory, changes the memory, and returns to the present. It often starts with a recent situation that carried the feeling. In an affect bridge, the client lets the present scene go, keeps the feeling, and searches freely for an early memory linked to it; the bridge is usually unnecessary in posttraumatic stress disorder (PTSD), where the memories are already in the foreground (Arntz, 2025). In the updated protocol, later sessions open by asking about the effects of the last rescripting, and changes in symptoms or emotions guide the choice of the next memory.
Bosch and Arntz (2023) describe the classic procedure in three phases: the client relives the memory as if it were happening now, enters the image as their adult self and changes the course of events, and then experiences the new version from the child's perspective. In a two-phase variant, the therapist does the rescripting while the client stays in the child's perspective throughout, an approach used early in treatment and with more severe psychopathology. The updated protocol uses both helpers in turn: over 12 sessions, the therapist rescripts in the first six and the client, as their adult self, in the last six, whereas the original protocol had the client enter as their current self from the start (Arntz, 2025). The session guide follows that order and hands the rescripting over to the client's Healthy Adult in later sessions, as it grows stronger (Lockwood, 2009).
Whoever rescripts, the work continues until the child feels fine and no further needs are left to meet, and it ends with a positive experience or activity, which the therapist suggests if the child does not (Arntz, 2025). The clinician then brings the client back to the room, and the debrief links what happened to the client's schemas and modes.
When Does Rescripting Begin, and How Do You Plan for Dissociation?
In the updated protocol, rescripting begins once the most difficult moment of the memory, the hotspot, has been reached and felt (Arntz, 2025). Earlier descriptions of the technique advised stepping in before the worst moment, before the trauma itself took place; Arntz (2025) cites a laboratory study, using an aversive film, in which rescripting that included the worst scenes worked much better. The therapist may fast-forward to that moment without dwelling on every detail along the way, which also keeps the memory brief. The updated protocol was developed for PTSD, first after childhood trauma and then for PTSD in general, and the session guide follows its timing.
Severe dissociation is the exception. When a client dissociates severely before the most difficult moment, the therapist starts rescripting early, and what matters most is restoring the client's control over the threat (Arntz, 2025). Grounding aids such as a balance board, or a scarf held by both client and therapist, can help; with extreme reliving, the therapist keeps the exercise going and steps in powerfully to restore control. Planning for dissociation starts before the first exercise: the guide's checks ask the clinician to assess dissociation and agree on a response with the client in advance, including grounding objects, slow breathing and whether a light touch is acceptable.
How Strong Is the Evidence for Imagery Rescripting?
A meta-analysis by Morina et al. (2017) found large effects and called imagery rescripting promising, while noting that few randomized trials exist. It included 19 trials, seven of them randomized controlled trials, with 363 adults who had PTSD, social anxiety, body dysmorphic disorder, depression, bulimia or obsessive-compulsive disorder and who received a mean of 4.5 sessions. Rescripting showed a large effect from before to after treatment (Hedges' g = 1.22, rising to 1.79 at follow-up) and a large effect against passive control conditions (g = 0.90). A later meta-analysis limited to randomized trials pooled 17 trials with 908 participants and found an effect of g = 0.68 against passive control conditions, mostly waitlists, and no difference from active treatments such as exposure, cognitive restructuring and EMDR (g = −0.01; Kip et al., 2023).
Keep reading
Chair Work Session Guide, the companion guide for dialogues with critic, child and coping modes
Schema Flashcard Template, for carrying the message of a rescripting into the week
Schema Therapy Case Conceptualization Form, the formulation that points to the memories and needs to work on
Deliberate Practice in Schema Therapy, the free webinar with Wendy T. Behary and Joan M. Farrell
Frequently Asked Questions
Is there an imagery rescripting script?
A fixed script is not how the method works. What the helper says and does in the image follows the memory the client brings and the needs of the child in it, and the rescripting continues until the child feels fine and no need is left unmet. What a clinician can prepare is the structure: the rationale, the phases, the decision at each one, the plan for dissociation and the closing. Arntz's 2025 update of the treatment protocol sets out the method in detail.
Who rescripts, the therapist or the client?
Both, at different stages. In the classic procedure the client enters the image as their adult self and changes what happens. In a two-phase variant the therapist rescripts while the client stays in the child's perspective, an approach used early in treatment and with more severe psychopathology. The updated protocol uses both: across 12 sessions, the therapist rescripts in the first six and the client in the last six. The session guide has the therapist rescript first and hand over to the client's Healthy Adult in later sessions, as it grows stronger.
What if the client dissociates during imagery rescripting?
Plan for it before the first exercise by assessing dissociation and agreeing on a response, such as an object to hold, slow breathing and, if the client accepts it, a light touch. In the updated protocol, severe dissociation before the most difficult moment is a reason to begin rescripting early, and what matters most is restoring the client's control over the threat. Grounding aids such as a balance board or a scarf held by both client and therapist can help.
How many sessions of imagery rescripting does a client need?
It depends on the client and the treatment. The updated protocol sets out a 12-session course, with the therapist rescripting in the first six sessions and the client in the last six, and asks clients beginning trauma-focused rescripting to commit to a set number of sessions within a limited period. In the 19 trials pooled by Morina et al. (2017), clients received a mean of 4.5 sessions.
References
Arntz, A. (2012). Imagery rescripting as a therapeutic technique: Review of clinical trials, basic studies, and research agenda. Journal of Experimental Psychopathology, 3(2), 189–208. https://doi.org/10.5127/jep.024211
Arntz, A. (2025). Imagery rescripting: An update of the treatment protocol. Behaviour Research and Therapy, 195, Article 104913. https://doi.org/10.1016/j.brat.2025.104913
Arntz, A., & Weertman, A. (1999). Treatment of childhood memories: Theory and practice. Behaviour Research and Therapy, 37(8), 715–740. https://doi.org/10.1016/S0005-7967(98)00173-9
Bosch, M., & Arntz, A. (2023). Imagery rescripting for patients with posttraumatic stress disorder: A qualitative study of patients' and therapists' perspectives about the elements of change. Cognitive and Behavioral Practice, 30(1), 18–34. https://doi.org/10.1016/j.cbpra.2021.08.001
Kip, A., Schoppe, L., Arntz, A., & Morina, N. (2023). Efficacy of imagery rescripting in treating mental disorders associated with aversive memories: An updated meta-analysis. Journal of Anxiety Disorders, 99, Article 102772. https://doi.org/10.1016/j.janxdis.2023.102772
Lockwood, G. (2009). Techniques. International Society of Schema Therapy. https://schematherapysociety.org/Techniques
Morina, N., Lancee, J., & Arntz, A. (2017). Imagery rescripting as a clinical intervention for aversive memories: A meta-analysis. Journal of Behavior Therapy and Experimental Psychiatry, 55, 6–15. https://doi.org/10.1016/j.jbtep.2016.11.003
