Imagery Rescripting as an adjunct treatment for depression

All participants will receive evidence based group CBT psychological intervention (Mood and Anxiety Management Programs, MAMP), consisting of one session per day of approximately 3 hours duration, from Monday to Friday (i.e. 5 sessions per week). In addition, participants will be randomly assigned to three treatment conditions. The CBT group work is undertaken in the mornings during this time and the additional individual treatment sessions would take place over the two weeks of the group program in the afternoon, with at least one day between these individual sessions. Participants will continue to receive MAMP sessions in addition to the intervention sessions for the duration of the study period. All group treatment sessions are delivered face-to-face at the Hollywood Hospital clinic. While we will aim to complete individual sessions face-to-face, this may not always be feasible in light of the current pandemic. Therefore, sessions will be carried out via telehealth in instances where face-to-face interaction is not feasible (e.g., state lockdowns, researchers needing to quarantine/isolate). Evidence suggests that both of our proposed interventions (ImRs and CBT-based interventions) can be effectively delivered via telehealth (Osenbach et al., 2013; Paulik et al., 2021). Our preferred telehealth software will be Zoom, which has been approved for use by the Australian Psychological Society. To monitor adherence to group and individuals sessions, attendance will be monitored using a client session checklist. Arm 1. Three individual 90 minute sessions utilising imagery rescripting (ImRs). ImRs is an evidence based psychological intervention for posttraumatic stress disorder. In ImRs, the patient is asked to focus on an aversive memory from their child-self perspective, identifying their thoughts, feelings and needs. Next they are then guided to imagine a different ending, such as someone intervening by stopping the abuse and caring for the needs of the child. Multiple suggestions are made until the patient identifies that the new imagined experience meets the core need of the child self in the original memory. The initial ImRs session would entail giving information on the intervention, establishing a safe place via imagery and identifying memories that would be targeting in subsequent session. The second and third session would involve rescripting identified memories as per ImRs procedure. Arm 2. Three individual 90 minute sessions utilising Cognitive Behavioural Therapy Assertiveness Training (CBT-AT). CBT is an evidence based practice that is widely used in the treatment of psychological disorders. CBT-AT supports an individual to identify and alter unhelpful thoughts, feelings and behaviours. Sessions would focus on assertive communication, looking at the individuals beliefs around assertiveness and supporting them to practice more assertive behaviour Arm 3. Treatment as usual / Delayed treatment. Participation in the group program with no additional individual sessions. however will be offered individual sessions following their six week follow up assessment. All treatment sessions will be delivered by the researchers who are in their second year of their clinical masters and who are trained in both interventions. The first cohort (2-4 participants) to be administered the assessments and intervention are treated as a trial and as such their data will not be included in the data analysis.