Is there evidence that guided imagery works?

In the last 20 years, as more people turn to whole person health approaches, more researchers have explored how guided imagery can help different conditions.

• Fibromyalgia patients who received guided imagery for eight weeks saw a significant decrease in their depression and pain symptoms. ¹
• Gut-directed guided imagery for irritable bowel syndrome was as effective as diet monitoring and modification for people suffering from irritable bowel syndrome. Patients who received guided imagery experienced an increase in quality of life not seen in patients just receiving diet monitoring and modification. ²
• People hospitalized for depressive disorders who listened to a guided imagery once a day for 10 days in addition to their treatment as usual experienced significant decreases in depression, anxiety and perceived stress. ³
• Breast cancer patients who used guided imagery for 20 minutes for 7 days after undergoing chemotherapy experienced a significant decrease in insomnia, anxiety, pain and depression. ⁴
• A systematic review and meta-analysis found that people suffering from PTSD, sleep disturbances, nightmares and insomnia saw significant improvements when they engaged in a daily guided imagery practice. These effects lasted six to 12 months even after they had stopped the guided imagery program. ⁵
• Marines with PTSD had significantly more improvement in all measures than those receiving only usual care when they engaged in daily guided imagery for three weeks. ⁶

Guided imagery in cancer treatment

Guided imagery in cancer treatment has been shown to help relieve symptoms and side effects. It can help people manage pain, reduce anxiety and fatigue, and improve their overall quality of life.

• It’s important to know that using guided imagery is not linked with better response to cancer treatment or improved survival. ⁷
• Guided imagery can be helpful for cancer pain. ⁸
• Guided imagery helped patients’ quality of life during the process of receiving a stem cell (bone marrow) transplant. ⁹

Health care providers at major cancer centers are now using guided imagery as part of cancer care, to help patients cope with procedures and treatment-related concerns and symptoms. ¹⁰, ¹¹

Is guided imagery safe?

Guided imagery is widely considered a safe way of addressing many physical and mental conditions. However, it is not appropriate for everyone. Experienced health care providers should consider who will benefit from guided imagery and who may not. ¹⁰, ¹²

Do I need to go to classes or find a guided imagery health care provider?

No, although it’s a good idea to talk with your own doctor or other health care provider about it. They may have resources to recommend. Therapists, social workers, and other health care providers are often trained and may be certified in guided imagery, so ask your health care team for recommendations.

If you have cancer, ask your cancer care team about any resources available at the hospital or cancer center for guided imagery.

There are many free or low-cost ways to practice guided imagery, including apps and YouTube videos, like those at www.healingworksfoundation.org/meditate We also recommend Belleruth Naparstek’s content at Hay House Media: www.hayhouse.com/shop/audio/health-journeys

What training or certifications do guided imagery clinicians have?

There is no national organization that regulates guided imagery providers. However, the Academy for Guided Imagery (AGI) is the most widely recognized and attended guided imagery certification program. Imagery International is a professional association of guided imagery practitioners that provides more information on training.

Before making an appointment, ask any therapist who offers guided imagery about their qualifications and training. www.danafarber.org/health-library/guided-imagery

How do I find guided imagery classes near me?

Visit ImageryInternational.org to search for a provider near you.

Will my insurance company cover the cost of seeing a guided imagery practitioner?

Your insurance may help pay for guided imagery if you see a therapist certified in any other discipline, such as psychiatry or cancer care, or the guided imagery is part of your treatment for a specific condition.

Should I tell my doctor or other health care provider I am using guided imagery?

Absolutely! Let your doctor know you have added guided imagery to your self-care, especially if you are seeing a therapist or taking a class. Always talk with your health care provider before making any changes to your treatment, and never change or stop medications before talking with your doctor.

References

1. Onieva-Zafra, M.D., García, L.H., & Del Valle, M.G. (2015). Effectiveness of guided imagery relaxation on levels of pain and depression in patients diagnosed with fibromyalgia. Holistic Nursing Practice, 29(1): pp. 13-21.
2. Boltin, D., Sahar, N., Gil, E., Aizic, S., Hod, K., Levi-Drummer, R., Niv, Y., & Dickman, R. (2015). Gut-directed guided affective imagery as an adjunct to dietary modification in irritable bowel syndrome. Journal of Health Psychology, 20(6): pp. 712-720.
3. Apóstolo, J.L. & Kolcaba, K. (2009). The effects of guided imagery on comfort, depression, anxiety, and stress of psychiatric inpatients with depressive disorders. Archive of Psychiatric Nurses, 23(6): pp. 403-411.
4. Chen SF, Wang HH, Yang HY, Chung UL. Effect of Relaxation With Guided Imagery on The Physical and Psychological Symptoms of Breast Cancer Patients Undergoing Chemotherapy. Iran Red Crescent Med J. 2015 Nov 28;17(11)
5. Casement, M.D. & Swanson, L.M. (2012). A meta-analysis of imagery rehearsal for post-trauma nightmares: effects on nightmare frequency, sleep quality, and posttraumatic stress. Clinical Psychology Review, 32(6): pp. 566-574.
6. Jain S., McMahon, G.F., Hasen, P., Kozub, M.P., Porter, V., King ,R., & Guarneri, E.M. (2012). Healing Touch with Guided Imagery for PTSD in returning active duty military: a randomized controlled trial. Military Medicine,. 177(9): pp. 1015-1021.
7. CancerChoices. Guided imagery. Available at cancerchoices.org/therapy/guided-imagery/evidence-regarding-guided-imagery-and-cancer. Accessed September 16, 2024.
8. Carvalho V, Rangrej SB, Rathore R. The benefits of integrative medicine for pain management in oncology: A narrative review of the current evidence. Cureus. 2023 Jun 30;15(6):e41203. doi: 10.7759/cureus.41203.
9. Silva LAAD, Machado CAM, Santana EO, et al. Guided imagery relaxation in quality of life of patients undergoing hematopoietic stem cell transplantation: a quasi-experiment. Asian Pac J Cancer Prev. 2021 Aug 1;22(8):2453-2460. doi:10.31557/APJCP.2021.22.8.2453.
10. Dana Farber Cancer Institute. Guided imagery. Available at www.dana-farber.org/health-library/guided-imagery. Accessed September 17, 2024.
11. Memorial Sloan Kettering Cancer Center. Guided imagery. Last updated July 28, 2022. Available at www.mskcc.org/cancer-care/integrative-medicine/therapies/guided-imagery. Accessed September 17, 2024.
12. Bauckhage J, Sell C. When and for whom do psychodynamic therapists use guided imagery? Explicating practitioners’ tacit knowledge. Res Psychother. 2021 Dec 20;24(3):577.

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