Accepted for/Published in: JMIR Formative Research
Date Submitted: Aug 24, 2025
Date Accepted: Oct 28, 2025
A Brief Technique to Reduce Flashbacks of Sexual Trauma in an Adolescent: Proof-of-Concept Case Study using Imagery Interference
ABSTRACT
Background:
Trauma exposure, including sexual harm, is prevalent in adolescents. A key resulting symptom relates to re-experiencing mental images of trauma, such as intrusive memories and flashbacks. Established treatments are used to address intrusive memories but are hard to access, often leave remaining symptoms, and require extensive exposure to traumatic materials. An emerging approach with adult populations suggests intrusive imagery symptoms can be precisely targeted with simple cognitive tasks.
Objective:
We describe a first proof-of-concept demonstration of an imagery interference technique in a 15-year-old to target residual intrusive memory symptoms after a course of PTSD treatment for sexual trauma, to lay the groundwork for further evaluations.
Methods:
A case study (Mia) was presented drawing from routine clinical practice within the United Kingdom’s National Health Service. After 23 sessions of trauma-focused cognitive behavioural therapy, Mia received the imagery interference technique on session 24, and a month later returned for session 25 (final). The technique involves playing Tetris within a wider protocol informed by the science of memory malleability (e.g. including brief memory recall and working memory taxation). Memory ratings (frequency, vividness, and distress) were assessed before and immediately after applying the technique, and a month later. Symptoms of PTSD, anxiety, and depression were gathered on the first and final sessions. Views from Mia and her parents were also obtained.
Results:
For the specific flashback targeted by Mia, vividness reduced within the session (40% to 15%), distress reduced within the session (40% to 15%) and a month later (then to 10%), and frequency a month later (once to zero a week; 100% reduction). The other non-targeted flashbacks also reduced in frequency (four to once a month; 75% reduction). Mia described the memories as more “distant”. Symptoms of PTSD, depression, and anxiety also reduced overall.
Conclusions:
Pending further rigorous testing, the imagery interference approach has potential as a low-intensity and early intervention for adolescents to address intrusive imagery of trauma, such as sexual harm, and in other clinical contexts (e.g., anxiety). Clinical Trial: Not applicable
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