Therapy Worksheet for Nightmares

What is the theory behind this Therapy Worksheet for Nightmares?

Nightmares are vivid dreams with disturbing content that make one feel anxious, scared or threatened. An occasional nightmare isn’t worrisome but recurrent nightmares significantly affects one’s sleep quality eventually leading to further mental and physical health issues. 

It is  also a recurrent symptom for people with Post Traumatic Stress Disorder.

Among its treatment options is Image Rehearsal Therapy (IRT) which can reduce the frequency of nightmares, help manage the distress they cause and eventually improve one’s sleep quality as well. 

How will the worksheet help?

The worksheet will provide step by step details of a technique called ‘Image Rescripting’ used in Image Rehearsal Therapy to reduce nightmares using the Image Rescripting Technique.  The worksheet can serve as a guide and reminder for clients seeking help for nightmares to practise the technique when needed. 

How to use the worksheet?

This guide can be used as a client handout to remind them about the steps of image restructuring that they have learned in therapy sessions to target their nightmares. Instruct the clients to practise the steps as needed and share their feedback on its effectiveness. 

Therapy Worksheet for Nightmares

Go through the step by step guide in this handout to recall how to practice image restructuring for your nightmares. 

Step 1: Take notesThe content of your nightmareAll the important elements that you can recall Can be recorded by keeping a pen and paper beside your bed OR keep an audio recorderRemember to focus on the most disturbing and uncomfortable elements of your nightmareThey can be images, sounds, feelings and any vital information that associated with that nightmare
Step 2: Rewrite your nightmareOnce you have all the details of your nightmare penned down begin by rewriting that nightmare in a positive lightIntroduce positive characters or even yourself as a superhero capable of fighting the bad aspects of your nightmare.Own your nightmare and turn it into a positive story with a positive ending
Step 3: Before falling asleep, practise this technique to re-dream the nightmareTell yourself: “If or when I have the beginnings of thesame bad dream, I will be able to INSTEAD have this much better dream with a positive outcome.”Now recall the aspects of your rewritten dream from beginning to end making sure nothing is left behindTell yourself the same thing as mentioned above before falling asleep. 
Step 4: Repeat, review , rejoice!This will take some practice but with time you will be able to reduce the distressing quality of your nightmares.The process can be repeated as many times as needed. It can take up to 10 trials for it to start working.Remember to maintain good sleep hygieneIt will be a process of trial and error, Make sure to note down your attempts as it can provide important information to your therapist. 


Aurora, R. N., Zak, R. S., Auerbach, et al. (2010). Best practice guide for the treatment of nightmare disorder in adults. Journal of Clinical Sleep Medicine, 6, 389-401

You can download this worksheet here.

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