Self-guided mental imagery training shows promise in reducing anxiety

A recent study published in Behaviour Research and Therapy suggests that a self-guided digital mental imagery program can successfully lower anxiety levels in university students. The intervention helps individuals vividly imagine achieving their personal goals, which tends to reduce their motivation to avoid stressful situations. This provides evidence that practicing positive, multisensory mental imagery can be an effective and accessible tool for managing anxiety before it requires clinical treatment.

Anxiety disorders are a major public health challenge across the globe, particularly among university students. Anxiety is often driven by a cycle of excessive worry that amplifies how people perceive threats. When people experience this worry, they often rely on safety behaviors, which are actions taken to avoid those perceived threats.

While these safety behaviors provide immediate relief, they tend to maintain or worsen the anxiety over time by reinforcing fear. They prevent the individual from getting used to the anxiety and realizing that the threat is not as bad as it seems.

Traditional treatments like cognitive behavioral therapy work well to break this cycle, but they require many hours of contact with a trained professional. Because many students have limited access to therapy, scientists wanted to test a preventative, self-guided approach. They adapted a technique called functional imagery training into a digital program designed to keep anxiety low.

“Everyone feels anxious sometimes. When anxiety becomes an enduring problem, it does so through a cycle of thoughts, feelings and behaviors,” said study author Jackie Andrade, a professor of psychology at the University of Plymouth and head of the Functional Imagery Training research group.

“For example, someone with social anxiety might contemplate attending a party, think about all the things that could go wrong socially, notice their anxiety level increasing, and turn down the invitation. This ‘safety behavior’ of avoiding the activity that causes anxiety results in an immediate reduction of anxiety – relief that the looming problem has been avoided.”

“But it feeds the cycle of anxiety by reinforcing the idea that social situations are extremely difficult and can only be coped with by staying away. The alternative is to engage with the event, discovering that it is not impossibly hard to deal with and practicing coping skills that make the next social invitation feel less daunting to think about.”

“We have developed a new approach to anxiety management, with the potential to prevent anxiety getting to the point where it needed professional treatment,” Andrade continued. “Our approach is called functional imagery training, or FIT for short. It shifts focus away from the reasons for anxiety and towards the person’s life goals or values and how engagement activities will help achieve those goals.”

“FIT helps the person develop and practice multisensory mental imagery of how they will work towards those goals and how good it will feel to achieve them. This process builds motivation for engaging with anxiety-provoking situations, and by doing so it reduces motivation to avoid them. FIKA (Functional Imagery for Keeping Anxiety low) is a self-guided form of FIT designed to teach this skill of imaging positive future outcomes.”

To explore how users experienced this new digital tool, the scientists conducted an initial qualitative study. They recruited 12 female university students who self-identified as experiencing anxiety. The researchers measured the participants’ anxiety levels using a standard seven-item questionnaire, which assesses how often people feel nervous, on edge, or unable to stop worrying.

After completing the initial assessment, the participants were given access to the digital program to use at their own pace over two weeks. The program consisted of seven short modules that included video explanations, journaling tasks, and guided audio exercises. The exercises instructed users to identify a personal goal and imagine how it would feel to achieve it using all their senses.

Participants were encouraged to practice this mental imagery during normal daily routines, like preparing a hot drink. During the third week, the researchers interviewed the 10 participants who successfully completed the study. The interviews were audio-recorded and analyzed to find common themes in the users’ experiences.

The interview data provided evidence that the participants found the program to be compassionate and gentle. Many reported that the mental imagery exercises felt calming and helped them view their situations more rationally. Creating a calm mental space helped participants move away from the negative thoughts that typically fuel their anxiety.

The quantitative data from the questionnaires supported these qualitative reports. On average, the participants’ anxiety scores dropped from a level of moderate anxiety down to mild anxiety. Eight of the ten participants shifted to a completely lower classification of anxiety severity.

Following this initial exploration, the researchers conducted a second study to test the program against a control group. They recruited 60 undergraduate students who experienced anxiety that interfered with their daily lives. The participants completed the same baseline anxiety questionnaire and were randomly assigned to either receive the digital program immediately or be placed on a waitlist.

The waitlist participants were told they would receive access to the program at the end of the study period. Data from participants who did not meet the threshold for at least mild anxiety were excluded, leaving 48 participants in the final analysis. This left 25 students in the intervention group and 23 students in the waitlist group.

The intervention group completed the digital modules over two weeks, while the waitlist group received no intervention during this time. Afterward, all participants completed the anxiety questionnaire again. The researchers found that the digital intervention significantly reduced anxiety compared to the waitlist control.

The participants who completed the program experienced an average symptom reduction of 6.40 points on the anxiety scale. Those on the waitlist experienced no significant change in their anxiety levels. This provides evidence that the reductions in anxiety were caused by the digital intervention itself, rather than natural changes over time.

Engagement with the program was high among the intervention group. Out of the 25 participants, 21 completed all seven modules and 23 practiced their mental imagery exercises between sessions. When asked to evaluate the program, the vast majority of users said they would use it again and recommend it to others.

Many participants specifically noted that setting achievable goals and imagining future positive outcomes kept them motivated. A few participants also highlighted that writing their feelings down in a journal helped make their emotions feel more manageable. At the same time, some users noted that confronting the reality of their anxiety on paper was an uncomfortable challenge.

“We succeeded in our aim of reducing anxiety to a level that felt manageable,” Andrade told PsyPost. “FIKA reduced university students’ anxiety from an average score of moderate anxiety to an average score of mild anxiety. Qualitative feedback showed that participants found positive future imagery a useful mental skill that helped them keep things in perspective and that they found the FIT approach to be compassionate and gentle.”

While the findings are promising, there are some common misinterpretations to avoid. The scientists note that functional imagery training is not the same as self-hypnosis or basic visualization. Instead, the technique requires multisensory imagery, which creates a stronger emotional connection to the goal than simply picturing it.

Some people might worry that an inability to visualize images would prevent them from using this program. About two to four percent of the population experiences aphantasia, which is a total lack of visual imagination. However, the researchers suggest that these individuals can still benefit by using other senses, such as imagining the sounds or physical feelings associated with a goal. “Jon Rhodes at the University of Plymouth has published research showing benefits of FIT even for people with aphantasia,” Andrade noted.

The study also has a few limitations that require consideration. The follow-up period was very short, lasting only about three weeks for most participants. Because of this brief timeframe, it remains unclear whether the self-guided mental imagery training provides long-lasting anxiety relief.

Some users also found the program time-consuming and struggled to practice their mental imagery during moments of intense anxiety. In the future, the scientists plan to evaluate the self-guided program in real-world contexts over longer time spans. They also hope to compare its effectiveness directly against other established digital treatments for anxiety.

The study, “Self-guided functional imagery training to reduce anxiety,” was authored by Jackie Andrade, Stephanie Hartgen-Walker, Caroline Morgan, Ayan, Idil Aytekin, Khadijah Sekoni, Kardelen Sengul, and Jonathan Rhodes.