Cognitive Behavioral Interventions for Nightmares

Doesn’t it just break your heart when you hear a child tell about not being able to sleep due to nightmares? Due to working with elementary aged children most of the time this is a common occurrence for me.  Sometimes the nightmares are related to watching scary movies, related to general anxiety, or are associated with trauma. While this is not an area of expertise for me, I have had some great success in helping children overcome nightmares.

When a child reports they have had a nightmare, I encourage them to draw a picture of it. As they are drawing or towards the end of their drawing I have them tell me what happened in the nightmare.  They are to describe in as much detail as possible.  I also ask questions about their senses in the dream to see if they could recall sights, smells, sounds, tastes, or things they could feel. Next, we discuss the villain or the theme causing the fear from the nightmare.  If it is a monster or a bad guy, we discuss his powers that make him scary.   Next, we discuss a superhero who could beat the bad guy.  They will then talk about what kind of superhero it would have to be.  They call tell the story of how the superhero beats the villain from their nightmare. In the end, I have the draw a picture of the superhero overcoming the villain. 

I have had clients as young as 3 years old put this into practice and overcome nightmares.  It can sometimes be a repetitive process of rescripting the nightmares, especially for a child who has experienced more extensive trauma.  However, my experience has been that they make great progress.  I also explain the process to parents so they can work with their children at home.  Having them talk about the nightmare and draw a picture soon after it occurs can help then process it before they start to forget the details.

Update: I recently created a therapy game for nightmares.  It is called Nightmare Ninja.  You can read about it here: http://pathwaystopeacecounseling.blogspot.com/2018/03/nightmare-ninja.html

Credits: I learned about rescripting nightmares in a CEU class by Lisa Demarni Cromer, PhD from Tulsa University.  Her experience and research far exceeds the information I gleaned form the class.

photo credit: donnierayjones Rise 'N Shine via photopin (license)