An interventional study of Internet-Based Written Imagery Rescripting (W-ImRs) and Psychoeducation in Shame, Childhood Emotional Neglect and Adult Survivors of Child Adverse Events, sponsored by Taylor's University. Completed at 1 site in Malaysia. Open to participants aged 18 Years to 58 Years. Per ClinicalTrials.gov, last updated 2026-11-05.
Sponsored by Taylor's University · Not applicable, Interventional, and Treatment
The goal of this clinical trial is to learn if an online written imagery rescripting program (W-ImRs) can reduce shame and negative beliefs about oneself in Malaysian adults aged 18 to 58 who experienced childhood emotional neglect.
The main questions it aims to answer are:
Researcher will compare W-ImRs to a single psychoeducation session to see if W-ImRs reduces shame and negative self-beliefs. Participants in the psychoeducation group will be offered W-ImRs after the study.
Participants will:
This is a two-arm, parallel, open-label randomized controlled trial with a waitlist design. The intervention protocol is adapted from Wagner et al. (2022, 2024), and the rescripting procedure is aligned with the updated imagery rescripting protocol by Arntz (2025). The protocol is grounded in schema therapy.
The trial is open-label because the therapist, outcome assessor, and data analyst are the same person. Investigator bias is reduced through self-administered online instruments and standardized scoring.
All participants receive a Self-Help Kit with relaxation exercises, a crisis safety plan template, and Malaysian crisis contacts. Item 9 of the PHQ-9 is used as a suicidality checkpoint at pre and post-assessment, and the therapist reviews every written submission for signs of risk. Different safety protocol response is used for mild, moderate, and acute distress. Participants at acute risk are withdrawn on the same day and referred to clinical services. The therapist receives weekly supervision from the research supervisor throughout data collection.
Analyses will be performed in IBM SPSS Version 29 with significance set at α = .05. The main analysis is a 2 (Group) × 2 (Time) mixed-design repeated-measures ANOVA on the EISS and PTCI-9 separately. Effect sizes will be reported as partial η² and Cohen's d. The Reliable Change Index (Jacobson \& Truax, 1991) will be used to identify participants whose change exceeds measurement error.
Taylor's University is the lead sponsor of 4 studies on the registry; none are open to participants now.
Counted across the registry records on this site, refreshed daily.
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Exclusion Criteria:
Participants receive psychoeducation followed by Internet-Based Written Imagery Rescripting (W-ImRs) over approximately 4 weeks.
Behavioral: Internet-Based Written Imagery Rescripting (W-ImRs) · Behavioral: Psychoeducation
Participants receive a single psychoeducation session. They are offered the full W-ImRs intervention after completing the post-assessment.
Behavioral: Psychoeducation
A four-session protocol delivered over approximately 4 weeks. Session 1 is a live video session on Microsoft Teams (about 60 minutes) in which the psychoeducation session is extended to identify a target memory, explain the rationale for W-ImRs, and schedule the written sessions. Session 2 is an asynchronous writing task in a private Google Document: participants write a detailed first-person, present-tense account of the target memory and a letter to the person responsible for the memory. Session 3 is a second writing task: participants rescript the memory so that their adult self meets the child's unmet needs, and write a comforting letter to their younger self. The therapist gives written feedback after Sessions 2 and 3. Session 4 is a live debriefing session on Microsoft Teams (about 60 minutes).
A single live video session on Microsoft Teams (about 60 minutes) covering childhood emotional neglect, shame, and negative self-cognitions, with a verbal risk assessment. The shared psychoeducation content is identical across both arms.
Change From Baseline in Shame on the External and Internal Shame Scale (EISS) at Post-Intervention
The EISS is an 8-item self-report questionnaire measuring external and internal shame. Items are rated from 0 to 4, giving a total score from 0 to 32. Higher scores indicate greater shame.
Time frame: Baseline (Day 0) and Post-Intervention (Collected 3 days after each participant's final session)
Change From Baseline in Negative Self-Cognitions on the Posttraumatic Cognitions Inventory-9 (PTCI-9) at Post-Intervention
The PTCI-9 is a 9-item self-report questionnaire measuring negative cognitions about the self, negative cognitions about the world, and self-blame. Items are rated from 1 to 7, giving a total score from 9 to 63. Higher scores indicate more negative cognitions.
Time frame: Baseline (Day 0) and Post-Intervention (Collected 3 days after each participant's final session)
Number of Participants Showing Reliable Improvement in Shame on the EISS
Reliable improvement is defined as a decrease in EISS total score from baseline to post-intervention with a Reliable Change Index (RCI) greater than 1.96 (Jacobson \& Truax, 1991). An RCI above 1.96 means there is 95% confidence that the decrease is a real change, and not due to chance or small day-to-day differences in how a person answers the questionnaire.
Time frame: Baseline (Day 0) and Post-Intervention (Collected 3 days after each participant's final session)
Number of Participants Showing Reliable Improvement in Negative Self-Cognitions on the PTCI-9
Reliable improvement is defined as a decrease in PTCI-9 total score from baseline to post-intervention with a Reliable Change Index (RCI) greater than 1.96 (Jacobson \& Truax, 1991). An RCI above 1.96 means there is 95% confidence that the decrease is a real change, and not due to chance or small day-to-day differences in how a person answers the questionnaire.
Time frame: Baseline (Day 0) and Post-Intervention (Collected 3 days after each participant's final session)
Plan to share: No — Individual participant data will not be shared. Participants disclosed sensitive information about childhood emotional neglect, and the informed consent form states that their data will not be shared with anyone other than the researcher and the research supervisor. Because of the small sample size, sharing individual data could also risk identifying participants. All data will be stored securely for at least three years after the study is completed and then permanently deleted.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
This study is completed, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.
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