ANXIETY DISORDERS (A PELISSOLO, SECTION EDITOR) Imagery Rescripting for Anxiety Disorders and Obsessive-Compulsive Disorder: Recent Advances and Future Directions Laura P. Strachan 1 & Matthew P. Hyett 1 & Peter M. McEvoy 1,2 # Springer Science+Business Media, LLC, part of Springer Nature 2020 Abstract Purpose of Review This review describes imagery rescripting (ImRs) and its clinical application to anxiety disorders and obsessive-compulsive disorder (OCD). Variations in ImRs delivery, clinical evidence, and theories of potential mechanisms of change are also reviewed. Finally, we propose a future research agenda. Recent Findings There is some evidence that ImRs affects memory processes and schemas. ImRs is associated with reductions in cognitive-affective, physiological and behavioural symptoms of social anxiety disorder and reductions in OCD-related distress and OCD symptoms. ImRs for other anxiety disorders has not been evaluated. Summary While ImRs appears to be an effective intervention for social anxiety disorder and OCD, more research is needed to (a) systematically compare ImRs to established interventions, (b) evaluate ImRs for other anxiety disorders, (c) test theorized mechanisms of change, and (d) evaluate the impact of moderating factors and treatment variations on therapeutic outcomes. Keywords Imagery rescripting . Social anxiety disorder . Obsessive-compulsive disorder . Anxiety disorders . Review Introduction Anxiety disorders are the most prevalent of all mental disor- ders globally [1, 2]. Obsessive-compulsive disorder (OCD) and anxiety disorders are associated with significant disability burden [2–4] and high rates of comorbidity with psychologi- cal (e.g., mood, other anxiety, substance use disorders) and physical disorders [3, 5, 6]. Such comorbidity is associated with chronicity of mental disorders, greater functional disabil- ity, and increased use of healthcare services [7–9]. Thus, the development of effective treatments is essential [10]. According to cognitive theory, cognitions (e.g., thoughts) determine affective experiences and represent a cen- tral maintaining factor in psychological disorders [11]. Mental imagery is one aspect of cognition that reflects internally gen- erated perception, which is represented across sensory modal- ities [ 12]. Intrusive and distressing mental images are associated with a range of psychological problems [13, 14] and cognitive therapy has long-emphasized the use of mental imagery to correct maladaptive cognitions [11, 15]. Imagery rescripting is one imagery-based technique with a burgeoning evidence-base for the treatment of emotional disorders. This paper will describe the key features of imagery rescripting, summarize recent evidence for its clinical applications to anx- iety disorders and OCD, outline theories describing potential mechanisms of change and review experimental evidence for these mechanisms, before proposing potential future research directions. What Is Imagery Rescripting? Imagery Rescripting (ImRs) is a therapeutic technique that uses mental imagery to modify the meaning of distressing autobiographical memories that are associated with current psychological problems [16]. ImRs integrates benign or pos- itive imagery into aversive memories to alter the context of the event that is represented in that memory [17] and differs from imaginal exposure techniques. Although both techniques re- peatedly activate aversive memories, exposure to distressing aspects of memories is minimized during ImRs and instead, individuals are required to focus on inserting information that This article is part of the Topical Collection on Anxiety Disorders * Peter M. McEvoy peter.mcevoy@curtin.edu.au 1 School of Psychology, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia 2 Centre for Clinical Interventions, Perth, Australia Current Psychiatry Reports (2020) 22:17 https://doi.org/10.1007/s11920-020-1139-4