Imagery Techniques
Imagery techniques are described as methods of creating mental images to create an altered state of consciousness and have been shown to be effective in reducing anxiety137,138. Two types of imagery techniques will be discussed in this section: guided imagery (GI) and hypnosis. Hypnosis and GI are cognitive-based therapies that use the power of suggestion and thoughts to create positive mental images that promote relaxation and healing137,138.
This cognitive-based therapy has been shown to be effective when practiced for 15 minutes or less, making it a quick and potentially valuable MRI anxiety intervention138. A study by researchers Thompson and Coppens evaluated guided imagery as an MRI anxiety intervention139. Their study results showed a reduction in both anxiety and movement of the experimental group, with no decrease in either anxiety or movement observed in the control group139 Another study used guided imagery in a study assessing three psychological interventions for MRI claustrophobia. In the guided imagery study, subjects experienced significantly less anxiety than the other two interventions, which were written information and counseling in conjunction with written information13. Furthermore, it should be noted that the guided imagery was implemented for 12 minutes, supporting the fast and efficient implementation of this treatment for MRI anxiety13,138.
Hypnosis has been successfully used to reduce anxiety in a number of medical situations including use in both the MRI environment and surgical suite138,140. A study by Tusek et al. showed post-surgical colorectal patients experienced not only less anxiety and pain but needed half as much pain medication as the control group140.
Hypnosis has been shown to successfully reduce anxiety in the MRI environment in two cases131,141. The first study looked at the effect of hypnosis and rapport training of technologists and support staff on reducing the number of canceled MRI examinations due to anxiety. This study concluded that hypnosis and staff training were effective in reducing the number of prematurely terminated exams131. Although this study showed favorable results, its limitations should also be mentioned. First, the study ended prematurely due to changes in the study site’s organizational structure131. Second, the study stated patients could be put into a hypnotic state in less than 12 minutes, yet there is not mention of how long it took to accomplish hypnosis in their methods section. Lastly, it takes 20 hours to train technologists in this technique, which is a considerable amount of training131. The second study, conducted by Friday and Kubal, showed hypnosis helped 10 patients complete their MRI examination141. Like the study mentioned above, training to perform hypnosis was extensive and it took 45 minutes to place patients in a hypnotic state141.
In conclusion, hypnosis has been shown to be an effective intervention in reducing MRI anxiety131,141. Although hypnosis is an effective intervention for anxious MRI patients, it requires substantial training and implementation time. That being said, this technique for reducing anxiety is more of a preventative or prep MRI intervention and, therefore, is less suitable for acute situations such as panic attacks and other anxiety issues seen in the MRI environment. As a practicing MRI technologist, I feel that anything that helps a patient complete their exam is a positive step in MRI patient care.