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Guided imagery involves using a series of multi-sensory images designed to trigger specific changes in physiology, emotions, or mental state for the purpose of increasing healing response or unconscious changes. Guided Imagery often begins with a series of relaxation techniques, although this is not always so. Often guided imagery is performed as a self-help option without the involvement of a professional. However, in more complex situations, guided imagery is done in a clinical setting either 1:1 or in group.
Background and Policy on in VA
Guided imagery is one of the evidence-based complementary and integrative health (CIH) approaches covered by the Veterans medical benefits package when deemed clinically necessary by their care team per VHA Directive 1137 – Provision of Complementary and Integrative Health, published in May 2017. Based on literature review these approaches were found to be safe and have sufficient evidence of benefit to be recommended as appropriate components of care for the Veteran population.
Guided Imagery Safety and Effectiveness
An evidence map of guided imagery was developed by the VA Health Services Research & Development office. This review limited itself to published meta-analysis studies. Conditions with evidence of a potential positive effect include: Cancer (diagnosis-related), Cardiac surgery, critical illness/ICU, menstrual disorders, Parkinson’s, stroke, and Fibromyalgia (secondary outcomes only). Conditions with evidence of positive effect include: Arthritis/rheumatic diseases (diagnosis related outcomes) and Cancer (secondary outcomes).
Guided Imagery does NOT need to be offered by a licensed provider. Non-LIPs in VA with appropriate training should only provide guided imagery for general well-being. Non-mental health clinicians are recommended to complete a guided imagery training (internal VA online training or equivalent external training). Licensed or qualified health care professionals with appropriate training and scope of practice can provide guided imagery for well-being OR for treatment, depending on the context.
Sessions are typically 20 to 30 minutes in length and may be practiced several times a week. Guided imagery interventions should be at least 5 minutes in duration if provided as one of multiple interventions in a general clinic. If it is the sole approach in a dedicated clinic, then it should be a minimum of 20 minutes.
A number of facilities are expanding access to guided imagery and other CIH services using VA’s Telehealth technology.