Rehearsing a different nightmare ending
Choose a manageable recurring nightmare with your therapist, create a version you prefer, and review what happens when you practise it while awake.
Written by Tarun Vermani, Trainee Clinical Psychologist Last reviewed
Assign and Download open signup, then return you to this worksheet. No card required. Resource access depends on your plan or trial. Already have an account? Sign in
Worksheet preview
Rehearsing a different nightmare ending
PreviewLive preview — type in any field to try it. Nothing is saved here.
Choose and change
Start with a less distressing nightmare that you and your therapist agree is manageable.
Agree daytime rehearsal
Rehearse the new version, not the old nightmare. There is no need to force a vivid picture.
Review sleep and distress
Agree with your therapist what signs mean you should pause. You can stop at any time. If you feel overwhelmed, far away or unsafe, stop rehearsing, look around and remind yourself where you are. Contact your therapist through the agreed route before trying again. If you need urgent help while they are unavailable, use your agreed urgent-care contact.
This worksheet is for feelings you can manage. If you have urges to hurt yourself, or you feel unsafe, use your safety plan if you have one and tell your therapist. If you might act on the urges, call 999 or go to A&E. To talk to someone now, call Samaritans free on 116 123.
Try it here — nothing you type is saved. Sign up to assign it and let clients complete it on any device.
When to use ‘Rehearsing a different nightmare ending’
‘Rehearsing a different nightmare ending’ is an interactive cognitive behavioural therapy (CBT) worksheet, most often used in CBT for trauma and PTSD. It is also commonly drawn on when working with insomnia and sleep problems.
It is designed to be used within therapy rather than as a standalone self-help tool: a therapist introduces it, works through it collaboratively, and helps make sense of what it surfaces. You can preview the full worksheet above, then assign it digitally for clients to complete between sessions on any device or download it as a print-ready PDF.
How it works
Most people work through it in around 20 minutes. It moves through three short steps:
- Choose and change: Start with a less distressing nightmare that you and your therapist agree is manageable.
- Agree daytime rehearsal: Rehearse the new version, not the old nightmare. There is no need to force a vivid picture.
- Review sleep and distress: Agree with your therapist what signs mean you should pause. You can stop at any time. If you feel overwhelmed, far away or unsafe, stop…
Completed on the Formulate platform, your client's answers are saved automatically and shared straight back to you, so you can review them before the next session rather than waiting for a paper copy to come back.
The CBT approach behind it
In common with other CBT methods, ‘Rehearsing a different nightmare ending’ works by noticing the links between situations, thoughts, feelings, physical sensations and behaviour and finding practical ways to change unhelpful patterns. The aim is not positive thinking but a clearer, shared understanding of what keeps a difficulty going and practical, testable ways to change it.
Because it is a CBT tool it stays focused on the here-and-now links between thoughts, feelings, the body and behaviour, and it works best as one part of a wider course of therapy rather than as advice or a diagnosis.
Evidence & sources
This worksheet is grounded in established cognitive behavioural therapy theory and practice. Key sources include:
- Krakow, B., & Zadra, A. (2006). Clinical management of chronic nightmares: imagery rehearsal therapy. Behavioral Sleep Medicine.
- Krakow, B., Hollifield, M., Johnston, L., et al. (2001). Imagery rehearsal therapy for chronic nightmares in sexual assault survivors with posttraumatic stress disorder: a randomized controlled trial. JAMA.
For use alongside professional support
Formulate provides educational CBT resources for use with a qualified therapist. They are not a substitute for professional assessment, diagnosis, or crisis care.
If you need urgent help now:
- Emergency services: 999 — if you or someone else is in immediate danger
- NHS 111 (NHS 24 in Scotland): 111 — choose the mental health option for urgent help, in England, Scotland and Wales (in Wales, press 2)
- Lifeline: 0808 808 8000 — for urgent help in Northern Ireland, free, day or night
- Samaritans: 116 123 — free, day or night, 365 days a year
- Shout: 85258 — text SHOUT, free, day or night
- SANEline: 0300 304 7000 — 4pm–10pm, every day
More PTSD / Trauma worksheets
View all PTSD / Trauma worksheets →PTSD / Trauma
PTSD Formulation (Ehlers & Clark)
A formulation based on Ehlers and Clark's cognitive model of PTSD — mapping the nature of the trauma memory, negative appraisals, sense of current threat, and the maintaining strategies.
PTSD / Trauma
Trauma impact statement
Write about how the trauma or traumas have affected your beliefs about yourself, other people and the world, and how your life has changed. Based on Resick and Schnicke (1993): the impact statement is split into structured prompts, and a life-areas table is added.
PTSD / Trauma
Trigger discrimination worksheet (then vs now)
Identify triggers that activate trauma memories and compare the original trauma context with the present, which with practice can help triggers feel less powerful. Based on Ehlers and Clark (2000): telling then from now, with distress rated before and after and a reminder for next time added, and the then side kept brief.
PTSD / Trauma
Grounding techniques practice
Practise grounding when you feel overwhelmed, cut off or caught in a flashback, and record what helped. Based on Ehlers and Clark (2000): the then-versus-now check follows their model; the log and the grounding steps are our own.
PTSD / Trauma
Reliving preparation and processing worksheet
Prepare for a reliving session with your therapist, then record the hotspot moments, how you felt and the updated meanings. Based on Ehlers and Clark (2000): a record sheet for the reliving and updating steps, with the layout added.
PTSD / Trauma
Hotspot identification and meaning worksheet
Identify the "hotspot" moments in a trauma memory (the moments of peak emotion) and update their personal meaning, with your therapist. Based on Ehlers and Clark (2000): the hotspot table and the before and after ratings are added.
Want to assign this to a client?
Create a free therapist account to use the homework and library download tools. Clients can complete assigned homework online or use a blank PDF. See how the homework workflow works.
No card required. The Free plan includes 10 worksheet uses a month. Check plan access and limits.