How can guided imagery help me? What the research says

This mind-body therapy uses your imagination to help you relax, relieve symptoms, stimulate your body’s healing responses, access inner strengths and resources, and tolerate procedures and treatments better.

How can guided imagery help me? What the research says

We summarize the clinical evidence for each medical benefit here. We begin with our assessment of the strength of evidence within each category, followed by a brief summary of individual studies or reviews of several studies. In assessing the strength of evidence, we consider the study design, number of participants, and the size of the treatment effect (how much outcomes changed with treatment).

Our assessments of evidence for each medical benefit fall into one of these categories:

Strong evidence: consistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analysesa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results
Good evidence: significant effects in one large or several mid-sized and well-designed clinical studies ( randomized controlled trialsa study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects with an appropriate placebo or other strong comparison control or observational studies that control for confounds)
Modest evidence: significant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies), or several small studies aggregated into a meta-analysis
Preliminary evidence: significant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect
Weak evidence: one or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects
Insufficient evidence: preclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example)

How We Rate Therapies

Learn more about how we research and rate therapies and practices.

Much of the evidence regarding guided imagery involves studies that used other mind-body therapiesapproaches that enhance your mind’s capacity to positively affect your body’s function and symptoms. Some interventions focus on calming your mind, improving focus, enhancing decision-making capacity, managing stress, or resolving conflict. Other interventions have a goal of relaxing both your mind and your body. along with guided imagery. We are often not able to assess the effects of guided imagery alone.

Improving treatment outcomes

Is guided imagery linked to improved survival? Is it linked to less cancer growth or metastasis? Does it enhance the anticancer action of other treatments or therapies? We present the evidence.

Breast cancer

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on proliferation or response to radiotherapy or chemotherapy among people with breast cancer participating in relaxation and visualization therapy in small trials

Optimizing your body terrain

Does guided imagery promote an environment within your body that is less supportive of cancer development, growth, or spread? We present the evidence.

Optimizing Your Body Terrain

Research has only begun studying the connections between body terrain factors and cancer outcomes, and the oncology community is not yet sure how to interpret all the findings. If any of these terrain factors could be an issue for you, we recommend that you ask your doctor if you need any diagnostic tests to detect terrain imbalances or any adjustments to your lifestyle or medications.

We also recommend that you share with your doctor the information here about how guided imagery might affect these terrain factors if you have any imbalances.

Hormone imbalance

Preliminary (conflicting) evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of lower cortisol levels—a marker of stress—around the time of surgery among people treated with guided imagery, either with or without a relaxation intervention

Lower levels of cortisol but higher levels of noradrenaline immediately before and after abdominal surgery among people treated with guided imagery compared to controls who received background information about the hospital in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects³Manyande A, Berg S et al. Preoperative rehearsal of active coping imagery influences subjective and hormonal responses to abdominal surgery. Psychosomatic Medicine. 1995 Mar-Apr;57(2):177-82.
Lower cortisol levels 1 day after cholecystectomy among people treated with relaxation and guided imagery compared to controls given a quiet period in a small RCT⁴Holden-Lund C. Effects of relaxation with guided imagery on surgical stress and wound healing. Research in Nursing & Health. 1988 Aug;11(4):235-44.
A very weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward lower cortisol 6 weeks to 1 year after completing cancer treatment among people with breast cancer participating in an 8-week imagery stress-reduction program compared to baseline in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design⁵Freeman L, Cohen L et al. Imagery intervention for recovering breast cancer patients: clinical trial of safety and efficacy. Journal of the Society for Integrative Oncology. 2008 Spring;6(2):67-75.
No changes in stress hormones during radiotherapy among people with breast cancer treated with relaxation and visualization therapy compared to radiotherapy alone in a small RCT⁶Nunes DF, Rodriguez AL et al. Relaxation and guided imagery program in patients with breast cancer undergoing radiotherapy is not associated with neuroimmunomodulatory effects. Journal of Psychosomatic Research. 2007 Dec;63(6):647-55.

Immune function

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of better immune system function among people receiving guided imagery with other mind-body therapies

Better markers of immune function among men undergoing surgery for prostate cancer participating in a stress-management intervention including discussing concerns about the surgery, diaphragmatic breathing, guided imagery, and adaptive coping skills compared to 2 sessions of supportive attention or standard care in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁷Cohen L, Parker PA et al. Presurgical stress management improves postoperative immune function in men with prostate cancer undergoing radical prostatectomy. Psychosomatic Medicine. 2011 Apr;73(3):218-25.
Better markers of immune function during chemotherapy followed by surgery, radiotherapy, and hormone therapy among women with large or locally advanced breast cancers receiving relaxation training and guided imagery, especially among those who rated their imagery vividness highly in a small RCT⁸Eremin O, Walker MB et al. Immuno-modulatory effects of relaxation training and guided imagery in women with locally advanced breast cancer undergoing multimodality therapy: a randomised controlled trial. Breast. 2009 Feb;18(1):17-25.
Better markers of immune function among women with stage 1 breast cancer participating in relaxation, guided imagery, and biofeedback training compared to no intervention in a small RCT⁹Gruber BL, Hersh SP et al. Immunological responses of breast cancer patients to behavioral interventions. Biofeedback and Self-Regulation. 1993 Mar;18(1):1-22.
Better immune system response among women with stage 0–2 breast cancer treated with relaxation and guided imagery compared to standard care in a small RCT¹⁰Lengacher CA, Bennett MP et al. Immune responses to guided imagery during breast cancer treatment. Biological Research for Nursing. 2008 Jan;9(3):205-14.
Better markers of immune function among people being treated for stage 1 or 2 breast cancer participating in an 8-week hypnotic-guided imagery intervention compared to baseline, but the effects did not continue once the intervention ended in an uncontrolled studya study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design¹¹Bakke AC, Purtzer MZ, Newton P. The effect of hypnotic-guided imagery on psychological well-being and immune function in patients with prior breast cancer. Journal of Psychosomatic Research. 2002 Dec;53(6):1131-7.

Managing side effects and promoting wellness

Is guided imagery linked to fewer or less severe side effects or symptoms? Is it linked to less toxicity from cancer treatment? Does it support your quality of life or promote general well-being? We present the evidence.

Side effects and symptoms as a whole

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of better global symptom scores after completing cancer treatment among people with breast cancer participating in an imagery stress-reduction program

Anxiety

Weak evidence of less anxiety without regard to treatment phase among people with breast cancer treated with guided imagery and other mind-body therapiesapproaches that enhance your mind’s capacity to positively affect your body’s function and symptoms. Some interventions focus on calming your mind, improving focus, enhancing decision-making capacity, managing stress, or resolving conflict. Other interventions have a goal of relaxing both your mind and your body.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less anxiety during chemotherapy among people treated with guided imagery and perhaps other mind-body therapies

Preliminary evidence of less anxiety during radiotherapy among people treated with relaxation and guided imagery

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on anxiety among people with cancer undergoing surgery treated with guided imagery in a preliminary trial

Preliminary evidence of less anxiety among people with terminal cancer receiving interactive guided imagery and progressive muscle relaxation

Preliminary evidence of less anxiety among hospitalized children or their parents receiving guided imagery

Changes in appetite

Preliminary evidence of better appetite during chemotherapy among people with cancer treated with guided imagery

Cognitive difficulties

Preliminary evidence of less cognitive dysfunction after completing cancer treatment among people with breast cancer participating in an imagery-based group intervention

Depression or mood

No evidence of an effect on mood among people with metastatic breast cancer in pain treated with relaxation and visualization training in a preliminary study

Weak evidence of less depression among people with breast cancer treated with guided imagery and other mind-body therapies

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of less depression, better mood, or less negative emotions during chemotherapy among people with cancer treated with guided imagery, often with other mind-body therapies

Modest evidence of less depression during radiotherapy among people treated with guided imagery and relaxation

Preliminary evidence of better mood among men undergoing surgery for prostate cancer treated with guided imagery and other mind-body therapies

Weak evidence of less depression among people with terminal cancer treated with interactive guided imagery and progressive muscle relaxation

Preliminary evidence of less sadness among parents of hospitalized children with cancer participating in progressive muscle relaxation and guided imagery

Without regard to treatment phase

No evidence of an effect on mood among people with metastatic breast cancer in pain treated with relaxation and visualization training in a preliminary study

Weak evidence of less depression among people with breast cancer treated with guided imagery and other mind-body therapies

No evidence of an effect on mood among people with metastatic breast cancer experiencing physical pain treated with relaxation and visualization training, whether with or without cognitive coping skills training, compared to no intervention in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects²⁷Arathuzik D. Effects of cognitive-behavioral strategies on pain in cancer patients. Cancer Nursing. 1994 Jun;17(3):207-14.
Less depression, comparable to combined cognitive-behavioral approaches with group sharing and support, among women with breast cancer participating in meditation, affirmation, imagery and ritual compared to baseline in a mid-sized uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design²⁸Targ EF, Levine EG. The efficacy of a mind-body-spirit group for women with breast cancer: a randomized controlled trial. General Hospital Psychiatry. 2002 Jul-Aug;24(4):238-48.
Less depression among people being treated for stage 1 or 2 breast cancer participating in an 8-week hypnotic-guided imagery intervention compared to baseline, but the effects did not continue once the intervention ended in an uncontrolled study²⁹Bakke AC, Purtzer MZ, Newton P. The effect of hypnotic-guided imagery on psychological well-being and immune function in patients with prior breast cancer. Journal of Psychosomatic Research. 2002 Dec;53(6):1131-7.

During chemotherapy: modest evidence of less depression, better mood, or less negative emotions during chemotherapy among people with cancer treated with guided imagery, often with other mind-body therapies

Less depression during chemotherapy among people treated with guided imagery and progressive muscle relaxation compared to standard care in a mid-sized RCT³⁰Charalambous A, Giannakopoulou M et al. Guided imagery and progressive muscle relaxation as a cluster of symptoms management intervention in patients receiving chemotherapy: a randomized control trial. PLoS One. 2016 Jun 24;11(6):e0156911.
Less depression during chemotherapy among people with cancer treated with guided imagery once a day for a week compared to controls in an RCT³¹Mahdizadeh MJ, Tirgari B, Abadi OSRR, Bahaadinbeigy K. Guided imagery: reducing anxiety, depression, and selected side effects associated with chemotherapy. Clinical Journal of Oncology Nursing. 2019 Oct 1;23(5):E87-E92.
Less depression among non-hospitalized people with cancer who had recently received at least 1 cycle of chemotherapy treated with guided imagery and/or hypnosis compared to standard care in a small RCT³²Feldman CS, Salzberg HC. The role of imagery in the hypnotic treatment of adverse reactions to cancer therapy. Journal of the South Carolina Medical Association. 1990 May;86(5):303-6.
Less depression among people with breast cancer new to chemotherapy participating in progressive muscle relaxation training and guided imagery compared to controls in a small RCT³³Yoo HJ, Ahn SH, Kim SB, Kim WK, Han OS. Efficacy of progressive muscle relaxation training and guided imagery in reducing chemotherapy side effects in patients with breast cancer and in improving their quality of life. Supportive Care in Cancer. 2005 Oct;13(10):826-33.
Better mood scores during 6 cycles of chemotherapy among women with newly diagnosed large or locally advanced breast cancer treated with standard care plus relaxation training and imagery compared to standard care alone in a small RCT³⁴Walker LG, Walker MB et al. Psychological, clinical and pathological effects of relaxation training and guided imagery during primary chemotherapy. British Journal of Cancer. 1999 Apr;80(1-2):262-8.
A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward less negative emotions (negative affect) during chemotherapy among people with cancer treated with relaxation training with guided relaxation imagery compared to standard care in a small RCT³⁵Burish TG, Snyder SL, Jenkins RA. Preparing patients for cancer chemotherapy: effect of coping preparation and relaxation interventions. Journal of Consulting and Clinical Psychology. 1991 Aug;59(4):518-25.

During radiotherapy: modest evidence of less depression during radiotherapy among people treated with guided imagery and relaxation

Lower depression scores after a first session of a 6-week course of radiotherapy among women with stage 1 or 2 breast cancer treated with relaxation training or imagery and relaxation, with tapes and instructions to practice 15 minutes a day, compared to encouragement to talk about themselves, and especially among women aged 55 and over in a mid-sized RCT³⁶Bridge LR, Benson P, Pietroni PC, Priest RG. Relaxation and imagery in the treatment of breast cancer. BMJ. 1988 Nov 5;297(6657):1169-72.
Lower depression scores during radiotherapy among people with breast cancer treated with relaxation and visualization therapy compared to radiotherapy alone in a small RCT³⁷Nunes DF, Rodriguez AL et al. Relaxation and guided imagery program in patients with breast cancer undergoing radiotherapy is not associated with neuroimmunomodulatory effects. Journal of Psychosomatic Research. 2007 Dec;63(6):647-55.
Less depression during hospitalization among people with gynecologic or breast cancer undergoing brachytherapy and treated with relaxation and guided imagery compared to controls in a small RCT³⁸León-Pizarro C, Gich I et al. A randomized trial of the effect of training in relaxation and guided imagery techniques in improving psychological and quality-of-life indices for gynecologic and breast brachytherapy patients. Psycho-oncology. 2007 Nov;16(11):971-9.

With surgery: preliminary evidence of better mood among men undergoing surgery for prostate cancer treated with guided imagery and other mind-body therapies

Better mood scores among men undergoing surgery for prostate cancer participating in a stress-management intervention including discussing concerns about the surgery, diaphragmatic breathing, guided imagery, and adaptive coping skills compared to either 2 sessions of supportive attention or standard care in a mid-sized RCT³⁹Cohen L, Parker PA et al. Presurgical stress management improves postoperative immune function in men with prostate cancer undergoing radical prostatectomy. Psychosomatic Medicine. 2011 Apr;73(3):218-25.

During hospice care: weak evidence of less depression among people with terminal cancer treated with interactive guided imagery and progressive muscle relaxation

Less depression among hospice patients with terminal cancer treated with interactive guided imagery and progressive muscle relaxation compared to baseline, and an apparently larger benefit than with usual care in a mid-sized randomized trial⁴⁰De Paolis G, Naccarato A et al. The effectiveness of progressive muscle relaxation and interactive guided imagery as a pain-reducing intervention in advanced cancer patients: a multicentre randomised controlled non-pharmacological trial. Complementary Therapies in Clinical Practice. 2019 Feb;34:280-287.

Among parents of hospitalized children with cancer: preliminary evidence of less sadness among parents of hospitalized children with cancer participating in progressive muscle relaxation and guided imagery

Less sadness among parents of children hospitalized with a malignancy participating in progressive muscle relaxation and guided imagery compared to no intervention in a small RCT⁴¹Tsitsi T, Charalambous A, Papastavrou E, Raftopoulos V. Effectiveness of a relaxation intervention (progressive muscle relaxation and guided imagery techniques) to reduce anxiety and improve mood of parents of hospitalized children with malignancies: a randomized controlled trial in Republic of Cyprus and Greece. European Journal of Oncology Nursing. 2017 Feb;26:9-18.

Fatigue

Preliminary evidence of less fatigue among people participating in guided imagery and progressive muscle relaxation

No evidence of an effect on fatigue after surgery among elderly people treated with guided imagery in a preliminary study

Preliminary evidence of less fatigue more than 6 weeks after completing treatment among people participating in imagery-based group interventions

During chemotherapy: preliminary evidence of less fatigue among people participating in guided imagery and progressive muscle relaxation

Substantially less fatigue (fatigue decreased with the intervention and increased without it) during chemotherapy among people participating in guided imagery and progressive muscle relaxation compared to no intervention in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁴²Charalambous A, Giannakopoulou M et al. Guided imagery and progressive muscle relaxation as a cluster of symptoms management intervention in patients receiving chemotherapy: a randomized control trial. PLoS One. 2016 Jun 24;11(6):e0156911.

With surgery: no evidence of an effect on fatigue after surgery among elderly people treated with guided imagery in a preliminary study

No evidence of an effect on reported fatigue after conventional resection of colorectal carcinoma among elderly people treated with guided imagery compared to relaxation or controls (no intervention) in a small RCT⁴³Haase O, Schwenk W, Hermann C, Müller JM. Guided imagery and relaxation in conventional colorectal resections: a randomized, controlled, partially blinded trial. Diseases of the Colon and Rectum. 2005 Oct;48(10):1955-63.

After treatment: preliminary evidence of less fatigue more than 6 weeks after completing treatment among people participating in imagery-based group interventions

Less fatigue more than 6 weeks after completing treatment among people with breast cancer participating in 5 weekly 4-hour imagery-based group intervention sessions with a therapist present, or with a therapist streamed via telemedicine, compared to no intervention in a mid-sized RCT⁴⁴Freeman LW, White R et al. A randomized trial comparing live and telemedicine deliveries of an imagery-based behavioral intervention for breast cancer survivors: reducing symptoms and barriers to care. Psycho-oncology. 2015 Aug;24(8):910-8.

Gastrointestinal symptoms, including nausea and vomiting

Modest evidence of less nausea and vomiting during chemotherapy among people treated with guided imagery, often with relaxation

No evidence of an effect of guided imagery on nausea, vomiting, or ileusa painful obstruction of the ileum or other part of the intestine from surgery among people treated with guided imagery in preliminary studies

Preliminary evidence of less nausea after transplantation among people with breast cancer undergoing autologous bone marrow/peripheral blood stem cell transplantation treated with mind-body therapies including guided imagery

During chemotherapy: modest evidence of less nausea and vomiting during chemotherapy among people treated with guided imagery, often with relaxation

Less nausea, vomiting, and retching during chemotherapy among people treated with guided imagery and progressive muscle relaxation compared to no intervention in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁴⁵Charalambous A, Giannakopoulou M et al. Guided imagery and progressive muscle relaxation as a cluster of symptoms management intervention in patients receiving chemotherapy: a randomized control trial. PLoS One. 2016 Jun 24;11(6):e0156911.
Less nausea during chemotherapy among people with cancer treated with guided imagery once a day for a week compared to controls in an RCT⁴⁶Mahdizadeh MJ, Tirgari B, Abadi OSRR, Bahaadinbeigy K. Guided imagery: reducing anxiety, depression, and selected side effects associated with chemotherapy. Clinical Journal of Oncology Nursing. 2019 Oct 1;23(5):E87-E92.
Less anticipatory and chemotherapy-induced nausea and vomiting in the 3 days following each of 6 cycles of chemotherapy among people with breast cancer new to chemotherapy treated with progressive muscle relaxation training and guided imagery compared to controls in a small RCT⁴⁷Yoo HJ, Ahn SH, Kim SB, Kim WK, Han OS. Efficacy of progressive muscle relaxation training and guided imagery in reducing chemotherapy side effects in patients with breast cancer and in improving their quality of life. Supportive Care in Cancer. 2005 Oct;13(10):826-33.
A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward less vomiting during chemotherapy among people with cancer treated with relaxation training with guided relaxation imagery compared to standard care in a small RCT⁴⁸Burish TG, Snyder SL, Jenkins RA. Preparing patients for cancer chemotherapy: effect of coping preparation and relaxation interventions. Journal of Consulting and Clinical Psychology. 1991 Aug;59(4):518-25.
Less nausea, but no evidence of an effect on frequency of vomiting, among people with negative conditioned responses to their chemotherapy treated with progressive muscle relaxation training and guided relaxation imagery instructions immediately before and during their chemotherapy treatments compared to controls in an RCT⁴⁹Burish TG, Lyles JN. Effectiveness of relaxation training in reducing adverse reactions to cancer chemotherapy. Journal of Behavioral Medicine. 1981 Mar;4(1):65-78.
Shorter duration of nausea and vomiting, with weak trends toward lower frequency of nausea and vomiting but no evidence of an effect on intensity, among people with breast cancer new to chemotherapy treated with progressive muscle relaxation training and imaging techniques 1 hour before and for 5 days following chemotherapy sessions compared to controls in a small RCT⁵⁰Molassiotis A, Yung HP, Yam BM, Chan FY, Mok TS. The effectiveness of progressive muscle relaxation training in managing chemotherapy-induced nausea and vomiting in Chinese breast cancer patients: a randomised controlled trial. Supportive Care in Cancer. 2002 Apr;10(3):237-46.
No evidence of an effect on nausea and vomiting during cisplatin treatment among people newly diagnosed with cancer treated with guided imagery compared to standard care in a small RCT⁵¹Troesch LM, Rodehaver CB, Delaney EA, Yanes B. The influence of guided imagery on chemotherapy-related nausea and vomiting. Oncology Nursing Forum. 1993 Sep;20(8):1179-85.

With surgery: no evidence of an effect of guided imagery on nausea, vomiting, or ileus from surgery among people treated with guided imagery in preliminary studies

No evidence of an effect on nausea or vomiting among people undergoing their first elective colorectal surgery treated with guided imagery before and for 6 days after surgery, plus music during surgery and in the recovery room, compared to standard care in an RCT⁵²Tusek DL, Church JM, Strong SA, Grass JA, Fazio VW. Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery. Diseases of the Colon and Rectum. 1997 Feb;40(2):172-8.
No evidence of an effect on duration of ileus after conventional resection of colorectal carcinoma among elderly people treated with guided imagery compared to relaxation or controls in a small RCT⁵³Haase O, Schwenk W, Hermann C, Müller JM. Guided imagery and relaxation in conventional colorectal resections: a randomized, controlled, partially blinded trial. Diseases of the Colon and Rectum. 2005 Oct;48(10):1955-63.

During transplantation: preliminary evidence of less nausea after transplantation among people with breast cancer undergoing autologous bone marrow/peripheral blood stem cell transplantation treated with mind-body therapies including guided imagery

Less nausea, either with or without fatigue, 7 days after autologous bone marrow/peripheral blood stem cell transplantation among people with breast cancer receiving preparatory information, cognitive restructuring, and relaxation with guided imagery compared to controls in a mid-sized RCT⁵⁴Gaston-Johansson F, Fall-Dickson JM et al. The effectiveness of the comprehensive coping strategy program on clinical outcomes in breast cancer autologous bone marrow transplantation. Cancer Nursing. 2000 Aug;23(4):277-85.

Oral symptoms

Preliminary evidence of lower oral mucositisinflammation and ulceration of the mucous membranes lining the digestive tract, usually as an adverse effect of chemotherapy and radiotherapy treatment for cancer pain levels among people undergoing bone marrow transplants treated with relaxation and imagery

Pain

Preliminary evidence of better ability to decrease pain, but no difference in pain intensity, without regard to treatment phase among people participating in relaxation and visualization training

Modest evidence of less pain during chemotherapy among people treated with guided imagery, sometimes with progressive muscle relaxation

Preliminary evidence of less discomfort during hospitalization among people undergoing brachytherapy participating in relaxation and guided imagery

No evidence of an effect on pain from surgery among people with cancer treated with guided imagery, sometimes with other mind-body therapies, in several studies

Preliminary evidence of less pain and related distress, and more perceived control over pain during hospitalization, among people treated with analgesic imagery, and comparable to effects with progressive muscle relaxation

Preliminary evidence of less pain intensity among people with terminal cancer in hospice treated with interactive guided imagery and progressive muscle relaxation

Preliminary evidence of less pain among hospitalized children treated with imagery

Without regard to treatment phase: preliminary evidence of better ability to decrease pain, but no difference in pain intensity, among people participating in relaxation and visualization training

Better ability to decrease pain but no difference in pain intensity among people with metastatic breast cancer who were experiencing physical pain treated with relaxation and visualization training, whether with or without cognitive coping skills training, compared to no intervention in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁵⁶Arathuzik D. Effects of cognitive-behavioral strategies on pain in cancer patients. Cancer Nursing. 1994 Jun;17(3):207-14.

During chemotherapy: modest evidence of less pain during chemotherapy among people treated with guided imagery, sometimes with progressive muscle relaxation

Substantially less pain (pain decreased with the intervention and increased without it) during chemotherapy among people treated with guided imagery and progressive muscle relaxation compared to no intervention in a mid-sized RCT⁵⁷Charalambous A, Giannakopoulou M et al. Guided imagery and progressive muscle relaxation as a cluster of symptoms management intervention in patients receiving chemotherapy: a randomized control trial. PLoS One. 2016 Jun 24;11(6):e0156911.
Less pain during chemotherapy among people treated with guided imagery once a day for a week compared to controls in an RCT⁵⁸Mahdizadeh MJ, Tirgari B, Abadi OSRR, Bahaadinbeigy K. Guided imagery: reducing anxiety, depression, and selected side effects associated with chemotherapy. Clinical Journal of Oncology Nursing. 2019 Oct 1;23(5):E87-E92.

During radiotherapy: preliminary evidence of less discomfort during hospitalization among people undergoing brachytherapy participating in relaxation and guided imagery

Less body discomfort during hospitalization among people with gynecologic or breast cancer undergoing brachytherapy treated with relaxation and guided imagery compared to controls in a small RCT⁵⁹León-Pizarro C, Gich I et al. A randomized trial of the effect of training in relaxation and guided imagery techniques in improving psychological and quality-of-life indices for gynecologic and breast brachytherapy patients. Psycho-oncology. 2007 Nov;16(11):971-9.

With surgery: no evidence of an effect on pain from surgery among people with cancer treated with guided imagery, sometimes with other mind-body therapies, in several studies

No evidence of an effect on pain among people undergoing excisional surgery for basal and squamous cell carcinoma treated with guided imagery compared to relaxing music or controls in a mid-sized RCT⁶⁰Alam M, Roongpisuthipong W et al. Utility of recorded guided imagery and relaxing music in reducing patient pain and anxiety, and surgeon anxiety, during cutaneous surgical procedures: a single-blinded randomized controlled trial. Journal of the American Academy of Dermatology. 2016 Sep;75(3):585-589.
No evidence of an effect on analgesic use or subjective pain intensity at rest or while coughing after conventional resection of colorectal carcinoma among elderly people treated with guided imagery compared to relaxation or controls (no intervention) in a small RCT⁶¹Haase O, Schwenk W, Hermann C, Müller JM. Guided imagery and relaxation in conventional colorectal resections: a randomized, controlled, partially blinded trial. Diseases of the Colon and Rectum. 2005 Oct;48(10):1955-63.
No evidence of an effect on pain scores among women undergoing surgery for breast or gynecologic cancers treated with standard care (analgesic medications) and guided imagery compared to standard care alone in a small RCT⁶²Kwekkeboom KL. 1999. The role of imaging ability in successful use of guided imagery for cancer related pain. PhD, The University of Wisconsin-Madison.

During hospitalization: preliminary evidence of less pain and related distress, and more perceived control over pain during hospitalization, among people treated with analgesic imagery, and comparable to effects with progressive muscle relaxation

Lower pain intensity, less pain-related distress, and more perceived control over pain among hospitalized patients with cancer pain treated with either analgesic imagery or progressive muscle relaxation compared to controls, mostly among people with greater imaging ability, more positive outcome expectancy, and fewer concurrent symptoms, in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial⁶³Kwekkeboom KL, Wanta B, Bumpus M. Individual difference variables and the effects of progressive muscle relaxation and analgesic imagery interventions on cancer pain. Journal of Pain and Symptom Management. 2008 Dec;36(6):604-15.

During hospice care: preliminary evidence of less pain intensity among people with terminal cancer in hospice treated with interactive guided imagery and progressive muscle relaxation

Less pain intensity among hospice patients with terminal cancer treated with interactive guided imagery and progressive muscle relaxation compared to baseline, and an apparently larger benefit than with usual care in a mid-sized randomized trial⁶⁴De Paolis G, Naccarato A et al. The effectiveness of progressive muscle relaxation and interactive guided imagery as a pain-reducing intervention in advanced cancer patients: a multicentre randomised controlled non-pharmacological trial. Complementary Therapies in Clinical Practice. 2019 Feb;34:280-287.

Among children: weak evidence of less pain among hospitalized children with cancer treated with imagery

Less neuropathic pain among children with cancer with graded motor imagery and neural mobilization compared to baseline in a small uncontrolled study⁶⁵Casanova-García C, Lerma Lara S, Pérez Ruiz M, Ruano Domínguez D, Santana Sosa E. Non-pharmacological treatment for neuropathic pain in children with cancer. Medical Hypotheses. 2015 Dec;85(6):791-7.

Quality of life and function

Preliminary evidence of better quality of life and indicators of satisfaction without regard to treatment phase among people treated with meditation, affirmation, imagery, and ritual

Modest evidence of better quality of life and related measures during chemotherapy among people treated with guided imagery, sometimes with other mind-body therapies

Preliminary evidence of more comfort during radiation therapy among women with early stage breast cancer treated with guided imagery

Preliminary evidence of better quality of life during cancer treatment after mastectomy among women participating in mind-body therapies including mental images

Modest evidence of better quality of life and function after completing cancer treatment among people treated with guided imagery, sometimes with other mind-body therapies

Without regard to treatment phase: preliminary evidence of better quality of life and indicators of satisfaction among people treated with meditation, affirmation, imagery, and ritual

Better quality of life and spiritual integration, plus higher satisfaction and fewer dropouts among women with breast cancer treated with meditation, affirmation, imagery and ritual compared to combined cognitive-behavioral approaches with group sharing and support in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁶⁶Targ EF, Levine EG. The efficacy of a mind-body-spirit group for women with breast cancer: a randomized controlled trial. General Hospital Psychiatry. 2002 Jul-Aug;24(4):238-48.

During chemotherapy: modest evidence of better quality of life and related measures during chemotherapy among people treated with guided imagery, sometimes with other mind-body therapies

Substantially better health-related quality of life (quality increased with the intervention and decreased without it) during chemotherapy among people treated with guided imagery and progressive muscle relaxation compared to no intervention in a mid-sized RCT⁶⁷Charalambous A, Giannakopoulou M et al. Guided imagery and progressive muscle relaxation as a cluster of symptoms management intervention in patients receiving chemotherapy: a randomized control trial. PLoS One. 2016 Jun 24;11(6):e0156911.
Better quality of life, health, functioning, and psychological/spiritual well-being among people with stage 2–4 breast cancer scheduled to receive high-dose chemotherapy and autologous hematopoietic stem cell transplantation and treated with a comprehensive coping strategy program of educational information, cognitive restructuring, coping skills enhancement, and relaxation with guided imagery compared to no program in a mid-sized RCT⁶⁸Gaston-Johansson F, Fall-Dickson JM et al. Long-term effect of the self-management comprehensive coping strategy program on quality of life in patients with breast cancer treated with high-dose chemotherapy. Psycho-oncology. 2013 Mar;22(3):530-9.
More positive experience with cisplatin chemotherapy among people newly diagnosed with cancer treated with guided imagery compared to standard care in a small RCT⁶⁹Troesch LM, Rodehaver CB, Delaney EA, Yanes B. The influence of guided imagery on chemotherapy-related nausea and vomiting. Oncology Nursing Forum. 1993 Sep;20(8):1179-85.

During radiotherapy: preliminary evidence of more comfort during radiation therapy among women with early stage breast cancer treated with guided imagery

Higher reported comfort during radiation therapy among women with early stage breast cancer treated with guided imagery compared to controls in a small RCT⁷⁰Kolcaba K, Fox C. The effects of guided imagery on comfort of women with early stage breast cancer undergoing radiation therapy. Oncology Nursing Forum. 1999 Jan-Feb;26(1):67-72.

During treatment after mastectomy: preliminary evidence of better quality of life during treatment after mastectomy among women treated with mind-body therapies including mental images

Better perceived quality of life during cancer treatment after mastectomy among women treated with relaxation, mental images, and spirituality added to brief psychotherapy (average of 6 sessions) compared to brief psychotherapy alone in a small RCT⁷¹Elias AC, Ricci MD et al. The biopsychosocial spiritual model applied to the treatment of women with breast cancer, through RIME intervention (relaxation, mental images, spirituality). Complementary Therapies in Clinical Practice. 2015 Feb;21(1):1-6.

After treatment: modest evidence of better quality of life and function after completing treatment among people treated with guided imagery, sometimes with other mind-body therapies

Better health-related quality of life more than 6 weeks after completing cancer treatment among people with breast cancer treated with 5 weekly 4-hour imagery-based group intervention sessions with therapist present, or with a therapist streamed via telemedicine, compared to no intervention in a mid-sized RCT⁷²Freeman LW, White R et al. A randomized trial comparing live and telemedicine deliveries of an imagery-based behavioral intervention for breast cancer survivors: reducing symptoms and barriers to care. Psycho-oncology. 2015 Aug;24(8):910-8.
A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward increased vigor and improved functional and social quality of life after completing cancer treatment for primary breast cancer, excluding stage 4, among women treated with imagery compared to standard care in a small RCT⁷³Richardson MA, Post-White J et al. Coping, life attitudes, and immune responses to imagery and group support after breast cancer treatment. Alternative Therapies in Health and Medicine. 1997 Sep;3(5):62-70.
Better quality of life 6 months after chemotherapy among people with breast cancer new to chemotherapy participating in progressive muscle relaxation training and guided imagery compared to controls in a small RCT⁷⁴Yoo HJ, Ahn SH, Kim SB, Kim WK, Han OS. Efficacy of progressive muscle relaxation training and guided imagery in reducing chemotherapy side effects in patients with breast cancer and in improving their quality of life. Supportive Care in Cancer. 2005 Oct;13(10):826-33.
Better quality of life after recent chemotherapy among non-hospitalized people with cancer treated with guided imagery and/or hypnosis compared to standard care in a small RCT⁷⁵Feldman CS, Salzberg HC. The role of imagery in the hypnotic treatment of adverse reactions to cancer therapy. Journal of the South Carolina Medical Association. 1990 May;86(5):303-6.
Better quality of life related to physical, social/family, emotional, and function well-being, plus breast cancer and spiritual subscales, 6 weeks to 1 year after completing treatment among people with breast cancer participating in an 8-week imagery stress reduction program compared to baseline in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design⁷⁶Freeman L, Cohen L et al. Imagery intervention for recovering breast cancer patients: clinical trial of safety and efficacy. Journal of the Society for Integrative Oncology. 2008 Spring;6(2):67-75.

Sleep disruption

Preliminary evidence of less sleep disturbance among people with cancer treated with imagery, sometimes with other mind-body therapies

Stress, tension, or distress

Preliminary evidence of less distressemotional, social, spiritual, or physical pain or suffering that may cause a person to feel sad, afraid, depressed, anxious, or lonely; people in distress may also feel that they are not able to manage or cope with changes caused by normal life activities or by having a disease, such as cancer among people recently diagnosed participating in progressive muscle relaxation with guided imagery

No evidence of an effect on distress among people with cancer and with pain participating in relaxation and visualization training in a preliminary study

Modest evidence of less stress or tension during radiotherapy among people treated with relaxation training and imagery

Preliminary evidence of better levels of stress hormones after surgery among people treated with guided imagery and relaxation

Preliminary evidence of less stress after cancer treatment among people treated with imagery

Preliminary evidence of less tension among parents of hospitalized children with cancer participating in progressive muscle relaxation and guided imagery

Recently diagnosed: preliminary evidence of less distress among people recently diagnosed participating in progressive muscle relaxation with guided imagery

Moderately less psychological distress among people recently diagnosed with localized cancer treated with progressive muscle relaxation with guided imagery compared to controls in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁷⁸Baider L, Peretz T, Hadani PE, Koch U. Psychological intervention in cancer patients: a randomized study. General Hospital Psychiatry. 2001 Sep-Oct;23(5):272-7.

Without regard to treatment phase: no evidence of an effect on distress among people with cancer and with pain participating in relaxation and visualization training in a preliminary study

No evidence of an effect on distress among people with metastatic breast cancer who were experiencing physical pain treated with relaxation and visualization training, whether with or without cognitive coping skills training compared to no intervention in a small RCT⁷⁹Arathuzik D. Effects of cognitive-behavioral strategies on pain in cancer patients. Cancer Nursing. 1994 Jun;17(3):207-14.

During radiotherapy: modest evidence of less stress or tension during radiotherapy among people treated with relaxation training and imagery

Lower tension scores after a first session of a 6-week course of radiotherapy among women with stage 1 or 2 breast cancer treated with relaxation training or imagery and relaxation, with tapes and instructions to practice 15 minutes a day, compared to encouragement to talk about themselves, and especially among women aged 55 and over, in a mid-sized RCT⁸⁰Bridge LR, Benson P, Pietroni PC, Priest RG. Relaxation and imagery in the treatment of breast cancer. BMJ. 1988 Nov 5;297(6657):1169-72.
Lower stress scores but no changes in stress hormones during radiotherapy among people with breast cancer treated with relaxation and visualization therapy compared to radiotherapy alone in a small RCT⁸¹Nunes DF, Rodriguez AL et al. Relaxation and guided imagery program in patients with breast cancer undergoing radiotherapy is not associated with neuroimmunomodulatory effects. Journal of Psychosomatic Research. 2007 Dec;63(6):647-55.

With surgery: preliminary evidence of better levels of stress hormones after surgery among people treated with guided imagery and relaxation

Lower cortisol levels 1 day following surgery among people undergoing cholecystectomy participating in relaxation with guided imagery compared to controls given a quiet period in a small RCT⁸²Holden-Lund C. Effects of relaxation with guided imagery on surgical stress and wound healing. Research in Nursing & Health. 1988 Aug;11(4):235-44.

After treatment: preliminary evidence of less stress after cancer treatment among people treated with imagery

Better coping skills (seeking support) and perceived social support and a weak trend toward better overall coping and death acceptance and less stress after treatment for primary breast cancer, excluding stage 4, among women treated with imagery compared to standard care in a small RCT⁸³Richardson MA, Post-White J et al. Coping, life attitudes, and immune responses to imagery and group support after breast cancer treatment. Alternative Therapies in Health and Medicine. 1997 Sep;3(5):62-70.
Less stress 6 weeks to 1 year after completing treatment among people with breast cancer participating with an 8-week imagery stress-reduction program compared to baseline in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design⁸⁴Freeman L, Cohen L et al. Imagery intervention for recovering breast cancer patients: clinical trial of safety and efficacy. Journal of the Society for Integrative Oncology. 2008 Spring;6(2):67-75.

During hospice care: preliminary evidence of less distress among people with terminal cancer in hospice treated with interactive guided imagery and progressive muscle relaxation

Less distress among hospice patients with terminal cancer treated with interactive guided imagery and progressive muscle relaxation compared to baseline, and an apparently larger benefit than with usual care in a mid-sized randomized trial⁸⁵De Paolis G, Naccarato A et al. The effectiveness of progressive muscle relaxation and interactive guided imagery as a pain-reducing intervention in advanced cancer patients: a multicentre randomised controlled non-pharmacological trial. Complementary Therapies in Clinical Practice. 2019 Feb;34:280-287.

Among parents of hospitalized children with cancer: preliminary evidence of less tension among parents participating in progressive muscle relaxation and guided imagery

Less tension among parents of children hospitalized with a malignancy treated with progressive muscle relaxation and guided imagery compared to no intervention in a small RCT⁸⁶Tsitsi T, Charalambous A, Papastavrou E, Raftopoulos V. Effectiveness of a relaxation intervention (progressive muscle relaxation and guided imagery techniques) to reduce anxiety and improve mood of parents of hospitalized children with malignancies: a randomized controlled trial in Republic of Cyprus and Greece. European Journal of Oncology Nursing. 2017 Feb;26:9-18.

Among caregivers: weak evidence of less distress among caregivers participating in a guided imagery intervention

Less psychological distress among caregivers of people with lung cancer participating in guided imagery in a telephone symptom management intervention compared to baseline in a mid-sized uncontrolled trial⁸⁷Winger JG, Rand KL et al. Coping skills practice and symptom change: a secondary analysis of a pilot telephone symptom management intervention for lung cancer patients and their family caregivers. Journal of Pain and Symptom Management. 2018 May;55(5):1341-1349.e4.

Other side effects and symptoms

No evidence of an effect on lung (pulmonary) function after surgery among elderly people treated with guided imagery in a small study

Guided therapy in combination with complementary therapies beyond mind-body therapies

Preliminary evidence of less anxiety, fatigue, and pain among women with breast cancer undergoing initial surgery receiving a self-care toolkit of audio-files of guided mind-body techniques (breathing, progressive muscle relaxation, meditation, guided imagery, and self-hypnosis) and acupressure antinausea wristbands

Symptoms and side effects not specific to cancer

Modest evidence of less anxiety at the time of surgery among people treated with guided imagery

Modest evidence of less pain related to surgery among people treated with guided imagery, sometimes with music

Preliminary evidence of better quality of sleep scores at the time of surgery among people treated with a guided imagery tape with music and relaxing text

Preliminary evidence of shorter time to first bowel movement after colorectal surgery, but no evidence of an effect on complications or itching (pruritus) among people treated with guided imagery and music

Preliminary evidence of less surgical wound redness among people participating in relaxation with guided imagery

Lower anxiety levels among people undergoing elective colorectal surgical procedures using guided imagery tapes from 3 days before until 6 days after the procedures compared to routine care in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁹⁰Tusek D, Church JM, Fazio VW. Guided imagery as a coping strategy for perioperative patients. AORN Journal. 1997 Oct;66(4):644-9.
Less anxiety among people undergoing their first elective colorectal surgery treated with guided imagery before and for 6 days after surgery, and music during surgery and in the recovery room compared to standard care in an RCT⁹¹Tusek DL, Church JM, Strong SA, Grass JA, Fazio VW. Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery. Diseases of the Colon and Rectum. 1997 Feb;40(2):172-8.
Lower anxiety at the time of listening to imagery tapes, but not about 24 hours after discharge among children undergoing ambulatory tonsillectomy and/or adenoidectomy with taped guided imagery before and after surgery compared to standard care in a small RCT⁹²Huth MM, Broome ME, Good M. Imagery reduces children’s post-operative pain. Pain. 2004 Jul;110(1-2):439-48.
Less state anxiety among people undergoing cholecystectomy treated with relaxation with guided imagery compared to controls given a quiet period in a small RCT⁹³Holden-Lund C. Effects of relaxation with guided imagery on surgical stress and wound healing. Research in Nursing & Health. 1988 Aug;11(4):235-44.
Less pain and substantially less use of narcotics among people undergoing elective colorectal surgical procedures treated with guided imagery tapes from 3 days before until 6 days after the procedures compared to routine care in a mid-sized RCT⁹⁴Tusek D, Church JM, Fazio VW. Guided imagery as a coping strategy for perioperative patients. AORN Journal. 1997 Oct;66(4):644-9.
Less pain and distress about pain and fewer requests for analgesia after abdominal surgery among people treated with guided imagery compared to controls who received background information about the hospital in a small RCT⁹⁵Manyande A, Berg S et al. Preoperative rehearsal of active coping imagery influences subjective and hormonal responses to abdominal surgery. Psychosomatic Medicine. 1995 Mar-Apr;57(2):177-82.
Less pain and less painful first urination among people undergoing surgery for anorectal diseases treated with a guided imagery tape with music and relaxing text before, during, and after surgery compared to standard care in a small RCT⁹⁶Renzi C, Peticca L, Pescatori M. The use of relaxation techniques in the perioperative management of proctological patients: preliminary results. International Journal of Colorectal Disease. 2000 Nov;15(5-6):313-6.
Less pain at discharge from the post anesthesia care unit to home among people undergoing gynecologic laparoscopic surgery using guided imagery audiotapes compared to standard care in a small RCT⁹⁷Laurion S, Fetzer SJ. The effect of two nursing interventions on the postoperative outcomes of gynecologic laparoscopic patients. Journal of Perianesthesia Nursing. 2003 Aug;18(4):254-61.
Less pain and use of opioids among people undergoing their first elective colorectal surgery treated with guided imagery before and for 6 days after surgery, plus music during surgery and in the recovery room, compared to standard care in an RCT⁹⁸Tusek DL, Church JM, Strong SA, Grass JA, Fazio VW. Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery. Diseases of the Colon and Rectum. 1997 Feb;40(2):172-8.
Substantially less use of sedative and analgesic drugs among people undergoing interventional procedures treated with anodyne imagery compared to no imagery in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial⁹⁹Lang EV, Hamilton D. Anodyne imagery: an alternative to IV sedation in interventional radiology. AJR American Journal of Roentgenology. 1994 May;162(5):1221-6.
Lower pain at the time of listening to imagery tapes, but not about 24 hours after discharge, and no evidence of an effect on combined opioid and non-opioid use among children undergoing ambulatory tonsillectomy and/or adenoidectomy with taped guided imagery before and after surgery compared to standard care in a small RCT¹⁰⁰Huth MM, Broome ME, Good M. Imagery reduces children’s post-operative pain. Pain. 2004 Jul;110(1-2):439-48.
Better quality of sleep scores among people undergoing surgery for anorectal diseases treated with a guided imagery tape with music and relaxing text before, during, and after surgery compared to standard care in a small RCT¹⁰¹Renzi C, Peticca L, Pescatori M. The use of relaxation techniques in the perioperative management of proctological patients: preliminary results. International Journal of Colorectal Disease. 2000 Nov;15(5-6):313-6.
Shorter time to first bowel movement, but no evidence of an effect on complications or itching among people undergoing their first elective colorectal surgery treated with guided imagery before and for 6 days after surgery, plus music during surgery and in the recovery room compared to standard care in an RCT¹⁰²Tusek DL, Church JM, Strong SA, Grass JA, Fazio VW. Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery. Diseases of the Colon and Rectum. 1997 Feb;40(2):172-8.
Less surgical wound redness (erythema) among people undergoing gallbladder surgery (cholecystectomy) participating in relaxation with guided imagery compared to controls given a quiet period in a small RCT¹⁰³Holden-Lund C. Effects of relaxation with guided imagery on surgical stress and wound healing. Research in Nursing & Health. 1988 Aug;11(4):235-44.

Keep reading about guided imagery

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Authors

Nancy Hepp, MS

Lead Researcher and Program Manager

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Martin L. Rossman, MD

Co-founder of the Academy for Guided Imagery, physician, acupuncturist, and author

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Reviewer

Laura Pole, RN, MSN, OCNS

Senior Clinical Consultant

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Last update: October 7, 2022

Last full literature review: October 2021

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

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References[+]

References
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