DreamEZ: A Professional Review

Product Description

DreamEZ is intended for service members, veterans, and others who have experienced trauma and are suffering from PTSD-related nightmares.  The app can serve as a dream diary for storing dreams, and nightmares, in particular, and guides users through several levels of dream re-scripting training.  Users are provided with multiple examples of how to rescript negative dreams or nightmares using audio demonstrations that include visualizations of negative dream-like sequences and more positive rescripting of the same sequences.  The app has a range of features and tools to help with falling & staying asleep. There is a truly outstanding breathing exercise, in addition to an audio-based progressive muscle relaxation exercise. There are capabilities for tracking and charting dreams; the app provides a nice journaling feature for recording dreams and the impact of dreams on mood and sleep.  Users can then create nice graphs or charts of the impact of specific dreams on functioning over time. There are four levels of training for recording and playing back dreams and re-scripting of dreams. Users can see their progress and history; the app provides the user with a complete history or summary of their activities within the app. In terms of customizable settings, the app allows users to set personalized reminders, change their security PIN, or send feedback to the development team.  

Recommendations for Use

This app should be used in conjunction with a clinical provider experienced in Image Rehearsal Therapy (IRT). It could also be used by those who have completed treatment, who wish to continue to log dreams and to re-script nightmares. The app is designed to be used for a number of use cases, including logging or monitoring dreams (e.g., in the middle of the night), rehearsing non-threatening ways to end unpleasant dreams or nightmares, calming down/relaxing prior to sleep or upon awakening in the middle of the night, etc. Although general consumers should not expect to get the most out of Dream EZ without the assistance of a provider, there are many useful features that anyone can make use of, particularly: dream logs, relaxation exercises, deep breathing exercises, and practice of “rescripting” (i.e., replacing or changing unpleasant dream experiences with more pleasant experiences) unpleasant dreams or nightmares. There is a detailed user guide that explains the basis of IRT and how to use the app to implement core features of IRT on a mobile device.

Clinicians will need to be trained in IRT to make the best use of this app. They should also familiarize themselves with the intricacies of using the app before introducing the app to patients.  The Defense Health Agency provides extensive outreach to providers working with active duty service members and veterans and offers training in the use of Dream EZ and other DoD/VA mobile apps. The ideal use case for this app is in the context of clinical treatment of nightmares, particularly in those with PTSD.  Providers who are attempting to reduce the frequency or intensity of nightmares can use the app to reinforce important IRT-related concepts introduced in therapy, to train patients to understand and use dream re-scripting, to encourage dream tracking and monitoring, and to provide useful, on-time tools for promoting relaxation and sleep.   

Content

Dream EZ is squarely based on Imagery Rehearsal Therapy for nightmares in PTSD, which is an evidence-based treatment with considerable support as a provider-delivered, in-person treatment (Casement & Swanson, 2012) and as a stand-alone technology-based intervention (Gieselmann et al., 2017).  Dream EZ provides extremely high-quality, evidence-based information in a visually-pleasing package. The app has a simple, but graphically-rich user interface and is fun to use. Dream EZ provides a great deal of psychoeducational content about how to make the most of the app, nightmares, and Imagery Rehearsal Therapy. The app provides a complete set of tools for those who are or have received Imagery Rehearsal Therapy.  Dream EZ provides clear instruction and has a very easy-to-use interface.

Ease of Use and User Experience

The app is extremely easy to navigate and has a very clean user interface, and is well-designed for a diverse audience.  If you aren’t engaged with Imagery Rehearsal Therapy, or haven’t been in the past, this app is probably not for you; it won’t give you much help for when and how to use all of the exercises.  The app is meant to be used with a clinical provider. For users that have received IRT, this app provides a very simple, elegant interface for recording, tracking, and rescripting nightmares.  

Visual Design and User Interface

Dream EZ is very graphically appealing & the design of the home screen and welcome sequence in particular are excellent.  The app is well-organized with an intuitive user interface, derived from the developer’s experience with dozens of other mental health-focused apps created for service members.

Overall Impression

Dream EZ provides a lot of features in a free, easy-to-use package, including tools for managing anxiety and distress, rich ways of journaling and tracking dreams, exercises for rescripting nightmares, tons of great information about nightmares and IRT, and reminders.  The app is pleasant and enjoyable to use, and it offers excellent security and privacy. The app is designed to assist both patients and providers with getting the most out of Image Rehearsal Therapy and it accomplishes that goal. If you’re using Image Rehearsal Therapy for your own nightmares, this app will help you make the most out of that treatment.