Online Course for Clinicians

Working with Nightmares: What Clinicians Need to Know

Nightmares are among the most treatable conditions in mental health, yet they remain among the most overlooked. This course changes that.

6 Hours • 5 APA Continuing Education Credits • Self-Paced

Enroll Now

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The Case:

A Health Issue Hiding in Plain Sight

Most clinicians know that nightmares accompany post-traumatic stress. Fewer realize that frequent nightmares are independently linked to cardiovascular disease, premature death, and a fourfold increase in suicide risk. A recent study of more than 183,000 adults found that weekly nightmares are a stronger predictor of dying before age 70 than smoking, obesity, or a sedentary lifestyle. These findings make understanding nightmares a clinical imperative, particularly for those who work with trauma.

What strikes me most, after twenty-five years of working with dreams clinically, is how treatable nightmares are once you know what to do. Multiple empirically supported approaches exist, and emerging research suggests that nearly every structured nightmare intervention helps to some measurable degree. Imagery rehearsal therapy, the leading approach, has a strong evidence base from several randomized controlled trials. The techniques are gentler than most clinicians expect, and the changes, both in the dreams themselves and in daytime wellbeing, tend to be lasting. Yet the vast majority of therapists have never been trained to address nightmares directly. This course is my attempt to close that gap.

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The Statistics

4x

increased suicide risk with frequent nightmares.

3x

greater risk of premature death.

5%

of the population meets criteria for nightmare disorder.

<30%

of nightmare sufferers report them to a clinician.

Why This Training Matters

Nightmares are often overlooked in clinical practice, even though research links frequent nightmares with post-traumatic stress, suicide risk, and physical health concerns. This course helps clinicians understand when nightmares warrant focused attention and how to respond with evidence-informed, practical treatment approaches.

What This Course Covers

This course moves from the science of dreaming through diagnostic assessment and health implications to practical treatment, with experiential exercises and clinical examples woven throughout. The goal is not just knowledge but clinical fluency: understanding when nightmares warrant intervention, what the current evidence supports, and how to do the work with your own clients.

  • Module 1. The Nature and Function of Dreams

    • Dreaming as an active mental state involving emotion, memory, bodily state, and current concerns. The role of dreaming in emotional regulation and integration.

  • Module 2. Dreams and Nightmares: Core Processes

    • Emotion as the primary driver of dream formation. How disruptions in normal dreaming processes lead to nightmares.

  • Module 3. Experiential Practice: Finding and Embodying Help

    • An introduction to experiential resourcing practices that establish safety, grounding, and regulation before working with distressing dream material.

  • Module 4. Emotion, Meaning, and Agency in Dreams

    • Working from a non interpretive stance. Restoring agency within dreams as a pathway to emotional regulation and therapeutic change.

  • Module 5. Nightmares: Definition, Types, and Intensity

    • Distinguishing bad dreams from nightmares. Trauma related, idiopathic, and complex nightmares. The dream intensity continuum.

  • Module 6. Diagnosing Nightmare Disorder and Differential Assessment

    • Applying DSM 5 TR criteria. Differentiating Nightmare Disorder from parasomnias and other sleep related conditions.

  • Module 7. Nightmares, the Nervous System, and Physical Health

    • Nightmares as expressions of autonomic dysregulation. Associations with cardiovascular health and broader physiological risk.

  • Module 8. Nightmares and Suicide Risk

    • Nightmares as expressions of autonomic dysregulation. Associations with cardiovascular health and broader physiological risk.

  • Module 9. Clinical Approaches to Nightmare Treatment

    • Evidence informed approaches including Imagery Rehearsal Therapy, Exposure Relaxation and Rescripting Therapy, CBT for Nightmares, and the Nightmare Relief framework.

  • Module 10. Case Examples and Clinical Application

    • Illustrative cases demonstrating assessment, pacing, and treatment integration.

Learning Objectives

Upon completion of this course, participants will be able to:

  1. Explain how emotion drives dream formation and content selection.

  2. Distinguish between normal dreaming processes and disruptions that lead to nightmares.

  3. Identify the role of safety, grounding, and embodiment when working with emotionally charged dream content.

  4. Explain how restoring agency within dreams supports emotional regulation and therapeutic change.

  5. Identify major nightmare types and describe the dream intensity continuum.

  6. Apply DSM-5-TR criteria to determine when nightmares meet diagnostic threshold for Nightmare Disorder.

  7. Differentiate Nightmare Disorder from other parasomnias and sleep-related conditions.

  8. Identify physical health risks associated with frequent nightmares.

  9. Describe the relationship between nightmare frequency, content, and suicide risk.

  10. Identify clinical indicators that warrant increased assessment and monitoring.

  11. Describe the core components of the Nightmare Relief treatment framework.

Your Instructor

Dr. Leslie Ellis is the author of A Clinician's Guide to Dream Therapy (Routledge, 2025), and has spent twenty-five years in clinical practice specializing in dreamwork and somatic psychology. She has published reviews on the nightmare-suicide link and on nightmare causes and treatment in Dreaming, Person-Centered & Experiential Psychotherapies, and the Journal of Projective Psychology and Mental Health.

Leslie's approach bridges experiential depth with clinical rigor, drawing on Gendlin's focusing-oriented therapy, Jungian and Gestalt traditions, and current research and developments in the field of dreams and nightmares. She has extensively studied our best current understanding of nightmares and their treatment, and has developed an integrative treatment protocol that incorporates evidence-based, experiential, and trauma-informed ways to help those who suffer from nightmares. This is the knowledge base that will be shared with you in this course.

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FAQs

  • Who is this course for?

    • Licensed clinicians, registered counselors, psychologists, social workers, and other mental health professionals who want to understand nightmares as a clinical issue and learn practical, evidence-informed treatment approaches. No prior training in dreamwork is required.

  • How does the continuing education credit work?

    • This course is eligible for 5 CE credits. You will complete the self-paced video modules and a brief assessment to receive your certificate.

    • Information on Continuing Education Credit for Health Professionals

    • CE credits for psychologists are provided by the Spiritual Competency Academy (SCA) which is co-sponsoring this program. The Spiritual Competency Academy is approved by the American Psychological Association to sponsor continuing education for psychologists. Spiritual Competency Academy maintains responsibility for this program and its content.

    • The California Board of Behavioral Sciences accepts CE credits for LCSW, LPCC, LEP, and LMFT license renewal for programs offered by approved sponsors of CE by the American Psychological Association.

    • LCSW, LPCC, LEP, and LMFTs, and other mental health professionals from states other than California need to check with their state licensing board as to whether or not they accept programs offered by approved sponsors of CE by the American Psychological Association.

    • SCA is approved by the California Board of Registered Nursing (BRN Provider CEP16887) for licensed nurses in California. RNs must retain their certificate of attendance for 4 years after the course concludes.

    • For questions about receiving your Certificate of Attendance, contact Dr. Leslie Ellis at leslie@drleslieellis.com

    • For questions about CE, contact Spiritual Competency at info@spiritualcompetencyacademy.com.

  • What if I have no experience with dreamwork?

    • This course assumes clinical experience but not dream expertise. The material is designed to bring you from the fundamentals of dream science through to a working treatment protocol, with guided practice along the way. Many participants find this is the permission and framework they needed to begin integrating dreams into their clinical work.

  • How long do I have access?

    • Once enrolled, you have lifetime access to all course materials, including any future updates to the content.

  • Do I need to work with the nightmares of trauma survivors?

    • The course covers the full spectrum, from idiopathic nightmares with no known origin to trauma-related and replicative nightmares. You will learn to assess and calibrate your approach to the clinical situation. The treatment techniques are gentle and emphasize safety and resourcing before any exposure to dream material.

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“I’ve always been a really frequent dreamer, and would have vivid, epic dreams. But when I started getting the nightmares, I was scared to go to sleep. Now that we have addressed the nightmares, my curious attitude toward dreams has come back. I enjoy them like I used to.

I had no idea such techniques existed. Now I feel like I have some control over my dream life instead of the dreams controlling me.”

Nightmare Client

“I tried your re-scripting method with one of my PTSD clients who has intrusive nightmares that keep her in a hyper-aroused state for several hours. This technique worked so well that she was able to calm down within 20 minutes. She was so pleased that she asked me to thank you.”

Registered Psychologist

Victoria, BC

“I had never known how to treat nightmares… from what I learned in this course, I now feel very empowered."

Brian Whitley

LMFT

“After I followed the steps with my recurring nightmare, it just went away. I never had it again. I appreciate that the process is gentle and feels safe enough to explore even my scariest dreams.”

Course Participant

5 APA-level continuing education credits for licensed mental health professionals.

CE credits are awarded upon completion of all course modules and the post course assessment.