Challenges in Assessing and Treating Patients with Body Dysmorphic Disorder and Recommended Approaches

Clinicians commonly encounter multiple challenges when assessing and treating individuals with body dysmorphic disorder (BDD). Some of the major challenges include poor insight and low motivation for appropriate treatment, delay in seeking treatment, desire for usually ineffective cosmetic treatment (e.g., surgery or dermatologic treatment) instead of mental health treatment, co-occurring substance use disorders, and frequent and sometimes severe suicidality. This chapter discusses recommended approaches to these challenges that clinicians can implement when assessing and treating patients with BDD. Strategies for engaging patients in cognitive-behavioral treatment and pharmacotherapy, and for disengaging patients from cosmetic treatment, are reviewed. Suggestions for treating patients with comorbid substance use disorders and suicidal patients are offered.