Cognitive-Behavioral Therapy for Body Dysmorphic Disorder

2017 ◽  
Author(s):  
Jessica Rasmussen ◽  
Angelina F. Gómez ◽  
Sabine Wilhelm
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Body Dysmorphic Disorder ◽  
Behavioral Therapy ◽  
Therapeutic Process ◽  
Cognitive Strategies ◽  
Psychosocial Treatment ◽  
Cognitive Behavioral ◽  
Core Beliefs ◽  
Theoretical Understanding ◽  
Associated Symptoms

Cognitive-behavioral therapy (CBT) that is tailored to the unique clinical features of body dysmorphic disorder (BDD) is currently the psychosocial treatment of choice for BDD. Researchers have made great strides in understanding the cognitive-behavioral processes that contribute to the development and maintenance of BDD. CBT for BDD is based on this theoretical understanding and has been shown to be highly effective in reducing BDD symptom severity and associated symptoms. The key components of CBT include identifying and rationally disputing maladaptive appearance-related thoughts, and exposure with response prevention for feared and avoided situations. CBT for BDD also integrates educating the patient on the mental and behavioral processes involved in the BDD experience with mindfulness/perceptual retraining (e.g., techniques aimed at helping patients to view their appearance with a neutral, global, and aware perspective) to augment the therapeutic process. Advanced cognitive strategies are used to address negative core beliefs. Because BDD is typically characterized by poor or absent insight, motivational interviewing is often needed to overcome ambivalence towards treatment.

Beyond basic communication: The role of the mother tongue in cognitive-behavioral therapy (CBT)

2020 ◽  
Vol 24 (4) ◽  
pp. 881-892
Author(s):  
Michal Tannenbaum ◽  
Eden Har
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Minority Groups ◽  
Mother Tongue ◽  
Behavioral Therapy ◽  
Therapeutic Process ◽  
Point Of View ◽  
Cognitive Behavioral ◽  
Theoretical Understanding ◽  
Complex Process ◽  
Understanding Emotions

Immigration is a crisis-prone, complex process, often involving the need to acquire a new language, frequently at the expense of the mother tongue. Thus, the phenomenon of immigrants requiring various forms of mental health assistance while having limited fluency in the therapist’s language is widespread. Cognitive behavioral therapy (CBT) has become a widely prevalent therapeutic approach in many countries, including countries absorbing immigrants. This article reviews case studies that relate to the use of CBT with immigrants, both in individual and group sessions, focusing on the position of the patient’s mother tongue in the process. Research has persistently shown that the mother tongue is emotionally significant—using it, being exposed to it, expressing emotions and understanding emotions expressed in it, having access to it and to memories encoded in it, and the like. Given these dimensions, it plays a potentially important role in the therapeutic process. The pivotal question, then, is whether a therapeutic process that is essentially emotional can be effective if the mother tongue is not an inherent part of it. This article addresses this issue while examining the mother tongue’s position in CBT, the therapists’ awareness of these issues, the accommodations, if any, made in this regard, the therapists’ point of view, and suggestions for improving the use of CBT with immigrants. It is written to be of relevance to a diverse audience including researchers from varied disciplinary backgrounds, therapists who work with multilingual patients (especially immigrants or members of other minority groups) or are multilingual themselves. Our aims, therefore, are to contribute to the theoretical understanding of the mother tongue’s centrality in emotional processes and to offer some practical recommendations for therapists and training institutions.

Mechanisms of cognitive-behavioral therapy effects on symptoms of body dysmorphic disorder: a network intervention analysis

2021 ◽  
pp. 1-9
Author(s):  
Emily E. Bernstein ◽  
Katharine A. Phillips ◽  
Jennifer L. Greenberg ◽  
Joshua Curtiss ◽  
Susanne S. Hoeppner ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Time Course ◽  
Body Dysmorphic Disorder ◽  
Behavioral Therapy ◽  
Psychosocial Treatment ◽  
Cognitive Behavioral ◽  
Large Trial ◽  
Multiple Time ◽  
Symptom Level ◽  
Network Intervention

Abstract Background Body dysmorphic disorder (BDD) is a severe and undertreated condition. Although cognitive-behavioral therapy (CBT) is the first-line psychosocial treatment for this common disorder, how the intervention works is insufficiently understood. Specific pathways have been hypothesized, but only one small study has examined the precise nature of treatment effects of CBT, and no prior study has examined the effects of supportive psychotherapy (SPT). Methods This study re-examined a large trial (n = 120) comparing CBT to SPT for BDD. Network intervention analyses were used to explore symptom-level data across time. We computed mixed graphical models at multiple time points to examine relative differences in direct and indirect effects of the two interventions. Results In the resulting networks, CBT and SPT appeared to differentially target certain symptoms. The largest differences included CBT increasing efforts to disengage from and restructure unhelpful thoughts and resist BDD rituals, while SPT was directly related to improvement in BDD-related insight. Additionally, the time course of differences aligned with the intended targets of CBT; cognitive effects emerged first and behavioral effects second, paralleling cognitive restructuring in earlier sessions and the emphasis on exposure and ritual prevention in later sessions. Differences in favor of CBT were most consistent for behavioral targets. Conclusions CBT and SPT primarily affected different symptoms. To improve patient care, the field needs a better understanding of how and when BDD treatments and treatment components succeed. Considering patient experiences at the symptom level and over time can aid in refining or reorganizing treatments to better fit patient needs.

Mechanisms of Change in Cognitive Behavioral Therapy for Body Dysmorphic Disorder

2020 ◽  
Vol 44 (3) ◽  
pp. 596-610
Author(s):  
Angela Fang ◽  
Gail Steketee ◽  
Aparna Keshaviah ◽  
Elizabeth Didie ◽  
Katharine A. Phillips ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Body Dysmorphic Disorder ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Mechanisms Of Change

scholarly journals Culturally Adapted Cognitive Behavioral Therapy for Body Dysmorphic Disorder: Case Examples

2011 ◽  
Vol 4 (4) ◽  
pp. 381-396 ◽  
Author(s):  
Hilary Weingarden ◽  
Luana Marques ◽  
Angela Fang ◽  
Nicole LeBlanc ◽  
Ulrike Buhlmann ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Body Dysmorphic Disorder ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Case Examples ◽  
Culturally Adapted

Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder

2010 ◽  
Vol 17 (3) ◽  
pp. 248-258 ◽  
Author(s):  
Jennifer L. Greenberg ◽  
Sarah Markowitz ◽  
Michael R. Petronko ◽  
Caitlin E. Taylor ◽  
Sabine Wilhelm ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Body Dysmorphic Disorder ◽  
Behavioral Therapy ◽  
Cognitive Behavioral

scholarly journals Emotion-Abstraction Patterns and Cognitive Interventions in a Single Case of Standard Cognitive-Behavioral Therapy

2015 ◽  
Vol 17 (2) ◽  
Author(s):  
Sandra Sassaroli ◽  
Romina Brambilla ◽  
Eva Cislaghi ◽  
Roberta Colombo ◽  
Eva Cislaghi ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Therapeutic Process ◽  
Therapeutic Change ◽  
Cognitive Behavioral ◽  
Therapeutic Interventions ◽  
Abstract Thinking ◽  
Cognitive Content ◽  
Cognitive Interventions

Cognitive-behavioral therapy (CBT) assumes that therapeutic change de-pends mainly on change of cognitive content, while, from a theoretical viewpoint, other processes are excluded. This study aims to explore standard CBT interventions using a model of therapeutic change that includes both emotional and cognitive processes, i.e., the therapeutic cycle model (TCM; Mergenthaler, 1985; 1996), which describes the pro-cesses of therapeutic change in terms of cycles involving both emotional arousal and ab-stract thinking activation. We classified standard CBT interventions in three main are-as: assessing, disputing, and reframing biased beliefs. In 10 individual cognitive therapy sessions with a 30-year-old patient affected by a panic disorder with agoraphobia (PDA), this study aimed to explore whether cognitive interventions are not only related to abstract thinking but also to the emotional activation phases of TCM. Three inde-pendent judges assessed the presence of cognitive therapeutic interventions using the Comprehensive Psychotherapeutic Interventions Rating Scale (CPIRS; Trijsburg et al., 2002). A software program measured the TCM cognitive and emotional variables. The measures revealed significant correlations between cognitive therapeutic interventions and phases of abstract thinking activation during the therapeutic process. The results clarified the role of cognitive interventions in the therapeutic process as a useful instru-ment aimed to increase reality testing.

Treating a Patient with Body Dysmorphic Disorder Using Medication and Cognitive-Behavioral Therapy: An Illustrative Case Example

2017 ◽  
Author(s):  
Katharine A. Phillips ◽  
Rachel A. Simmons
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Mental Health Treatment ◽  
Body Dysmorphic Disorder ◽  
Behavioral Therapy ◽  
Treatment Strategies ◽  
Cognitive Behavioral ◽  
Treatment Modalities ◽  
Illustrative Case ◽  
Recommended Treatment ◽  
Decision Points

This chapter illustrates how the authors treated a representative patient with body dysmorphic disorder (BDD) using both medication and cognitive-behavioral therapy (CBT). The case example illustrates engagement strategies, treatment selection, implementation of recommended treatment strategies, approaches to some commonly encountered decision points, and possible solutions to frequently encountered treatment challenges. Following the case example, the authors comment on these issues. The chapter discusses approaches to patients who desire cosmetic treatment rather than mental health treatment. Factors involved in the decision to use CBT, pharmacotherapy, or both treatment modalities for BDD are also covered.

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