Cognitive-Behavioral Therapy for Body Dysmorphic Disorder: A Review and Future Directions

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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Historical perspective and future directions in Cognitive Behavioral Therapy for insomnia and behavioral sleep medicine

Clinical Psychology Review ◽

10.1016/j.cpr.2005.04.002 ◽

2005 ◽

Vol 25 (5) ◽

pp. 535-538 ◽

Cited By ~ 3

Author(s):

Rachel Manber ◽

Allison Harvey

Keyword(s):

Cognitive Behavioral Therapy ◽

Historical Perspective ◽

Behavioral Therapy ◽

Sleep Medicine ◽

Cognitive Behavioral ◽

Future Directions

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When Adolescents Feel Ugly: Cognitive Behavioral Therapy for Body Dysmorphic Disorder in Youth

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.31.4.242 ◽

2017 ◽

Vol 31 (4) ◽

pp. 242-254 ◽

Cited By ~ 2

Author(s):

Cynthia Turner ◽

Jacinda Cadman

Keyword(s):

Young People ◽

Cognitive Behavioral Therapy ◽

Body Dysmorphic Disorder ◽

Behavioral Therapy ◽

Critical Time ◽

Population Group ◽

Psychological Therapy ◽

Cognitive Behavioral ◽

Complex Population ◽

Significant Impairment

Adolescence is a critical time for physical development and maturation, and with these important physiological changes comes greater awareness of body image and appearance, which, for a proportion of young people can become excessive, signaling the onset of body dysmorphic disorder (BDD). BDD in adolescence is associated with significant impairment and suicidality, is poorly understood, and currently there is limited evidence for the effectiveness of psychological therapy. Cognitive behavioral therapy (CBT) is currently the most promising and best available psychological therapy for BDD in youth. The aim of this article is to provide clinicians with information on CBT treatment for BDD in young people and to provide guidance based on clinical experience of working with this complex population group. The article will include discussion of strategies including maximizing psychoeducation with parental involvement, the use of cognitive therapy techniques, exposure with response prevention, and perceptual visual training techniques, including attention training and mirror retraining.

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Optimizing Smartphone-Delivered Cognitive Behavioral Therapy for Body Dysmorphic Disorder Using Passive Smartphone Data: Initial Insights From an Open Pilot Trial

JMIR mhealth and uhealth ◽

10.2196/16350 ◽

2020 ◽

Vol 8 (6) ◽

pp. e16350

Author(s):

Hilary Weingarden ◽

Aleksandar Matic ◽

Roger Garriga Calleja ◽

Jennifer L Greenberg ◽

Oliver Harrison ◽

...

Keyword(s):

Cognitive Behavioral Therapy ◽

Symptom Severity ◽

Body Dysmorphic Disorder ◽

Behavioral Therapy ◽

Pilot Trial ◽

Cognitive Behavioral ◽

Sensor Data ◽

Mobility Patterns ◽

Insight Into ◽

Open Pilot

Background Smartphone-delivered cognitive behavioral therapy (CBT) is becoming more common, but research on the topic remains in its infancy. Little is known about how people typically engage with smartphone CBT or which engagement and mobility patterns may optimize treatment. Passive smartphone data offer a unique opportunity to gain insight into these knowledge gaps. Objective This study aimed to examine passive smartphone data across a pilot course of smartphone CBT for body dysmorphic disorder (BDD), a psychiatric illness characterized by a preoccupation with a perceived defect in physical appearance, to inform hypothesis generation and the design of subsequent, larger trials. Methods A total of 10 adults with primary diagnoses of BDD were recruited nationally and completed telehealth clinician assessments with a reliable evaluator. In a 12-week open pilot trial of smartphone CBT, we initially characterized natural patterns of engagement with the treatment and tested how engagement and mobility patterns across treatment corresponded with treatment response. Results Most participants interacted briefly and frequently with smartphone-delivered treatment. More frequent app usage (r=–0.57), as opposed to greater usage duration (r=–0.084), correlated strongly with response. GPS-detected time at home, a potential digital marker of avoidance, decreased across treatment and correlated moderately with BDD severity (r=0.49). Conclusions The sample was small in this pilot study; thus, results should be used to inform the hypotheses and design of subsequent trials. The results provide initial evidence that frequent (even if brief) practice of CBT skills may optimize response to smartphone CBT and that mobility patterns may serve as useful passive markers of symptom severity. This is one of the first studies to examine the value that passively collected sensor data may contribute to understanding and optimizing users’ response to smartphone CBT. With further validation, the results can inform how to enhance smartphone CBT design.

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