Cognitive-Behavioral Therapy for Body Dysmorphic Disorder

Sabine Wilhelm, PhD, is Professor of Psychology in the Department of Psychiatry at Harvard Medical School and Chief of Psychology and Director of the Obsessive–Compulsive Disorder (OCD) and Related Disorders Program at Massachusetts General Hospital. She is Vice Chair of the Scientific Advisory Board of the International OCD Foundation, serves on the Scientific Council of the Anxiety and Depression Association of America, and is on the editorial boards of eight journals. Dr. Wilhelm's clinical work and research focus on body dysmorphic disorder, OCD, and tic disorders. She is the author of more than 200 articles and book chapters and several books, including the self-help guide Feeling Good about the Way You Look: A Program for Overcoming Body Image Problems, which was cited as a Self-Help Book of Merit by the Association for Behavioral and Cognitive Therapies (ABCT). She is a Fellow of ABCT and the Association for Psychological Science.Katharine A. Phillips, MD, is Director of the Body Dysmorphic Disorder (BDD) Program, Director of Research for Adult Psychiatry, and Senior Research Scientist at Rhode Island Hospital, and Professor of Psychiatry and Human Behavior at the Alpert Medical School of Brown University. A Fellow of the American College of Neuropsychopharmacology and a Distinguished Fellow of the American Psychiatric Association, she is the recipient of a Special Presidential Commendation from the American Psychiatric Association for her research on BDD. Dr. Phillips has repeatedly been included in Best Doctors in America and Castle Connolly's America's Top Doctors. She has more than 290 scientific publications and has written a number of books on BDD for professionals and the public, including Understanding Body Dysmorphic Disorder: An Essential Guide.Gail Steketee, PhD, is Dean and Professor at the Boston University School of Social Work. Her scholarly work has focused on developing and testing treatments for obsessive–compulsive spectrum disorders, including obsessive–compulsive disorder (OCD), body dysmorphic disorder, and hoarding disorder. She has published over 200 articles and chapters and more than a dozen books on these topics. Dr. Steketee is a recipient of the Outstanding Career Achievement Award from the International OCD Foundation and is 2016–2017 President Elect of the Association for Behavioral and Cognitive Therapies. She gives frequent lectures and workshops on hoarding and related conditions to professional and public audiences in the United States and internationally.

"BDD entails substantial suffering and requires skilled therapeutic intervention. This unique treatment manual lives up to the stellar reputations of Wilhelm, Phillips, and Steketee. Their systematic treatment is science based, clinically informed, and practitioner friendly. The manual is generous in its provision of reproducible handouts and assessment tools, and it wisely guides therapy that is tailored to the individual client’s needs."--Thomas F. Cash, PhD, Department of Psychology (Emeritus), Old Dominion University"Wilhelm, Phillips, and Steketee are among a small handful of internationally recognized authorities on the etiology and treatment of BDD and related conditions. It is next to impossible to think of a better qualified group of authors for this definitive treatment manual."--David B. Sarwer, PhD, Departments of Psychiatry and Surgery, Perelman School of Medicine at the University of Pennsylvania"BDD is a common and often crippling psychiatric disorder, yet too frequently it is not diagnosed or not competently treated. This book fills a critical niche by providing concrete, hands-on guidance for conducting state-of-the-art cognitive-behavioral therapy for BDD. The guidelines in this book will be accessible and useful for a wide range of readers, from students just beginning their training in behavioral therapies to seasoned professionals who are already experienced with BDD. An invaluable addition to the field."--Harrison G. Pope Jr., MD, Department of Psychiatry, Harvard Medical School"This essential, richly detailed guide is written at a level of specificity that will enable even the clinician new to working with BDD to be comfortable implementing the strategies. The manual also provides a concise review of the scientific basis for the approach. All clinicians who treat patients with BDD or other clinically meaningful body image disturbances now have a go-to guide to add to their clinical bookshelves."--J. Kevin Thompson, PhD, Department of Psychology, University of South Florida"Helping patients accept that their problem is psychological rather than medical is a daunting prospect that is at the heart of treatment for BDD. This book encapsulates the wisdom from extensive clinical experience. It provides the therapist with an evidence-based map for navigating the challenges of this disorder, and has relevance for treating other obsessive-compulsive problems as well."--Janet Treasure, PhD, FRCP, FRCPsych, Director, Eating Disorders Research Unit, Kings College London, United Kingdom

• I. Fundamentals of Body Dysmorphic Disorder and Its Treatment1. Introduction to BDD 2. Treatment Overview and Roadmap3. Special Considerations in Treating Patients with BDD4. Diagnosing and Assessing BDD and Associated Symptoms5. Enhancing MotivationII. Introductory Sessions: Laying the Foundation for Successful Treatment6. Session 1: Assessing BDD, Orienting the Patient to CBT-BDD, and Assessing Motivation7. Session 2: Education and Case Formulation8. Session 3: Setting Goals, Describing CBT-BDD, and Assessing ThoughtsIII. Core Treatment Components9. Sessions 4-5: Evaluating Self-Defeating Thoughts 10. Session 6: Introducing Exposure 11. Sessions 7-9: Adding Ritual Prevention12. Session 10: Perceptual Retraining for Mirror Checking 13. Sessions 11-20: Introducing Advanced Cognitive Strategies and Moving Forward 14. Termination Sessions, Relapse Prevention, and Booster SessionsIV. Optional Modules for Patients with Relevant Symptoms15. Skin Picking and Hair Pulling 16. Weight, Shape, and Muscularity 17. Cosmetic Treatment 18. Depression