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McGuire 2015 case study of successful Misophonia treatment via CBT

In a 2015 case study of two youths, McGuire and colleagues described a then-novel cognitive-behavioral treatment for misophonia that included psychoeducation, development of an individualized trigger hierarchy, and graduated exposure with response prevention (ERP) in which sound exposures were systematically intensified and avoidance or aggressive responses were prevented. The intervention also incorporated cognitive restructuring to address maladaptive beliefs about trigger sounds, stepwise reduction of family accommodation, use of reinforcement strategies (for the younger child), and relapse prevention planning. Both youths demonstrated reductions in misophonia severity on objective rating scales. The authors concluded that CBT incorporating ERP and cognitive restructuring may significantly reduce misophonia symptoms in youth, that habituation through exposure is a key mechanism, and that reducing family accommodation is a critical component of effective treatment. (McGuire et al., 2015)