In-Congress Workshop 14 - Adapting and Expanding Your CBT Skills for Working with Misophonia

Misophonia is a newly identified phenomenon of auditory over-responsivity, where sounds like chewing, coughing and typing evoke reactions of anger, panic and helplessness. Treatment-seeking individuals report significant distress and impairment in their daily lives, often with co-occurring depression and anxiety symptoms.

There is evidence that CBT approaches can reduce distress and improve functioning and mental health outcomes for individuals with misophonia. Given the relative infancy of misophonia treatment literature, interventions must be highly individualised and collaborative. Therapist and client develop shared theories about maintaining factors and target those mechanisms using established CBT strategies, continually revising theories to incorporate new information.

This workshop introduces two frameworks for formulating misophonia, one targeting misophonia-specific maintenance factors and the other targeting transdiagnostic processes impacting misophonia and other mental health outcomes. Based on feedback from experts by experience, neither framework endorses habituation-based exposure, instead applying inhibitory learning principles to support clients to create novel and safe experiences of engaging with sounds to develop new associations.

The “Three Cycles of Misophonia” approach targets the individual’s specific maintenance factors with behavioural experiments and practical strategies. It maps out three interrelated cycles: sensory processing and attention; escalation in response to triggers; problem maintenance between triggers.

Process-based therapy for Misophonia involves collaboratively identifying and prioritising transdiagnostic processes driving impaired functioning in misophonia, and targeting these using well-established, transdiagnostic interventions.

The workshop includes a live Q&A with someone with lived experience, highlighting the importance of awareness and compassion. Attendees will construct a formulation, adapt their existing skills to work with this underserved client group, use self-practice to try specific techniques for helping clients engage with sounds in new ways, and discuss applications of these strategies to children and families.