Cognitive-Behavioral Therapy for an Adolescent Female Presenting With Misophonia: A Case Example

The case illustrates the effective assessment and treatment of misophonia in a 14-year-old adolescent female in which short-term cognitive-behavioral therapy (CBT) and exposure and response prevention (ERP) principles were utilized. Misophonia-related symptomology declined significantly during treatment, and partial gains were consolidated over time with the use of ongoing sporadic booster sessions to maintain reported improvements and to address the variable nature of the patient's symptom expression. Significant tolerance of noise triggers occurred, both within and in between sessions, and the patient achieved concurrent behavioral changes and tolerated a marked reduction in relevant avoidance behaviors. Self-reported and observed psychological and physiological distress diminished when confronted with identified trigger noises, both during conducted in vivo exposures and, more broadly, in the patient's home and school environments. The case serves as a contribution to the growing body of psychiatric literature recognizing misophonia as a distinct phenomenon, and offers anecdotal evidence regarding assessment treatment implications.