Cognitive-behavioral assessment of body image disturbances

The construct of body image is multidimensional in nature and multidisciplinary in scope. The purpose of this review is to help clinicians navigate the basic theoretical and practical considerations associated with body image assessment. Common pitfalls reflect methodological problems and conceptual confusion surrounding the subjectivity, heterogeneity, lability, and complexity of the body image construct. By highlighting these core concepts, we provide a framework for conducting a comprehensive cognitive-behavioral assessment to inform case formulation and treatment planning. The strength and utility of a cognitive-behavioral therapy (CBT) model lies in its broad applicability and ability to identify the proximal factors that precipitate and maintain body image concerns, such as distorted patterns of thinking and maladaptive behavior (e.g., body checking, mirror gazing, avoidance, social comparison, reassurance seeking). Although the evidence base is still evolving, the basic tenets of a CBT approach appear to transcend disciplines and specialties. The article concludes by providing an example of self-monitoring, which is a cornerstone of CBT assessment and treatment, and referencing the steps of an established CBT manualized treatment program.