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Does rational role-play enhance the outcome of exposure therapy in dysmorphophobia? A case study
1Psychological Treatment Unit, Maudsley Hospital, London.
Background:
Dysmorphophobia may improve after a variety or combination of treatments, but which elements of a treatment are useful is usually not certain.
Method:
In a single out-patient case study rational role-play ('paradoxical discourse') was added to exposure plus cognitive restructuring (CR) for a dysmorphic delusion study comprised of 20-minute sessions one week apart.
Results:
Previous exposure plus attempted CR had improved anxiety, phobias, work and social leisure, but not dysmorphic belief. Added brief rational role-play was followed by resolution of the dysmorphic belief. All measures remained much improved at 18-month follow-up.
Conclusions:
Rational role-play deserves a controlled trial in dysmorphophobia and other problems and exploration of its mechanism of action.