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Does Rational Role-play Enhance the Outcome of Exposure Therapy in Dysmorphophobia?

A Case Study

Published online by Cambridge University Press:  02 January 2018

Paul Cromarty*
Affiliation:
Psychological Treatment Unit, Maudsley Hospital
Isaac Marks
Affiliation:
Institute of Psychiatry, London
*
Mr Cromarty, Department of Behavioural Psychotherapy, St Nicholas' Hospital, Gosford, Newcastle upon Tyne NE3 3XT. Fax: (0191) 273 2340

Abstract

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.

Type
Papers
Copyright
Copyright © 1995 The Royal College of Psychiatrists

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