Unfortunately, there are no evidence-based treatments that have been developed and tested scientifically for Misophonia. That means we don't know yet what works best to help people overcome Misophonia. It doesn't mean that nothing can help.
One main challenge in treating people with Misophonia is that this is a problem that can develop alone, in combination with a psychiatric disorder (e.g., an anxiety disorder), with several psychiatric disorders (e.g., an anxiety disorder and personality disorder), an audiological disorder (e.g., hyperacusis) or another sensory processing condition (e.g., sensory processing disorder), or, in some cases, with some combination of psychiatric, audiologic, and other sensory processing disorders. Because of this complexity in the different ways people might present for treatment with Misophonia, we strongly suggest using a multi-disciplinary approach to assessment and treatment planning for Misophonia.
At Duke, we first conduct an evaluation and make recommendations for the next steps in care. This evaluation includes time for psychoeducation and Q&A with Dr. Rosenthal about what is known scientifically about Misophonia and strategies to prevent and manage symptoms. It is common in this visit to discuss the possible benefits of receiving evaluations from other kinds of providers, including audiology, neuropsychology, psychiatry, occupational therapy, music therapy, and neurology. We believe that a team of experts talking to each other about how to help is the ideal way to develop a personalized treatment plan.
If there are other disorders or problems that are present and have evidence-based treatments, we will discuss with you the option of first receiving such care. For example, if you meet criteria for PTSD, have associated Misophonia triggers, and have not ever received an evidence-based treatment for PTSD, we might first talk about the pros and cons of receiving such a treatment. Many people with Misophonia who come to our clinic report having been to counseling or supportive psychotherapy and finding those approaches somewhat or very unhelpful in managing Misophonia. At Duke, we help carefully discriminate between general supportive counseling and high-quality evidence-based treatments for particular problems that may co-occur with Misophonia. We value and provide recommendations using interventions and change processes grounded in scientific support.