A new internet-based program may help people suffering from a mental illness known as body dysmorphic disorder according to a new study published in the BMJ. This one of the first studies to evaluate an online program for the condition and it is also one of the largest clinical trials for body dysmorphic disorder ever conducted.
The program used to treat the disorder is therapist-guided and uses internet-based cognitive behavioral therapy which may be more accessible and less costly for patients suffering from body dysmorphia. It appears to be a promising option for people that don't have access to evidence-based treatment or cognitive behavioral therapy through one-on-one counseling sessions.
Because online treatment has proven effective it could be a useful strategy to increase the use of information and communication technology to improve care and access to mental health services.
Using Cognitive Behavioral Therapy
Body dysmorphic disorder is actually a common anxiety disorder that causes a person to have a distorted view of how they look and to also spend a lot of time worrying about their appearance. In many cases it is a problem that can lead to other disorders such as anorexia and bulimia, substance use disorder and depression.
People with BDD are preoccupied with perceived defects in their physical appearance and can engage in compulsive behaviors such as mirror gazing or excessive efforts to hide their perceived defects. Cognitive behavioral therapy or CBT is usually recommended as a treatment strategy but the cost and availability can limit access to this type of solution.
A team of researchers based in Sweden and the UK set out to evaluate if an online therapy program using CBT could be more effective than online supportive therapy. For their study they used 94 adult patients with a diagnosis of body dysmorphic disorder and each person was randomly assigned to receive either an online CBT program tailored to BDD called BDD-NET or online supportive therapy in the form of talk-based therapy.
Evaluating Two Online Programs
The online program, BDD-NET uses eight interactive nodules which each over a different theme. The main intervention is a kind of systematic exposure to fear-eliciting situations or events that are combined with response prevention until anxiety and urges to ritualize, such as compulsive mirror checking, subside.
In the next module patients complete homework assignments such as reading text material, answering a quiz, filling out worksheets and practicing exposure or response prevention. Patients have contact with a therapist throughout the program whose role is to guide, coach and provide feedback.
The other online therapy simply employed talk therapy and counseling techniques such as empathizing and summarizing. Patients in this group discussed their problems including thoughts and feelings about it and how the disorder affected their life. The treatment continued for both groups for 12 weeks and they were then followed for 3 months after treatment.
The outcome of the study showed that online CBT was more effective than online supportive therapy. Symptoms of depression tended to decrease through online CBT but not through internet talk therapy.
Online CBT also provided an increase in function and an improvement in quality of life after 6 months. Among the group that was provided with BBD-NET 56% were classified as improved or much improved while the other group only had 16% in that category. The online CBT group also has 32% of patients who were classified as being in remission or no longer meeting the criteria for BDD.
Although the online program proved effective in this study, further research needs to be conducted to determine its effectiveness in relation to CBT delivered in an office setting. The results of the study prove promising though, for a more cost-efficient therapy that is easier to access for patients with body dysmorphia.
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