Does rational role-play enhance the outcome of exposure therapy in dysmorphophobia? A case study.
BACKGROUND
Dysmorphophobia may improve after a variety or combination of treatments, but which elements of a treatment are useful is usually not certain.


METHODS
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.
D000328:Adult; D001828:Body Image; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003702:Delusions / Q000523:psychology / Q000628:therapy; D003887:Desensitization, Psychologic; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000523:psychology / Q000628:therapy*; D012381:Role Playing; D012917:Social Adjustment; D016896:Treatment Outcome