Therapeutic Approach

Cognitive behavioral therapy, which is specific for BDD (CBT-BDD), provides the basis for the different components used in our treatment program. The methods of  CBT are  evidence-based, representing the only psychotherapeutic approach thus far proven to be effective in treating BDD. Overall, CBT works as a form of guided self-help therapy that aims at changing the way the patient thinks and acts. CBT-BDD has been specifically designed to provide the patient with new ways of dealing with the body areas of concern, thereby reducing the associated preoccupation while improving everyday functioning. Specifically, treatment components include actively challenging the repetitive thinking, rituals and avoidance associated with BDD as well as testing relevant fears and assumptions. Further, our treatment consists of a series of additional modules (e.g., addressing skin picking behavior, concerns regarding the size or shape of one’s muscles) that may be used if needed. Thus, every patient will receive a treatment that is specifically tailored to his or her personal needs.

Some individuals with BDD may need a combined treatment of medication (e.g., selective serotonin reuptake inhibitor) and CBT-BDD. This  combined therapeutic approach has also been shown to effectively reduce BDD symptoms.

At the BDD outpatient unit, we see ourselves as a treatment team that works on the basis of evidence-based state-of-the-art therapeutic interventions. The close connection to the University of Muenster and the psychotherapy outpatient unit guarantees high quality standards for both the training of our clinicians and the treatment of our patients. Detailed assessments and treatment sessions, combined with continuous supervision of our trained staff, are core features of our work. We also cooperate with other BDD outpatient units, such as the OCD & related Disorders Program at the Massachusetts General Hospital / Harvard Medical School, to enable a continuous exchange regarding therapeutic and research-related issues.

Therapy procedure

Entrance questionnaire and free telephone screening

Prior to your first appointment, we would like you to fill out the intake survey and send it to the secretary of the psychotherapy outpatient unit. We will then contact you and arrange an appointment for a telephone interview. During this interview, our trained staff will ask you several questions about your current appearance concerns. We will also provide you with further information about possible treatment options.

First interview

If the telephone interview indicates that you might suffer from BDD, we will offer you an appointment with Prof. Dr. Ulrike Buhlmann. During this appointment, we will ask you some questions about your appearance concerns, your current life situation and your treatment goals. Based on this information, we will discuss whether we can offer you special treatment in our outpatient unit or inform you about alternative treatment options.

Diagnostic phase

Upon the decision to start treatment in our outpatient unit, we proceed with a careful and detailed diagnostic phase.. During these first five sessions, we will focus on your appearance-related concerns in more detail to develop a treatment plan and to set specific treatment goals. Subsequently, we will apply to your health care provider for treatment coverage.

Treatment phase

If your health care provider has confirmed coverage, the treatment proceeds with different phases. These phases are determined individually and depend on your personal problem areas and goals.

First, you and your therapist will develop personalized strategies in order to reduce avoidance of social activities or situations, rituals, and repetitive thinking associated with BDD. To achieve this, we will discuss and integrate individualized therapeutic interventon strategies into your treatment plan. Performing these strategies between sessions will allow you to gradually gain control over your symptoms. You will thus learn new, more productive ways to cope with your appearance concerns, which will give you back more and more freedom over the course of your treatment.

Assessing whether you have reached your personal goals during therapy is a vital quality feature of our treatment concept. By means of surveys, we will continuously monitor the therapeutic process to adapt the treatment concept to your current needs.

Final phase

During the final phase of treatment, you will once again check your goal attainment together with your therapist and review treatment gains. In this phase, it is important to establish strategies that will help you maintain your gains and prevent relapse. 
When treatment is completed, we regularly offer refresher sessions (“booster sessions”) for patients to regain the progress achieved during the initial program and to facilitate the transfer of relevant behavioral skills into daily life.