Demystifying Treatment for Body Dysmorphic Disorder
Treatment for Kids
BDD typically develops around 13 years old, though younger kids can also have the disorder. It seems to occur equally in boys and girls.
CBT also is helpful for kids and teens; however, “it is important for treatment providers to consider age-appropriate language and strategies,” said Greenberg. “Most teens with BDD have not yet developed the emotional and cognitive skills to fully and openly address their body image concerns,” according to Corboy. Adolescents might have a tough time “articulating what they are thinking and feeling, and may not even recognize that their fears are exaggerated and unrealistic,” he said.
Younger patients also might feel uncomfortable disclosing information to a person they’ve just met—many rarely even talk to their parents. They also may deny body concerns because they feel ashamed or embarrassed and hope their concerns will simply go away, Corboy said.
When looking for a therapist for your child, make sure the professional has experience treating children with BDD, Corby said. Along with finding a reputable and experienced therapist, parents should get involved in both the assessment and treatment process, said Greenberg. For instance, during the clinical interview, parents can provide information about the child’s symptoms. In treatment, parents can become “great allies,” said Greenberg. “Parents can remind children to use their CBT skills and provide praise and rewards for their child’s hard work.”
Together, parents and children can develop a reward system for improvements such as spending less time checking the mirror and attending class regularly, according to Greenberg, who said this helps keep the child “active and interested in the treatment.”
“As BDD and appearance becomes less important and time-consuming, it is important that the patient is working to improve other skills—sports, music, art—friendships and experiences—such as dating, going to parties—which are important in helping to improve the child’s overall quality of life,” Greenberg said.
Case reports suggest that SSRIs, which already are used to treat pediatric OCD, are effective for treating childhood BDD, she said. Currently, three hospitals are conducting the first multi-site controlled trial of SSRIs in children.
Important Factors for Treatment
“Most individuals probably need at least 18-22 sessions of CBT for BDD in order for their symptoms to improve,” Greenberg said. With one session per week, treatment typically lasts four to six months, though patients who want to see dramatic improvements in their symptoms might want to stay in treatment longer, said Shepphird.
Length of treatment can depend on the severity of symptoms, whether the patient is delusional—wholeheartedly believes the flaw is real and can’t be convinced otherwise—or has another untreated disorder, Corboy said. For instance, if a delusional patient refuses to take medication, this prolongs treatment. As Greenberg points out, patients who have delusional BDD respond as well to SSRIs as those with nondelusional BDD.
Tartakovsky, M. (2016). Demystifying Treatment for Body Dysmorphic Disorder. Psych Central. Retrieved on November 22, 2017, from https://psychcentral.com/lib/demystifying-treatment-for-body-dysmorphic-disorder/