What question did this study set out to answer?

The study aims to compare the effectiveness of brief self-administered exposure therapy and tinnitus retraining therapy for misophonia.

April 22, 2026Open Access

Comparison of brief, self-administered exposure and sound therapy in the treatment of misophonia: an open-label, randomised study

Key Points

The study aims to compare the effectiveness of brief self-administered exposure therapy and tinnitus retraining therapy for misophonia.
Conducted a randomized study with 58 adults with misophonia over six weeks.
Participants received either exposure therapy or tinnitus retraining therapy, with assessments at baseline, week 3, and week 6.
Used self-report measures and assessor ratings to evaluate treatment outcomes.
No significant difference in self-rated misophonia severity between groups at week 6.
Assessor ratings favored exposure therapy, with a low response rate; only six participants showed moderate or significant improvement.
Five out of those six participants were in the exposure therapy group.

Abstract

Abstract Misophonia is a condition characterised by intense emotional reactions to sounds that would not bother most people. Currently, there is no widely accepted and effective treatment for misophonia. Most published studies on treatment have used behavioural therapy, cognitive interventions, or audiological treatments; however, there is no comparison of the effectiveness of these approaches. This 6-week study aimed to compare the effects of brief, self-administered versions of exposure and tinnitus retraining therapy (TRT) in 58 adults with misophonia. The participants, randomly assigned to the two treatment groups and a wait-list group, were assessed at three time points (baseline, week 3, and week 6). The exposure group was given self-exposure homework assignments, where the patient was expected to self-expose to the live or recorded misophonic sound that was agreed upon during the week 0 assessment, for 20–40 minutes, three times a week. The patients in the TRT group were given a set of pre-recorded music pieces and asked to listen to any piece of their choosing for 20–40 minutes a day, three times a week. Self-report measures of misophonia severity (Misophonia Checklist), and interference due to symptoms were rated at each time point by the patients. The assessor also rated improvement at each time point. The study is registered in ClinicalTrials.gov (registration no. NCT05993286). The Intention to Treat (ITT) analyses revealed no difference between the three groups in terms of self-rated misophonia severity at week 6. The assessor-rated percentage of improvement favoured exposure, although the response rate was very low; only six out of 39 participants were rated as moderately or much improved, five of whom were in the exposure therapy group. The results underscore the need for finding ways to increase treatment response in misophonia. Key learning aims (1) To become familiar with the concept of misophonia; i.e. hatred of sounds. (2) To evaluate the potential effectiveness of existing interventions for the treatment of misophonia. (3) To gain insight into adapting established therapy methods to novel settings.

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