Developmentally Tailored Telehealth-Delivered Cognitive-Behavioural Therapy for Adolescents with Body Dysmorphic Disorder: A Multiple Baseline Design

There is a paucity of research on the treatment of adolescent body dysmorphic disorder (BDD). Cognitive-behavioural therapy (CBT) has shown initial promise, yet many adolescents do not recover and face significant barriers in accessing treatment. The current study examined the acceptability and preliminary efficacy of developmentally tailored telehealth-delivered CBT for adolescents with BDD, using a single-case, nonconcurrent, multiple baseline design. Recruited from a broader study of correlates of BDD, 22 adolescents were eligible and were offered treatment. Sixteen (12 to 16 years; n = 5 boys) enrolled and were randomised to a one-, two- or three-week baseline period. Primary outcomes, assessed at post-treatment and again at 2-month follow-up, included BDD diagnostic status and symptom severity. Secondary outcomes included insight, functional impairment, comorbidity, anxiety, and depression. Acceptability and feasibility were examined by measuring participants’ treatment satisfaction, as well as examining drop-out rates. Seven participants dropped out of the study early, while 8 completed the 12-session treatment, and 1 completed 9 sessions. Among the treated sample, treatment satisfaction was high. BDD severity remained stable throughout the baseline and tended to improve following CBT. At post-treatment, 66.7% of the treated sample (37.5% of the total enrolled) participants were treatment responders, and 55.6% (31.3% enrolled) were still responders at 2-month follow-up. Significant reductions on most secondary outcomes were also observed. However, most participants remained symptomatic following treatment, and many dropped out early in treatment. Future studies are much needed to improve outcomes for adolescents with BDD.