Cognitive-Behavioural Therapy applied to Misophonia, a scoping review

• Mapped how cognitive behavioral therapy is delivered for misophonia in clinics • Reports suggest symptom and daily-life gains, but evidence is mostly uncontrolled • Reactions depend on context and relationships, not simply sound loudness • Inconsistent measures and reporting limit conclusions; shared outcomes needed • Many pre-existing therapies explored, future trials should seek misophonia-tailored therapy Misophonia is characterized by negative emotional, cognitive, and sometimes physical reactions to specific sounds, with impact that depends on context and meaning. Cognitive- behavioural therapy (CBT) is the most commonly described psychological approach for misophonia, but implementations vary and the clinical literature is heterogeneous. We conducted a focused scoping review of CBT applications to misophonia in clinical settings. Searches of PubMed, PsycINFO, and Google Scholar (2013–2025) identified 30 publications that delivered CBT-family procedures with pre- to post-treatment measurement. Fourteen reports that introduced novel protocols or provided the greatest procedural detail were synthesized in depth; the remainder were summarized. We extracted setting, format, session dose, main procedures, trigger selection and progression, homework structure, outcome measures, and follow-up where available. Across single-case exposure and response-prevention applications, counterconditioning programs, inhibitory-learning-informed procedures, standardized group packages, service-based CBT repertoires, and early adaptations of a transdiagnostic protocol, CBT-family interventions were generally feasible to deliver and often associated with reductions on misophonia-specific measures. However, designs were mostly uncontrolled and samples small. Interpretation is constrained by heterogeneous designs, inconsistent reporting of procedures, and variability in measurement (e.g., MQ, A-MISO-S/AMISOS-R, MAQ, S-Five, DMQ). We did not pool effects. The available evidence supports CBT-family procedures as deliverable and potentially helpful for misophonia, while falling short of firm efficacy claims. Future studies should adopt core outcome batteries, specify procedures at a granular level, and test whether particular ingredients (e.g., graded exposure with response prevention, counterconditioning, expectancy-violation strategies, attentional training, cognitive restructuring formats) contribute uniquely, or in combination, to clinically meaningful change.