Misophonia is characterized by decreased tolerance to idiosyncratic and repetitive human-generated sounds (ie, triggers), coupled with affective-based reactions that result in impairment and distress. Often having its onset in youth, misophonia can become especially prominent during key developmental periods, including emerging adulthood. While efforts to develop interventions for misophonia remain ongoing, a consensus has not yet been reached concerning recommended first-line treatments. Acceptance and commitment therapy (ACT), which has demonstrated efficacy in treating various psychiatric disorders via targeting psychological flexibility processes, represents one potentially feasible approach for addressing misophonia. This case study describes the application of an individually delivered, 12-session ACT intervention for a black female in her early 20s with misophonia. Descriptive data collected at 4 time points (pretreatment, mid-treatment, posttreatment, and at 2-month follow-up) suggested the potential promise of ACT as a treatment for misophonia, improving psychological flexibility processes and reducing secondary depression and anxiety symptoms. Findings are discussed in the context of the possible mechanisms of ACT most likely responsible for misophonia-related clinical improvement. More rigorous studies (eg, clinical trials) are needed to confirm promising findings from existing case studies.
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