Psychological Intervention for Misophonia

Overseen By Michael Twohig, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Utah State University

Must be taking: Psychotropic

Disqualifiers: Psychological, Neurological, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to evaluate how well two different therapies help people with misophonia, a condition where certain sounds trigger strong emotional reactions. One group will receive Acceptance and Commitment Therapy (ACT) combined with traditional sound management, focusing on mindfulness and personal values. The other group will try Progressive Relaxation Training (PRT), which teaches muscle relaxation to reduce stress. Ideal participants are adults who have been dealing with misophonia and are currently on stable medication. Those who find everyday sounds cause significant distress might consider participating in this trial. As an unphased trial, this study offers a unique opportunity to explore innovative therapies for misophonia.

Do I need to stop my current medications to join the trial?

The trial does not specify if you need to stop your current medications, but you must be stable on any psychotropic medication for at least 30 days before joining.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that Acceptance and Commitment Therapy (ACT) is a promising treatment for misophonia. In past studies, participants found it easier to manage their symptoms with ACT. No major reports of harm have emerged, indicating it is generally safe. One case demonstrated success in reducing misophonia symptoms with a 12-session ACT program.

Similarly, Progressive Relaxation Training (PRT) appears promising. A case study found that PRT helped lessen the severity of misophonia over 13 weeks. Participants reported feeling better after learning to tense and relax their muscles.

Both treatments seem safe, with no serious side effects reported. This suggests that prospective trial participants can feel confident about the safety of these methods. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these treatments for misophonia because they offer a novel, holistic approach compared to traditional methods like cognitive-behavioral therapy or sound therapy. Acceptance and commitment therapy (ACT) stands out by integrating mindfulness and acceptance strategies with a behavioral intervention, helping patients manage their emotional reactions while aligning actions with personal values. Meanwhile, progressive relaxation training (PRT) focuses on physical relaxation techniques, teaching patients to control muscle tension as a way to reduce distress. These innovative strategies aim to provide more comprehensive relief and improve lifestyle quality for those struggling with misophonia.

What evidence suggests that this trial's treatments could be effective for misophonia?

Research suggests that Acceptance and Commitment Therapy (ACT), one of the treatments in this trial, may help treat misophonia. ACT teaches skills to accept tough feelings, stay focused on the present, and make positive choices based on values. Although mostly tested in individual cases, early results are promising. Progressive Relaxation Training (PRT) is another treatment option in this trial, involving learning to tense and relax muscles, often used to manage stress and tension. Participants consider both treatments credible and acceptable, but ACT has shown potential in improving misophonia symptoms. More solid evidence is still needed to confirm the effectiveness of both treatments for this condition. ^{1 6 7 8 9}

Who Is on the Research Team?

Michael P Twohig, PhD

Principal Investigator

Utah State University

Are You a Good Fit for This Trial?

This trial is for adults who score at least five on the Misophonia Questionnaire, are stable on psychotropic medication for a month, speak English, and seek treatment for misophonia. It excludes those with psychological/neurological issues that overshadow their misophonia or require urgent care like psychosis or active self-harm.

Inclusion Criteria

English speaking

Meet clinical cut-off for misophonia (minimum score of five on the Misophonia Questionnaire)

I have been on the same mental health medication for over a month.

Exclusion Criteria

Presence of psychological and/or neurological impairments that would preclude someone from participating in the study or exceed misophonia as the primary presenting problem (e.g. active self-harm or need for treatment for psychosis)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive 12 sessions of either ACT+behavioral intervention or PRT+psychoeducation

12 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

9-12 months

What Are the Treatments Tested in This Trial?

Interventions

• Acceptance and commitment therapy
• Progressive relaxation training

Trial Overview The study tests Acceptance and Commitment Therapy (ACT) combined with traditional behavioral intervention against progressive relaxation training plus psychoeducation in treating misophonia. Participants will be randomly assigned to one of these two approaches over 12 sessions.

How Is the Trial Designed?

Group I: Acceptance and commitment therapy Experimental Treatment 1 Intervention

ACT teaches skills to develop acceptance, mindfulness, and defusion from difficult internal experiences while increasing connections with personal values and encouraging meaningful behavioral changes. ACT for misophonia combines core ACT processes with a traditional audiological behavioral intervention for a integrated, multi-disciplinary approach for the assessment and treatment of misophonia. Treatment begins with a brief focus on the behavioral intervention, followed by the teaching of ACT skills to support the use of the behavioral methods. The intervention consists of 12 total individual sessions of ACT+behavioral management.

Group II: Progressive relaxation training Active Control 1 Intervention

PRT for misophonia consists of basic psychoeducation for misophonia followed by PRT. PRT involves learning to tense and relax muscles. Early sessions focus on tensing and relaxing smaller muscle groups, while later sessions focus on larger muscle groups. Final sessions focus on relaxation as produced by recalling previous relaxation and a review of skills learned. PRT consists of 12 individual total sessions.

Who Is Running the Clinical Trial?

Utah State University

Lead Sponsor

Trials

48

Recruited

5,200+

Published Research Related to This Trial

Internet-based Acceptance and Commitment Therapy (iACT) shows small effects in reducing depressive symptoms, anxiety, stress, psychological distress, and improving quality of life, based on a systematic review of 39 randomized controlled trials.

While iACT was effective compared to passive control groups, it did not show significant advantages over active control groups, indicating the need for further high-quality studies to compare its efficacy with other established therapies like cognitive behavioral therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of Internet-Based Acceptance and Commitment Therapy for Depressive Symptoms, Anxiety, Stress, Psychological Distress, and Quality of Life: Systematic Review and Meta-analysis. Han, A., Kim, TH.[2022]

A multi-site randomized clinical trial is currently evaluating Acceptance and Commitment Therapy (ACT) as a treatment for trauma-related mental health issues in military personnel, addressing the need for effective therapies for veterans with high comorbidity.

ACT is considered a promising transdiagnostic treatment approach, which means it can be beneficial for multiple mental health diagnoses, making it potentially more efficient for veterans readjusting after service.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluating transdiagnostic treatment for distress and impairment in veterans: a multi-site randomized controlled trial of Acceptance and Commitment Therapy. Lang, AJ., Schnurr, PP., Jain, S., et al.[2013]

Acceptance and Commitment Therapy (ACT) has shown effectiveness in improving outcomes for patients with chronic pain and may also benefit those with mild to moderate depression, making it a valuable tool for general practitioners.

ACT employs mindfulness and acceptance strategies to help patients align their behaviors with their values, and it has shown preliminary benefits in various conditions, including obsessive-compulsive disorder and emotional issues after gastric band surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acceptance and commitment therapy - pathways for general practitioners. Smout, M.[2012]

Citations

1. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1551714424002544

Acceptance and commitment therapy versus progressive ... Acceptance and commitment therapy (ACT) is a promising psychotherapy for treating misophonia, but has only been previously tested in case studies. This paper ...

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/?linkname=pubmed_pubmed_citedin&from_uid=41076156

Acceptance and commitment therapy versus progressive ... Results: Both treatments were rated as credible and acceptable. Response rates for participant-rated misophonia (MQ scores) were small to modest ...

3. clinicaltrials.gov clinicaltrials.gov/study/NCT07220941

Digital Intervention for Adults With Misophonia: A ... Acceptance and Commitment Therapy (ACT) has shown promise in addressing misophonia symptoms by fostering psychological flexibility. While recent ...

4. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/39182828/

Acceptance and commitment therapy versus progressive ... Acceptance and commitment therapy (ACT) is a promising psychotherapy for treating misophonia, but has only been previously tested in case studies. This paper ...

5. digitalcommons.usu.edu digitalcommons.usu.edu/cgi/viewcontent.cgi?article=3070&context=psych_facpub

Acceptance and Commitment Therapy for a Child With ... ACT FOR A CHILD WITH MISOPHONIA. 17. As the first study to use ACT for misophonia in a child, this case presents promising and unique outcomes.

6. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/39357020/

Acceptance and Commitment Therapy for an Emerging ... This case study describes the application of an individually delivered, 12-session ACT intervention for a black female in her early 20s with misophonia.

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10276561/

A systematic review of treatments for misophonia - PMC This systematic review extracted and synthesized relevant treatment research on misophonia to examine the efficacy of various intervention modalities and ...

8. researchgate.net researchgate.net/publication/384573201_Acceptance_and_Commitment_Therapy_for_an_Emerging_Adult_Female_With_Misophonia_A_Case_Study

Acceptance and Commitment Therapy for an Emerging ... This case study describes the application of an individually delivered, 12-session ACT intervention for a black female in her early 20s with misophonia.

9. researchgate.net researchgate.net/publication/396391122_Acceptance_and_commitment_therapy_versus_progressive_relaxation_training_for_misophonia_A_randomized_controlled_trial

Acceptance and commitment therapy versus progressive ... Acceptance and commitment therapy versus progressive relaxation training for misophonia: A randomized controlled trial. October 2025; Journal of ...