the waves of CBT in misophonia research

Detroy and Norena (2026) conducted a scoping review of Cognitive-Behavioral Therapy (CBT) applications to misophonia, following PRISMA guidance for scoping reviews and synthesizing 30 included publications, 14 of which were described in depth. They organized the methods used across these studies into four historical waves: a first, behavioral wave built from classical and operant conditioning (exposure and response prevention, counterconditioning, relaxation, stimulus manipulation), a second, cognitive wave addressing appraisals (inhibitory-learning-oriented exposure, attentional training, cognitive restructuring, the Unified Protocol), and a third wave (Acceptance and Commitment Therapy, Dialectical Behavior Therapy, Mindfulness-Based Cognitive Therapy) emphasizing acceptance, mindfulness, and values-based action across diagnoses; a fourth wave, used inconsistently in the broader literature to describe well-being- or compassion-focused, technology-enabled process-based care, was noted but not tied to any specific misophonia protocol reviewed. The authors concluded that because each major CBT method was shaped by a different disorder's logic, redeploying wave-specific techniques to misophonia without adaptation risks missing what is distinctive about the condition (Detroy & Norena, 2026).