CBT-MISO™ is a specialized clinical framework developed by Shaylynn Hayes-Raymond. It adapts the principles of Cognitive Behavioral Therapy specifically for the unique neurophysiological and emotional profile of misophonia. Unlike general CBT, which may treat sound sensitivity as a standard phobia or anxiety, Hayes-Raymond’s CBT-MISO™ approach recognizes misophonia as a complex sensory processing issue that requires a multi-disciplinary toolkit. Core Pillars of the CBT-MISO™ Framework Neurophysiological Psychoeducation: This foundational stage focuses on understanding misophonia through the lens of the autonomic nervous system. It explains why the “fight-or-flight” response is triggered by specific sounds and how the brain’s “threat-detection” system is involved. Cognitive Reframing & Pattern Identification: Hayes-Raymond’s model helps individuals identify the automatic, often distressing thoughts that accompany a trigger. The goal is to separate the sensory input (the sound) from the perceived intent of the person making it. A “Sensory-First” Approach: Acknowledging that the physiological response is real and intense, the framework integrates sensory diets and the use of adaptive tools (like noise-canceling technology) rather than relying solely on cognitive restructuring or exposure. Strategic Accommodations & Planning: The model provides structured guidance on how to negotiate environmental changes and communicate needs to family, friends, and coworkers to reduce the frequency of trigger events. As outlined in the professional guide Cognitive Behavioral Therapy (CBT) for Misophonia, the approach is traditionally delivered in a 10-week sequence which is also available in a workbook. This allows participants to move from the initial understanding of the condition into active skill-building, such as physiological regulation and value-based goal setting, eventually culminating in a plan for sustaining clinical progress.Â
CBT-MISO™ Class for Clinicians and Misophonia Adults, Teens, & Parents
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The 10 Week CBT Workbook for Misophonia
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This page includes links to external resources, some of which are paid products. The inclusion of these resources does not constitute an endorsement by the International Misophonia Foundation (IMF). Shaylynn Hayes-Raymond, Director of the IMF, is also the developer of CBT-MISO and the author of its associated educational materials and resources. The IMF is conducting research involving CBT-MISO under Shaylynn’s direction. Shaylynn receives no personal financial compensation from these research activities. Any commercial interests associated with CBT-MISO resources are separate from the Foundation’s research activities. All research findings will be reported transparently, including results that are unfavorable, inconclusive, or do not demonstrate improvement. Findings will be presented with their methodological limitations, without selective reporting or concealment of unfavorable outcomes. The IMF’s involvement in studying CBT-MISO does not constitute an endorsement or establish its clinical effectiveness. The Foundation’s review and approval of a study protocol address research oversight; they do not constitute independent clinical validation of CBT-MISO, proof of efficacy, or endorsement of a commercial offering. IMF does not determine which misophonia treatments are effective. Such conclusions require appropriately designed, replicated research and broader scientific scrutiny.
