Barriers to Treatment

It often takes individuals with BDD years to initiate evidence-based treatment, despite adverse effects (e.g., chronicity, suicidality) of longer illness duration. Relatedly, those with BDD experience various individual and systemic treatment barriers that impede timely access to care. This chapter aims to synthesize research about treatment barriers in BDD by summarizing concurrent survey studies and drawing from the overarching treatment barrier literature. Across studies, shame and stigma emerged as the most prominent barriers to treatment, endorsed by about 50%. Among self-reported treatment barriers, insight-related barriers (e.g., the conviction that only cosmetic treatments can help) ranked second, followed by barriers associated with health care systems (e.g., high treatment costs). In integrating the main findings from the current literature, we delineate ways in which clinicians may support access to and engagement in treatment, and we propose directions for future research and practice.