Cognitive behaviour therapy for olfactory reference disorder (ORD): A case study

•We present a case of successful use of Cognitive Behavioural Therapy (CBT) in the treatment of Olfactory Reference Disorder (ORD).•Techniques such as Theory A/B, behavioural experiments, surveys and video feedback were useful to change the beliefs maintaining ORD.•Empirically supported CBT approaches to treating BDD and OCD translate well to treatment of ORD.•CBT significantly reduces core symptoms of ORD in addition to depressive and anxious symptoms.•Change in symptoms is best measured using an ORD focused measure.

Olfactory Reference Disorder (ORD) is preoccupation with the belief that one is emitting a foul odour. It can be a distressing and substantially impairing problem. However, very little is known about its successful treatment. This study describes the treatment of a 38-year-old female with longstanding ORD using Cognitive Behavioural Therapy (CBT). Case conceptualisation focused on identifying unhelpful beliefs and maintaining factors including safety-seeking behaviours, self-focus and avoidance. These were then targeted using a variety of techniques including discussion and behavioural experiments to facilitate belief and behaviour change. Following a 12-week treatment, measures of anxiety and depression reduced to below clinical thresholds. In addition, there were reductions on a specific measure of symptoms of ORD. Issues regarding the use of CBT to treat this particular disorder are considered.