Sequent repatterning therapy for misophonia

Misophonia is a term used to describe an abnormal or extreme emotional response to a sound that is generally regarded as benign or unremarkable. Sequent Repatterning therapy for misophonia aims to break the linkage between the trigger and the subsequent emotional response. Developed in the United Kingdom by Chris Pearson in 2014, the therapy has now become more widely available. It is based on the idea that emotional responses are learnt and consolidated over time, rather than innate, which makes it a form of cognitive behavioral therapy.

Sequent Repatterning

Sequent Repatterning therapy was developed as a specific therapy to help those suffering from misophonia. Its development began in 2012 when Christopher Pearson applied aspects of hypnotherapy, parts work therapy and NLP to create a therapy model which fits the condition misophonia.

The Sequent Repatterning therapy process is associated with this logo, registered in 2019

Chris Pearson presented to the International Association of Neuropsychotherapy in 2017 and an article Reviewing Misophonia and its Treatment was published in International Journal of Neuropsychotherapy later that year. Chris Pearson also contributed to the proposals for diagnostic criteria for misophonia, published in Frontiers. It is these diagnostic steps that Sequent Repatterning practitioners apply to assessment of potential clients. These criteria were more recently referenced in psychometrically assessing the condition by Williams, et al.

Sequent Repatterning is often known as sequent repatterning therapy or SRT. Since 2001 the published, peer-reviewed work on misophonia has increased almost exponentially. A significant increase has been seen since 2017 when this approach to treatment was initially proposed. Its development has continued and, during the last five years, has embraced the therapeutic reconsolidation process (TRP, a key feature in Coherence Therapy) as a key element in transformational change.

For those having misophonia, therapy often begins with a structured programme with a suitably qualified therapist. This programme consists four distinct phases, categorised as

1. Pre-therapy
2. Foundation
3. Active Therapy
4. Future Pacing

and is usually completed over a period of about three months. At the conclusion of the Active Therapy Phase, around 80% of those engaging with the process achieve a significant improvement in symptom severity, as measured by the scale MAQ-4. The reduction in MAQ-4 score that aligns with 'significant improvement' is 20%. The current (2023) arithmetic average improvement of that 80% is a reduction of around 70%.

Training for Sequent Repatterning practitioners is restricted to those already meeting specific skills and professional credentials. Those assigned the status of Certified Sequent Repatterning Practitioner will have completed a comprehensive training course, followed by assessment of a case study. More can be found out about Sequent Repatterning and those therapists who use this approach to working with misophonia at the web site sequent-repatterning.com Each member of the Sequent Repatterning therapeutic community participates in clinical supervision, peer review and a regular, monthly Round Table exchange of information to maintain and enhance clinical outcomes for their clients. Presently (2023) there are accredited therapists in UK, mainland Europe, South Africa, United States of America and Australia, providing global coverage utilising VSee - the purpose-designed telemedicine platform - and Zoom to deliver therapy remotely, as well as some members of the team meeting with individuals in person, in their therapy rooms.