In this episode of Practice Matters, Rachel is joined once again by Professor David Veale, this time to explore emetophobia, the specific phobia of vomiting. David explains why this is the most common specific phobia presenting for treatment, despite being largely overlooked by researchers for years, and the devastating impact it can have, from avoided pregnancies to missed medical care.

Together they unpack what drives the fear, how it differs from OCD and eating disorders, and why tolerating uncertainty rather than seeking reassurance is at the heart of effective treatment. David also shares his "vicious flower" formulation, practical tips for therapists who might be squeamish themselves, and exciting developments in virtual reality treatment.

Further resources:
David's self-help book, Free Yourself from Emetophobia, co-authored with Alexandra Keyes, is available here

Find out more about David's work and publications here

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• Follow us on BlueSky and Instagram: @BABCPpodcasts
• Send us your questions and suggestions: podcasts@babcp.com
• Subscribe and leave a review – and don't forget to share this episode with your colleagues!

If you enjoyed this episode, check out our sister podcasts, Let's Talk About CBT and Let's Talk About CBT – Research Matters for more discussions on evidence-based therapy.

Credits:
Music is Autumn Coffee by Bosnow from Uppbeat
Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee
License code: 3F32NRBYH67P5MIF
This podcast was edited by Steph Curnow

In this episode of Practice Matters, Rachel Handley is joined by Professor David Veale, consultant psychiatrist and cognitive behavioural therapist, to explore body dysmorphic disorder (BDD). Together they unpack what BDD really is, how it differs from vanity, social anxiety, and OCD, and why so many people suffering with it end up seeking cosmetic solutions rather than psychological support.

David shares the CBT formulation for BDD and explains the key maintenance processes that keep people locked in distress: self-focused attention, comparing, ruminating, checking, and safety behaviours. He also discusses imagery rescripting, the challenges of engagement, and why targeting processes rather than the content of beliefs is so important in this work.

The episode also covers what effective therapy looks like in practice, who is most likely to benefit and why persistence matters, the current evidence base, and where David hopes future research will take the field.

Further resources:

Find out more about David's work and publications here

More information on BDD can be found via the BDD Foundation

Stay Connected:

• Follow us on BlueSky and Instagram: @BABCPpodcasts
• Send us your questions and suggestions: podcasts@babcp.com
• Subscribe and leave a review – and don't forget to share this episode with your colleagues!

If you enjoyed this episode, check out our sister podcasts, Let's Talk About CBT and Let's Talk About CBT – Research Matters for more discussions on evidence-based therapy.

Credits: Music is Autumn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This podcast was edited by Steph Curnow

In this episode of Practice Matters, Rachel Handley is joined by Professor Alicia Meuret to explore anhedonia, the reduced ability to feel pleasure, and the development of Positive Affect Therapy (PAT). Together, they unpack why so many clients struggle not just with feeling bad, but with a profound absence of positive emotion, and why traditional CBT approaches may not fully address this gap.

Alicia explains the science behind the brain's reward system, breaking it down into three key processes: wanting, liking, and learning. She also introduces PAT, the evidence-based treatment she developed with Professor Michelle Craske, and shares what the randomised controlled trial evidence tells us about its effectiveness compared to more traditional CBT approaches to treating depression.

The episode also offers a practical overview of what PAT looks like in the therapy room, including behavioural activation with a positive focus, savouring, gratitude practices, and building a richer emotional vocabulary. Alicia addresses some of the trickier clinical questions too, including how to present a positive-focused rationale without invalidating clients' very real distress, and how these ideas might just change how you look after yourself as a therapist.

Further resources:

Find out more about Alicia's work here- including links to all the trials mentioned in the podcast

Alicia's most recent trial published in JAMA Network Open can be found here

Positive Affect Treatment for Depression and Anxiety: Therapist Guide can be bought from Oxford University Press here

Stay Connected:

• Follow us on BlueSky and Instagram: @BABCPpodcasts
• Send us your questions and suggestions: podcasts@babcp.com
• Subscribe and leave a review – and don't forget to share this episode with your colleagues!

If you enjoyed this episode, check out our sister podcasts, Let's Talk About CBT and Let's Talk About CBT – Research Matters for more discussions on evidence-based therapy.

Credits:

Music is Autmn Coffee by Bosnow from Uppbeat

Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee

License code: 3F32NRBYH67P5MIF

This podcast was edited by Steph Curnow