USU Doctoral Student Leads National Effort to Expand Treatment Access for Misophonia

For individuals living with misophonia, everyday sounds can trigger intense emotional and physical reactions that disrupt daily life. Though the condition has likely always existed, misophonia remains underrecognized, underresearched, and without widely accessible, evidence-based treatment. Utah State University doctoral student Emily Bowers is working to change that.

Bowers, a Ph.D. candidate in the Combined Clinical/Counseling program in the Psychology Department within the Emma Eccles Jones College of Education and Human Services at USU, is the principal investigator on a newly funded study from the Misophonia Research Fund (MRF). The two-year Data Discovery Award supports the development and testing of a fully digital, self-guided treatment program for misophonia based on Acceptance and Commitment Therapy (ACT), a form of psychotherapy that uses acceptance, mindfulness, and values-based strategies to promote mental health and wellbeing.

“I am grateful for the great work that Emily is doing,” said Mike Twohig, faculty member in the Combined Clinical/Counseling specialization and Bowers’ graduate advisor. “She saw that ACT could successfully help individuals with misophonia and proposed this project where she is testing this intervention through an online program. Emily has always had a keen eye for ways to help solve social problems. I think a lot of people will be helped because of this program and Emily’s efforts.”

“This is a population I care deeply about,” Bowers said. “Misophonia is still widely misunderstood, and many people struggle to find appropriate care. If my work can play even a small role in addressing that gap, that would be meaningful.”

Misophonia is defined as a decreased tolerance to specific sounds or related stimuli. While many people are bothered by certain noises, individuals with misophonia experience reactions that are severe, persistent, and often debilitating. Trigger sounds vary widely and include chewing, slurping, throat clearing, typing, clicking pens, ticking clocks, or even noises made by pets. These sounds can provoke anxiety, panic, anger, or a powerful urge to escape.

“When misophonia is clinically impairing, it affects core areas of life,” Bowers explained. “People living with misophonia experience significant distress sitting at the dinner table with family or attending work meetings. They can feel trapped because they can’t escape the sound.”

The condition is not yet listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which means it is not formally recognized for diagnostic or insurance purposes. As a result, people with misophonia can’t access treatment. Researchers are still working to understand the condition’s psychological, sensory, and biological components, making progress toward formal classification difficult.

Bowers came to USU four years ago to work with Michael Twohig, a faculty member in the Combined Clinical/Counseling specialization and a globally recognized expert in ACT. Twohig co-leads the ACT Research Group at USU with Michael Levin, professor in the Combined Clinical/Counseling Specialization.

As part of her doctoral training, Bowers worked with Twohig and Levin as a researcher on a large, in-person randomized controlled trial that compared ACT to progressive relaxation therapy for misophonia. That project, which was also funded by the Misophonia Research Fund, provided evidence that ACT can help reduce misophonia-related distress.

Once the researchers knew ACT could be helpful for people with misophonia, the question became whether they could create a digital program that people could access on their own. The Misophonia Research Fund’s Data Discovery Award made answering that question possible. Designed to support innovative, early-stage research, the grant is open to graduate students, postdoctoral fellows, and early-career investigators—a rarity in clinical research funding.

“Usually, I wouldn’t be able to serve as a principal investigator until after my Ph.D.,” Bowers said. “This grant really encourages early-career researchers to lead.” Bowers is one of four recipients in the inaugural cohort of the MRF’s Data Discovery Awards. She is co-mentored on the grant by Twohig and Levin.

Last summer, the team converted a 12-session in-person therapy protocol into an eight-module, fully self-guided online program called the ACT Guide for Misophonia. The research team partnered with soQuiet, a nonprofit organization composed of individuals across the country who live with misophonia. Volunteers reviewed the program content to ensure it was accurate, respectful, and non-stigmatizing.

“This community is deeply invested in misophonia research,” Bowers said. “They want the science to move forward in ways that reflect their lived experiences and translate into accessible resources.”

Recruitment for the study began in October and aims to enroll 100 participants, randomly assigning half to the ACT-based intervention and half to a control group. Participants will complete diagnostic interviews, self-report measures of misophonia severity, distress, impairment, and psychological flexibility, as well as broader measures of well-being and quality of life. Those in the control group will receive delayed access to the intervention after completing the study.

Randomized controlled trials allow researchers to determine whether improvements are due to the treatment rather than to time or external factors. This is the first randomized controlled trial of a digital intervention for misophonia.

Bowers is supported by a collaborative research team within the ACT Research Group, including graduate students and undergraduate research assistants who will assist with participant interviews and data collection. The grant funding supports personnel, participant compensation, digital development, and data analysis.

While Bowers is cautious about expectations, she is hopeful the intervention will provide meaningful relief for people with misophonia who currently have few treatment options. If successful, the ACT Guide for Misophonia could be made publicly available within the next two years, dramatically expanding access to care for people.

For Bowers, the project reflects the kind of impact she hopes to have throughout her career. “I’m doing this work because it matters,” she said. “If we can help move the field forward and make treatment more accessible for people with misophonia, that’s incredibly rewarding.”