Table 1.

Components of CBT intervention

Psycho-education/shared formulation  • Psycho-education about depersonalisation  • Individualised CBT shared formulations for current pattern of depersonalisation  • Assessing factors which influence fluctuations in severity  • Rationale for keeping a diary for homework  • Example of diary completion Behavioural  • Planning and testing impact of environmental/behavioural changes to manipulate and manage depersonalisation symptoms Emotion regulation  • Examining the role of emotions associated with depersonalisation  • Identifying anxiety/distress management strategies  • Psycho-education about grounding strategies and practice of these Cognitive  • Identifying unhelpful thoughts about depersonalisation  • Cognitive restructuring—reviewing the evidence for and against unhelpful depersonalisation related thoughts Thinking processing  • Role of attention in maintaining depersonalisation  • Reducing hyper-vigilance/symptom monitoring/checking behaviours  • Acceptance and mindfulness approaches to depersonalisation Review and relapse prevention  • Summary of what has been learnt from the sessions  • Depersonalisation action plan After each session, participants will be given a small ‘homework’ task to practice techniques introduced in the session and to monitor symptoms using a diary