A 14-session CBT intervention using a specific-phobia formulation (graded in vivo exposure and behavioural experiments) was delivered to one older adult male (70s) with Multiple Chemical Sensitivity (MCS) following acute toxic inhalation, with follow-up at 10 and 22 months.
By end of treatment, the patient achieved all pre-defined functional goals (e.g., hoovering without a mask, daily dog walks, driving). GAD-7 dropped below clinical cut-off; at 22-month follow-up, GAD-7 = 1 and BAI = 3. Harm-belief ratings for most triggers approached zero.
- Single case report with no control condition; causal attribution to treatment is not possible. - No validated MCS-specific outcome measure; GAD-7 was introduced mid-treatment, so no true pre-treatment baseline exists. - Findings may not generalise to MCS presentations with different physical comorbidities or symptom profiles.
For patients with MCS where medical evaluation finds no organic pathology, a specific-phobia CBT model using graded exposure and behavioural experiments may be worth considering after careful differential diagnosis. Early virtual sessions can reduce barriers to engagement when avoidance is severe.
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