A 22-year-old man presents with a 4-year history of preoccupation with perceived facial asymmetry and skin imperfections that others cannot observe. He spends 4 to 5 hours daily mirror checking, comparing his face to others, and researching cosmetic procedures. He has consulted three dermatologists and two plastic surgeons, all of whom found no significant abnormalities. He recently withdrew from college due to the distress and avoidance associated with his appearance concerns. He has poor insight, stating he knows something is wrong with his face and that others are just being polite. He denies depressive symptoms, suicidal ideation, or substance use. The Yale-Brown Obsessive Compulsive Scale modified for BDD (BDD-YBOCS) score is 32. Which treatment plan is most appropriate?