scholarly journals Cognitive behavioural therapy for individuals with longstanding anorexia nervosa: Adaptations, clinician survival and system issues

2010 ◽  
Vol 20 (1) ◽  
pp. 49-59 ◽  
Author(s):  
Bryony H. Bamford ◽  
Victoria A. Mountford
2016 ◽  
Vol 46 (16) ◽  
pp. 3291-3301 ◽  
Author(s):  
N. Egger ◽  
B. Wild ◽  
S. Zipfel ◽  
F. Junne ◽  
A. Konnopka ◽  
...  

BackgroundAnorexia nervosa (AN) is a serious illness leading to substantial morbidity and mortality. The treatment of AN very often is protracted; repeated hospitalizations and lost productivity generate substantial economic costs in the health care system. Therefore, this study aimed to determine the differential cost-effectiveness of out-patient focal psychodynamic psychotherapy (FPT), enhanced cognitive–behavioural therapy (CBT-E), and optimized treatment as usual (TAU-O) in the treatment of adult women with AN.MethodThe analysis was conducted alongside the randomized controlled Anorexia Nervosa Treatment of OutPatients (ANTOP) study. Cost-effectiveness was determined using direct costs per recovery at 22 months post-randomization (n = 156). Unadjusted incremental cost-effectiveness ratios (ICERs) were calculated. To derive cost-effectiveness acceptability curves (CEACs) adjusted net-benefit regressions were applied assuming different values for the maximum willingness to pay (WTP) per additional recovery. Cost–utility and assumptions underlying the base case were investigated in exploratory analyses.ResultsCosts of in-patient treatment and the percentage of patients who required in-patient treatment were considerably lower in both intervention groups. The unadjusted ICERs indicated FPT and CBT-E to be dominant compared with TAU-O. Moreover, FPT was dominant compared with CBT-E. CEACs showed that the probability for cost-effectiveness of FTP compared with TAU-O and CBT-E was ⩾95% if the WTP per recovery was ⩾€9825 and ⩾€24 550, respectively. Comparing CBT-E with TAU-O, the probability of being cost-effective remained <90% for all WTPs. The exploratory analyses showed similar but less pronounced trends.ConclusionsDepending on the WTP, FPT proved cost-effective in the treatment of adult AN.


Children ◽  
2022 ◽  
Vol 9 (1) ◽  
pp. 92
Author(s):  
José I. Baile ◽  
María F. Rabito-Alcón

Introduction: The treatment of anorexia nervosa remains a matter of much debate. Though cognitive behavioural therapy would seem to offer good results, there is still no resounding evidence pointing to a single treatment of choice. The case presented in this paper examines the treatment with CBT of a patient presenting anorexia nervosa. Evaluation/diagnosis: An adolescent girl, 17 years of age, voluntarily attends psychological therapy to address eating behaviour problems. After administering the EAT-26, EDI-2, and BSQ standardised screening tests, as well as a clinical interview for assessment, a psychopathological profile is obtained, providing a diagnosis of anorexia nervosa, restricting subtype. Therapeutic goals: The therapeutic goals set were to reach a healthy weight for the patient’s age and height (specified as a minimum BMI of 18.5) and change the structure of thoughts, feelings, and behaviour that was justifying and maintaining the disorder. Treatment: Treatment lasted for 33 sessions and used cognitive behavioural techniques, such as cognitive restructuring, response cost, and positive reinforcement, in addition to family intervention techniques. Nutrition therapy was also carried out in parallel to the treatment sessions. Results: Following eight months of weekly sessions, the patient reached the target weight and changed attitudes towards food and body image, replacing them with healthy thoughts and behaviours. Follow-up made one and two years after the end of the treatment saw that these results were maintained. Discussion and conclusions: In this case, CBT proved effective in achieving the patient’s physical and psychological recovery. Therefore, this case contributes to the evidence of the efficacy of this therapeutic approach in certain cases of ED.


2016 ◽  
Vol 44 (6) ◽  
pp. 717-722 ◽  
Author(s):  
Felicity A. Cowdrey ◽  
Jennifer Davis

Background: Few studies have examined the acceptability and usefulness of enhanced cognitive behavioural therapy (CBT-E) for adolescents with eating disorders (EDs). Aim: To investigate whether CBT-E was an acceptable and efficacious treatment for an adolescent presenting to a routine clinical service with an ED. Method: Daily self-monitoring records were completed during a baseline (A) and intervention (B) phase in addition to routine outcome measures. Results: There were reductions in both ED behaviours and “feeling fat”, and increases in weight after 11 CBT-E sessions. Progress was only partially maintained at 8-month follow-up. Conclusion: CBT-E may be an acceptable and useful intervention for adolescents with EDs.


2019 ◽  
Vol 88 (4) ◽  
pp. 241-243 ◽  
Author(s):  
Timo Brockmeyer ◽  
Silke Michalek ◽  
Stephan Zipfel ◽  
Beate Wild ◽  
Gaby Resmark ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document