Cognitive Behaviour Therapy for Eating Disorders

2008 ◽  
Vol 36 (6) ◽  
pp. 713-722 ◽  
Author(s):  
Zafra Cooper ◽  
Roz Shafran

AbstractThe eating disorders provide one of the strongest indications for cognitive behaviour therapy (CBT). This bold claim arises from two sources: first, the fact that eating disorders are essentially cognitive disorders and second, the demonstrated effectiveness of CBT in the treatment of bulimia nervosa, which has led to the widespread acceptance that CBT is the treatment of choice. In this paper the cognitive behavioural approach to the understanding and treatment of eating disorders will be described. A brief summary of the evidence for this account and of the data supporting the efficacy and effectiveness of this form of treatment will be provided. Challenges for the future development and dissemination of the treatment will be identified.

Author(s):  
Zafra Cooper ◽  
Rebecca Murphy ◽  
Christopher G. Fairburn

The eating disorders provide one of the strongest indications for cognitive behaviour therapy. This bold claim arises from the demonstrated effectiveness of cognitive behaviour therapy in the treatment of bulimia nervosa and the widespread acceptance that cognitive behaviour therapy is the treatment of choice. Cognitive behaviour therapy is also widely used to treat anorexia nervosa although this application has not been adequately evaluated. Recently its use has been extended to ‘eating disorder not otherwise specified’ (eating disorder NOS), a diagnosis that applies to over 50 per cent of cases, and emerging evidence suggests that it is just as effective with these cases as it is with cases of bulimia nervosa. In this chapter the cognitive behavioural approach to the understanding and treatment of eating disorders will be described. The data on the efficacy and effectiveness of the treatment are considered in the chapters on anorexia nervosa and bulimia nervosa (see Chapters 4.10.1 and 4.10.2 respectively), as is their general management.


Author(s):  
Christopher G. Fairburn

Chapter 9 discusses eating disorders, including anorexia nervosa and bulimia nervosa. It reviews the scientific standing and practice of cognitive behaviour therapy as applied to eating disorders, including a rationale for the use of cognitive behaviour therapy, its efficacy, an outline of the treatments themselves, and the utility of the cognitive behavioural approach.


2015 ◽  
Vol 44 (2) ◽  
pp. 168-178 ◽  
Author(s):  
Louise Onslow ◽  
Debbie Woodward ◽  
Toni Hoefkens ◽  
Louise Waddington

Background: Recent quantitative studies provide support for an “enhanced” transdiagnostic approach of Cognitive Behaviour Therapy (CBT-E) for eating disorders; however it is not yet known how recipients of CBT-E experience therapy. Aims: The current study used a qualitative approach to explore service users’ experiences of CBT-E. Method: Individuals with a diagnosis of bulimia nervosa and who had completed CBT-E from one service in Wales were invited to participate. Semi-structured interviews were completed with eight individuals and analysed using Interpretative Phenomenological Analysis (IPA). Results: Participants valued both specific and non-specific elements of CBT-E. Therapist specialism in eating disorders was considered to enhance therapist empathy. The most helpful aspects specific to CBT-E were gaining insight into maintenance cycles and experiential learning. The most challenging aspects of CBT-E were changing behaviours and cognitions “in the moment” and in the longer-term. Conclusions: The implication of therapist specialism and empathy is further discussed, as well as the difficulty for CBT-E in changing service users’ long-standing core beliefs.


2016 ◽  
Vol 44 (6) ◽  
pp. 673-690 ◽  
Author(s):  
Philip Andersen ◽  
Paul Toner ◽  
Martin Bland ◽  
Dean McMillan

Background: Transdiagnostic Cognitive Behaviour Therapy (CBT) seeks to identify core cognitive-behavioural processes hypothesized to be important across a range of disorders and to develop a treatment that targets these. This contrasts with standard CBT approaches that are disorder-specific. Proponents of transdiagnostic CBT suggest that it may offer advantages over disorder-specific CBT, but little is known about the effectiveness of this approach. Aims: The review aimed to summarize trial-based clinical and cost-effectiveness data on transdiagnostic CBT for anxiety and depression. Method: A systematic review of electronic databases, including peer-reviewed and grey literature sources, was conducted (n = 1167 unique citations). Results: Eight trials were eligible for inclusion in the review. There was evidence of an effect for transdiagnostic CBT when compared to a control condition. There were no differences between transdiagnostic CBT and active treatments in two studies. We found no evidence of cost-effectiveness data. Conclusions: Quality assessment of the primary studies indicated a number of methodological concerns that may serve to inflate the observed effects of transdiagnostic approaches. Although there are positive signs of the value of transdiagnostic CBT, there is as yet insufficient evidence to recommend its use in place of disorder-specific CBT.


2014 ◽  
Vol 40 (2) ◽  
Author(s):  
Kim Minjoo ◽  
Elias Mpofu ◽  
Kaye Brock ◽  
Michael Millington ◽  
James Athanasou

Orientation: To identify the effects of interventions in cognitive-behaviour therapy (CBT) on employment-related outcomes world-wide for individuals with mental illness.Research purpose: A search of the relevant literature was conducted through PsychInfo, Medline, Scopus and Google Scholar™, covering the period between 1995 and August 2011. The methodological quality of included studies was assessed using the criteria from Evidence Based Library and Information Practice (EBLIP). Eleven studies met the inclusion criteria.Motivation for the study: Evidence is needed on best practices to support work participation by people with mental illness. Effective cognitive-behavioural intervention might enhance their personal control over participation in employment aside from systemic or policy-oriented interventions.Research approach, design and method: A scoping review was done to map trends in the evidence for CBT as an intervention to support employment participation by people with mental illness. A scoping review is exploratory, the evidence of which lays the basis for subsequent studies. The methodological quality of included studies was assessed using the EBLIP Critical Appraisal Checklist.Main findings: Cognitive-behaviour therapy was an effective intervention approach for better work productivity, longer work hours, higher re-employment rate and enhanced mental health for individuals with mental illness.Practical/managerial implications: Cognitive-behaviour therapy is a promising strategy for industrial and organisational psychologists dealing with people who have a mental illness. It enhances employment and maintains work adjustment. Additional clinical trials in diverse populations and contexts will further establish its efficacy.Contribution/value-add: This scoping review aggregated the preliminary evidence for the efficacy of cognitive-behaviour therapy as a work-participation intervention for people with mental illness.


1987 ◽  
Vol 21 (1) ◽  
pp. 5-15 ◽  
Author(s):  
Rosalyn A. Griffiths ◽  
Stephen W. Touyz ◽  
Philip B. Mitchell ◽  
Wendy Bacon

We review treatment approaches to bulimia nervosa, with particular emphasis on methodology and research design. The following treatments are considered: behaviour therapy, cognitive behaviour therapy, pharmacological treatment, group therapy, psychoanalytic psychotherapy, self-help and support groups, hypnosis and miscellaneous (family therapy and nutritional approaches). Several directions for future research and methodological recommendations are suggested.


This title provides a summary of the cognitive behavioural principles on which the therapy is based, followed by a detailed account of how to carry out a cognitive–behavioural assessment. Subsequent chapters provide self-contained descriptions of how to use the therapy to treat particular conditions: panic and generalized anxiety, phobic disorders, depression, obsessional disorders, somatic problems, eating disorders, chronic psychiatric handicaps, marital problems, and sexual dysfunctions. A final chapter provides a description of problem-solving training. Each chapter describes the condition, assessment procedures, factors likely to be important in formulating the problem, and then the treatment, step-by-step. Particular attention is paid to overcoming difficulties encountered during treatment, and extensive use is made of clinical material and case illustrations. This is an excellent guide to the practice of cognitive behaviour therapy for all those beginning to use the technique.


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