How Well Does Exposure Therapy Work for Eating Disorders?

2019 ◽  
pp. 45-54
Author(s):  
Carolyn Black Becker ◽  
Nicholas R. Farrell ◽  
Glenn Waller
Keyword(s):  
Eating Disorders ◽  
Body Image ◽  
Strong Evidence ◽  
Exposure Therapy ◽  
Single Case ◽  
Evidence Base ◽  
Current Evidence ◽  
Controlled Trials ◽  
Treatment Protocols ◽  
Missing Element

This chapter provides an overview of the current evidence supporting the use of exposure therapy for eating disorders. Although further research is needed (because the existing research base is relatively small compared to large exposure literature for anxiety disorders), exposure is an effective approach for addressing key transdiagnostic features in eating disorders, including eating-related fear and avoidance, body image anxiety, compulsive body checking and avoidance, and binge-eating and purging behaviors. Results are drawn from a range of study types, from single case studies to large, methodically rigorous controlled trials. Importantly, several of the studies reviewed in this chapter showed that exposure was helpful for patients who had been previously unable to derive benefit from viable alternative treatments. Thus, exposure may offer a critical “missing element” in treatment protocols that have a reasonably strong evidence base and yet leave room for improvement in outcomes.

Couple and Family Therapy

2017 ◽  
Author(s):  
Jessica ChenFeng ◽  
Diane Gehart
Keyword(s):  
Eating Disorders ◽  
Substance Use ◽  
Family Therapy ◽  
Couples Therapy ◽  
Evidence Base ◽  
Current Evidence ◽  
Evidence Based ◽  
Couple And Family Therapy ◽  
Current Evidence Base ◽  
Cord Injury

Evidence-based couple and family therapies have a robust and well-established evidence base as a cost-effective treatment for numerous conditions and are the treatment of choice for several childhood and adult mental health issues. This review provides a brief overview of systemic couple and family therapy principles and then reviews the evidence base for using these methods with specific disorders. Family therapy treatments have been identified as a primary intervention for several childhood and adolescent disorders, including conduct, alcohol and substance use, attention-deficit, autism, psychotic, mood, anxiety, and eating disorders, as well as certain physical disorders, including diabetes, enuresis, and asthma. For adults, the current evidence base supports couples therapy for major depressive disorder with couple distress, alcohol and substance use disorders, anxiety disorders, distressed couples, and interpersonal violence with certain batterers. In addition, couple and family therapy is indicated for certain adult chronic health conditions, including stroke, traumatic brain injury, spinal cord injury, cardiovascular diseases, cancer, dementia, and diabetes. The review concludes with a discussion of effective referral for and training in evidence-based family therapy approaches. This review contains 6 figures, 5 tables, and 53 references. Key words: ADD/ADHD, adolescent, childhood trauma, conduct disorder, couples therapy, depression, eating disorders, family therapy,  marital therapy, mood disorder

scholarly journals Challenging rigidity in Anorexia (treatment, training and supervision): questioning manual adherence in the face of complexity

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Annaleise Robertson ◽  
Chris Thornton
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Readiness To Change ◽  
Current Evidence ◽  
Future Research ◽  
Treatment Protocols ◽  
Strict Adherence ◽  
Training And Supervision ◽  
Adolescents And Adults ◽  
Treatment Manuals

Abstract Background Anorexia Nervosa is a debilitating illness. While there have been many advancements to treatment protocols and outcomes for people with eating disorders, the field acknowledges there remains considerable room for improvement. This timely Special Edition of the Journal of Eating Disorders has invited those of us in the field to consider a range of topics in aid of this task, including potential modifications and implementation of evidence-based practice, specific and common psychotherapy factors, treatment manuals, adherence and individualising treatment approaches for individuals and families. Body In this paper, we briefly outline the key manualised treatments currently available to treat children, adolescents and adults with Anorexia Nervosa, considering the benefits, potential reasons for adaptations and limitations. We then review the current evidence for training strict adherence to treatment manuals which is often a key focus in training and supervision, questioning the association of increased treatment adherence with improved therapeutic outcome. We then summarise some key evidence behind other therapeutic factors which have been demonstrated to affect outcome regardless of which manual is implemented, such as readiness to change and therapeutic alliance. Conclusion The paper concludes with implications and considerations for future research, clinical guidelines, training and supervision, highlighting the need to consider the therapeutic relationship and processes alongside manual content to conduct best evidence-informed practice.

Body Image Disturbance in Children and Adolescents with Eating Disorders

2014 ◽  
Vol 42 (1) ◽  
pp. 51-59 ◽  
Author(s):  
Tanja Legenbauer ◽  
Pia Thiemann ◽  
Silja Vocks
Keyword(s):  
Eating Disorders ◽  
Body Image ◽  
Adult Patients ◽  
Body Image Disturbance ◽  
Current Evidence ◽  
Cognitive Components ◽  
Adolescent Patients ◽  
Body Image Disturbances ◽  
The Individual ◽  
Image Component

Body image is multifaceted and incorporates perceptual, affective, and cognitive components as well as behavioral features. Only few studies have examined the character of body-image disturbance in children/adolescents with eating disorders. It is unknown whether body-image disturbances in children/adolescent with eating disturbances are comparable to those of adult patients with eating disorders. Body-image disturbance might differ quantitatively and qualitatively according to the cognitive developmental status and the age of the individual. This paper provides an overview of the current evidence for body-image disturbance in children/adolescents with eating disorders, and how they compare with those adults with eating disorders. Current evidence indicates that older adolescent patients show similar deficits as adult patients with eating disorders, in particular for the attitudinal body-image component. However, evidence for a perceptual body-image disturbance in adolescent patients, in particular anorexia nervosa, is not conclusive. Reliable statements for childhood can hardly be made because clinical studies are not available. Investigations of body-image disturbance in children have focused on the predictive value for eating disorders. Limitations of the current evidence are discussed, and future directions for research and therapy are indicated.

Current Evidence Base for the UP-C and UP-A

2021 ◽  
pp. 31-38
Author(s):  
Niza Tonarely ◽  
Dominique Phillips
Keyword(s):  
Randomized Controlled Trial ◽  
Children And Adolescents ◽  
Emotional Disorders ◽  
Controlled Trial ◽  
Evidence Base ◽  
Current Evidence ◽  
Controlled Trials ◽  
Transdiagnostic Treatment ◽  
Randomized Controlled ◽  
Current Evidence Base

This chapter summarizes current research support for Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C and UP-A), which have been found to be efficacious for children and adolescents with a range of emotional concerns. The UP-A has been investigated in randomized controlled trials and has demonstrated efficacy in treating anxiety and depressive symptoms, with significant decreases in symptoms during treatment and maintenance of gains following treatment. The UP-C has been investigated using open and randomized controlled trial designs and was found to be as efficacious as an established anxiety protocol. This chapter also presents research on patterns of change across symptoms and individuals in response to the UP-C and UP-A, including response trajectories, the timing of change, and comparisons of rates of change by symptom and reporter.

scholarly journals Psychological treatments in intellectual disability: the challenges of building a good evidence base

2011 ◽  
Vol 198 (6) ◽  
pp. 428-430 ◽  
Author(s):  
Sabyasachi Bhaumik ◽  
Satheesh Gangadharan ◽  
Avinash Hiremath ◽  
Paul Swamidhas Sudhakar Russell
Keyword(s):  
Randomised Controlled Trials ◽  
Evidence Base ◽  
Good Evidence ◽  
Current Evidence ◽  
Controlled Trials ◽  
Psychological Treatments ◽  
Current Evidence Base ◽  
People With Intellectual Disabilities ◽  
Randomised Controlled ◽  
The Cost

SummaryPsychological treatments are widely used for the management of mental health and behavioural problems in people with intellectual disabilities. The evidence base, including the cost-effectiveness of such interventions, is limited. This editorial explores the current evidence base and analyses its strengths and limitations. The editorial also highlights current problems in conducting randomised controlled trials in this area and suggests a way forward.

scholarly journals Eating Disorders and Female Sexuality: Current Evidence-base and Future Implications

Psico-USF ◽  
2020 ◽  
Vol 25 (1) ◽  
pp. 101-113
Author(s):  
Carolina Leonidas ◽  
Manoel Antônio dos Santos
Keyword(s):  
Eating Disorders ◽  
Gender Role ◽  
Body Shape ◽  
Female Sexuality ◽  
Female Gender ◽  
Evidence Base ◽  
Current Evidence ◽  
Negative Consequences ◽  
Biological Sex ◽  
Current Evidence Base

Abstract This study aimed to examine current scientific production regarding sexuality-related issues in the context of eating disorders (ED). Searches were performed on PubMed, LILACS, CINAHL and PsycINFO, including papers published between 2008 and 2018, using the following descriptors: eating disorders, femininity, sexuality and sexual behavior. Nineteen studies were selected. Findings were systematized into two main thematic categories and showed, in general, that femininity can be a risk factor to the development of ED. Studies indicated that endorsing a gender role that is socially considered discrepant from biological sex, despite feminine or masculine, is related to ED symptomatology. Moreover, body dissatisfaction is positively correlated to sexual dysfunction. Interventions targeting prevention of ED should include sexuality-related issues by approaching probable negative consequences of adhering to female gender role social requirements and stereotypes, especially those related to body weight and body shape.

Final Summary

2019 ◽  
pp. 213-216
Author(s):  
Carolyn Black Becker ◽  
Nicholas R. Farrell ◽  
Glenn Waller
Keyword(s):  
Eating Disorders ◽  
Body Image ◽  
Clinical Practice ◽  
Exposure Therapy ◽  
Future Directions ◽  
Key Points ◽  
Growing Body

The objective of this summary chapter is to provide readers with a synopsis of the key points made about exposure-based therapy for eating disorders throughout the book. Readers are reminded of the theoretically derived rationale for applying exposure-based therapy to eating disorders and that a growing body of literature demonstrates the efficacy of this approach. Readers are also reminded of several critical steps that need to be taken to prepare patients for exposure therapy effectively. The chapter summarizes the problem-specific exposure interventions that are covered in the book, such as body-focused exposure for body image anxiety. Lastly, the chapter provides a discussion of future directions in both research and clinical practice of exposure therapy for eating disorders.

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