scholarly journals Delivering CBT-E In an Online Group Format: A Pilot Study in a Child and Adolescent Eating Disorder Service

2021 ◽  
Author(s):  
Layla Hamadi ◽  
Reece Hilson ◽  
Amy Lunn ◽  
Emily Ralph ◽  
Evangeline Rodrigues ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Pilot Study ◽  
Behavioral Therapy ◽  
Child And Adolescent ◽  
Service Evaluation ◽  
Psychosocial Impairment ◽  
Medical Risk ◽  
Qualitative Feedback ◽  
Online Group

Abstract Background: The increased prevalence of eating disorders during the COVID-19 pandemic has placed services for children and adolescents under immense pressure. The high number of people at medical risk has led to longer waiting lists for psychological support for those who are physically stable. A pilot study was conducted to evaluate the feasibility and effectiveness of providing group enhanced cognitive behavioral therapy for eating disorders (CBT-E), in a virtual setting, as a way of increasing the provision of evidence-based treatment during the pandemic.Method: Clinicians in a child and adolescent eating disorder service were invited to refer patients to take part in a six-session course of therapy comprising the CBT-E Stage Three Body Image module. Primary outcomes were acceptance rates, completion rates, qualitative feedback and quantitative data from routine measures of eating disorder psychopathology and psychosocial impairment.Results: From 22 eligible referrals, 12 participants accepted and enrolled in therapy. Eight completed all six sessions. Qualitative feedback was positive. Both the content and group nature of the intervention were described as helpful. There was an improvement in all scores on the psychometric tests. Conclusions: This pilot study demonstrated that online group CBT-E was a feasible method of providing psychological therapy within the service. A larger trial is recommended to robustly test the effectiveness of the intervention compared to one-to-one in-person CBT-E, and to test whether other modules of the CBT-E protocol can be similarly delivered in this population.Trial registration: This study was pre-registered and approved as a clinical service evaluation by the Oxford Health NHS Foundation Trust, United Kingdom

scholarly journals Emotion regulation group skills training: a pilot study of an add-on treatment for eating disorders in a clinical setting

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Kristina Holmqvist Larsson ◽  
Anna Lowén ◽  
Linda Hellerstedt ◽  
Linn Bergcrona ◽  
Mimmi Salerud ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Emotion Regulation ◽  
Eating Disorder ◽  
Pilot Study ◽  
Clinical Setting ◽  
Skills Training ◽  
Adjunctive Treatment ◽  
Paired Samples ◽  
Clinical Impairment ◽  
Group Skills

Abstract Background Emotion regulation difficulties appear to play a role in the development and maintenance of several eating disorders. This pilot study aimed at examining whether a short add-on group skills training in emotion regulation for young adults with different eating disorders was feasible in a psychiatric clinical setting. We also investigated if the treatment increased knowledge of emotions, and decreased self-reported difficulties with emotion regulation, alexithymia, symptoms of eating disorder, anxiety and depression, as well as clinical impairment. Methods Six skills training groups were piloted with a total of 29 participants (M = 21.41 years, SD = 1.92). The treatment consisted of five sessions dealing with psychoeducation about emotions and emotion regulation skills training. Paired samples t-test was used to compare differences between before-and-after measures. Results The primary outcomes measures difficulties in emotion regulation (p <  0.001) and alexithymia (p <  0.001) showed significant improvement after treatment. The total eating disorder score (p = 0.009) was also significantly reduced, as was clinical impairment (p <  0.001). Acceptance/valued direction, identifying primary emotions and learning about secondary emotions was rated as especially helpful. Conclusions This preliminary pilot study showed that group training targeting emotion regulation skills was feasible and appreciated by participants, as well as being potentially promising as an adjunctive treatment for different eating disorders. Further controlled studies are needed. Trial registration The study was retrospectively registered NCT04148014 on October 30th 2019.

Eating Disorders

2014 ◽  
pp. 391-409
Author(s):  
Robyn Sysko ◽  
G. Terence Wilson
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
American Psychiatric Association ◽  
Behavioral Therapy ◽  
Future Research ◽  
Pharmacological Treatments ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Not Otherwise Specified ◽  
Dsm Iv

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) describes two eating disorder diagnoses, anorexia nervosa (AN) and bulimia nervosa (BN). Provisional criteria are also provided in DSM-IV for binge eating disorder (BED), which is an example of an eating disorder not otherwise specified. This chapter presents a summary and synthesis of research related to the clinical features and treatment of AN, BN, and BED, including studies of prevalence, common comorbidities, and treatment efficacy. Both psychological and pharmacological treatments are reviewed, including cognitive-behavioral therapy, interpersonal psychotherapy, family therapy, and the use of antidepressant medications. Recommendations are made for future research across the eating disorders.

Cognitive-Behavior Therapy With Eating Disorders: The Role of Medications in Treatment

2007 ◽  
Vol 21 (1) ◽  
pp. 16-27 ◽  
Author(s):  
Wayne A. Bowers ◽  
Arnold E. Andersen
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Cognitive Behavioral Therapy ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Behavioral Therapy ◽  
Combined Treatment ◽  
Comprehensive Treatment

Cognitive-behavioral therapy has demonstrated efficacy in the treatment of bulimia nervosa, but there is less empirical data on its usefulness with anorexia nervosa or binge-eating disorder. The use of cognitive-behavioral therapy (CBT) is recommended as the first line of treatment for bulimia nervosa and strongly recommended in combination when medications alone have not been effective. Combined treatment also improves symptoms such as anxiety, depression, and dietary restriction. Empirical studies support the usefulness of CBT with binge-eating disorder and suggest higher remission rates with combined treatment. No single psychotherapy or medicine alone is effective in treating anorexia nervosa. CBT is typically used as part of a comprehensive treatment program with nutritional rehabilitation and prudent use of medication. Both CBT and medication may have benefits in maintaining gains for anorexia nervosa patients after inpatient treatment. More research on CBT alone and in combination with medication is needed to adequately understand the respective roles of these therapies in a comprehensive treatment of eating disorders.

Treatments for Eating Disorders

2015 ◽  
Author(s):  
Kathleen M. Pike ◽  
Loren M. Gianini ◽  
Katharine L. Loeb ◽  
Daniel Le Grange
Keyword(s):  
Eating Disorders ◽  
Weight Loss ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
Evidence Based Treatments ◽  
Substantial Progress

Substantial progress in advancing evidence-based treatments for eating disorders has been made. Many well-designed studies provide cumulative support for cognitive-behavioral therapy (CBT) as the treatment of choice for bulimia nervosa. Interpersonal psychotherapy (IPT) and pharmacotherapy are considered appropriate alternative treatments for bulimia nervosa. While CBT, IPT and pharmacotherapy often produce significant reductions in binge eating and compensatory behaviors, these treatment options need to be improved to help more individuals achieve full and lasting recovery. In the treatment of binge eating disorder, CBT and IPT have been shown to be the most efficacious in reducing symptoms and improving psychological outcomes. Weight loss is often an additional goal of those entering treatment for binge eating disorder; however, existing treatments have generally been unsuccessful in producing significant maintainable weight loss. Initial studies suggest that CBT may be associated with improved outcome both in the acute and maintenance phases of treatment for anorexia nervosa.

Controversies and Questions in Current Evaluation, Treatment, and Research Related to Child and Adolescent Eating Disorders

2010 ◽  
pp. 50-72
Author(s):  
James Lock
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Emotional Disorders ◽  
Child And Adolescent ◽  
Outpatient Setting ◽  
Future Research ◽  
Research Issues ◽  
Not Otherwise Specified ◽  
Disorder Symptom ◽  
Adolescent Eating Disorders

This chapter addresses specific diagnostic, treatment, and research issues related to child and adolescent eating disorders. Current diagnostic formulations are inadequate for diagnosing eating disorders such as selective eating, food avoidance emotional disorders, and food phobias in children. Classification schemes for anorexia and bulimia nervosa are not developmentally sensitive, leading to overuse of “eating disorder not otherwise specified” as a diagnosis. Treatment studies in children and adolescents are few; however, those available suggest that certain guidelines are generally applicable. Adolescents with eating disorders should be treated as early as possible in an outpatient setting utilizing parents as resources. Medications, if used, should address comorbid conditions. Data hopefully forthcoming in the next 5 to 10 years will shed light on how best to classify and treat these disorders. Future research should integrate neuropsychological and neurofunctional findings related to brain development, cognitive functioning, and eating disorder symptom development in this age group.

Experience of transition between a child and adolescent service and adult service for the treatment of eating disorders

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jackie Wales ◽  
Nicola Brewin ◽  
Karima Susi ◽  
Alison Eivors ◽  
Debbie Whight ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Qualitative Methodology ◽  
Geographical Location ◽  
Child And Adolescent ◽  
Service Evaluation ◽  
Valuable Insight ◽  
Content Type ◽  
Adult Services ◽  
The Uk ◽  
Effective Transfer

Purpose There is a dearth of research on what constitutes effective transfer of care from children’s and young people services to adult services for patients with eating disorders (EDs) in the UK. Transition has implications for continuity of care and particularly for early intervention which has the best prognosis. The purpose of this paper is to understand the experience of transition and identify facilitators and barriers to this. Design/methodology/approach Qualitative methodology was used. Focus groups (n = 4) were held with clinicians (n = 22) working in Child and Adolescent Mental Health Services or adult ED services. Individual interviews were conducted with patients (n = 5) who had commenced/completed transition to adult services and with parents/carers (n = 6) of patients invited for interview. Findings A number of factors may facilitate or impede transition and can be grouped into the broad themes of communication, managing the differences between services and timing of transition. Improvements in communication, clear explanation of service differences and flexibility around the timing of transitions may enhance the experience for patients and parents/carers. Research limitations/implications The service evaluation was limited to transition between two specialist ED services in one geographical location. The findings provide the basis for a wider research study to examine which factors are most important when planning transition from the perspectives of patients, parents/carers and clinicians. Originality/value This is the first study examining ED transitions in the UK. It provides valuable insight of the experience of service users and carers and highlights potential improvements when planning transitions for this patient group.

Psychopharmacology in the Treatment of Eating Disorders

2018 ◽  
pp. 384-403
Author(s):  
Lindsay J. Moskowitz ◽  
Benson Ku ◽  
Shervin Shadianloo ◽  
Victor M. Fornari
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Behavioral Therapy ◽  
Mood Stabilizers ◽  
United States Food ◽  
Family Based

Given the high morbidity and mortality rates associated with eating disorders (EDs), many studies have examined the use of medications to treat these disorders. However, with the exception of fluoxetine (for those 12 years and older with bulimia nervosa) and lisdexamfetamine (for adults with moderate-to-severe binge eating disorder), no other medications have been approved by the United States Food and Drug Administration to treat any eating disorder. This article will review many of the positive and negative studies for use of medication in the treatment of eating disorders, including anorexia nervosa, bulimia nervosa, atypical anorexia nervosa, avoidant/restrictive food intake disorder, and binge eating disorder. Various classes of medication will be reviewed, including antidepressants, antipsychotics, mood stabilizers, and anxiolytics. Although the information in this article is important in the education of both patients and their parents, medications should be used cautiously in those with EDs. It should be emphasized that to date, therapy—family-based therapy and enhanced cognitive behavioral therapy—is the mainstay of treatment, with nutrition therapy and correction of malnutrition as the crucial first step in treatment.

Cognitive Behavioral Therapy for the Eating Disorders

2021 ◽  
Vol 17 (1) ◽  
pp. 417-438
Author(s):  
W. Stewart Agras ◽  
Cara Bohon
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Clinical Practice ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Research Findings ◽  
Short And Long Term

Research findings strongly suggest that cognitive behavioral therapy for the eating disorders (CBT-ED) is more effective than other treatments for bulimia nervosa (BN) and for binge eating disorder (BED), although interpersonal psychotherapy appears to be equally effective for BED. Evidence for the effectiveness of CBT-ED for the persistent (adult) form of anorexia nervosa (AN) is insufficient at present and is essentially absent for AN in adolescents except for some evidence from uncontrolled trials. This article begins with an overview of the early studies in the development of CBT-ED that showed a similar effectiveness of other symptom-focused psychotherapies—a finding that was neglected at the time. Later developments are then considered, including comparisons of CBT-ED with other psychotherapies, efforts to develop Internet-based training and treatment, and electronic applications for treatment. Finally, implications of the findings for future short- and long-term research and for clinical practice are considered.

Cognitive Behavioral Therapy for Eating Disorders

2010 ◽  
pp. 330-347 ◽  
Author(s):  
Gregory D. Wilson
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Behavioral Therapy ◽  
Evidence Based ◽  
Cognitive Behavior ◽  
Evidence Based Treatment ◽  
Not Otherwise Specified ◽  
Self Help ◽  
Clinical Strategies

Cognitive behavior therapy (CBT) is the most effective treatment of bulimia nervosa (BN) and binge eating disorder (BED). Initial findings with eating disorder not otherwise specified (EDNOS) other than BED promise similar outcomes. Options for improving upon the efficacy and efficiency of CBT are discussed, primarily by incorporating an expanded range of principles and clinical strategies from CBT in general. Fairburn’s (2008) enhanced CBT provides an illustration. Dissemination of CBT is poor. Guided self-help based on CBT principles is effective for a subset of patients with BN and BED and provides the means for making evidence-based treatment available to a wider range of patients. There is scant research on CBT for anorexia nervosa, and evidence of efficacy is lacking.

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