Cognitive-Behavioral Therapy For Eating Disorders
There are many things to consider when looking for treatment for an eating disorder. Is hospitalization necessary? How do I convince him/her to get treatment? How long does it take to overcome an eating disorder? Where do I go for help? And … What are the treatments anyway? One type of psychological treatment, known as Cognitive-behavioral therapy (CBT), will be described here.
Cognitive-behavioral therapy is a well-researched and proven method for the treatment of eating disorders. The cognitive-behavioral model for the treatment of eating disorders emphasizes the important role of both the cognitive (e.g., attitudes regarding weight and appearance) and behavioral (e.g., dietary restriction, binge-eating) factors that maintain the eating disorder and associated problems. It is a structured treatment that focuses on the present and the future. It is time-limited, although the amount of time may vary from 6 months to several years. The treatment is presented in stages with an initial emphasis on stabilization of symptoms and behavioral change. The patient and therapist work together to formulate a plan for stabilizing eating and eliminating symptoms, beginning with the very first session. Because emotions often intensify during this phase of treatment, tools (coping strategies) for managing these feelings are developed and become an important part of the work. CBT includes in-session activities as well as homework so that new behaviors can be practiced.
As treatment progresses, cognitive restructuring techniques (e.g., techniques aimed at recognizing and changing problem thinking patterns) are introduced. Thoughts and beliefs that perpetuate the problems (e.g., “I’m so fat and disgusting”; “I will only be happy if I can lose this weight”) are identified and work aimed at developing new perspectives and ideas (“my self-worth doesn’t depend on my size or shape”) begins. Additionally, during this stage of treatment, broader concerns such as relationship problems, body image, self-esteem problems, and emotion regulation are addressed. Even though CBT is focused on the elimination of symptoms, the overall goal of the treatment is to assist the patient in making their return to a happy life. So, very often, once symptoms are stabilized, treatment will expand to include other areas of concern and conflict. The final stage of CBT concentrates on relapse prevention and maintenance planning.
Although CBT is widely recognized as a first-line psychological treatment for eating disorders, not all therapists are trained in this treatment model. If you are looking for treatment for an eating disorder, it is always a good idea to make inquiries into the type of treatment provided and the training of the therapist.
The Center for Eating Disorders has well-trained and highly experienced clinicians who provide CBT at all levels of care. If you would like information regarding CBT available at the Center, please call (410) 938-5252 or email EatingDisorderInfo@sheppardpratt.org.
Submitted by Kim Anderson, Ph.D., Director of Psychology, CED