The Center for Eating Disorders Blog

Cognitive Process and Remediation in Anorexia Nervosa, with James Lock, MD, PhD

The Center for Eating Disorders at Sheppard Pratt is excited to welcome Dr. James Lock to Baltimore on September 25, 2010 as one of six featured speakers at our annual professional symposium, Eating Disorders: State of the Art Treatment.

James Lock, MD, Ph.D. is a Professor of Child Psychiatry and Pediatrics in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine where he also serves as Director of the Eating Disorder Program for Children and Adolescents. Dr. Lock is the co-author of the only evidenced-based treatment manual for anorexia nervosa, and one of his newest publications is a treatment manual for adolescent bulimia entitled: Treating Bulimia in Adolescents: A Family-Based Approach. Dr. Lock has lectured extensively across the U.S., Canada, Europe, South America, Asia and Australia. More recently, Dr. Lock has been involved in research regarding a form of treatment called Cognitive Remediation Therapy (CRT) for individuals with eating disorders. Prior to his presentation in Baltimore on September 25th, we were eager to hear what Dr. Lock had to say about CRT and what attendees could expect to learn from his upcoming talk, “Cognitive Process and Remediation in Anorexia Nervosa”. Read Dr. Lock’s responses below and register for the upcoming professional symposium in Baltimore to hear more.

Q & A with James Lock, MD:

What is CRT and how did it originate?

JL: Cognitive Remediation Therapy (CRT) is a therapy designed to improve brain processing inefficiencies such as difficulty focusing, staying on task, and processing speed. CRT was originally devised for remediating thinking processes in people with brain injuries. It has subsequently been used in schizophrenia and obsessive-compulsive disorders. Most recently it was refined for use with adults with anorexia nervosa to specifically address difficulties in flexibility in thinking and over focus on details to the neglect of the big picture.

What sets CRT apart from other therapeutic approaches such as cognitive behavior therapy (CBT) or dialectic behavior therapy (DBT)?

JL: CRT does not focus on eating disorder symptoms, but rather on thinking style. CBT focuses on thoughts, behaviors, and beliefs that putatively maintain the eating disorder. DBT focuses on thoughts and emotional processes using skill-based learning and groups focused on eating disorder symptoms or general emotional and cognitive functioning. In other words, CRT does not aim to address the specific problems related to the eating or psychiatric disorders per se, but rather focuses on a problematic thinking style that may contribute to the development and maintenance of symptoms.

What general benefits could CRT offer individuals with eating disorders? Are there specific individuals who are particularly well-suited for CRT?

JL: The main benefit of CRT for individuals with eating disorders is that they could learn how their particular thinking style effects their thinking processes. In addition, they can learn ways to change some aspects of this thinking style using cognitive exercises. This in turn could help them understand how this relates to decisions they make about eating, exercise, and related behaviors. It is unknown if there are specific individuals who would make particularly good candidates for CRT. It should be stressed that CRT is a very new treatment in the context of eating disorders and its benefits remain largely unknown.

The title of your Sept. 25thpresentation is “Cognitive Process and Remediation in Anorexia Nervosa” what do you hope attendees will take away from this talk?

JL: I hope attendees learn what CRT is (and isn’t) and to understand how it may be useful in the context of other eating disorder specific treatments to enhance therapeutic alliance and increase motivation.

Where can professionals go to read more about the use of CRT in the treatment of individuals with eating disorders?

JL: There are a number of articles that have been published on CRT by Kate Tchanturia, Ph.D and colleagues from the Maudsley Hospital in London. Reading these would be a good place to start.

We are greatly appreciative to Dr. Lock for his responses and look forward to hearing more about this intriguing new treatment approach on September 25th. To register for the symposium (7 cme/ceu credits) please download the program brochure (pdf) or visit our Events page. Don’t delay, space is limited and discounts expire soon! For more information about Dr. Lock’s publications, please click on the images of the books below:

Leave a Reply