Retrospective Accounts of Cognitive Behaviour Therapy For Eating Disorders: Which Aspects Were Most Useful?
Brown, N. Lancaster D.Clin.Psych. 2008 B2c 59-13297
The trans-diagnostic model of eating disorders (Fairburn, Cooper & Shafran, 2003) proposes that differential eating disorder diagnosis is irrelevant, as eating disorders are similar disorders sharing common processes. This model suggests that in addition to extreme concerns about shape, weight and controlling food intake, four additional mechanisms may create barriers to successful change in individuals with eating disorders. These mechanisms are core low self-esteem, mood intolerance, clinical perfectionism and interpersonal difficulties.
The literature review focuses specifically on the mechanism of ‘mood intolerance’. Studies investigating relationships between negative affect, coping, emotional regulation and disordered eating are reviewed. Evidence suggests that difficulties with affect regulation are associated with the use of disordered eating. Individuals with higher levels of disordered eating engage in more avoidant and emotional coping than individuals with less disordered eating. Additionally, negative affect is associated with avoidant coping and disordered eating.
Therefore, affect regulation is a key area to consider in eating disorder treatment.
The research paper is a qualitative study investigating people’s experiences of cognitive behaviour therapy (CBT) for an eating disorder, in order to find out more about how change occurs during therapy, specifically in relation to the mechanisms outlined by the trans-diagnostic model of eating disorders.
Ten women were interviewed and data were analysed using Framework Analysis. Responses covered four main themes: support for the trans-diagnostic model; CBT related change; the therapeutic alliance; and personal factors. The trans-diagnostic model for eating disorders provides a useful framework for understanding experiences of change during CBT for an eating disorder.