Monday, December 15, 2008

CBT-E and eating disorders

The hot article of the day is about about a "new" form of Cognitive Behavioral Therapy (CBT) called Cognitive Behavioral Therapy-Enhanced (CBT-E). It's interesting to see how the media decides to title the article. Words range from "potential" to "curing" eating disorders.

CBT-E, developed by Christopher Fairburn, professor and researcher at Oxford University, is an extension of the standard CBT treatment used for bulimia. Fairburn developed two forms of CBT-E--one focuses only on the eating disorder, while the other also delves into low self-esteem and extreme perfectionism issues.

In a study of 154 patients with bulimia and "atypical" eating disorders, results found the majority showed improvement and had sustained effects over a period of a year with both forms of
CBT-E. Two-thirds of those finishing the study had complete and lasting responses.

Fairburn says, "
Now for the first time, we have a single treatment which can be effective at treating the majority of cases without the need for patients to be admitted into hospital." He is now currently studying a large-scale trial using CBT-E with anorexic individuals.

I guess I'm not quite seeing what the big hoopla is and how this
CBT-E is "different" from standard CBT. I'm certainly not a fan of some media outlets saying how this therapy could "cure" eating disorders. Perhaps, that's just the skeptic in me.

I guess my other qualm with all this is, well, shouldn't issues of perfectionism, low self-esteem, depression, etc. already be addressed in whatever therapy is considered?

Obviously, more information on this new psychotherapy needs to be given. Maybe those of you in the UK might know more about this since it is apparently increasingly being used there.

Here's an interesting article
The Independent which asks similar questions and looks at both sides of the coin in how CBT is effective and also its problems.

12 comments:

Kara said...

Interesting. I'd heard of CBT, but not CBT-E. I read the linked article, and I too would like more specifics on CBT-E. For me though, regardless of the type of therapy used, the relationship with the therapist is paramount. If I don't like my therapist or can't connect with her, I'm not motivated to work.

kb said...

As a CBT drop-out, I must say that I'm skeptical. Maybe this "CBT-E" is a *better* form of cognitive therapy, I'm not sure. I totally agree with Kara, regarding the relationship with the therapist. Also, CBT has been shown to be very ineffective when treating depression, and I would guess that, oh, maybe a few people struggling with bulimia also suffer from depression.
It often seems that people want an easy cure-all rather than to say that it takes time, resources and a great deal of effort and will to recover from an eating disorder.
- Kristina

Lola Snow said...

From the ridiculous amount of reading I've done, they know their stuff apparently, but I'm with Kristina. CBT or CBT-E, to steal may favorite quote: CBT: it's the magic process of changing "Nasty thoughts" into "Nice Thoughts". Adding an E on the end makes it no less impressive to me :)

Tiptoe said...

I agree with all your points. I definitely think the relationship between the therapist and client is very important and can be as much a deciding factor as a certain type of treatment.

I think a lot more research needs to be done or at least stated more clearly to the public.

Lola, yeah, Fairburn is apparently very well recognized, so I'm sure he does have a lot of information. Love the quote about CBT!

CEDquiz said...

CBT really seems to be a popular and beneficial form of treatment. The Center for Eating Disorders at Sheppard Pratt discusses what this form of therapy entails and weighs in with their opinion on CBT. To find out more information on CBT and see what CED thinks go here: http://eatingdisorder.org/blog/2008/12/17/what-are-the-treatments-anyway/

symonds said...

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Anonymous said...

i'm surprised you'd say that CBT is ineffective for depression. as a scholar-therapist who has used this technique for some time i find it extremely effective for depression as do my clients. for eating disorders DBT (which is in the same family) is very effective. not everything works for everyone--- but i'd be surprised if some techniques or combination of these couldnt work for almost everyone.

Tiptoe said...

Anon, I'm not sure who you are directing that comment to. Nowhere in my piece did I say CBT was ineffective. Yes, another commenter said that in her reply.

My mere argument is the message claiming that one technique can be used to treat all eating disorders. If so, then CBT-E needs to be proven among a wide scale population as well as shown the differences to actual standard CBT which yes has often been used in treating eating disorders as well as other illnesses.

Anonymous said...

thanks for the informartion i was searching what does it mean CBT-E and now i found

Jeremy said...

@Tiptoe: Why are you asking for the differences between CBT and CBT-E? CBT-E is a specific model using the theory of cognitive behavioural therapy in order to target patients with eating disorders. CBT provides the general principles on how to treat patients, and Fairburn has simply made a specific model of CBT that focuses on the key aspects that are associated with Bulimia Nervosa, and now other eating disorders as well.
CBT is simply a theoretical model taught to therapists in a way that they can manipulate it and modify it to any specific individuals needs. As it happens, CBT is arguably the most effective type of treatment for treating Bulimia, and Bulimia is unfortuntely a common problem within todays society. So due to the prevalence of Bulimia and other eating disorders, it makes sense for someone to form an explanatory model of CBT that focuses on its specific psychopathology. So when a person with Bulimia seeks help from a therapist, instead of the therapist having to try to apply a general theoretical model of CBT to their case, they can use model of CBT already designed for eating disorder patients, which still allows for the therapy to be tailored to that specific patients needs. So asking for a difference between the theoretical model of CBT, and an explanatory model of CBT-E is pretty redundant.
Unless of course you are refering to the difference between Fairburn's old model of CBT for Bulimia patients (CBT-BN), and his new model (CBT-E).. which in that case, you have already answered yourself - "one focuses only on the eating disorder, while the other also delves into low self-esteem and extreme perfectionism issues."

Jeremy said...

Wow.. I just realised how old this blog actually is. Sorry, I was just doing a google search about CBT-E and this popped up. I didn't think to check its date!

EmilyRF said...

I've had depression for years and since taking several courses of CBT I now have longer periods between my really severe episodes. But, once I enter into that realm I can no longer put to use the CUT strategies. Only medication has been helpful at getting me back to a more normal state. The unfortunate fact for me is that I cannot tolerate any of the medications for very long because of side effects. Just my bad luck I guess. But, I am happy with the help I have gotten from CUT I believe it is too simple to assume any one therapy is always going to be effective for all clients.