Page 13 - The efficacy and effectiveness of psychological treatments for eating disorders - Elske van den Berg
P. 13

  Chapter 1 13
 materials (National Institute for Health and Care Excellence, 2017).
In the systematic review by De Jong et al., posttreatment remission rates ranged from 22% to 68% for bulimia nervosa, binge eating disorder and atypical, non-under- weight eating disorders (De Jong, Schoorl, & Hoek, 2018).
Status Cognitive behavior therapy-Enhanced
Individually based Cognitive behavior therapy for eating disorders, like CBT-E, is the leading empirically supported treatment for bulimia nervosa and for binge eating disorder (National Institute for Health and Care Excellence, 2004; National Institute for Health and Care Excellence, 2017). Starting in 2003, the cognitive behavioral treatment for bulimia nervosa as developed by Fairburn et al. at Oxford University was adapted to make it suitable for the whole range of eating disorders, including anorexia nervosa, by focusing on modifying the mechanisms supposed to perpetuate all forms of eating disorder psychopathology. In 2008, the new enhanced form of the treatment (CBT-E) was officially published (Fairburn, 2008; Fairburn, Cooper, & Shafran, 2003).
CBT-E, an individually based treatment, takes different forms, the regular CBT-E has been developed for eating disorder patients with normal weight. For underweight eating disorder patients with a minimum BMI of 15 who can safely be treated in an outpatient setting, CBT-E Underweight has been developed (Fairburn, 2008). Both the normal weight and the underweight version can be delivered in the so-called focused version, which is the core treatment, or in the so-called broad version. The CBT-E broad version is designed for eating disorder patients who are additionally diagnosed with comorbid psychopathology of interpersonal difficulties, core low self-esteem and /or clinical perfectionism.
The default version of CBT-E for normal weight eating disorder patients takes 20 sessions; CBT-E Underweight takes up to 40 sessions, depending on the degree of underweight (Fairburn, 2008).
With regard to effectiveness, Fairburn et al. reported the following findings on CBT-E focused version for normal weight patients in 2009: at end of treatment, 51.3% of patients were in remission, defined as having a global EDE-score below one standard deviation above the community mean (i.e. below 1.74). Of the 77.9% of patients completing treatment, 66.1% were in remission (Fairburn et al., 2009). In the 2015 study for normal weight patients, 65.5% of patients were in remission at end of treat- ment. Of the 73.8% of patients completing treatment, 75% were in remission at end of treatment (Fairburn et al., 2015).



























































































   11   12   13   14   15