AN Cognitive Behavioural Therapy
11 November 2020 10:04
Beck (1979), developed CBT for depression, but the basic principles have been adapted to treat AN
as well, as the core psychopathology of AN is cognitive
S - Fairburn et al (2015), compared CBT with IBT, found CBT-E resulted in a higher remission rate
(65.5% - 33.3%) and less time consuming
C - All ppts had a BMI over 17.5, so unclear results for severe AN
Fairburn (2008), created enhanced CBT (CBT-E) to specifically treat anorexia. CBT-Eb treats the
central pathology as well as external symptoms whilst CBT-Ef only treats the central part
S - Pike (2003), compared CBT with nutritional counselling, concluded relapse rate of CBT(22%) lower
than nutritional (73%)
S - Byrne et al (2011), two thirds of patients showed improvements in symptoms compared to
control group
Stage 1 - 'Start Well', client and therapist work together to identify key cognitions and behaviours,
weekly weighing and an eating plan are produced
S - CBT-E can be adapted to clients needs and BMI, flexible and takes into account individual
differences
W - Demanding therapy, requires commitment with both attending session and completely
homework tasks. Carter et al (2012), drop out rate of 45% for CBT-E
Stage 2 - Client and therapist review progress over 2 sessions, identifying barriers to change and
planning for the next stage
W - Sodersten or al (2017), compared CBT with normalisation of eating procedure, which is
encouraging eating and giving positive feedback during mealtimes, CBT (remission rate 45%) BT
(remission rate, 75%)
C - Relapse 30% to 10%
Stage 3 - Client and therapist identify the ways the client's self-evaluation is dependent on body
weight and shape, teaching them how to focus on other areas of their lives instead, behavioural
experiments break dietary rules
A - People with AN are very vulnerable, need extra ethical care, since individuals experience intense
fear of becoming fat, CBT can be a major step towards overcoming that fear, helps to better support
participants in research
A - Preventing AN taking over patients' lives by learning skills and techniques which can be applied
throughout life, client can become their own therapist
Stage 4 - 'End Well', weekly weighing continues at home, client continues with strategies like rule-
breaking and avoiding body-checking, aims to prevent relapse
W - Most of the ppts in research studies into AN are female, need for more research on males with
AN, also implications for gender of the therapist
W - Allan et al (2013), meta-analysis of 16 articles of CBT use in AN treatment, not constantly
superior to other treatments such as behavioural family therapy, as well as finding multiple
methodological limitations in available evidence
Clinical Psychology Page 1
11 November 2020 10:04
Beck (1979), developed CBT for depression, but the basic principles have been adapted to treat AN
as well, as the core psychopathology of AN is cognitive
S - Fairburn et al (2015), compared CBT with IBT, found CBT-E resulted in a higher remission rate
(65.5% - 33.3%) and less time consuming
C - All ppts had a BMI over 17.5, so unclear results for severe AN
Fairburn (2008), created enhanced CBT (CBT-E) to specifically treat anorexia. CBT-Eb treats the
central pathology as well as external symptoms whilst CBT-Ef only treats the central part
S - Pike (2003), compared CBT with nutritional counselling, concluded relapse rate of CBT(22%) lower
than nutritional (73%)
S - Byrne et al (2011), two thirds of patients showed improvements in symptoms compared to
control group
Stage 1 - 'Start Well', client and therapist work together to identify key cognitions and behaviours,
weekly weighing and an eating plan are produced
S - CBT-E can be adapted to clients needs and BMI, flexible and takes into account individual
differences
W - Demanding therapy, requires commitment with both attending session and completely
homework tasks. Carter et al (2012), drop out rate of 45% for CBT-E
Stage 2 - Client and therapist review progress over 2 sessions, identifying barriers to change and
planning for the next stage
W - Sodersten or al (2017), compared CBT with normalisation of eating procedure, which is
encouraging eating and giving positive feedback during mealtimes, CBT (remission rate 45%) BT
(remission rate, 75%)
C - Relapse 30% to 10%
Stage 3 - Client and therapist identify the ways the client's self-evaluation is dependent on body
weight and shape, teaching them how to focus on other areas of their lives instead, behavioural
experiments break dietary rules
A - People with AN are very vulnerable, need extra ethical care, since individuals experience intense
fear of becoming fat, CBT can be a major step towards overcoming that fear, helps to better support
participants in research
A - Preventing AN taking over patients' lives by learning skills and techniques which can be applied
throughout life, client can become their own therapist
Stage 4 - 'End Well', weekly weighing continues at home, client continues with strategies like rule-
breaking and avoiding body-checking, aims to prevent relapse
W - Most of the ppts in research studies into AN are female, need for more research on males with
AN, also implications for gender of the therapist
W - Allan et al (2013), meta-analysis of 16 articles of CBT use in AN treatment, not constantly
superior to other treatments such as behavioural family therapy, as well as finding multiple
methodological limitations in available evidence
Clinical Psychology Page 1
