A pragmatic effectiveness study of 10-session cognitive behavioural therapy (CBT-T) for eating disorders: Targeting barriers to treatment provision.

Abstract

OBJECTIVE\nTen-session cognitive behavioural therapy (CBT-T) for transdiagnostic eating disorders targets several barriers to treatment, including cost, therapist expertise, and lengthy wait lists.\n\n\nMETHOD\nWe used a case series design to investigate the effectiveness of CBT-T delivered by trainee psychologists in a postgraduate training clinic. Participants were randomly allocated to commence treatment either immediately or after a 4-week waitlist period. CBT-T was delivered to 52 patients, by six different trainees under supervision. Measures of eating disorder cognitions and behaviours, quality of life, and general psychopathology were examined in completer and intention-to-treat analyses using multilevel modelling. Last observation carried forward was applied for abstinence, remission, and good outcome analyses to aid comparison with prior studies.\n\n\nRESULTS\nSignificant improvements, associated with medium to large effect sizes, were found for eating disorder cognitions, behaviours quality of life, and negative affect from baseline to posttreatment, and at 1- and 3-month follow-up. Attrition (38.5%) was comparable with other treatment studies.\n\n\nCONCLUSION\nResults provide evidence for the effectiveness of CBT-T delivered by trainee psychologists for transdiagnostic eating disorder patients, thus tackling some important barriers for treatment. Longer follow-up, randomised controlled trial designs, and moderator analyses will provide more robust evidence about which patients do best with a shorter therapy.