Objective: Whilst there is evidence to support the use of group dialectical behavioral therapy (DBT) in the treatment of binge-eating disorder (BED), few studies have reported on its effectiveness when delivered in routine clinical practice. This study addressed this gap by exploring the effectiveness of group DBT for BED when delivered in a community eating disorder service. Method: Participants were 56 adults who presented with BED, and were offered a 20-week DBT group. Eight groups were conducted. Measures of eating disorder pathology, anxiety, depression and emotion regulation were completed at start and end of treatment, and one-month follow-up. Results: The attrition rate was 16.1%. Abstinence rates (no objective binges in the previous month) were approximately 60% at the end of treatment and 50% at follow-up. There were significant reductions in eating disorder psychopathology (but not in mood) by end of treatment and improvements were maintained at follow-up. Discussion: Group DBT is an acceptable and effective treatment for adults with BED when delivered in a routine community setting. Findings are broadly comparable with those from research trials. The lack of significant effect on mood suggests that DBT can be effective by teaching new emotion-regulation skills, rather than changing mood per se.
Objective Although it is important to analyze the effectiveness of new therapies, it is also necessary to consider how patients experience them. This is particularly important if we are to maximize treatment acceptability and reduce attrition. This study examined patient experiences of a new 10‐session cognitive‐behavioral therapy (CBT‐T), using a qualitative approach. Method The sample was 17 patients with a diagnosis of bulimia nervosa who had received CBT‐T (including treatment completers and non‐completers) within the previous 2 years. Sample size was determined by saturation of the emergent themes. Responses were analyzed using a six‐step thematic analysis process. Results Rated acceptability and effectiveness of CBT‐T were high. Five themes emerged, with subthemes. The key elements of patient experience of the therapy were: the therapeutic relationship; the nature of the therapy; its challenging but beneficial aspects; ending therapy; and the overall experience of CBT‐T (including comparison with other therapies). Discussion The findings build on the effectiveness research for CBT‐T, suggesting that it is an acceptable therapy that addresses many of the same themes that matter to patients as other therapies. The findings show that patients were positive about CBT‐T relative to other therapies, and offer suggestions as to how CBT‐T might be delivered to emphasize the importance of the time‐limited nature of the therapy.
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