Acceptance-based skill acquisition and cognitive reappraisal in a culturally responsive treatment for binge eating in adolescence

Kamody, Rebecca C.; Thurston, Idia B.; Burton, E. Thomaseo

doi:10.1080/10640266.2020.1731055

Cited by 14 publications

(13 citation statements)

References 58 publications

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“…Two studies with Spanish-speaking clients used culturally familiar sayings and stories (dichos and cuentos) to build therapeutic rapport and explain concepts (McFarr et al, 2014; Mercado & Hinojosa, 2017). Two studies added visual images of individuals from the clients’ cultures onto handouts (Arunagiri, 2021; Kamody et al, 2020). Two studies described keeping metaphors from the natural world at the forefront to be more consistent with the Native American worldview (e.g., breathing with the rhythm of wind through the trees; Kinsey, 2014; Kohrt et al, 2017).…”

Section: Resultsmentioning

confidence: 99%

“…Finally, clinicians can also address access barriers (e.g., transportation), which contributed to attrition in several studies (Arunagiri, 2021; Cancian et al, 2019; Kinsey, 2014; Kohrt et al, 2017). Flexible meeting times can help families from low socioeconomic backgrounds with demanding work schedules (Kamody et al, 2020). Telehealth could increase access but may also could pose other challenges, such as lack of stable internet or privacy (Hyland et al, 2021; O’Hayer, 2021; Zalewski et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

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Cultural adaptations of dialectical behavior therapy: A systematic review.

Haft¹,

O’Grady²,

Shaller³

et al. 2022

Journal of Consulting and Clinical Psychology

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Objective: Adapting mental health-care interventions to the race, ethnicity, or culture of the target group can enhance the acceptance and effectiveness of the treatment. Dialectical behavior therapy (DBT) is an evidence-based treatment that is principle-driven, rendering it well-suited for adaptations across cultural contexts. This article conducts a systematic review of the literature to determine the nature and extent of cultural adaptations of DBT to date. Method: We searched databases for original articles describing cultural adaptations of DBT, as applied to both (a) people of color within Western countries and (b) populations within non-Western countries. Consistent with the focus on descriptively characterizing extant DBT cultural adaptations, we included both published and nonpublished studies, as well as both observational and experimental studies. Results: Our search yielded 18 articles that met inclusion criteria. Of these articles, half described adaptations made with people and communities of color within the U.S. Most adaptations involved modifications to language, metaphors, methods, and context. Conclusions: Culturally adapted DBT has been implemented and accepted among several racial, ethnic, and cultural groups, although there is insufficient evidence to determine whether culturally adapted DBT is more efficacious than nonadapted DBT. We conclude with recommendations for best practices for DBT researchers and clinicians, and situate our findings among larger efforts to render existing evidence-based psychotherapies more optimal for people of color and people from non-Western countries.What is the public health significance of this article? Dialectical behavior therapy (DBT) may require cultural adaptation to be efficacious and accepted by all racial, ethnic, and cultural groups. The studies reviewed detail a number of cultural adaptations of DBT, most commonly in terms of language translation and addition of culturally congruent metaphors and sayings. The field must continue to both train culturally competent DBT clinicians and further adapt DBT to different cultural contexts.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cultural adaptations of dialectical behavior therapy: A systematic review.

Haft¹,

O’Grady²,

Shaller³

et al. 2022

Journal of Consulting and Clinical Psychology

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“…In studies that examined DBT skills group mechanisms, patients with BED consistently rated radical acceptance as the most helpful skill [ 64 , 67 ], followed by mindful eating, and three mind states [ 67 ]. By the end of treatment, patients showed increases in distress tolerance, cognitive reappraisal, and expressive suppression.…”

Section: Resultsmentioning

confidence: 99%

“…Youth and caregiver reports showed reductions in emotional eating (EES-C) and binge-eating post-treatment (EDE-Q). Acceptability ratings were high among treatment completers: 86.7% ( n = 13) reported they would be willing to participate again; 93.3% ( n = 14) reported they would suggest the intervention to someone else with eating problems; all participants (100%, n = 15) reported feeling confident in their ability to use learned skills to combat emotional overeating Fair a Kamody et al (2020) † [ 67 ] Secondary analysis of cohort study data (Kamody et al, 2019; [ 65 ]) BED 15.4 [14–18] DBT skills group (15) 0 10 sessions over 10 wks (≈ 2 mo) None Statistically significant increases in distress tolerance appraisal (DTS; d = 0.23), cognitive reappraisal (ERQ-CA; d = 0.38), and expressive suppression (ERQ-CA; d = 0.27) from BL to EOT. DBT was evaluated as both acceptable and feasible by patients (DBT-SRS), with radical acceptance possessing the highest mean rating, followed by mindful eating and three mind states Fair a Mazzeo et al (2016) [ 70 ] RCT BED, LOC eating 15.4 [13–17] DBT skills group (28), versus weight mgmt.…”

Section: Methodsmentioning

confidence: 99%

A systematic review of cognitive behavior therapy and dialectical behavior therapy for adolescent eating disorders

2021

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Background Eating disorders have serious psychological and physical consequences. Current evidence-based treatments for adolescents with eating disorders have modest effects, underscoring the need to improve current treatment approaches. Cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT) have been proposed as alternative treatment options, with burgeoning research in this area. This review aims to summarize and critically analyze the current literature on the feasibility, acceptability, effectiveness, and efficacy of CBT and DBT for adolescent eating disorders, and then proposes areas of future research. Methods PsycINFO and PubMed were searched using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines to identify studies examining the feasibility, acceptability, effectiveness and/or efficacy of CBT or DBT for adolescent eating disorders. Results Eligible studies (N = 50; CBT: n = 40, DBT: n = 10) indicated that both treatments are reasonably feasible, acceptable, and possibly effective for adolescent eating disorders across diagnoses and levels of care, though efficacy trials are lacking. Conclusions CBT and DBT demonstrate promise as alternatives to family-based approaches for adolescent eating disorders. Adequately powered trials to establish the effectiveness and efficacy of CBT and DBT are needed, particularly ones that compare these treatments against other leading approaches. Plain English summary Despite high rates of relapse and likelihood for severe and enduring illness, there is a dearth of evidence-based treatment options for adolescents with eating disorders. Potentially viable but less well-studied treatments for adolescents with eating disorders include cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT). This systematic review of CBT and DBT for adolescent eating disorders focuses on feasibility (i.e., how easy it was to implement the treatment), acceptability (i.e., how well the intervention was received by patients and therapists), effectiveness (i.e., how well the intervention performed under routine, real-world circumstances), and efficacy (i.e., how well the intervention performed in highly-controlled research settings). This review concludes that research supports the feasibility and acceptability of these approaches, as well as preliminary evidence of their effectiveness. However, the field is lacking studies that systematically compare CBT and DBT to other evidence-based approaches. Recommendations to advance research on CBT and DBT for adolescent eating disorders are provided, including a call for efficacy studies that clarify their performance compared to other leading approaches.

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“…Thus, intervention approaches that promote positive self-image and help youth gain control of their eating behaviors, through non-stigmatizing approaches, are of the utmost importance [17,18]. Specifically, interventions focused less on weight loss as the goal, and more so on acceptance and skill acquisition to promote regulation of food intake, may hold promise [19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Adolescent Engagement in a Binge-Eating Behavioral Health Intervention: Influence of Perceptions of Physical Appearance and Locus of Control

2021

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Traditional weight management approaches focused solely on weight loss as a measure of success may lead youth to internalize negative beliefs about their appearance, and feel they have little control over their health. We examined how perceptions of appearance and health-related locus of control (HRLOC) influenced engagement and outcomes in a behavioral health intervention for binge eating. Thirty adolescents aged 14–18 years completed measures of self-perception, HRLOC, and eating behaviors. Half (n = 15) completed baseline assessments only, while the other half participated in a 10-week intervention targeting dysregulated eating behaviors. Analyses revealed negative perceptions of physical appearance and internal HRLOC were higher at baseline among youth who completed the intervention compared to those who completed baseline assessments only. Among those completing the intervention, however, greater internal HRLOC and more positive perception of physical appearance at baseline was associated with greater reduction in objective binge episodes and emotional eating post-intervention. Findings of the present study suggest that while having a more negative perception of one’s appearance may initially motivate youth to participate in weight-related interventions, such perceptions can actually lead to poorer health outcomes, and further supports the extant literature on the benefits of interventions that engender positive body image.

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Acceptance-based skill acquisition and cognitive reappraisal in a culturally responsive treatment for binge eating in adolescence

Cited by 14 publications

References 58 publications

Cultural adaptations of dialectical behavior therapy: A systematic review.

Cultural adaptations of dialectical behavior therapy: A systematic review.

A systematic review of cognitive behavior therapy and dialectical behavior therapy for adolescent eating disorders

Adolescent Engagement in a Binge-Eating Behavioral Health Intervention: Influence of Perceptions of Physical Appearance and Locus of Control

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