An open trial of outpatient group therapy for bulimic disorders: Combination program of cognitive behavioral therapy with assertive training and self‐esteem enhancement

Abstract

The purposes of this study were to examine the therapeutic efficacy of combined group cognitive behavioral therapy (CGCBT) and to explore the characteristics of the patients who failed to complete it. Our group cognitive behavioral therapy combined with assertiveness training for alexithymia and self-esteem enhancement therapy were attended over a 10-week period. Twentyfive participants were enrolled in the study. The clinical symptoms were assessed before and after treatment, using rating scales including the Eating Disorder Inventory-2, the Bulimic Investigatory Test, Edinburgh, the Toronto Alexithymia Scale, the Rosenberg Self-Esteem Scale, and Global Assessment of Functioning. Sixteen participants (64%) completed the CGCBT program. Completion of the CGCBT resulted in significant improvements in reducing binge-eating behavior and improving social functioning. Eight patients (32%) significantly improved using the Clinical Global Impression Change (CGI-C). Stepwise logistic regression analysis of the results indicated that a lower age ( P = 0.04) and psychiatric comorbidity ( P = 0.06) were predictors of dropout from the CGCBT program. Our CGCBT program is a promising first-line treatment for bulimic outpatients. Lower age and the presence of comorbidity had effects on dropout rates.

Evaluation of assertiveness training for psychiatric patients

“…In contrast to the results for assertiveness, the differences in self‐esteem between the experimental and comparison group at posttest and follow‐up test did not reach significance. This result differs from those obtained by some previous researchers (Temple & Robson 1991, Brown & Carmichael 1992, Shiina et al. 2005).…”

“…Assertiveness training has been shown to increase social skill and social problem solving. Although the majority of findings have suggest that assertiveness training improved patients’ social anxiety, the absence of follow‐up data limited the conclusions from these studies (Aschen 1997, Shiina et al. 2005).…”

“…Low self‐esteem is linked with maladaptive behaviour. Assertiveness training involves the practice of new skills and focuses on the development of new attitudes toward the self (Temple & Robson 1991, Brown & Carmichael 1992, Shiina et al. 2005).…”

“…The influence of assertiveness training on social anxiety has also been examined; training was found to decrease anxiety and improve social functioning. Most post‐training testing was done immediately after completion of training (Temple & Robson 1991, Brown & Carmichael 1992, Shiina et al. 2005).…”

Emotion-Focused Group Therapy for Women With Symptoms of Bulimia Nervosa

“…Participation in EFT-G was associated with significant decreases in the frequency of binge episodes, improvements in eating disorder symptoms, depression, emotion regulation, general psychiatric distress, and self-efficacy. The reductions in binge episode frequency are consistent with the results from research on other group treatments for eating disorders (Jacobi, Dahme, & Dittman, 2002;Riess, 2002;Shiina, Nakazato, Mitsumori, & Koizumi, 2005). Our findings are consistent with those of Lafrance Robinson et al (2014) in showing that a group EFT approach may result in successful client outcomes.…”