Compassion-Focused Therapy for Bulimia Nervosa and Bulimic Presentations: A Preliminary Case Series

Abstract

Objectives: Validated treatments for adults with bulimia nervosa (BN) and related presentations are scarce, and the current most evidenced treatment — cognitive behaviour therapy for eating disorders — is resource intensive and has suboptimal remission rates; there is, therefore, a need to evaluate the effectiveness of other approaches for treating such conditions in routine NHS services. Design: Data from nine patients in an NHS eating disorder service who received compassion-focused therapy (CFT) for BN or bulimic presentations were analysed retrospectively. Methods: Patients routinely completed a validated scale of eating disorder severity (the EDE-Q) at baseline and end of treatment. Results: All five scales of the EDE-Q showed a mean significant reduction (N = 9), indicating a significant reduction in eating disorder symptomatology, and individual analyses showed clinically reliable reduction in seven out of nine patients’ EDE-Q scores. Conclusions: This is the first article to report a case series of patients who benefitted significantly from receiving CFT for their eating disorder. Limitations of this study are considered along with future directions for research into effective treatments for eating disorders.

Online Compassion Focused Therapy for overeating: Feasibility and acceptability pilot study

“…Our findings, with large effect sizes, add to those of previous research, indicating that a compassion‐focused approach may be helpful for individuals with eating difficulties (Gale et al, 2014; Haley et al, 2022; Kelly et al, 2017; Kelly & Carter, 2015; Williams et al, 2017). However, longer‐term follow‐up is required to see whether participants remain in recovery.…”

“…Kelly and Carter (2015) found a reduction in the weekly binge days and global eating disorder pathology in a sample of 41 individuals with BED who underwent a 3‐week compassion‐based intervention. Williams et al (2017) found a significant improvement in eating psychopathology when delivering individual CFT to eight adults with BN or bulimic presentations. Haley et al (2022) also found a reduction in eating disorder symptoms in women with overweight/obesity and internalized weight bias after a 3‐session self‐compassion intervention.…”

The development of the Compassion Focused Therapy Therapist Competence Rating Scale

“…It was initially developed for people with high levels of shame and self‐criticism (Gilbert & Irons, ). There is emerging evidence for the effectiveness of CFT across range of clinical problems including depression and anxiety (Gilbert & Procter, ; Judge, Cleghorn, McEwan, & Gilbert, ), personality disorder (Lucre & Corten, ), eating disorders (Gale, Gilbert, Read, & Goss, ; Kelly & Carter, ; Williams, Tsivos, Brown, Whitelock, & Sampson, ), psychosis (Braehler et al ., ; Heriot‐Maitland, Vidal, Ball, & Irons, ; Kennedy & Ellerby, ; Laithwaite et al ., ; Mayhew & Gilbert, ), acquired brain injury (Ashworth, Clarke, Jones, Jennings, & Longworth, ; Ashworth, Gracey, & Gilbert, ), and post‐traumatic stress disorder (Au et al ., ; Beaumont, Durkin, McAndrew, & Martin, ; Beaumont, Galpin, & Jenkins, ). However, these studies are primarily pilot/feasibility studies or service evaluations, and hence, the conclusions that can be drawn are limited.…”