Perceptions and use of empirically-supported psychotherapies among eating disorder professionals

Clinicians' concerns about delivering cognitive-behavioural therapy for eating disorders

“…However, they are commonly not delivered adequately in such settings (von Ranson et al, 2013;Wallace & von Ranson, 2012;. This study extended existing research into the potential reasons why evidence-based CBT for the eating disorders is not implemented appropriately, considering the reasons for clinicians' concerns about delivering different elements of the therapy.…”

Psychotherapies provided for eating disorders by community clinicians: Infrequent use of evidence-based treatment

“…This information may help to bridge the gap between researchers who promote empirically supported treatments (ESTs; i.e., treatments that have been demonstrated to be efficacious through controlled research trials) and front-line clinicians who provide treatment, to evaluate the need for improved dissemination into clinical settings of ESTs, and ultimately increase the effectiveness of treatments provided to individuals in need. For example, some of the better-established ESTs for eating disorders (EDs) include cognitivebehavior therapy (CBT) and interpersonal psychotherapy (IPT) for bulimia nervosa (BN) and binge eating disorder (BED), and family-based therapy for anorexia nervosa (AN) (Wallace & von Ranson, 2012). Although recovery rates remain far from perfect and there is still room for improvement of ED psychotherapies, randomized controlled trials have demonstrated that these treatments perform better than wait-list, placebo, and/or active treatment control groups, suggesting greater likelihood of symptom improvement when these treatments are provided (Wilson, Grilo, & Vitousek, 2007).…”

“…However, multiple factors beyond evidence from research trials influence treatment decisions. In the field of EDs, studies examining psychotherapy use have indicated that ESTs for EDs are underused in clinical practice (e.g., Crow, Mussell, Peterson, Knopke, & Mitchell, 1999;Haas & Clopton, 2003;Herzog, Keller, Strober, Yeh, & Pai, 1992;McAlpine, Schroder, Pankratz, & Maurer, 2003;Mussell et al, 2000;Simmons, Milnes, & Anderson, 2008;Tobin, Banker, Weisberg, & Bowers, 2007;von Ranson & Robinson, 2006;Wallace & von Ranson, 2012). Although an expanded conceptualization of what constitutes evidence has been endorsed by the American Psychological Association (APA; APA, 2005), lack of use of ESTs in clinical practice suggests that the type of treatment provided in clinical practice may not be as effective as possible.…”

“…First, previous research has largely ignored treatment provision by community clinicians from whom clients with EDs regularly seek services, instead focusing on selected groups, such as specialists in EDs (e.g., Herzog et al, 1992;Simmons et al, 2008;Tobin et al, 2007;Wallace & von Ranson, 2012), affiliates of academic medical centers (McAlpine et al, 2004), and psychologists (Haas & Clopton, 2003;Mussell et al, 2000). However, clinicians in the community with various levels and types of training* including psychologists, social workers, nurses, psychiatrists, counselors, and others*often provide psychological interventions, or psychotherapy, for EDs (von Ranson & Robinson, 2006).…”

A system of evidenced‐based techniques and collaborative clinical interventions with a chronically ill patient

“…1 Moreover, there is a wide gap between the evidence base and what is delivered in practice. 2 Mental health practitioners who attempt to implement EBTs are often faced with using treatments of fixed content, length, intensity, and a single target with severely ill patients who present with complex issues. 3 This case presentation attempts to resolve this dilemma in small part by weaving together multiple evidence-based approaches within a framework of attachment and collaboration in a treatment resistant case.…”