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

Abstract

This study describes the psychological interventions used for eating disorders (EDs) by community practitioners. Of 573 clinicians we screened across Alberta, 130 (22.7%) had treated EDs; 118 (90.8%) were interviewed. Clinicians reported varied reasons for psychotherapy choice and diverse training experiences; the primary approaches used varied by education and field. The most common primary approach was eclectic (43.2%), followed by cognitive-behavior therapy (CBT; 22.9%). However, self-reported CBT clinicians used specific CBT techniques infrequently. Half of clinicians incorporated addictions-based techniques. These results indicate that ED treatment provided by community clinicians is varied and generally does not align with evidence-based practice guidelines.

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.…”

“…The use of manuals to direct CBT for the eating disorders is associated with greater use of core techniques, such as cognitive restructuring, goal setting, problem solving techniques, relapse prevention, self-monitoring, nutritional counseling, stress management, and homework assignments (Simmons, Milnes, & Anderson, 2008). However, relatively few clinicians use manuals and evidence-based techniques with the eating disorders (Tobin, Banker, Weisberg & Bowers, 2007; Ranson, Wallace & Stevenson 2013;Wallace & von Ranson, 2011;Waller, Stringer & Meyer, 2012).…”

Therapist drift redux: Why well-meaning clinicians fail to deliver evidence-based therapy, and how to get back on track

“…In the field of eating disorders, clinicians show good levels of awareness of evidencebased therapies, but report using them relatively infrequently (Simmons, Milnes & Anderson, 2008;von Ranson, Wallace & Stevenson, 2013a;Waller, Stringer & Meyer, 2012), Taken as a whole, these findings remind us that simply labelling what one does as 'CBT' is no guarantee of what will be delivered or the ability of the therapist to deliver it.…”

Weighing patients within cognitive-behavioural therapy for eating disorders: How, when and why

“…However, relatively few therapists espouse or use evidence-based therapies when working with eating disorders (e.g., Tobin et al, 2007; von Ranson et al, 2013). Even when they label what they do as an evidence-based therapy, many clinicians miss key components (e.g., Kosmerley et al, in press;Simmons et al, 2008;.…”