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

Waller, Glenn; Mountford, Victoria

doi:10.1016/j.brat.2015.04.004

Cited by 57 publications

(65 citation statements)

References 29 publications

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“…For example, despite the manual clearly stating that the patient should be weighed by the therapist prior to every session, and that weight loss or weight gain sets the tone for the session, over one third of therapists in the Couturier et al56 study said that they did not weigh their FBT patients. Although the reasons for this were not detailed in the study, Waller and Mountford60 outlined several reasons given by therapists for not weighing their patients in the context of CBT. These included concerns that it will ruin the therapeutic relationship, a belief that weighing is unnecessary because the patient weighs him/herself or is already weighed by another professional, concern that the patient will be too upset if weighed, stating that there is not enough time in the session to weigh the patient, or believing that the therapist can judge weight gain or weight loss by looking at the patient.…”

Section: Implementation Of Family-based Treatmentmentioning

confidence: 99%

Family-based treatment of eating disorders in adolescents: current insights

Rienecke¹

2017

AHMT

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Eating disorders are serious illnesses associated with significant morbidity and mortality. Family-based treatment (FBT) has emerged as an effective intervention for adolescents with anorexia nervosa, and preliminary evidence suggests that it may be efficacious in the treatment of adolescents with bulimia nervosa. Multifamily therapy for anorexia nervosa provides a more intensive experience for families needing additional support. This review outlines the three phases of treatment, key tenets of family-based treatment, and empirical support for FBT. In addition, FBT in higher levels of care is described, as well as challenges in the implementation of FBT and recent adaptations to FBT, including offering additional support to eating-disorder caregivers. Future research is needed to identify families for whom FBT does not work, determine adaptations to FBT that may increase its efficacy, develop ways to improve treatment adherence among clinicians, and find ways to support caregivers better during treatment.

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Section: Implementation Of Family-based Treatmentmentioning

confidence: 99%

Family-based treatment of eating disorders in adolescents: current insights

Rienecke¹

2017

AHMT

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“…This includes eating disorders, where anxiety is a key maintaining factor for behaviours such as restriction, bingeing, purging and body avoidance (e.g., Pallister & Waller, 2008). Furthermore, anxiety can lead the eating-disordered patient to want to avoid central elements of therapy, such as weighing (e.g., Waller & Mountford, 2015). These processes in eating pathology explain why evidence-based cognitive-behavioural therapy (CBT) for eating disorders has a strong exposure-based element (e.g., Fairburn, 2008;Waller, Cordery, Corstorphine, Hinrichsen, Lawson, Mountford & Russell, 2007).…”

Section: Impact Of Education On Clinicians' Attitudes To Exposure Thementioning

confidence: 99%

Impact of education on clinicians' attitudes to exposure therapy for eating disorders

Waller

Walsh

Wright

2016

Behaviour Research and Therapy

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Article available under the terms of the CC-BY-NC-ND licence (https://creativecommons.org/licenses/by-nc-nd/4.0/) eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/ Reuse Unless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version -refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher's website. TakedownIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. Addressing clinicians' attitudes to exposure therapy AbstractIt is well established that clinicians use exposure therapy far less often than the evidence would suggest is justified. This shortfall has been explained as being at least partly a result of clinicians' beliefs and attitudes about exposure and their trait anxiety. Recent studies have shown that attitudes to exposure therapy for anxiety disorders can be improved through a simple educational approach. This study aimed to determine whether a similar educational approach can improve therapists' attitudes to exposure therapy for the eating disorders, and whether clinician's pre-intervention characteristics influenced the impact of the training. Thirty-four eating disorder clinicians (30 female, four male; mean age = 39.0 years; 85.3% Caucasian) attended a 90-minute didactic teaching session on the subject of the use of exposure in treatment of eating disorders. Their attitudes to exposure therapy were measured before and after the workshop, in a within-subject design. The outcome was a substantial improvement in attitudes, with a strong effect size (Cohen's d = 1.68) that was comparable to the outcome of a similar intervention among clinicians working with anxiety disorders. The improvement was not related to clinicians' anxiety levels, but was greater among those whose attitudes were more negative at the outset of the teaching. While this finding needs to be tested for long-term maintenance and its relationship to change in clinical practice, it adds to the evidence that a simple educational intervention is sufficient to result in substantial improvement in clinicians' attitudes to exposure therapy.

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“…Recent research hypothesizes that individuals with AN believe that food consumption will cause catastrophic weight gain, and any degree of weight gain stimulates a fear of uncontrollable and exponential weight gain. 24-25 Persons with AN also fear that weight restoration will lead to intolerable emotions, or violate their sense of self. 24 Acute treatment for AN is often perceived as direct opposition to individuals' desire for control over body weight, which may result in power struggles between patients and nurses.…”

Section: The Roy Adaptation Modelmentioning

confidence: 99%

“…41,44 Ongoing and regular knowledge about nutrition and fluid, electrolyte, and acid-base balance, will guide nursing interventions to reestablish an adaptive state of homeostasis and avoid refeeding syndrome, while simultaneously challenging patients' beliefs about food consumption and catastrophic weight gain and how weight gain will lead to intolerable emotions, or violate sense of self. 24-25 …”

Section: The Roy Adaptation Modelmentioning

confidence: 99%

The Roy Adaptation Model

Jennings

2017

Advances in Nursing Science

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Using a nursing theoretical framework to understand, elucidate, and propose nursing research is fundamental to knowledge development. This article presents the Roy Adaptation Model as a theoretical framework to better understand individuals with anorexia nervosa during acute treatment, and the role of nursing assessments and interventions in the promotion of weight restoration. Nursing assessments and interventions situated within the Roy Adaptation Model take into consideration how weight restoration does not occur in isolation but rather reflects an adaptive process within external and internal environments, and has the potential for more holistic care.

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

Cited by 57 publications

References 29 publications

Family-based treatment of eating disorders in adolescents: current insights

Family-based treatment of eating disorders in adolescents: current insights

Impact of education on clinicians' attitudes to exposure therapy for eating disorders

The Roy Adaptation Model

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