Eating disorders are complex and devastating mental health conditions that can have severe physical and psychological consequences. In recent years, the field of psychology has witnessed significant advancements in treatment models, one of which stands out for its effectiveness and innovation – Enhanced Cognitive Behavioural Therapy (CBT-E). Developed by Christopher Fairburn and his team, CBT-E has revolutionized the way we approach eating disorder treatment, offering hope and healing to countless individuals around the world.
Development and Origins
Enhanced Cognitive Behavioural Therapy (CBT-E) was developed by Christopher Fairburn, a renowned psychologist and researcher, along with his colleagues at the University of Oxford. Building upon the foundations of traditional Cognitive Behavioural Therapy (CBT), CBT-E was designed specifically to address the complexities of eating disorders, such as anorexia nervosa, bulimia nervosa, and binge eating disorder. Unlike a one-size-fits-all approach, CBT-E recognizes the diverse nature of eating disorders. Dr. Fairburn’s team meticulously examined the underlying factors contributing to these conditions, crafting a treatment that’s precise and responsive to the nuances of each disorder.
Suitability and Duration
CBT-E is a versatile treatment model suitable for individuals across a wide range of ages and eating disorder diagnoses. It has been shown to be effective for adults, adolescents, and even individuals with complex cases or comorbidities. While the duration of CBT-E can vary depending on individual needs, it typically spans over 20 sessions, often conducted over a period of 20 weeks. The flexibility of CBT-E allows therapists to tailor the treatment to each individual’s unique circumstances and progress.
Components of Treatment
CBT-E is a structured and comprehensive treatment model that addresses the multifaceted nature of eating disorders. It comprises several key components:
- Psychoeducation: Clients gain a deep understanding of their eating disorder, its underlying factors, and the principles of CBT-E.
- Monitoring: Clients track their eating behaviours, emotions, and thoughts, which helps identify patterns and triggers.
- Regular Eating: Establishing regular, structured eating patterns to stabilize eating habits and reduce the frequency of bingeing or restricting.
- Cognitive Restructuring: Challenging and altering distorted thoughts and beliefs related to body image, weight, and food.
- Problem-Solving: Developing effective coping strategies for managing difficult situations and emotions without resorting to disordered eating behaviours.
- Gradual Exposure: Addressing fear foods or situations through controlled exposure, helping clients build tolerance and reduce anxiety.
- Relapse Prevention: Equipping clients with skills to prevent relapse and maintain progress over the long term.
The success of CBT-E as an evidence-based treatment for eating disorders is well-documented in clinical research. Numerous studies have demonstrated its effectiveness in reducing symptoms, improving overall well-being, and promoting long-term recovery. For example, a landmark randomized controlled trial by Fairburn et al. (2015) found that CBT-E was superior to interpersonal psychotherapy in treating bulimia nervosa. Additionally, a 2020 randomized control trial published in the International Journal of Eating Disorders found that recovery rates at 20 weeks of CBT-E treatment were significantly higher than “treatment as usual”, and a systematic review conducted in the same year supported the efficacy and effectiveness of CBT-E in treatment of older adolescents and adults with a range of eating disorder diagnoses.
Enhanced Cognitive Behavioural Therapy (CBT-E) has emerged as a groundbreaking treatment model that offers hope and recovery to individuals struggling with eating disorders. Developed by Christopher Fairburn and his team, CBT-E has been supported by a wealth of evidence showcasing its efficacy in clinical settings. This versatile approach is suitable for a wide range of individuals, with treatment duration and content tailored to each person’s unique needs. As we continue to advance in the field of mental health, CBT-E stands as a shining example of how innovation and evidence-based practice can lead to transformative outcomes for those on the path to healing.
Fairburn, C. G., Bailey-Straebler, S., Basden, S., Doll, H. A., Jones, R., Murphy, R., … & Cooper, Z. (2015). A transdiagnostic comparison of enhanced cognitive behaviour therapy (CBT-E) and interpersonal psychotherapy in the treatment of eating disorders. Behaviour Research and Therapy, 70, 64-71.
Fairburn, C. G., Cooper, Z., Doll, H. A., O’Connor, M. E., Bohn, K., Hawker, D. M., … & Palmer, R. L. (2009). Transdiagnostic cognitive-behavioral therapy for patients with eating disorders: A two-site trial with 60-week follow-up. American Journal of Psychiatry, 166(3), 311-319
Atwood, ME, Friedman, A. A systematic review of enhanced cognitive behavioral therapy (CBT-E) for eating disorders. Int J Eat Disord. 2020; 53: 311–330. https://doi.org/10.1002/eat.23206
de Jong, M, Spinhoven, P, Korrelboom, K, et al. Effectiveness of enhanced cognitive behavior therapy for eating disorders: A randomized controlled trial. Int J Eat Disord. 2020; 53: 717–727. https://doi.org/10.1002/eat.23239