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Enhanced Cognitive Behaviour Therapy for adolescents with eating disorders: An effective alternative to family-based treatment

Date: May 20 and 27, 2021 – Time: 9 a.m. to noon (two half-day sessions)

Facilitator: Riccardo Dalle Grave, MD, FAED,

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This training is suitable for:  Medical and mental health professionals

Level of training: Intermediate

Client age category: For professionals that work with clients age 12 to adulthood

Participants of this webinar will receive a copy of Dr. Riccardo Dalle Grave’s book “Cognitive Behavior Therapy for Adolescents with Eating Disorders” delivered to their home/work!*

*Registration includes a copy of Dr. Dalle Grave’s book please note; additional shipping fees may apply for international participants (outside Canada and the US).

COVID-19 related content: Learn how to deliver distance Enhanced Cognitive Behaviour Therapy (CBT-E).

Description: Enhanced Cognitive Behaviour Therapy (CBT-E) has demonstrated efficacy in adult with anorexia nervosa (AN) and bulimia nervosa (BN) and has recently been adapted for use with adolescents with eating disorders.

CBT-E for younger patients has been evaluated in four cohort studies of patients aged between 13 and 19 years. Three studies included adolescents with severe AN and one was of adolescents who were not underweight with other eating disorders. The promising results obtained by these studies led the National Institute for Health and Clinical Excellence to recommend CBT-E for adolescence as an alternative to Family Based Treatment (FBT) both for AN and BN.

CBT-E has a number of advantages. It is acceptable to young people, and its collaborative nature is well suited to ambivalent young patients who may be particularly concerned about issues of control. The transdiagnostic scope of the treatment is an advantage as it is able to treat the full range of disorders that occur in adolescent patients. It therefore provides a good alternative to FBT.

In this training the CBT-E for adolescents will be described in detail, together with data on its effectiveness, and the  webinar will be illustrated with numerous clinical vignettes.

Learning objectives:

  • How to adapt the CBT-E for adolescents
  • Gain knowledge on the use of a “manualized” treatment in a real-world clinical setting
  • Understand how CBT-E differs from FBT

AED Special Interest Group Annual Meeting

Date for your diary!
Thursday, June 4th at 8:00 AM EDT (US)

If you are a member of the Academy for Eating Disorders (AED) then you may wish to join our new special interest group (SIG) which focuses on CBT for eating disorders.

Practicalities

Our SIG annual meeting, will be held via Zoom at this link: https://zoom.us/j/93956107865.

NOTE
That the time given is EDT (US) and is NOT European time so if you are not in this time zone and you need a tool to convert the time for scheduling purposes, TimeandDate.com may be useful to you.

Enhanced cognitive-behavior therapy and family-based treatment for adolescents with an eating disorder: A non-randomized effectiveness trial

Family-based treatment (FBT) is an efficacious intervention for adolescents with an eating disorder. Evaluated to a lesser degree among adolescents, enhanced cognitive-behavior therapy (CBT-E) has shown promising results.

A new study published in Psychological Medicine compared the relative effectiveness of FBT and CBT-E delivered by the Center for the Treatment of Eating Disorders (CTED) at Children’s Minnesota, MN, a pediatric specialty clinic in the USA, provides inpatient and outpatient treatment to youth and their families.

Over the course of the study period (July 2015–November 2019), 107 patients met the eligibility criteria for the study. Of those, 10 families withdrew consent, and 97 patients (83%) and their families were enrolled and offered a choice between one of two manualized treatments: FBT or CBT-E. Fifty-one (52.5%) chose FBT, and 46 (47.5%) CBT-E.

The sample was divided into a lower weight cohort [<90% median body mass index (mBMI); 38% of participants) and higher weight choort. Regardless of weight cohort, participants who selected CBT-E were older, had been ill longer, presented with higher depression and anxiety, more prior mental health treatment, and higher rates of psychosocial impairment due to eating disorder features (all ps 0.034–0.0001).

Assessments were administered at baseline, end-of-treatment (EOT), and follow-up (6 and 12 months). Treatment comprised of 20 sessions over 6 months, except for the lower weight cohort where CBT-E comprised 40 sessions over 9-12 months. Primary outcomes were slope of weight gain and change in Eating Disorder Examination (EDE) Global Score at EOT.

Regardless of weight cohort, FBT was more efficient than CBT-E in terms of the slope of weight gain from baseline to the EOT. However, this was no longer the case at either the 6- or 12-month follow-up.

Initial more gradual weight gains achieved by CBT-E compared to FBT at EOT seems due to distinct strategies used to achieve weight gain across these two treatments. In CBT-E, weight gain (when indicated) is addressed after 4 weeks of treatment, and only when patients reach the conclusion that they need to attend to their low weight. In contrast, weight gain in FBT (when indicated) is addressed at the outset, while parents are supported to drive this agenda.

However, for a substantial minority of patients in the higher weight cohort (∼22%), weight gain was not a treatment goal. Therefore, relative effectiveness was defined in terms of weight gain and/or improvement in eating disorders psychopathology. In this domain, both treatments demonstrated improvements in the EDE/Q Global Score with no significant differences across time. In terms of the secondary outcomes (controlling for baseline differences), the two treatments largely established similar gains across measures of general psychopathology and clinical impairment.

An interesting data is that choosing between FBT and CBT-E resulted in older and less well participants opting for CBT-E. Albeit speculatively, it seems that parents considered an individual therapy rather than a family-based one to be more appropriate when their offspring was older and more unwell.

In conclusion, results show that FBT and CBT-E achieved similar outcomes in the treatment of adolescents with eating disorders, making CBT-E a viable treatment for adolescents with an eating disorder.

Le Grange, D., Eckhardt, S., Dalle Grave, R., Crosby, R. D., Peterson, C. B., Keery, H., Lesser, J. Martell, C. (2020). Enhanced cognitive-behavior therapy and family-based treatment for adolescents with an eating disorder: a non-randomized effectiveness trial. Psychological Medicine, 1-11. doi:10.1017/s0033291720004407

 

Introduction to CBT-E Clinical Workshop

30th September & 1st October 2019, Oxford
  Programme and registration information
CBT-E

CBT-E is the abbreviation for “enhanced cognitive behaviour therapy” and it refers to a “transdiagnostic” psychological treatment for eating disorders. It is an individualised treatment with four stages. CBT-E is a NICE recommended treatment for all forms of eating disorders in adults (anorexia nervosa, bulimia nervosa and binge eating disorder). NICE recommends CBT-E for young people where family-based approaches are not appropriate.

A Two-Day Training Workshop for Clinicians

This workshop is primarily intended for those who have relatively limited experience of CBT-E and would like an introduction to using CBT-E. It will also be suitable for practitioners who would like a refresher course. The workshop will focus on CBT-E for use with adult outpatients but other versions will also be discussed. It will include clinical demonstrations and practical exercises. Both presenters have extensive experience of CBT-E and are trained CBT-E research trial therapists.

Programme
  • CBT-E and its current status
  • Stage 1: Starting Well
  • Stage 2: Taking Stock
  • Stage 3: Body Image, Dietary Restraint, Events and Moods
  • Stage 4: Ending Well
  • Underweight Patients
  • Guided Self-Help for Binge Eating
  • CBT-E Resources and Further Training
Practicalities

Cost: £250. Includes lunch and refreshments.
Venue: Richard Doll Building, University of Oxford, Oxford OX3 7LF

Please book early to avoid disappointment as spaces are limited.

To book your place go to: CLICK HERE
For further details email: cbte.enquiries@gmail.com

Congresso Nazionale AIDAP 2019

18-19 October 2019 – Garda (VR) Italy
  Programme and registration information
La terapia cognitivo comportamentale dei disturbi dell’alimentazione: ricerca, implementazione e disseminazione – 19 October

08:30-09:15 AM | Cognitive Behavior Therapy for eating disorders: past, present and future – Christopher Fairburn (Lectio Magistralis)
09:15-09:45 AM | La ricerca sui processi cognitivi nella terapia cognitivo comportamentale dei disturbi dell’alimentazione (CBT-E) – Simona Calugi
10:15-10:45 AM | Strategies to improve the dissemination of CBT-E: progress and problems – Rebecca Murphy
11:30-12:15 AM | Terapia cognitivo comportamentale dei disturbi dell’alimentazione nell’adolescenza (CBT-E): un trattamento sviluppato in Italia e raccomandato dalle lingue guida NICE – Riccardo Dalle Grave (Lectio magistrali)

Advanced CBT-E Clinical Workshop 2019

28th & 29th November 2019, Oxford
Places are still available. Please book soon to avoid disappointment.
  Programme and registration information
  More detailed programme information
A two day workshop for CBT-E practitioners

This workshop is primarily intended for those who have received basic training in CBT-E and have had experience implementing it.

Programme
  • CBT-E: Past, Present and Future
  • Using CBT-E with adult outpatients
  • Using CBT-E with younger patients
  • Using CBT-E in intensive settings
  • Using CBT-E in real world clinical settings
  • Maximising the availability of CBT-E

Case consultation will follow sessions. There will be presentations throughout from other experienced practitioners of CBT-E. Further details to be confirmed.

Practicalities

Cost: £250. Includes lunch and refreshments.
Venue: Richard Doll Building, University of Oxford, Roosevelt Drive, Oxford OX3 7LF

Please book early to avoid disappointment.


For further details email: cbte.enquiries@gmail.com

New AED Special Interest Group

If you are a member of the Academy for Eating Disorders (AED) then you may wish to join our new special interest group (SIG) which focuses on CBT for eating disorders.

SIG description: The CBT-ED SIG intends to be a network of clinical and research professionals focused on the implementation, development and evaluation of evidence-based Cognitive Behavioral Therapy for Eating Disorders. Our work is based on manualized treatment protocols both for adults and adolescents with eating disorders. The main goals of this SIG are to provide a community that (1) supports clinicians in implementing these evidence-based treatments for eating disorders in real-world clinical settings and (2) to support researchers conducting studies of CBT-ED. It will also enable professionals to come together to discuss ways to further refine CBT-ED and extend its use, as well as to identify areas of need for future research.

If you wish to find out more about AED and its membership, please follow the link below:

For information: https://www.aedweb.org/home