Mod5 Art3 - Module 5 Article 3 TREATMENT HIGHLIGHTS...

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Unformatted text preview: Module 5 --- Article 3 TREATMENT HIGHLIGHTS COGNITIVE-BEHAVIORAL THERAPY FOR ANOREXIA NERVOSA Cognitive-behavioral therapy is found to be an effective posthospitalization treatment of anorexia nervosa. In a preliminary study, 33 patients (ages 18 to 45) with anorexia nervosa who had successfully completed inpatient treatment (ie, reached 90% of ideal body weight, normalized eating patterns, resolved acute medical problems) were randomly assigned to receive either cognitive-behavioral therapy (CBT) or nutritional counseling for 50 individual sessions over a 1-year period.1 The goal of each intervention was to maintain and consolidate participants’ gains achieved as inpatients, continue improvement and recovery, and prevent relapse. In this study, CBT focused “on cognitive and behavioral features associated with the maintenance of eating pathology and . . . [addressed] a range of issues related to self-esteem, self-schema, and interpersonal functioning.” The nutritional counseling intervention, which was psychoeducational and supportive, provided dietary analyses and helped patients plan balanced meals. Patients who were discharged from the hospital on antidepressant medication remained on that medication throughout the study and no new medications were initiated during the study. Eating pathology was assessed at the beginning and end of the study. Patients receiving CBT were less likely to have a posthospitalization treatment failure (ie, relapsing or dropping out of treatment) than were patients receiving nutritional counseling (22% vs 73% of patients). Specifically, among the CBT patients, 22% relapsed and 0% dropped out (ie, before the tenth session). In comparison, among the nutritional counseling patients, 53% relapsed and 20% dropped out. The authors conclude that this study offers “preliminary support for the use of cognitive behavior therapy in posthospitalization treatment of adult anorexia nervosa.” 1 The authors believe this to be the “first empirical evaluation of CBT as a posthospitalization treatment for anorexia nervosa in adults.” Pike K, Walsh BT, Vitousek K, Wilson GT, & Bauer J. Cognitive behavior therapy in the posthospitalization treatment of anorexia nervosa. American Journal of Psychiatry, 160:2046-2049, 2003. Support: Natl Inst of Mental Health. The CBT and nutritional counseling manuals used in this study are available on request from Dr. Pike, the lead author of the study. © Copyright 2011 MWK Publishing LLC; from The Complete Practitioner: Mental Health Applications (Vol. 6, No. 12 -- December 2003) For next article, go to next page. ...
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