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Beard J, Cooper Z, Masson P, Mountford VA, Murphy R, Raykos B, Tatham M, Thomas JJ, Turner HM, Wade TD, Waller G. Assessing clinician competence in the delivery of cognitive-behavioural therapy for eating disorders: development of the Cognitive-Behavioural Therapy Scale for Eating Disorders (CBTS-ED). Cogn Behav Ther 2024; 53:29-47. [PMID: 37807843 DOI: 10.1080/16506073.2023.2263640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 09/20/2023] [Indexed: 10/10/2023]
Abstract
Evidence-based cognitive-behaviour therapy for eating disorders (CBT-ED) differs from other forms of CBT for psychological disorders, making existing generic CBT measures of therapist competence inadequate for evaluating CBT-ED. This study developed and piloted the reliability of a novel measure of therapist competence in this domain-the Cognitive Behaviour Therapy Scale for Eating Disorders (CBTS-ED). Initially, a team of CBT-ED experts developed a 26-item measure, with general (i.e. present in every session) and specific (context- or case-dependent) items. To determine statistical properties of the measure, nine CBT-ED experts and eight non-experts independently observed six role-played mock CBT-ED therapy sessions, rating the therapists' performance using the CBTS-ED. The inter-item consistency (Cronbach's alpha and McDonald's omega) and inter-rater reliability (ICC) were assessed, as appropriate to the clustering of the items. The CBTS-ED demonstrated good internal consistency and moderate/good inter-rater reliability for the general items, at least comparable to existing generic CBT scales in other domains. An updated version is proposed, where five of the 16 "specific" items are reallocated to the general group. These preliminary results suggest that the CBTS-ED can be used effectively across both expert and non-expert raters, though less experienced raters might benefit from additional training in its use.
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Affiliation(s)
- Jessica Beard
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Zafra Cooper
- Department of Psychiatry, Yale University, New Haven, USA
| | - Philip Masson
- Department of Psychology, Western University, London, Canada
| | - Victoria A Mountford
- Sage Clinics, Dubai, UAE
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Rebecca Murphy
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Bronwyn Raykos
- Centre for Clinical Interventions, Northbridge, Western Australia
| | - Madeleine Tatham
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Jennifer J Thomas
- Department of Psychiatry, Harvard Medical School Massachusetts General Hospital, Boston, USA
| | - Hannah M Turner
- Eating Disorders Service, Southern Health NHS Foundation Trust, Southampton, UK
| | - Tracey D Wade
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, South Australia
| | - Glenn Waller
- Department of Psychology, University of Sheffield, Sheffield, UK
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Russell H, Aouad P, Le A, Marks P, Maloney D, Touyz S, Maguire S. Psychotherapies for eating disorders: findings from a rapid review. J Eat Disord 2023; 11:175. [PMID: 37794513 PMCID: PMC10548609 DOI: 10.1186/s40337-023-00886-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 09/11/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Psychotherapy is considered central to the effective treatment of eating disorders-focusing on behavioural, psychological, and social factors that contribute to the illness. Research indicates psychotherapeutic interventions out-perform placebo, waitlist, and/or other treatments; but, outcomes vary with room for major improvement. Thus, this review aims to (1) establish and consolidate knowledge on efficacious eating disorder psychotherapies; (2) highlight select emerging psychotherapeutic interventions; and (3) identify knowledge gaps to better inform future treatment research and development. METHODS The current review forms part of a series of Rapid Reviews published in a special issue in the Journal of Eating Disorders to inform the development of the Australian-government-funded National Eating Disorder Research and Translation Strategy 2021-2031. Three databases were searched for studies published between 2009 and 2023, published in English, and comprising high-level evidence studies (meta-analyses, systematic reviews, moderately sized randomised controlled studies, moderately sized controlled-cohort studies, and population studies). Data pertaining to psychotherapies for eating disorders were synthesised and outlined in the current paper. RESULTS 281 studies met inclusion criteria. Behavioural therapies were most commonly studied, with cognitive-behavioural and family-based therapies being the most researched; and thus, having the largest evidence-base for treating anorexia nervosa, bulimia nervosa, and binge eating disorder. Other therapies, such as interpersonal and dialectical behaviour therapies also demonstrated positive treatment outcomes. Emerging evidence supports specific use of Acceptance and Commitment; Integrative Cognitive Affective; Exposure; Mindfulness; and Emotionally-Focused therapies; however further research is needed to determine their efficacy. Similarly, growing support for self-help, group, and computer/internet-based therapeutic modalities was noted. Psychotherapies for avoidant/restrictive food intake disorder; other, and unspecified feeding and eating disorders were lacking evidence. CONCLUSIONS Currently, clinical practice is largely supported by research indicating that behavioural and cognitive-behavioural psychotherapies are most effective for the treatment of eating disorders. However, the efficacy of psychotherapeutic interventions varies across studies, highlighting the need for investment and expansion of research into enhanced variants and novel psychotherapies to improve illness outcomes. There is also a pressing need for investigation into the whole range of eating disorder presentations and populations, to determine the most effective interventions.
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Affiliation(s)
- Haley Russell
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Level 2, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW, 2006, Australia
| | - Phillip Aouad
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Level 2, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW, 2006, Australia.
| | - Anvi Le
- Healthcare Management Advisors, Melbourne, Australia
| | - Peta Marks
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Level 2, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW, 2006, Australia
| | - Danielle Maloney
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Level 2, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW, 2006, Australia
- Sydney Local Health District, New South Wales Health, Sydney, Australia
| | - Stephen Touyz
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Level 2, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW, 2006, Australia
| | - Sarah Maguire
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Level 2, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW, 2006, Australia
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Lo YJ, Mishra VK, Lo HY, Dubey NK, Lo WC. Clinical Spectrum and Trajectory of Innovative Therapeutic Interventions for Insomnia: A Perspective. Aging Dis 2022:AD.2022.1203. [PMID: 37163444 PMCID: PMC10389812 DOI: 10.14336/ad.2022.1203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/03/2022] [Indexed: 05/12/2023] Open
Abstract
Increasing incidences of insomnia in adults, as well as the aging population, have been reported for their negative impact on the quality of life. Insomnia episodes may be associated with neurocognitive, musculoskeletal, cardiovascular, gastrointestinal, renal, hepatic, and metabolic disorders. Epidemiological evidence also revealed the association of insomnia with oncologic and asthmatic complications, which has been indicated as bidirectional. Two therapeutic approaches including cognitive behavioral therapy (CBT) and drugs-based therapies are being practiced for a long time. However, the adverse events associated with drugs limit their wide and long-term application. Further, Traditional Chinese medicine, acupressure, and pulsed magnetic field therapy may also provide therapeutic relief. Notably, the recently introduced cryotherapy has been demonstrated as a potential candidate for insomnia which could reduce pain, by suppressing oxidative stress and inflammation. It seems that the synergistic therapeutic approach of cryotherapy and the above-mentioned approaches might offer promising prospects to further improve efficacy and safety. Considering these facts, this perspective presents a comprehensive summary of recent advances in pathological aetiologies of insomnia including COVID-19, and its therapeutic management with a greater emphasis on cryotherapy.
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Affiliation(s)
| | | | | | - Navneet Kumar Dubey
- Victory Biotechnology Co., Ltd., Taipei 114757, Taiwan
- ShiNeo Technology Co., Ltd., New Taipei City 24262, Taiwan
| | - Wen-Cheng Lo
- Department of Surgery, Division of Neurosurgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Neurosurgery, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei 11031, Taiwan
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Liquori S, Faidutti G, Garzitto M, Saetti L, Bendotti M, Balestrieri M. Efficacy of a Group Psychoeducation Treatment in Binge Eating Disorder: An Open-Label Study. Front Psychiatry 2022; 13:822282. [PMID: 35558418 PMCID: PMC9086709 DOI: 10.3389/fpsyt.2022.822282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 03/29/2022] [Indexed: 11/30/2022] Open
Abstract
AIMS To evaluate the effectiveness of a multidisciplinary group psychoeducation treatment (GPT) in patients with Binge Eating Disorder (BED). METHODS We designed an open-label efficacy study that included a population of 45 patients diagnosed with BED. A measure of eating attitudes and associated psychological constructs was obtained through the use of the self-report instruments Eating Disorder Inventory (EDI-3), Binge Eating Scale (BES) and Body Uneasiness Test (BUT). The Symptom Checklist-90 (SCL-90) was also administered to assess general psychopathology. All participants participated in 12 weekly group psychoeducational treatment meetings, 8 of which were conducted by mental health professionals, and a second module of 4 meetings, oriented on health and nutrition education topics, conducted by a dietician. RESULTS At the end of treatment, patients showed significant improvements in body mass index (BMI) and binge eating. Paired t-tests showed significant differences at p-value < 0.05 in all eating disorder risk scales and for most of the general psychological scales related to eating disorders. In addition, patients experienced an improvement in their perception of overall body image, a decrease in concerns about physical appearance and less body image avoidance. Finally, results showed that psychoeducation treatment was associated with significant improvements in interpersonal sensitivity. CONCLUSIONS The results of this study may indicate that significant short-term improvements can be achieved through a psychoeducation group for BED patients. Although limited by the lack of a control condition, this study adds to a growing body of evidence with promising results, setting the stage for further case-control studies of BED treatment.
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Affiliation(s)
- Silvia Liquori
- Unit of Psychiatry, Department of Medicine (DAME), Centre for Eating Disorders, University of Udine and Friuli Centrale Health-University Trust (ASUFC), Udine, Italy
| | - Giovanni Faidutti
- Unit of Psychiatry, Department of Medicine (DAME), Centre for Eating Disorders, University of Udine and Friuli Centrale Health-University Trust (ASUFC), Udine, Italy
| | - Marco Garzitto
- Unit of Psychiatry, Department of Medicine (DAME), Centre for Eating Disorders, University of Udine and Friuli Centrale Health-University Trust (ASUFC), Udine, Italy
| | - Luana Saetti
- Unit of Psychiatry, Department of Medicine (DAME), Centre for Eating Disorders, University of Udine and Friuli Centrale Health-University Trust (ASUFC), Udine, Italy
| | - Monica Bendotti
- Unit of Psychiatry, Department of Medicine (DAME), Centre for Eating Disorders, University of Udine and Friuli Centrale Health-University Trust (ASUFC), Udine, Italy
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), Centre for Eating Disorders, University of Udine and Friuli Centrale Health-University Trust (ASUFC), Udine, Italy
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