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Clinician and practice characteristics influencing delivery and outcomes of the early part of outpatient cognitive behavioural therapy for anorexia nervosa

Published online by Cambridge University Press:  10 July 2014

Amy Brown ,
Victoria Mountford  and
Glenn Waller
Amy Brown*
Affiliation:
Institute of Psychiatry, King's College London, London, UK
Victoria Mountford
Affiliation:
Institute of Psychiatry, King's College London, London, UK South London and Maudsley Eating Disorder Service, South London and Maudsley NHS Foundation Trust, London, UK
Glenn Waller
Affiliation:
Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
*
*Author for correspondence: A. Brown, DClinPsy, Institute of Psychiatry, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK (email: amy.brown@kcl.ac.uk).
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Abstract

Cognitive-behavioural therapy (CBT) can be effective for anorexia nervosa. However, there is evidence that the delivery of treatments for the eating disorders is inconsistent. This study examined evidence that clinician characteristics and practice can influence the effective implementation of CBT. The participants were 100 qualified clinicians who routinely offered outpatient CBT to adults with anorexia nervosa. They completed a survey of their demographic characteristics, level of anxiety, clinical practice in CBT for anorexia nervosa, and beliefs about the relationship between weight gain and therapeutic alliance in the early part of such treatment. Greater reported levels of weight gain were associated with the use of manuals, early focus on weight gain as a target, structured eating, and a belief that weight gain precedes a good working alliance. Clinician anxiety and early focus on the therapeutic alliance rather than structured eating were associated with poorer outcomes. These conclusions need to be tested within clinical and research settings. However, they suggest that clinicians should be encouraged to use manual-based approaches when treating anorexia nervosa using CBT, as focusing on techniques might result in the best possible outcome in this early part of treatment.

Keywords

Anorexia nervosacognitive behavioural therapytherapeutic allianceweight gain
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 7 , December 2014 , e10
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2014 

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