10‐session Cognitive Behavioural Therapy (CBT-T) for Eating Disorders: A Systematic Review and Narrative Synthesis

Abstract

To review the literature examining the effectiveness and efficacy of a cognitive behavioural therapy (CBT) for eating disorders delivered in ten sessions for those who are not underweight (CBT-T). A systematic search of the literature (MEDLINE, EMBASE, PsycINFO, Scopus and ProQuest) was conducted to identify relevant publications to date at the time of March 2022 (re-run in May 2023). Intervention studies of any study design that investigated CBT-T offering outcome data at least pre- to post- intervention for eating disorder and related outcomes were included. Results were reported for treatment attrition, abstinence, remission, eating disorder psychopathology, disordered eating behaviours, psychosocial impairment, depression and anxiety and synthesised using a narrative synthesis framework. The Effective Public Health Practice Project (EPHPP) quality assessment tool (Thomas et al., 2004) was used to assess the quality of included studies. Outcomes for 555 people who received CBT-T across eight studies (one randomised control trial and seven non-randomised studies) were synthesised. Support was found for the effectiveness and efficacy of CBT-T for a range of non-underweight eating disorders, with respect to eating disorder psychopathology, disordered eating behaviours, psychosocial impairment, abstinence and remission. CBT-T also led to improvements for depression and anxiety symptoms. CBT-T appears to improve eating disorder and co-morbid outcomes for people with non-underweight eating disorders within ten sessions, with comparable results to standard-length CBT for eating disorders (CBT-ED). Although results for CBT-T are promising, there were concerns with the quality of the studies. Future research is required to strengthen the evidence base with larger, higher-quality studies which compare CBT-T directly with recommended psychological treatments, such as standard-length CBT-ED.