Cognitive behavioural therapy for eating disorders: how do clinician characteristics impact on treatment fidelity?

C. E. Brown,K. Nicholson Perry

doi:10.1186/s40337-018-0208-0

Abstract

BackgroundClinicians routinely report not practising evidence-based treatments with eating disorders. There has been limited research investigating the impact of adaptable clinician characteristics such as self-efficacy and therapeutic optimism in this area. This study evaluated if there is a relationship between clinician therapeutic optimism, self-efficacy and the provision of evidence-based practice in the treatment of bulimia nervosa and binge eating disorder.MethodA survey developed for this study was administered to 100 psychologists who were recruited online via a range of organisations affiliated with psychology and/or eating disorders. The survey measured demographic factors, eating disorder treatment knowledge, treatment fidelity, the use of individual treatment components and a range of clinician characteristics including self-efficacy and therapeutic optimism.ResultsResults demonstrated that clinician self-efficacy was positively associated with and predicted treatment fidelity. Therapeutic optimism had significant low correlations with treatment fidelity but did not predict treatment fidelity.ConclusionThese findings would suggest that strengthening clinician self-efficacy is useful in improving evidence-based practice in the treatment of binge eating disorder and bulimia nervosa and may also have implications in the training of clinicians. The study also demonstrated that the use of a range of knowledge translation strategies are valuable in enhancing clinician adherence to evidence-based practice. Further research with direct measures of treatment fidelity is needed to clarify these findings.

Highlights

Clinicians routinely report not practising evidence-based treatments with eating disorders
Therapeutic optimism had significant low correlations with treatment fidelity but did not predict treatment fidelity. These findings would suggest that strengthening clinician self-efficacy is useful in improving evidencebased practice in the treatment of binge eating disorder and bulimia nervosa and may have implications in the training of clinicians
The study demonstrated that the use of a range of knowledge translation strategies are valuable in enhancing clinician adherence to evidence-based practice

Summary

Introduction

Clinicians routinely report not practising evidence-based treatments with eating disorders. This study evaluated if there is a relationship between clinician therapeutic optimism, self-efficacy and the provision of evidence-based practice in the treatment of bulimia nervosa and binge eating disorder. Brown and Nicholson Perry Journal of Eating Disorders (2018) 6:19 shown that the most robust and established approach is the use of CBT [2,3,4,5,6] This is reflected in the recommendation of CBT for the treatment of BN and BED in National Institute for Care and Excellence (NICE) [7] guidelines and most recent version of clinical practice guidelines developed by a multi-disciplinary team with the Royal Australian and New Zealand College of Psychiatrists [8]. There is consensus that CBT is an effective evidence-based treatment (EBT) for BED and BN and we need to ensure that the treatment is implemented as intended to ensure the full benefits of treatment are received

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Conclusion