Group cognitive-behavioural therapy for anorexia nervosa: a case for treatment?

Abstract

Objectives There is a lack of empirical data regarding the efficacy of cognitive behavioural therapy (CBT) in anorexia nervosa. In addition, the narrow focus of traditional CBT on food- and weight-related negative thoughts and dysfunctional assumptions has been questioned. This study aimed to investigate the effectiveness of a CBT group for anorexic individuals, and to determine whether or not treatment outcome is associated with non-specific underlying cognitions (core beliefs). Method Twenty anorexic women participated in a 10-week cognitive-behavioural group programme. Eating cognitions and behaviours were assessed at the beginning and end of the programme. Core beliefs were assessed at the beginning of the group and were used as predictors of changes in anorectic cognitions and symptoms. Results Group CBT was found to be ineffective in symptom reduction, and core beliefs were irrelevant to outcome. These findings do not appear to be methodological artefacts. Conclusion It is suggested that group CBT in its current short form is insufficient to induce changes, due to its failure to address some process issues central to anorexia nervosa (such as poor motivation, lack of insight, and ambivalence towards treatment). Copyright © 1999 John Wiley & Sons, Ltd and Eating Disorders Association.