The effectiveness of enhanced cognitive behavioural therapy in an outpatient setting

Abstract

The Eating Disorders Outreach Service (EDOS) at the Royal Brisbane and Women's Hospital has offered Enhanced Cognitive Behaviour Therapy (CBT-E) since 2009. The current research aimed to evaluate the effectiveness of the EDOS CBT-E program by analysing the outcome data of 114 adult outpatients (Mage = 26.06 years, SD = 8.35) with a DSM-IV diagnosis of Anorexia Nervosa, Bulimia Nervosa, or Eating Disorder Not Otherwise Specified. Outpatients attended an average of 20-40 individual sessions with a psychologist or psychiatric registrar. Of those who commenced CBT-E, only 50% completed treatment. Although a higher proportion of non-completers had an Axis II diagnosis, regression analyses revealed that the only significant predictor of drop-out from treatment was the presence of Axis IV psychosocial and environmental problems. Amongst those who completed treatment, CBT-E resulted in statistically and clinically significant improvements in eating disorder and general psychopathology, which were maintained at the 20-week follow-up. When the total sample, including non-completers was considered, statistically (and some clinically) significant improvements in eating disorder and general psychopathology were observed. The findings indicate that CBT-E is an effective treatment for adults with all eating disorders within outpatient settings. However, the high attrition observed indicates that strategies need to be identified to minimise drop-out.