What effective therapies have in common

Abstract

In light of current debates about best practices in the eating disorders, at the 2013 International Conference for Eating Disorders, each speaker from the treatment plenary was asked to answer three questions: (i) How does the therapy in your trial engage and motivate patients? (ii) How does the therapy help patients develop skills and alternate ways of coping? and (iii) What are the boundaries and therapeutic expectations of the therapy? The treatments that were included in the plenary included Enhanced Cognitive Behaviour Therapy, the Maudsley Anorexia Nervosa Treatment for Adults, Specialist Supportive Clinical Management, Integrative Cognitive Affective Therapy and Internet-based therapies. Interestingly, there were far more similarities than differences across the treatment modalities. Practices that were common to all of the therapies included the use of a collaborative framework, the importance of psycho-education, emotion regulation, examining relationships, identifying higher values and the use of behavioural experiments. The discussion also raised interesting points to consider regarding treatment non-responders such as flexibility vs. firmness of therapeutic boundaries and behavioural expectations. This paper recognises and celebrates the established common ingredients of effective treatments, while challenging us to ask more complex research questions.