Psychotherapy as treatment for eating disorders will most often be delivered by a psychologist, however; psychiatrists, psychotherapists, counsellors, and social workers may use aspects of these approaches in their treatment of eating disorders. The following lists the main methods of psychotherapy used in the treatment of eating disorders.
Cognitive analytic therapy
Through cognitive analytic therapy people with Anorexia Nervosa can gain insight into how their eating disorder fits into their experience of life and their early relationships. These early experiences are examined in a safe, therapeutic environment and an important emphasis is placed on the relationship between the individual and the therapist.
Discovering personal strengths and incorporating these into daily coping strategies can help people with eating disorders manage their emotions and relationships. When effective, these methods can counteract the need for disordered eating behaviours. Cognitive Analytic Therapy combines aspects of cognitive therapy and psychodynamic therapy. This therapy has been found to be effective in the treatment of Anorexia Nervosa.
Cognitive Behavioural Therapy (CBT)
Cognitive behavioural therapy aims to adjust unhelpful patterns of thinking and behaviour in people with eating disorders. When used in the treatment of an eating disorder, cognitive behavioural therapy can help reduce the amount of importance individuals place on their weight, shape and eating behaviours.
Cognitive behavioural therapy programs will directly address eating disorder behaviours such as vomiting or laxative misuse, extreme dieting and compulsive exercising. Problems related to eating disorders including low self esteem, perfectionism, maintaining healthy relationships and how to regulate emotions are also addressed. Cognitive behavioural therapy has been found to be effective in the treatment of people with Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder.
Crisis intervention for Bulimia Nervosa
Crisis intervention is intended to prevent relapse in people with Bulimia Nervosa. It is offered as a treatment for people recovering from Bulimia Nervosa who are noticing a return of symptoms or fear relapse. Crisis Intervention is delivered in the form of additional therapy sessions. This treatment has been found to be effective in the treatment of people with Bulimia Nervosa and Binge Eating Disorder.
Dialectical Behavioural Therapy (DBT)
Dialectical behavioural therapy is based on an emotion regulation model of eating disorders. It proposes that disordered eating occurs as a way to cope with emotional distress when a person with an eating disorder does not have appropriate coping strategies. Dialectical behavioural therapy works to help people with eating disorders find ways to tolerate and manage their emotions. This treatment has been found to be effective in the treatment of people with Bulimia Nervosa and Binge Eating Disorder.
Ego-oriented individual therapy
Ego-oriented individual therapy is effective in the treatment of adolescents with eating disorders. This therapy focuses on building coping skills and developing the identity and autonomy of the adolescent with the eating disorder. Interpersonal issues regarding physical, social, and emotional development are also addressed. Treatment may involve meetings with the adolescent’s parents to support the individual treatment.
Focal psychoanalytic psychotherapy
Focal psychoanalytic psychotherapy for eating disorders involves the therapist taking a non-directive stance and not offering direct advice on eating behaviour or how to manage eating disorder symptoms. Instead, the therapy focuses on early life experiences and how these experiences impact the conscious and unconscious meanings of the eating disorder.
Focal psychoanalytic psychotherapy places importance on the relationship between the therapist and the person with the eating disorder. Through this process the person may gain insight into the true nature of their eating disorder and lead to recovery. This therapy has been found to be effective in the treatment of Anorexia Nervosa.
Guided imagery for people with eating disorders uses visualisation and relaxation activities to teach self-comforting techniques and self-awareness. Guided Imagery can be performed with a therapist or individually in the form of self help. This treatment has been found to be effective in the treatment of people with Bulimia Nervosa.
Interpersonal psychotherapy focuses on a person’s relational skills and how they contribute to their eating disorder. This is done so by examining established relationship patterns and behaviours and encouraging the person with the eating disorder to adapt to current roles and situations.
Interpersonal psychotherapy targets four areas: grief, interpersonal disputes, role transitions, and interpersonal deficits. Interpersonal psychotherapy has been found to be effective in the treatment of Anorexia Nervosa and Binge Eating Disorder.
Psychodynamic interpersonal psychotherapy
Psychodynamic interpersonal psychotherapy aims to help people with eating disorders understand how their early relationships and their historical life experiences impact on their personal relationships in the here-and-now. They are also encouraged to explore and understand binge eating as a means of coping. Psychodynamic Interpersonal Psychotherapy has been found to be effective in the treatment of Binge Eating Disorder.
Specialist (Formerly Nonspecific) supportive clinical management
Specialist supportive clinical management seeks to provide education, care, support, and supportive psychotherapy for people with eating disorders. Praise, reassurance, and advice are given to a person with an eating disorder in order to encourage treatment.
The person’s nutritional status is addressed, and the person with the eating disorder is given advice, information, and encouragement to adopt normal eating behaviours and restore weight. This treatment has been found to be effective in the treatment of Anorexia Nervosa.
Stress management can be helpful to people with eating disorders due to the relationship between disordered eating and stress. Stress management aims to increase the person’s ability to tolerate and manage stressors. Stress management has been found to be effective in the treatment of Bulimia Nervosa.
Motivational enhancement therapy
Motivation is an important part of the treatment and recovery process of an eating disorder.
Motivation enhancement therapy is a counselling approach which seeks to enhance motivation of people with eating disorders by discussing the consequences and risks of the eating disorder and focusing on a better lifestyle. This approach was modified to help people with eating disorders move from the pre-contemplation or contemplation stages to an action stage where they are more likely to make behavioural changes.