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ABCT Clinical Roundtable- Beyond Standard CBT: Innovative Developments in Behavioral Interventions for Eating Disorders

Location Atlanta, GA Date 22 Nov 2019Trainer Lori Prado, LMHC, LPC-S, CEDSCo-Host ABCT 2019 conference

Course Objectives

Abstract: Eating disorders (EDs) are complex conditions that are marked by significant medical complications as well as substantial psychiatric comorbidity. Cognitive behavioral therapy (CBT) has shown robust empirical evidence as a transdiagnostic intervention and is thus recommended as a frontline treatment across most EDs (National Institute for Health and Care Excellence, 2017). However, many patients experience minimal benefit from CBT (Cooper & Fairburn, 2011), and about one-third quickly relapse following an ostensibly successful treatment course (Carter et al., 2009). Moreover, there is differential effectiveness of CBT when applied across the ED diagnoses (Costa & Melnik, 2016). Taken together, these limitations with standard CBT warrant exploration of novel interventions that can enhance the magnitude and durability of treatment effects. Fortunately, there have been several novel behavioral approaches developed recently that have shown promise as either augmentations or alternative strategies to traditional CBT. The objective of this panel is to describe these new behavioral approaches and their unique applications to individuals with EDs.

In keeping with this year’s conference theme of extending the impact of cognitive behavioral science, our panel will first aim to identify the progress made in developing and refining CBT for EDs before identifying clinical presentations and features that CBT struggles to “reach.” Examples include individuals with emotion dysregulation difficulties and/or complex comorbidity. This will lead into our descriptions of innovative behavioral interventions that have shown promise in addressing complex ED pathology. The interventions include Dialectical Behavior Therapy (DBT), which can improve emotional regulation in individuals with EDs, and Radically Open DBT (RO DBT) which addresses rigid rule-governed behavior and social signaling deficits. Additionally, exposure therapy techniques for EDs (e.g., exposure to feared foods, body-focused exposure) can augment the benefits of CBT for EDs. Lastly, we will overview the newly developed Temperament-Based Treatment with Supports (TBT-S), which targets underlying neurobiological mechanisms and has yielded promising outcomes.

Learning Objectives:

  • Summarize the research on CBT effectiveness and limitations with eating disorders.
  • Describe four novel, evidence-based approaches to eating disorder treatment: CBT with exposure therapy techniques, DBT, RO DBT, and TBT-S.
  • Discuss how each treatment addresses the previous limitations of CBT with eating disorders.

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