A 10‐session cognitive‐behavioral therapy (CBT‐T) for eating disorders: Outcomes from a case series of nonunderweight adult patients

Waller, Glenn; Tatham, Madeleine; Turner, Hannah; Mountford, Victoria A.; Bennetts, Alison; Bramwell, Kate; Dodd, Julie; Ingram, Lauren

doi:10.1002/eat.22837

Cited by 98Eating Disorders and BehaviorsNutrition, Health and Food BehaviorAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

A 10‐session cognitive‐behavioral therapy (CBT‐T) for eating disorders: Outcomes from a case series of nonunderweight adult patients

Waller, Glenn, Tatham, Madeleine, Turner, Hannah, Mountford, Victoria A., Bennetts, Alison, Bramwell, Kate, Dodd, Julie, Ingram, Lauren·2018·International Journal of Eating Disorders

DOI 10.1002/eat.22837

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Abstract

Objective: Existing forms of evidence‐based cognitive behavior therapy for eating disorders (CBT‐ED) are relatively effective for nonunderweight cases. However, they are also expensive compared to CBT for other disorders. This study reports the first outcomes for a shorter, 10‐session form of CBT‐ED (CBT‐T) for such cases, designed to be less demanding of resources. Method: A case series of 106 nonunderweight eating disordered cases were considered for this effectiveness study. A protocolized 10‐session version of CBT‐ED was delivered by clinical assistants, under supervision. Measures assessed eating attitudes and behaviors, anxiety, depression, personality pathology, and the working alliance. Intention‐to‐treat analyses were used. Results: Suitability, acceptability, working alliance ratings, and retention were all positive. Outcomes by the end of therapy and at three‐month follow‐up were positive for all symptoms, with levels of change, abstinence and remission that were comparable to those from effectiveness studies of longer forms of CBT. Higher levels of pretreatment anxiety predicted retention in treatment, but no factors predicted poorer response. Early change in eating attitudes and the working alliance were the strongest predictors of a positive response. Discussion: This 10‐session form of CBT‐ED for nonunderweight eating disorders performed at a level that is comparable to versions of CBT‐ED that are twice as long, despite being delivered by nonspecialist therapists. Replication and longer‐term follow‐ups are needed to ensure retained effects. However, CBT‐T has promise as a therapy for use in a range of healthcare settings, to enhance access to treatment for such eating disorders.

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The low acceptance level relative to individual CBT-T and other individual therapies limits the utility of group CBT-T in clinical settings and impacts the viability of future trials.
“The low acceptance level relative to that found in individual CBT-T and other individual therapies (Waller et al., 2018) limits the utility of group CBT-T in clinical settings, and impacts the viability of setting up future trials to determine group CBT-T's efficacy and effectiveness.”
From Brief group cognitive‐behavioral therapy for bulimia nervosa and binge‐eating disorder: A pilot study of feasibility and acceptability. (2023) · cites this paper as Waller et al., 2018
The Results (p. 10) report high acceptability for CBT-T: 9 of 102 patients (8.8%) declined or did not attend. This supports the individual CBT-T benchmark, but the paper does not establish acceptance levels for other individual therapies. The claims about group CBT-T’s clinical utility and future trials are the citing authors’ conclusions, not findings attributed to this source. (LLM, conf=0.84)
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Additional file 5 of Clinician perspectives of the implementation of an early intervention service for eating disorders in England: a mixed method study
Richards, K. L., Phillips, M. D., Grycuk, L., Hyam, L., Allen, K., & Schmidt, U. (2024) · Figshare · doi:10.6084/m9.figshare.26702770
Additional file 1 of Effects of cognitive-behavioral and psychodynamic-interpersonal treatments for eating disorders: a meta-analytic inquiry into the role of patient characteristics and change in eating disorder-specific and general psychopathology in remission
Moberg, L. T., Solvang, B., Sæle, R. G., & Myrvang, A. D. (2021) · Figshare · doi:10.6084/m9.figshare.14853369
Additional file 3 of Clinician perspectives of the implementation of an early intervention service for eating disorders in England: a mixed method study
Richards, K. L., Phillips, M. D., Grycuk, L., Hyam, L., Allen, K., & Schmidt, U. (2024) · Figshare · doi:10.6084/m9.figshare.26702764
Additional file 2 of Clinician perspectives of the implementation of an early intervention service for eating disorders in England: a mixed method study
Richards, K. L., Phillips, M. D., Grycuk, L., Hyam, L., Allen, K., & Schmidt, U. (2024) · Figshare · doi:10.6084/m9.figshare.25556666
Additional file 4 of Clinician perspectives of the implementation of an early intervention service for eating disorders in England: a mixed method study
Richards, K. L., Phillips, M. D., Grycuk, L., Hyam, L., Allen, K., & Schmidt, U. (2024) · Figshare · doi:10.6084/m9.figshare.26702767
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Authors: Waller, G., Tatham, M., Turner, H., Mountford, V. A., Bennetts, A., Bramwell, K., Dodd, J., & Ingram, L.
Affiliations: University of Sheffield (GB)
Cambridgeshire and Peterborough NHS Foundation Trust (GB)
Southern Health NHS Foundation Trust (GB)
King's College London (GB)
Corresponding author: Waller, Glenn
ORCID: Waller, Glenn
Tatham, Madeleine
Turner, Hannah
Mountford, Victoria A.
Bennetts, Alison
Bramwell, Kate
Venue: International Journal of Eating Disorders
Publisher: Wiley
Published: 2018-02-08
Volume: 51
Issue: 3
Pages: 262-269
ISSN: 0276-3478 (ISSN-L)
1098-108X
DOI: 10.1002/eat.22837
OpenAlex: W2791942446
Cited by: 98
References: 32
Citations by year: 2026: 7 · 2025: 11 · 2024: 18 · 2023: 8 · 2022: 6 · 2021: 34 · 2020: 3 · 2019: 7 · 2018: 4
FWCI: 14.10
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: International Journal of Eating Disorders (publishedVersion)
PubMed (publishedVersion)
White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
ePrints Soton (University of Southampton) (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: brief psychotherapy, treatment retention, therapeutic relationship, eating attitudes, anxiety, depression, personality pathology, treatment accessibility, clinical assistants
MeSH terms: Adolescent, Adult, Feeding and Eating Disorders, Female, Humans, Male, Middle Aged, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult

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A 10‐session cognitive‐behavioral therapy (CBT‐T) for eating disorders: Outcomes from a case series of nonunderweight adult patients

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