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Cited by 210Eating Disorders and BehaviorsTelemedicine and Telehealth ImplementationNutrition, Health and Food Behavior

A randomized trial comparing the efficacy of cognitive–behavioral therapy for bulimia nervosa delivered via telemedicine versus face-to-face

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Mitchell, James E., Crosby, Ross D., Wonderlich, Stephen A., Crow, Scott, Lancaster, Kathy, Simonich, Heather, Swan-Kremeier, Lorraine, Lysne, Christianne +1 more·2008·Behaviour Research and Therapy
DOI 10.1016/j.brat.2008.02.004PMC PMC2633728
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Abstract

Objective A major problem in the delivery of mental health services is the lack of availability of empirically supported treatment, particularly in rural areas. To date no studies have evaluated the administration of an empirically supported manual-based psychotherapy for a psychiatric condition via telemedicine. The aim of this study was to compare the relative efficacy and acceptability of a manual-based cognitive-behavioral therapy (CBT) for bulimia nervosa (BN) delivered in person to a comparable therapy delivered via telemedicine.Method One hundred twenty-eight adults meeting DSM-IV criteria for BN or eating disorder-not otherwise specified with binge eating or purging at least once per week were recruited through referrals from clinicians and media advertisements in the targeted geographical areas. Participants were randomly assigned to receive 20 sessions of manual-based, CBT for BN over 16 weeks delivered either face-to-face (FTF-CBT) or via telemedicine (TV-CBT) by trained therapists. The primary outcome measures were binge eating and purging frequency as assessed by interview at the end of treatment, and again at 3- and 12-month follow-ups. Secondary outcome measures included other bulimic symptoms and changes in mood.Results Retention in treatment was comparable for TV-CBT and FTF-CBT. Abstinence rates at end-of-treatment were generally slightly higher for FTF-CBT compared with TV-CBT, but differences were not statistically significant. FTF-CBT patients also experienced significantly greater reductions in eating disordered cognitions and interview-assessed depression. However, the differences overall were few in number and of marginal clinical significance.Conclusions CBT for BN delivered via telemedicine was both acceptable to participants and roughly equivalent in outcome to therapy delivered in person.

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Authors
Mitchell, J. E., Crosby, R. D., Wonderlich, S. A., Crow, S., Lancaster, K., Simonich, H., Swan-Kremeier, L., Lysne, C., & Cook Myers, T.
Affiliations
  • University of North Dakota (US)
  • University of Minnesota (US)
  • Neuropsychiatric Research Institute (US)
Corresponding author
Mitchell, James E.
ORCID
Venue
Behaviour Research and Therapy
Publisher
Elsevier BV
Published
2008-05
Volume
46
Issue
5
Pages
581-592
ISSN
0005-7967 (ISSN-L)
DOI
10.1016/j.brat.2008.02.004
PMC
PMC2633728
OpenAlex
W2136536038
Cited by
210
References
36
Citations by year
2026: 4 · 2025: 3 · 2024: 11 · 2023: 11 · 2022: 14 · 2021: 20 · 2020: 19 · 2019: 10 · 2018: 12 · 2017: 12 · 2016: 17 · 2015: 15 · 2014: 9 · 2013: 14 · 2012: 16
FWCI
8.52
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Behaviour Research and Therapy (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • U.S. Public Health Service (R01-MHDK-58820)
  • National Institute of Mental Health (K02MH065919, R13MH081447, R01MH058820, R01MH059674, KO2 MH65919, R34MH077571)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Keywords
bulimia nervosa, cognitive behavioral therapy, telemedicine, remote psychotherapy, face-to-face therapy, treatment acceptability, treatment retention, binge eating, purging, eating disorder cognitions, depression, rural mental health services
MeSH terms
Adult, Female, Humans, Male, Patient Dropouts, Cognitive Behavioral Therapy, Treatment Outcome, Patient Satisfaction, Telemedicine, Diagnostic and Statistical Manual of Mental Disorders, Bulimia Nervosa, Young Adult

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