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Introduction to enhanced cognitive behaviour therapy (CBT-E) for eating disorders

Rebecca Murphy

12 Dec 2023

Introduction

CBT-E is the abbreviation for “enhanced cognitive behaviour therapy” and is one of the most effective treatments for the eating disorders. This is a one-to-one treatment that focuses on the characteristic disturbances in eating habits and attitudes to shape and weight. CBT-E is designed to be individualised to match the eating problem of the person receiving treatment. 

CBT-E was developed by Professor Christopher Fairburn as a treatment for bulimia nervosa and in this form, it has been the subject of numerous clinical trials. It was the first psychological treatment (for any mental disorder) to be strongly endorsed by UK’s independent and highly regarded National Institute for Health and Care Excellence (NICE).

In the early 2000s the treatment was modified to make it suitable for all forms of eating disorder, including anorexia nervosa, bulimia nervosa, binge eating disorder and other similar states (Fairburn, Cooper and Shafran, 2003). In fact, it is the only treatment which has been shown to be suitable for all forms of eating disorder encountered in adults (Fairburn et al, 2009; Fairburn et al, 2013) and has been tested across the full range of eating disorders in studies emanating from the UK, Australia, Denmark, Italy and the USA. Although originally developed as an outpatient treatment for adults, it has also been adapted for use as an intensive version for day patients and inpatients and for younger people.


The event will be equivalent to 2.3/4hrs of CPD.

Content

This workshop will aim to:
• Provide an introduction to the main principles and goals of CBT-E to treat people with anorexia nervosa, bulimia nervosa, binge eating disorder and other related eating disorders
• Describe the adult outpatient version of CBT-E used with non-underweight patients (the core version of treatment which can then be adapted for other patient groups), and to highlight other versions of the treatment
• Introduce you to the theoretical cognitive-behavioural model of eating disorders and provide guidance on how to formulate using CBT-E
• Describe specific therapeutic skills and procedures used within CBT-E

Learning Objectives

You will learn:
• What is CBT-E and the different versions of CBT-E
• How to formulate eating disorders using a CBT-E approach
• About each of the four stages of treatment and the therapeutic procedures used across these stages (including starting well, addressing body image, tackling dietary restraint, addressing event and mood triggered eating problems, and ending well)
• How to find further information on the different versions of CBT-E, including working with underweight patients, and to develop your skills beyond this introductory level

Training Modalities

Didactic content, reflective exercises, polls, Q&A.

Key References

Bailey-Straebler S, Cooper Z, Dalle Grave R, Calugi S, Murphy R. Development of the CBT-E Components Checklist: A tool for measuring therapist self-rated adherence to CBT-E. IJEDO. 2022;4. doi: https://www.doi.org/10.32044/ijedo.2022.02  
Cooper, Z., & Murphy, R. (2021). Eating disorders: a transdiagnostic protocol. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders: a step-by-step treatment  (6th edition ed.). New York: Guilford.
Dalle Grave  R. Treatment of eating disorders in adults and adolescents: The advantages of a unified treatment. Psychology Today. Published online March 1, 2021
Murphy, R., Calugi, S., Cooper, Z., & Dalle Grave, R. (2020). Challenges and Opportunities for enhanced cognitive behaviour therapy (CBT-E) in light of COVID-19. The Cognitive Behaviour Therapist, 1-31. doi:10.1017/S1754470X20000161 
Fairburn, C. G., Bailey-Straebler, S., Basden, S., Doll, H. A., Jones, R., Murphy, R., … Cooper, Z. (2015). A transdiagnostic comparison of enhanced cognitive behaviour therapy (CBT-E) and interpersonal psychotherapy in the treatment of eating disorders. Behaviour Research and Therapy, 70, 64-71. doi:10.1016/j.brat.2015.04.010
Dalle Grave, R., Calugi, S., Doll, H. A., & Fairburn, C. G. (2013). Enhanced cognitive behaviour therapy for adolescents with anorexia nervosa: an alternative to family therapy? Behaviour Research and Therapy, 51(1), R9-r12. doi:10.1016/j.brat.2012.09.008
Fairburn, C. G., Cooper, Z., Doll, H. A., O’Connor, M. E., Palmer, R. L., & Dalle Grave, R. (2013). Enhanced cognitive behaviour therapy for adults with anorexia nervosa: a UK-Italy study. Behaviour Research and Therapy, 51(1), R2-8. doi:10.1016/j.brat.2012.09.010
Fairburn, C. G., Cooper, Z., Doll, H. A., O’Connor, M. E., Bohn, K., Hawker, D. M., . . . Palmer, R. L. (2009). Transdiagnostic cognitive-behavioral therapy for patients with eating disorders: a two-site trial with 60-week follow-up. American Journal of Psychiatry, 166(3), 311-319. doi:10.1176/appi.ajp.2008.08040608
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003) Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41, 509-528.

About the presenter

Rebecca Murphy is a Senior Research Clinician at the University of Oxford; co-director of the Centre for Research on Eating Disorders at Oxford (CREDO); an NIHR Clinical Doctoral Research Fellow and an Honorary Clinical Psychologist at Oxford Health NHS Foundation Trust. Her clinical and research specialism is enhanced CBT for eating disorders (CBT-E). She delivered CBT-E as a trial therapist for many years under the supervision of Christopher Fairburn and Zafra Cooper. More recently, her work has included helping to develop and evaluate an online training programme for therapists learning CBT-E, which she continues to manage. Currently she is leading the development and evaluation of Digital CBTe, a digital self-help programme for eating disorders characterised by binge eating. She is an Associate Editor of Behavioural and Cognitive Psychotherapy and an advisor to the Academy for Eating Disorders CBT-ED Special Interest Group.

Who should attend

This webinar is suitable for practitioners wishing to have an introduction to CBT-E and guidance on how to develop their skills further. It is also suitable for those who may have participated in CBT-E training some time ago and would like a refresher or to review the basics again to maintain their skills.

Low Intensity clinical contact hours survey - BABCP Low Intensity Special Interest Group

Please click below if you are interested in contributing to the survey.

 

The BACP Low Intensity SIG are interested in the impact of clinical contact hours on Low Intensity/Wellbeing Practitioner wellbeing. This questionnaire contains six multi-choice questions and a free text box for you to share your experiences. The answers to these questions will help the BABCP SIG plan how to meet CPD topics and other developments within the SIG.  The SIG hope to produce a write up of the answers to this questionnaire to be shared with SIG members and to be used in training.

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This FREE conference is for Psychological Wellbeing Practitioners working in Talking Therapies for Anxiety and Depression services and is brought to you by Bespoke Mental Health in collaboration with the NHS England Talking Therapies National PWP Leads Network

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