What is the role of psychotherapies in the treatment of anorexia nervosa?

Updated: Jun 10, 2019
  • Author: Bettina E Bernstein, DO; Chief Editor: Caroly Pataki, MD  more...
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Answer

Various psychological therapies have proven helpful in treating patients with anorexia nervosa, including the following [3, 4] :

  • Individual therapy (insight-oriented)

  • Cognitive analytic therapy

  • Enhanced cognitive-behavioral therapy (CBT-E)

  • Cognitive remediation therapy (CRT)

  • Interpersonal therapy (IPT)

  • Motivational enhancement therapy

  • Dynamically informed therapies

  • Group therapy

  • Family-based therapy (FBT)

  • Specialist supportive clinical management (SSCM)

  • Conjoint family therapy

  • Separated family therapy

  • Multifamily groups

  • Relatives and caregiver support groups

Younger individuals with anorexia nervosa, especially adolescents, may respond best to family-based treatment (FBT), which appeared superior to individual therapy. [5] The recovery rate for adults appeared higher with CBT, however other treatments such as SSCM and the Maudsley method (MANTRA) showed an outpatient recovery rate of 15% in maintaining remission from anorexia nervosa. FBT also appeared superior to CBT although the rate of recovery from CBT-E was slightly improved over CBT. [107, 5, 108]

A modification of CBT called CRT (cognitive remediation therapy) may be more effective in helping the patient to gain better cognitive flexibility,  and is a manual-based program especially effective for motivated persons. [108]

Caregivers' interactions are most helpful when stigma is lessened and collusion, avoidance, accommodation to the illness, and negative expressed emotion such as overprotection and hostility were avoided. [71]


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