Anorexia Nervosa – Focal Psychodynamic Psychotherapy

Friederich, Hans‐Christoph; Wild, Beate; Zipfel, Stephan; Schauenburg, Henning; Herzog, Wolfgang; Schild, Sandra; Komo-Lang, Miriam

doi:10.1027/00554-000

Cited by 9 publications

(9 citation statements)

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“…At present, there is no evidence to suggest that current evidence‐based treatments for eating disorders are not appropriate for people with higher weight 11,16 . Box 4 presents a summary of the key elements of the main MBS‐listed 40 evidence‐based psychological therapies 46,54‐62 …”

Section: Current Status Of Treatments and Interventionsmentioning

confidence: 99%

“…11,16 Box 4 presents a summary of the key elements of the main MBS-listed 40 evidencebased psychological therapies. 46,[54][55][56][57][58][59][60][61][62] A comprehensive description of psychological therapies is found in the treatment guidelines from the National Institute for Health and Care Excellence. 11 Common to therapies specific to eating disorders are psycho-education and facilitation of physical health care through weight monitoring and nutritional counselling and meal planning, which are typically offered by a registered dietitian.…”

Section: Psychological Therapiesmentioning

confidence: 99%

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Current approaches in the recognition and management of eating disorders

Hay

Rankin

Ramjan

et al. 2023

Medical Journal of Australia

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Summary Eating disorders are now well acknowledged mental health problems that are common and present in people from diverse sociodemographic backgrounds. The past decade has seen a rapid expansion in research into eating disorder interventions. In response to the increasing burden of eating disorders, the Australian Government Department of Health and Aged Care has implemented significant policy changes to improve patient access to Medicare and inpatient treatment facilities. There are several international clinical practice guidelines and a robust evidence base particularly for first line care with specific psychological therapies, including guidelines for the management of eating disorders in individuals with a high weight. Medications play an important adjunct role in care, and novel neuromodulating treatments, such as psychostimulants, are under study. There is emerging evidence for increased person‐centred care, with more choice in the form of alternatives to hospital inpatient programs and more respectful consideration of care for all who experience an eating disorder, including people with high weight.

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Section: Current Status Of Treatments and Interventionsmentioning

confidence: 99%

Section: Psychological Therapiesmentioning

confidence: 99%

Current approaches in the recognition and management of eating disorders

Hay

Rankin

Ramjan

et al. 2023

Medical Journal of Australia

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“…The aim of the present study was to examine whether psychodynamic and CBT therapists can be distinguished in their vocabulary in the treatment of patients with anorexia nervosa (AN). To this end, we analyzed session transcripts from the Anorexia Nervosa Treatment of OutPatients study (Zipfel et al, 2014), a randomized controlled trial comparing manualized short-term focal psychodynamic therapy (Friederich et al, 2019) and enhanced cognitive behavioral therapy (Fairburn, 2008) with an optimized treatment as usual for patients with AN. We used the LIWC to examine therapist utterances regarding the proportion of words from different categories.…”

Section: The Present Studymentioning

confidence: 99%

Words count in psychotherapy: Differentiating language characteristics of cognitive behavioral therapy and focal psychodynamic therapy for anorexia nervosa.

Palmer,

Brockmeyer,

Zipfel

et al. 2023

Psychotherapy

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It is generally assumed that psychodynamic therapy and cognitive behavioral therapy (CBT) differ in terms of applied techniques and processes. To date, however, little is known about whether and how such differences can actually be observed at a basic linguistic level and in what the two treatment approaches differ most strongly (i.e., how psychodynamic and CBT therapists differ in what they actually say word-by-word in therapy sessions). Building on theoretical models and previous research that used observer ratings, we formulated specific hypotheses regarding which word categories psychodynamic and CBT therapists who treat patients with an eating disorder should differ in. To investigate these hypotheses, we used verbatim transcripts from 297 therapy sessions of a randomized controlled trial in which patients with anorexia nervosa (n = 88) received either focal psychodynamic therapy (FPT) or CBT. These transcripts were then examined using computerized quantitative text analysis. In line with our hypotheses, we found that CBT therapists overall spoke more than their FPT counterparts and that they used more words related to eating. Also in line with our hypotheses, FPT therapists used more words related to social processes. Contrary to our expectations, CBT therapists did not show a stronger focus on the future but talked more about emotions than FPT therapists. The latter effect, however, appears to be driven by a stronger focus on positive emotions. These findings suggest that computerized quantitative text analysis can differentiate meaningful language characteristics of CBT and FPT on spoken-word level and that it holds potential as a tool for researchers and therapists.

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“…For adults with AN, the NICE guidelines suggest Cognitive Behaviour Therapy (CBT) [4,5], Maudsley Anorexia Nervosa Treatment for Adults (MANTRA) [14] or Specialist Supportive Clinical Management (SSCM) [15], all of which have accompanying manuals. While not listed as a first line option, Focal Psychodynamic Therapy [16,17] is also suggested as an appropriate alternative if the above options are deemed unsuitable or ineffective. There are also other versions of psychotherapy, such as Interpersonal Psychotherapy (IPT), which achieve equivalent outcomes [18].…”

Section: Manualised Treatmentsmentioning

confidence: 99%

Challenging rigidity in Anorexia (treatment, training and supervision): questioning manual adherence in the face of complexity

Robertson

Thornton²

2021

J Eat Disord

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Background Anorexia Nervosa is a debilitating illness. While there have been many advancements to treatment protocols and outcomes for people with eating disorders, the field acknowledges there remains considerable room for improvement. This timely Special Edition of the Journal of Eating Disorders has invited those of us in the field to consider a range of topics in aid of this task, including potential modifications and implementation of evidence-based practice, specific and common psychotherapy factors, treatment manuals, adherence and individualising treatment approaches for individuals and families. Body In this paper, we briefly outline the key manualised treatments currently available to treat children, adolescents and adults with Anorexia Nervosa, considering the benefits, potential reasons for adaptations and limitations. We then review the current evidence for training strict adherence to treatment manuals which is often a key focus in training and supervision, questioning the association of increased treatment adherence with improved therapeutic outcome. We then summarise some key evidence behind other therapeutic factors which have been demonstrated to affect outcome regardless of which manual is implemented, such as readiness to change and therapeutic alliance. Conclusion The paper concludes with implications and considerations for future research, clinical guidelines, training and supervision, highlighting the need to consider the therapeutic relationship and processes alongside manual content to conduct best evidence-informed practice.

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Anorexia Nervosa – Focal Psychodynamic Psychotherapy

Cited by 9 publications

References 0 publications

Current approaches in the recognition and management of eating disorders

Current approaches in the recognition and management of eating disorders

Words count in psychotherapy: Differentiating language characteristics of cognitive behavioral therapy and focal psychodynamic therapy for anorexia nervosa.

Challenging rigidity in Anorexia (treatment, training and supervision): questioning manual adherence in the face of complexity

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