Stages and processes of change in eating disorders: implications for therapy

Abstract

The aim of this study was to examine the trans-theoretical model of change in 51 anorexia nervosa and 58 bulimia nervosa patients attending a specialist clinic. Self-report questionnaires were completed as to the stage of change, decisional balance, and processes of change before initial assessment. Of the BN patients 80% were in a stage of action compared to only half of the AN patients. There was a shift in decisional balance between the stages of change. The strong principle of change was supported in that the pros of change were increased by over 1 standard deviation from precontemplation to action. The weak principle of change was not supported as there was less shift in the cons. Few processes were used in precontemplation, self re-evaluation was increased in contemplation and self liberation in action. The transtheoretical model of change appears to be applicable to patients with eating disorders. These preliminary findings suggest ways in which therapy can be targeted to maximize the level of motivation and to promote change itself.

The Dissimilarity between Patients' and Relatives' Perception of Eating Disorders and its Relation to Patient Adjustment

“…In the same way, these discrepancies between patient and carer perceptions could contribute to expressed emotion. Expressed emotion and ambivalence are two of the major difficulties in treating women with ED (Barrowclough & Holey, 2003;Blake, Turnbull, & Treasure, 1997;Kyriacou, Treasure, & Schmidt, 2008;Winn et al, 2007). In the current study, an attempt is made to explore the relation between similar or dissimilar illness representations in patients and their relatives and patients' adjustment.…”

Trajectories of Eating and Clinical Symptoms Over the Course of a Day Hospital Program for Eating Disorders

“…EDs are usually associated with ambivalence toward recovery, denial of the severity of clinical symptoms, fear of losing affect regulation strategies associated with disordered eating, and therefore, with poorer treatment outcomes (Blake, Turnbull, & Treasure, 1997;Casasnovas et al, 2007;Feld, Woodside, Kaplan, Olmsted, & Carter, 2001;Strober, 2004;Treasure & Ward, 1997;Vandereycken, 2006a;2006b;Zaitsoff & Taylor, 2009). It is thus necessary to document the evolution of all patients, particularly those who prematurely abandon treatment or respond less positively to treatment because their symptoms' evolution may be markedly different from those who successfully complete treatment.…”

Familia y Trastornos del Comportamiento Alimentario: Avances en Evaluación y Diseño e Intervención Psicoeducativa

“…Este conflicto altera a las personas con TCA y podría generar un impulso de cambio si se manejara de manera apropiada. y los familiares pueden ser los agentes que ayuden a los profesionales a favorecer este cambio en los pacientes, a veces, puede servir para mejorar la adherencia al tratamiento (Blake et al, 1997, Treasure el al., 2007.…”

“…Mientras que las personas adultas con bulimia nerviosa (BN), iniciaban el tratamiento por su propia voluntad, a menudo tras un largo período de tiempo sin el mismo, y posteriormente, también tenían sentimientos ambivalentes sobre el cambio. Por un lado, estaban desesperadas por obtener el control sobre sus episodios de atracones, pero no estaban dispuestas a abandonar otras medidas de control del peso y figura (Blake et al, 1997).…”