Adjusting cognitive behavior therapy for adolescents with bulimia nervosa: results of case series.

Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA 94305, USA.
American journal of psychotherapy 02/2005; 59(3):267-81.
Source: PubMed

ABSTRACT This article reviews the types of adjustments needed to an adult protocol of cognitive-behavioral therapy (CBT) for bulimia nervosa (BN) to make it more acceptable to an adolescent population. Employing developmental principles as well as clinical experience as guidelines, these modifications include the involvement of parents, recognition of the interaction of treatment with normal adolescent developmental tasks, and allowances for typical cognitive and emotional immaturity on treatment procedures. Outcomes from a series of adolescents with BN who were treated with this modified-CBT approach show results similar to those expected in adult populations treated using CBT.

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    08/2014; 2(3):2014. DOI:10.1080/21662630.2014.938089
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    ABSTRACT: OBJECTIVE: Although eating disorders are common psychiatric disorders that usually onset during adolescence, few evidence-based treatments for this age group have been identified. A critical review of treatments used for Anorexia Nervosa (AN) and Bulimia Nervosa (BN) and related conditions (EDNOS) is provided that summarizes the rationale for the treatments, evidence of effectiveness available, and outcomes. METHOD: Critical review of published randomized clinical trials (RCTs). RESULTS: There are only seven published RCTs of psychotherapy for AN in adolescents with a total of 480 subjects. There are only two published RCTs for outpatient psychotherapy for adolescent BN with a total of 165 subjects. There are no published RCTs examining medications for adolescent AN or BN. For adolescent AN, Family-Based Treatment (FBT) is the treatment with the most evidence supporting its use. Three RCTs suggest that FBT is superior to individual therapy at the end of treatment; however, at follow-up differences between individual and family approaches are generally reduced. For adolescent BN, one study found no differences between Cognitive Behavioral Therapy and FBT at the end of treatment or follow-up, while the other found FBT superior to individual therapy. CONCLUSIONS: Although the evidence remains limited, FBT appears to be the first line treatment for adolescent AN. There is little evidence to support a specific treatment for adolescent BN. There is a need for additional studies of treatment of child and adolescent eating disorders. New treatments studies may build on current evidence as well as examine new approaches based on novel findings in the neurosciences about cognitive and emotional processes in eating disorders.
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