The therapeutic process in psychological treatments for eating disorders

• Main Authors: Brauhardt, Anne, de Zwaan, Martina, Hilbert, Anja
• Other Authors: Universität Leipzig, Universitätsklinikum Leipzig
• Format: Article
• Language: English
• Published: Universitätsbibliothek Leipzig 2017
• Subjects: psychotherapeutischer Prozess; Essstörungen; anorexia nervosa; bulimia nervosa; Binge-Eating-Störung; psychotherapeutic process; eating disorders; binge-eating disorder; ddc:610
• Online Access: http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-215571; http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-215571; http://www.qucosa.de/fileadmin/data/qucosa/documents/21557/Therapeutic_process.pdf

Objective: For eating disorders, a vast number of investigations have demonstrated the efficacy of psychological treatments. However, evidence supporting the impact of therapeutic process aspects on outcome (i.e., process-outcome research) has not been disentangled. Method: Using the Generic Model of Psychotherapy (GMP) to organize various process aspects, a systematic literature search was conducted on psychological treatment studies for anorexia nervosa, bulimia nervosa, binge-eating disorder, and eating disorders not otherwise specified. Results: Improved outcomes resulted for family-based treatment compared to individual treatment, for individual compared to group treatment, booster sessions, and positive patient expectations (GMP contract aspect); for nutritional counseling and exercising but not exposure with response prevention as adjunct interventions (therapeutic operations); for highly motivated patients and, to a lesser extent, for therapeutic alliance (therapeutic bond); as well as for rapid response and longer overall treatment duration (temporal patterns). Regarding other GMP aspects, studies on self-relatedness were completely lacking and in-session impacts were rarely investigated. Discussion: As most studies assessed only a limited number of process aspects, the ability to draw conclusions about their overall impact regarding outcome is rather limited. Therefore, future process-outcome research is needed beyond investigations of treatment efficacy for eating disorders.