None listed
Conditions
Brief summary
Treatment outcomes for existing eating disorder interventions are often inadequate, with around 60% of people continuing to have residual symptoms after treatment. It is possible that biased thinking styles contribute to dropout rates and reduce people with eating disorders’ ability to engage in benefit from existing interventions. Therefore, the present study aims to improve the effectiveness of 10-session cognitive behavioural therapy (CBT-T) for eating disorders by providing cognitive remediation therapy (CRT) to target biased thinking styles. Emerging research suggests that using the waitlist period to provide adjunct interventions may improve both treatment retention and outcomes. We will use this approach, and randomly allocate participants waiting for CBT-T to one of three different one-month waitlist conditions: (i) passive control, (ii) active control (psychoeducation), or (iii) CRT.
Interventions
Cognitive remediation therapy (CRT). Participants randomised to this condition receive one face-to-face CRT session prior to a one-month wait to receive 10-session cognitive behavioural therapy (CBT-T) for eating disorders. They are also assigned homework tasks to complete during the wait.
The CRT session will be administered by a provisional psychologist. The session is 50 minutes in length. The session involves an introduction to CRT and the following tasks: complex pictures, how to, switchi
Cognitive remediation therapy (CRT). Participants randomised to this condition receive one face-to-face CRT session prior to a one-month wait to receive 10-session cognitive behavioural therapy (CBT-T) for eating disorders. They are also assigned homework tasks to complete during the wait. The CRT session will be administered by a provisional psychologist. The session is 50 minutes in length. The session involves an introduction to CRT and the following tasks: complex pictures, how to, switching ability, and embedded words. All tasks aim to improve central coherence and set shifting. Session attendance is used to monitor adherence to the intervention. The CRT homework tasks, also targeting central coherence and set shifting, comprise the following tasks: prioritising, up and down, illusions, and behavioural changes. Homework is completed each week in a booklet, and adherence is monitored through a follow-up discussion in session. Participants are sent weekly email reminders to do so. There is one 15 minute homework task per week for four weeks. The CBT-T covers learning about and normalising eating, challenging beliefs around eating, food and weight, body image work, and relapse prevention. Sessions are weekly, for 4-10 weeks with two follow-up appointments, and 50 minutes in length. Sessions are conducted in-person or via telehealth for rural clients. The CBT-T is delivered by provisional psychologists supervised by Professors Wade and Waller. Session attendance and homework completion is used to monitor adherence. Sessions are delivered over a 4-10 week session, as therapy is terminated after session 4, as per the CBT-T protocol, if early progress has not been made to avoid wasting clients' time as this is a consistent predictor of treatment outcome.
Sponsors
Ella Keegan
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
15 Years to No maximum
Healthy volunteers
No
Inclusion criteria
To be eligible, participants must be at least 15 years old, have a body mass index greater than 18.5, have an eating disorder, and be willing for the therapist to communicate with their GP.
Exclusion criteria
Participants will be excluded if they have a severe physical and/or psychiatric condition that would interfere with treatment (e.g. high suicidality, psychosis), if they are already receiving psychotherapy for an eating disorder, if they have difficulty speaking or understanding English, or if they have binge eating disorder (people with binge eating disorder will be directed to self-help material but not offered sessions).
Outcome results
None listed