Non Biological Treatment for AN

Question 1

Core beliefs

Answer 1

• Our core beliefs are informed by our childhood experiences
• They are deeply rooted in how we view ourselves, our environment and the future along with out beliefs about these factors

Question 2

Dysfunctional assumptions

Answer 2

• Tends to hold onto negative more than positive which cause irrational thoughts and a distorted perception of reality

Question 3

Automatic negative thought

Answer 3

• Involuntary negative perception of reality thought that occur out of habit
• They are brief and cause negative emotion

Question 4

CBT-E

Answer 4

• Aims to target Core beliefs/Dysfunctional assumptions/Automatic negative thoughts
• It is conducted on a 1 to 1 basis between the patients with AN and therapist and it happens over 20 sessions
• A detailed interview takes place over 2 session to allow the therapist to assess the patient’s symptoms
• Tries to adjust thought, emotion and behaviour triggering AN

Question 5

Stage 1

Answer 5

• Focus on changing the patient’s eating behaviour
• Patient is weighed on a weekly basis and regular eating is encouraged over 3-4 weeks
• Patients is given information about AN to learn about their disorder
• This stage targets the symptoms of ‘Intense fear of gaining’

Question 6

Stage 2

Answer 6

• Patient and therapist are updated on any changes noticed in terms of weight gain and eating behaviour
• If there is no progress, the therapist can discover why
• Cognitive beliefs are identified
• This stage targets the symptom of ‘Disturbance on body weight and self evaluation’

Question 7

Stage 3

Answer 7

• Main treatment phase consists of 8-10 weekly session that aim to address symptoms
• Looking for any potential triggers in their life that changes their eating behaviour and how the therapy is interacting with the rest of their life
• Beliefs are targeted and challenged
• Triggers such as social media, trauma or certain social environments are identified and patients are encouraged to avoid these

Question 8

Stage 4

Answer 8

• 3 appointment around 2 weeks apart
• Patient is encourage to look into the future where they have to manage their own eating behaviour
• Drawing an agreed plan to prevent relapse
• Post treatment review around 5-6 months later to see how the patient has been

Question 9

Strength of CBT-E

Answer 9

• One strength is that Pike et al compared the effectiveness of CBT-E against nutritional counselling
• It was seen that from the 33 patients observed, the relapse rate for those in CBT-E was 22% compared to nutritional counselling which was 73%
• This shows the success of CBT-E due to low relapse rate

Question 10

Weakness of CBT-E

Answer 10

• One weakness of CBT is that it targes cognitive aspects of anorexia but other treatment seem to more effective
• Sodersten et al compared CBT and a ‘normalisation of eating procedure’. This involved providing the client with feedback at mealtimes to encourage eating behaviour
• The remission rate was 75% for this treatment over 5 years compared to CBT which was 45%
• Suggesting that there are other more effective treatments of AN
• Another weakness of CBT is that it has a high dropout rate
• Carter et al found that the dropout rate for CBT is 45%
• Factors such as waitlist times and initial low body weight significantly predicts dropout from therapy
• This suggests that that CBT is only effective is the patients finishes the treatment therefore questioning the effectiveness of CBT on AN