Find the Right CBT-E Therapist for Eating Disorders

Let's take a closer look at how to find the right CBT-E therapist for comprehensive eating disorder treatment. You’ve done your research and understand that the studies show Enhanced Cognitive Behavioral Therapy (CBT-E) is the recommended treatment for your eating disorder. Note that CBT-E is actually the treatment of choice for ANY eating disorder in an adult – binge eating disorder, bulimia, anorexia, emotional eating...Now how do you find a therapist who does CBT-E in the way it’s intended? Adherence to the treatment is essential for the best result.

As you set out to find a CBT-E therapist, here are a few tips:

• Be sure that your therapist is trained and experienced in CBT-E specifically.  Enhanced CBT is very different from standard CBT. There is no “certification” per se in CBT-E; any health care provider can use the manual. Ideally, though, the therapist can explain how he/she was trained in CBT-E. It’s best if he/she received consultation from an experienced CBT-E provider while implementing the treatment over time. Alternatively, The Centre for Research on Dissemination at Oxford (CREDO) provides an online training for professionals. This is an excellent way to learn CBT-E.

• Make sure that the therapist plans to adhere fully to the CBT-E treatment. “Using techniques” from CBT-E is not enough. Without a doubt, completing the treatment as it’s intended is how you will get the best result. In a therapist bio, you’d want to avoid eclectic or "integrated" therapist approaches(i.e. “integrating psychodynamic psychotherapy,” “insight-oriented therapy” etc). Again, for behavioral change, adherent CBT-E is the best course.

• You can get a sense of adherence if the therapist explains at the start that the treatment is time-limited (roughly 20 weeks for bulimia and binge eating; more like 40 weeks for anorexia). That it consists of three distinct stages. That there is a clear agenda for each and every session. That the focus is on the factors getting in the way of regular eating; issues unrelated to eating are important, of course, but should not occupy session time.  The treatment is solely focused on helping you with your eating problem.

• A “program” (i.e. multiple group therapies, yoga, art therapy) is not always necessary. In it's pure form, CBT-E can be THE intervention.  A lot of extra “stuff” adds little additional value. Note: for anorexia, supported meals can be helpful – even necessary - but other group interventions are mostly ineffective until the individual is weight-restored. For bulimia and binge eating, if we integrate group, it is typically DBT Skills training which when delivered properly, can be helpful.

• Children and adolescents require a very different and specific treatment approach.  The CBT-E therapist should be knowledgeable about Family-Based Treatment, which is the gold standard treatment for adolescent and childhood anorexia and bulimia. In most childhood/adolescent eating disorder cases, FBT should be the first line. CBT-E may be integrated in the case of Binge Eating Disorder in a child/adolescent or in some cases of Child/Adolescent Bulimia.

It is not at all easy to find the right treatment. And treatment can get very expensive – especially if you end up in open-ended, non-evidence-based treatments (note: another reason why CBT-E is ideal – it’s short-term and very cost-effective!). If you have questions, please feel free to reach out and contact us! We can help you navigate.