CBT is Effective for Body Dysmorphic Disorder

There are few effective treatments for body dysmorphic disorder (BDD) and a pressing need to develop such treatments. We examined the feasibility, acceptability, and efficacy of a manualized modular cognitive-behavioral therapy for BDD (CBT-BDD). CBT-BDD utilizes core elements relevant to all BDD patients (e.g., exposure, response prevention, perceptual retraining) and optional modules to address specific symptoms (e.g., surgery seeking). Thirty-six adults with BDD were randomized to 22 sessions of immediate individual CBT-BDD over 24 weeks (n=17) or to a 12-week waitlist (n=19). The Yale-Brown Obsessive-Compulsive Scale Modified for BDD (BDD-YBOCS), Brown Assessment of Beliefs Scale, and Beck Depression Inventory-II were completed pretreatment, monthly, posttreatment, and at 3- and 6-month follow-up. The Sheehan Disability Scale and Client Satisfaction Inventory (CSI) were also administered. Response to treatment was defined as ?30% reduction in BDD-YBOCS total from baseline. By week 12, 50% of participants receiving immediate CBT-BDD achieved response versus 12% of waitlisted participants (p=0.026). By posttreatment, 81% of all participants (immediate CBT-BDD plus waitlisted patients subsequently treated with CBT-BDD) met responder criteria. While no significant group differences in BDD symptom reduction emerged by Week 12, by posttreatment CBT-BDD resulted in significant decreases in BDD-YBOCS total over time (d=2.1, p

Wilhelm, S., Phillips, K. A., Didie, E., Buhlmann, U., Greenberg, J. L., Fama, J. M., & … Steketee, G. (2013). Modular cognitive-behavioral therapy for body dysmorphic disorder: A randomized controlled trial. Behavior Therapy, doi:10.1016/j.beth.2013.12.007


CBT Relapse Prevention

In this video from a recent Beck Institute Workshop, Dr. Aaron Beck describes examples of the  application of techniques such as mindfulness, acceptance, and validation. He also explains how these and other important techniques can be used to enhance relapse prevention.

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Anorexia Nervosa Relapse Prevention Benefited by CBT

NewStudy-Graphic-72x72_edited-3 A recent clinical study in the International Journal of Eating Disorders found preliminary evidence supporting the notion that Cognitive Behavioral Therapy (CBT) is beneficial to preventing relapse and improving outcomes in patients with weight-restored Anorexia Nervosa (AN). The aim of the present study was to compare the relapse prevention effectiveness of CBT versus maintenance treatment as usual (MTAU) for weight-restored AN.

Participants were patients suffering from AN who were part of the inpatient or day hospital program at the Toronto General Hospital Eating Disorders Program. After participants reached a body mass index (BMI) of at least 19.5 for 2-3 weeks, they were able to begin participation in the present study. About half of the participants chose to enter into the CBT treatment condition and the rest received MTAU. Participants in the CBT group focused on addressing thoughts and behaviors about eating and weight that increase the risk of relapse, and then changing those thoughts and behaviors to healthier strategies and skills. In addition cognitive strategies were taught for a broader range of issues, such as self-esteem, interpersonal problems, and developmental issues.

Results showed that participants in the CBT group had a significantly longer time to relapse than those in the MTAU group, with 65% of the CBT group and 34% of the MTAU not having relapsed after 1 year. The authors concluded that “the current findings provide preliminary evidence that CBT may be helpful in improving outcome and preventing relapse in weight-restored AN.”

Study authors: J. C. Carter, T. L. McFarlane, C. Bewell, M. P. Olmsted, D. B. Woodside, A. S. Kaplan, R. D. Crosby