Patients' perceptions of post-treatment factors that influenced skill use after cognitive-behavioral therapy for bulimia nervosa spectrum disorders.
bulimia nervosa
cognitive‐behavioral therapy
deterioration
skill practice
Journal
The International journal of eating disorders
ISSN: 1098-108X
Titre abrégé: Int J Eat Disord
Pays: United States
ID NLM: 8111226
Informations de publication
Date de publication:
01 Apr 2024
01 Apr 2024
Historique:
revised:
19
03
2024
received:
08
12
2023
accepted:
20
03
2024
medline:
1
4
2024
pubmed:
1
4
2024
entrez:
1
4
2024
Statut:
aheadofprint
Résumé
Deterioration rate among patients with bulimia-spectrum eating disorders (BN-EDs) after receiving enhanced cognitive-behavioral therapy (CBT-E) remains high. Previous studies identified body image concerns, environmental triggers, lack of social support, lack of resources, comorbidity, and discontinued skill use as predictors of deterioration. However, no studies have qualitatively explored patients' perceptions of how these factors influenced their skill use and led to deterioration after receiving outpatient CBT. This study aimed to qualitatively explore (1) what post-treatment factors patients believe contributed to deterioration, and (2) whether patients continued to practice the CBT skills they learned from treatment and identify motivators and barriers to post-treatment skill use. Twelve participants who had previously completed 16 sessions of CBT for their BN-EDs and experienced at least modest treatment responses participated in the qualitative interviews. Four themes were identified from the qualitative interviews. Post-treatment deterioration was primarily driven by decreased skill use due to a perceived sudden loss of accountability and continued body dissatisfaction after treatment ended. Discontinued practice of binge analysis led to decreased awareness of the relationship between poor skill use and ED behaviors. Difficulty accessing resources impeded participants from receiving external help to address challenges in skill practice, thus also contributing to deterioration. Findings suggested that outpatient treatment for BN-EDs patients should emphasize more on body image concern, and deterioration prevention for outpatient CBT-E should focus on building self-accountability to keep practicing skills after treatment ends. This study was the first to qualitatively explore post-treatment factors influencing skill use and deterioration in patients with bulimia-spectrum eating disorders after they completed outpatient CBT. Findings indicated that decreased skill use was a primary driver of post-treatment deterioration, and that relapse prevention for outpatient CBT for BN-EDs should focus on enhancing patients' self-accountability to continue practicing therapeutic skills independently after treatment ended.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NIMH NIH HHS
ID : R34MH116021
Pays : United States
Informations de copyright
© 2024 Wiley Periodicals LLC.
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