Emotion-Focused Therapy Promising for Eating Disorders

By London, Susan | Clinical Psychiatry News, August 2008 | Go to article overview

Emotion-Focused Therapy Promising for Eating Disorders


London, Susan, Clinical Psychiatry News


SEATTLE--Patients with eating disorders who receive emotion-focused therapy experience a decrease in psychological morbidity and possible reductions in bingeing and vomiting, preliminary results of the first evaluation of this therapy for eating disorders show.

"Affect has long been implicated in triggering eating disorder symptoms. Difficulties with affect regulation characterize the population," Leslie Greenberg, Ph.D., told people attending an international conference sponsored by the Academy for Eating Disorders.

In an emotion-focused therapy (EFT) model, the activation of emotion schematic memories and the experience of overwhelming affect play key roles in the pathogenesis of these disorders. "A central function in our view of the eating disorder [is that it] can be understood as an attempt to control affect," he said at the conference, which was cosponsored by the University of New Mexico.

EFT is an evidence-based treatment for depression, trauma, and couples distress, noted Dr. Greenberg, who is director of the psychotherapy research center at York University, Toronto.

"The hypothesized effect of EFT for eating disorders is that it will enhance people's sense of efficacy about dealing with the eating disorder, leading to change in dys-functional behavior patterns," he said. When patients are able to understand that the disorder is functioning to regulate their emotions, they are then able to handle their emotions in a new way, which gives rise to a sense of hope that they can also control the disorder, he said.

"Once the emotions have been dealt with, this will render the eating disorder unnecessary as a means of coping," he said.

Dr. Greenberg and his colleagues enrolled 14 women with eating disorders in the study. The average age of the women was 33 years. Seven (50%) of them had bulimia nervosa, four (29%) had binge-eating disorder, and three (21%) had an eating disorder not otherwise specified. The mean duration of eating problems was nearly 20 years.

The women were equally divided into two groups and received group EFT consisting of 16 weekly sessions, each lasting 2 hours. In the first session, the therapist focused on psychoeducation about eating and emotions, according to Dr. Greenberg. In the remaining sessions, two or three women engaged in dialogue on self-critical issues, self-interruptive issues, and unfinished business.

On average, the women attended about 12 sessions and had five chair-work treatments. Therapists reported that the women in group 1 (a start-up group) had a comparatively higher prevalence of atypical eating disorder presentations and Axis II disorders, as well as poorer attendance. …

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