Integration Strategy Strengthens Eating Disorder Tx. (Psychodynamic, Behavioral Approaches)

By Sherman, Carl | Clinical Psychiatry News, August 2002 | Go to article overview

Integration Strategy Strengthens Eating Disorder Tx. (Psychodynamic, Behavioral Approaches)


Sherman, Carl, Clinical Psychiatry News


BOSTON -- Psychotherapy that integrates behavioral with psychodynamic elements has a particular logic in the treatment of eating disorders, Laura Weisberg, Ph.D., said at a meeting of the Academy for Eating Disorders.

The empathic connection and relational perspective of psychodynamic therapy, as well as the "technology of change" provided by cognitive behavioral approaches, complement and strengthen each other, said Dr. Weisberg of Duke University Medical Center, Durham, N.C.

The eating disorders field in recent years has seen a narrowing perspective that favors behavior therapies.

But these disorders' high treatment failure and recidivism rates make it clear that "no one theory has all the answers, she commented. "We can learn from each other."

From a practical standpoint, many therapists practice therapeutic integration, using elements from diverse schools based on individual patient needs and their own training, Dr. Weisberg said at the meeting, sponsored by the University of New Mexico.

In severely disordered individuals, it may be imperative to address symptoms directly using behavioral methods. Once they abate, it is possible to focus on selfrelational issues that are the province of psychodynamic therapy

Conversely, a patient whose reluctance to relinquish the safety of her symptoms undermines behavioral treatment's -effectiveness may begin with psychodynamic therapy More typically, however, psychodynamic therapy is used along with psychoeducation and concrete coping strategies from the behavioral model, often in the same session, Dr. Weisberg added.

The empathic bond and affect generated by psychodynamic therapy "create a context for cognitive behavioral work to take place," he said, and may reduce the risk of dropout. …

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