ABSTRACT
Chapter 4 goes into detail about the first session of CBT-T, explaining how it is used to ensure that patients engage with treatment and understand the principles of the therapy. A clinician stance of ‘realistic optimism’ is outlined, stressing that change is necessary even though it is hard (firm empathy). The key roles of diary-keeping and weighing the patient are explained, along with how these two tasks should be linked to enhance cognitive change. Changes in eating patterns begin here, to reduce starvation symptoms and to address anxiety over the effects of food. We also stress psychoeducation at this stage. Clinical examples are used to illustrate these methods.
