ABSTRACT
This chapter aims to help young people decide whether enhanced cognitive behaviour therapy (CBT-E) will be the most suitable treatment for them. It outlines the two main strands of thinking on the best way to treat these ailments, respectively based on the disease model and the psychological model. As CBT-E is based on the psychological model, to be successful, the patient needs to be educated and empowered, as opposed to a passive recipient of treatment imposed by others. Hence, this chapter goes into cognitive behaviour theory in some detail. According to this theory, a distinctive self-evaluation scheme, i.e., the overvaluation of shape, weight, eating and their control, is of central importance in maintaining eating disorders (anorexia nervosa, bulimia nervosa, binge-eating disorder and other similar states). The other specific clinical features of eating disorders appear to derive directly from this core feature and, in turn, maintain in a state of continuous activation the preoccupation with and overvaluation of shape, weight and eating control. As a result, the eating-disorder mindset becomes locked in place in the sufferer’s mind. This chapter discusses how these psychological and behavioural processes operate and provides an overview of CBT-E, which is used to treat the processes operating in each young person in a personalised and flexible way. Adolescent patients are actively involved in the treatment, while parents are recruited as “helpers” with the aim of creating an environment that facilitates their child’s change. CBT-E for adolescents has been evaluated in several studies on patients aged between 13 and 19 years. The promising results obtained from these studies has led the National Institute for Health and Clinical Excellence to recommend CBT-E for adolescents as an alternative to family therapy for both anorexia nervosa and bulimia nervosa.
